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Yellow fever virus is found in tropical and subtropical areas in South America and Africa. The virus is transmitted to people by the bite of an infected mosquito. Yellow fever is a very rare cause of illness in U.S. travelers. Illness ranges in severity from a self-limited febrile illness to severe liver disease with bleeding. Yellow fever disease is diagnosed based on symptoms, physical findings, laboratory testing, and travel history, including the possibility of exposure to infected mosquitoes. There is no specific treatment for yellow fever; care is based on symptoms. Steps to prevent yellow fever virus infection include using insect repellent, wearing protective clothing, and getting vaccinated.


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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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Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.


Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay. Symptoms — ranging from amnesia to alternate identities — depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious.


Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.

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Some couples are almost desperate to conceive a baby of one particular gender. Fathers especially, can be eager to have a boy but there are also mothers who long for a son. Most couples however, are happy with either a boy or a girl baby, as long as it is healthy and strong. But if you are keen to try to sway the odds of having a boy then there is no harm in trying. Just remember that there are no guarantees and the odds of conceiving a boy or a girl are almost exactly the same for each and every pregnancy.

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If your doctor tells you that you've got an enlarged liver, it means it's swollen beyond its normal size. There's usually another condition that's causing it, such as hepatitis. You have a lot of treatment choices, but you first need to find out the source of the problem.


Getting treated is important. Your liver has a lot of big jobs to do. Just to name a few key ones, it helps clean your blood by getting rid of harmful chemicals that your body makes. It makes a liquid called bile, which helps you break down fat from food. And it also stores sugar, called glucose, which gives you a quick back-up energy boost when you need it.


Depending on what's causing your liver to swell, you could end up with long-term damage if you don't get treated.

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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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Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases.


Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver. To go around the blockages, blood flows into smaller blood vessels that aren't designed to carry large volumes of blood. The vessels can leak blood or even rupture, causing life-threatening bleeding.


A number of drugs and medical procedures can help prevent and stop bleeding from esophageal varices.

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Hangovers can occur at any time of day, but are usually more common in the morning directly after a night of heavy drinking.


As well as physical symptoms, the person may experience elevated levels of anxiety, regret, shame, embarrassment, and depression. The severity of a hangover is closely linked to how much alcohol was consumed, and whether the sufferer had enough sleep; the less sleep, the worse the hangover.


It is impossible really to say how much alcohol can be safely consumed to avoid a hangover - it depends on the individual and other factors, such as how tired they were before they began drinking, whether they were already dehydrated before the drinking began, whether they drank plenty of water during their drinking session, and how much sleep they got 

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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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You do not have AIDS as soon as you acquire HIV. You can live with HIV (be HIV+) for many years with no signs of disease, or only mild-to-moderate symptoms. People living with HIV and taking HIV drugs as prescribed have a very low risk of progressing to AIDS. But without treatment, HIV will eventually wear down the immune system in most people to the point that they have low numbers of CD4 cells and develop opportunistic infections. Without treatment, this usually happens in five to ten years.


The definition of AIDS was established before there was effective treatment for HIV. It indicated that a person was at higher risk for illness or death. In countries where HIV treatment is readily available, AIDS is no longer as relevant as it once was. This is because having access to effective treatment means people can stay healthier even with low CD4 counts. Also, someone could have received the AIDS diagnosis years ago, which means they still have that diagnosis--even though they no longer have a low CD4 count.


The US Centers for Disease Control and Prevention (CDC) identifies someone as having AIDS if she or he is living with HIV and has one or both of these conditions:


At least one AIDS-defining condition (see our list of AIDS-Defining Conditions)

A CD4 cell count of 200 cells or less (a normal CD4 count is about 500 to 1,500)

People with AIDS can rebuild their immune system with the help of HIV drugs and live a long healthy life. Even if your CD4 cell count goes back above 200 or an OI is successfully treated, you will still have a diagnosis of AIDS. This does not necessarily mean you are sick or will get sick in the future. It is just the way the public health system counts the number of people who have had advanced HIV disease.

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Hives — also known as urticaria (ur-tih-KAR-e-uh) — is a skin reaction that causes itchy welts, which can range in size from small spots to large blotches several inches in diameter. Hives can be triggered by exposure to certain foods, medications or other substances.


Angioedema is a related type of swelling that affects deeper layers in your skin, often around your face and lips. In most cases, hives and angioedema are harmless and don't leave any lasting marks, even without treatment.


The most common treatment for hives and angioedema is antihistamine medication. Serious angioedema can be life-threatening if swelling causes your throat or tongue to block your airway.

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HPV infection commonly causes skin or mucous membrane growths (warts). Certain types of HPV infection cause cervical cancers. More than 100 varieties of human papillomavirus (HPV) exist.


Different types of HPV infection cause warts on different parts of your body. For example, some types of HPV infection cause plantar warts on the feet, while others cause warts that mostly appear on the face or neck.


Most HPV infections don't lead to cancer. But some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (cervix). Other types of cancers, including cancers of the anus, penis, vagina, vulva and back of the throat (oropharyngeal), have been linked to HPV infection.


Vaccines can help protect against the strains of genital HPV most likely to cause genital warts or cervical cancer.

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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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An incompetent cervix, also called a cervical insufficiency, is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy.


Before pregnancy, your cervix — the lower part of the uterus that connects to the vagina — is normally closed and rigid. As pregnancy progresses and you prepare to give birth, the cervix gradually softens, decreases in length (effaces) and opens (dilates). If you have an incompetent cervix, your cervix might begin to open too soon — causing you to give birth too early.


An incompetent cervix can be difficult to diagnose and, as a result, treat. If your cervix begins to open early, your health care provider might recommend preventive medication during pregnancy, frequent ultrasounds or a procedure that closes the cervix with strong sutures (cervical cerclage).

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Creatinine is a chemical waste molecule that is generated from muscle metabolism.

Creatinine is produced from creatine, a molecule of major importance for energy production in muscles.

Approximately 2% of the body's creatine is converted to creatinine every day.

Creatinine is transported through the bloodstream to the kidneys. The kidneys filter out most of the creatinine and dispose of it in the urine.

Because the muscle mass in the body is relatively constant from day to day, the creatinine production normally remains essentially unchanged on a daily basis.

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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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A liver hemangioma is a tangled network of blood vessels in or on the surface of the liver. This tumor is noncancerous and usually doesn’t cause symptoms. In fact, most people don’t even know they have a liver hemangioma. It’s usually only discovered during a test or procedure for an unrelated condition. Even when they’re diagnosed, most liver hemangiomas don’t require treatment.


A liver hemangioma is noncancerous and doesn’t increase your risk of developing cancer. The tumor is usually small, measuring less than 4 centimeters in diameter. In some cases, however, it can grow much larger. A larger tumor is more likely to cause symptoms, such as abdominal pain and nausea. Pregnant women and women using estrogen replacement therapy have a higher risk of developing a large hemangioma. This is because estrogen may contribute to the growth of liver hemangiomas.


Most people only have one liver hemangioma. However, it’s possible for several hemangiomas to form on the liver at once.


A liver hemangioma typically doesn’t cause complications in adults, but it can be more dangerous when it develops in infants. In babies, the growth is called infantile hemangioendothelioma. It’s usually diagnosed before the baby is 6 months old. This is a rare condition in infants. Although the tumor isn’t cancerous, it has been linked to higher rates of heart failure.

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Mitral valve prolapse (MVP) occurs when the leaflets of the mitral valve bulge (prolapse) into the heart's left upper chamber (left atrium) like a parachute during the heart's contraction.Mitral (MY-trul) valve prolapse sometimes leads to blood leaking backward into the left atrium, a condition called mitral valve regurgitation.in most people, mitral valve prolapse isn't life-threatening and doesn't require treatment or changes in lifestyle. Some people with mitral valve prolapse, however, require treatment.

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Mitral valve stenosis — or mitral stenosis — is a narrowing of the heart's mitral valve. This abnormal valve doesn't open properly, blocking blood flow into the main pumping chamber of your heart (left ventricle). Mitral valve stenosis can make you tired and short of breath, among other problems.The main cause of mitral valve stenosis is an infection called rheumatic fever, which is related to strep infections. Rheumatic fever — now rare in the United States, but still common in developing countries — can scar the mitral valve. Left untreated, mitral valve stenosis can lead to serious heart complications.

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Movement disorders are clinical syndromes with either an excess of movement or a paucity of voluntary and involuntary movements, unrelated to weakness or spasticity.[1] Movement disorders are synonymous with basal ganglia or extrapyramidal diseases.[2] Movement disorders are conventionally divided into two major categories- hyperkinetic and hypokinetic.Hyperkinetic movement disorders refer to dyskinesia, or excessive, often repetitive, involuntary movements that intrude upon the normal flow of motor activity.Hypokinetic movement disorders refer to akinesia (lack of movement), hypokinesia (reduced amplitude of movements), bradykinesia (slow movement) and rigidity. In primary movement disorders, the abnormal movement is the primary manifestation of the disorder. In secondary movement disorders, the abnormal movement is a manifestation of another systemic or neurological disorde


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Myasthenia gravis (my-us-THEE-nee-uh GRAY-vis) is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control.Myasthenia gravis is caused by a breakdown in the normal communication between nerves and muscles.There is no cure for myasthenia gravis, but treatment can help relieve signs and symptoms, such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing.Though myasthenia gravis can affect people of any age, it's more common in women younger than 40 and in men older than 60.

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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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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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A foramen ovale is a hole in the heart. The small hole naturally exists in babies who are still in the womb for fetal circulation. It should close soon after birth. If it doesn’t close, the condition is called patent foramen ovale (PFO).PFOs are common. They occur in roughly one out of every four people. If you have no other heart conditions or complications, treatment for PFO is unnecessary.While a fetus develops in the womb, a small opening exists between the two upper chambers of the heart called the atria. This opening is called the foramen ovale. The purpose of the foramen ovale is to help circulate blood through the heart. A fetus doesn’t use their own lungs to oxygenate their blood. They rely on their mother’s circulation to provide oxygen to their blood from the placenta. The foramen ovale helps blood circulate more quickly in the absence of lung function.When your baby is born and their lungs begin to work, the pressure inside their heart usually causes the foramen ovale to close. Sometimes it may not happen for a year or two. In some people, the closure may never happen at all, resulting in PFO.

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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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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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A "pinched nerve" is the name given to the uncomfortable sensation, pain, or numbness caused when increased pressure leads to irritation or damage to a peripheral nerve (A peripheral nerve is one that is outside the brain and spinal cord.). Although this condition is often associated with back pain or a neck injury, almost any nerve is susceptible.

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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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If you have placenta previa, it means that your placenta is lying unusually low in your uterus, next to or covering your cervix. The placenta is the pancake-shaped organ – normally located near the top of the uterus – that supplies your baby with nutrients through the umbilical cord.If you're found to have placenta previa early in pregnancy, it's not usually considered a problem. But if the placenta is still close to the cervix later in pregnancy, it can cause bleeding, which can lead to other complications and may mean that you'll need to deliver early. If you have placenta previa when it's time to deliver your baby, you'll need to have a cesarean section.


If the placenta covers the cervix completely, it's called a complete or total previa. If it's right on the border of the cervix, it's called a marginal previa. (You may also hear the term "partial previa," which refers to a placenta that covers part of the cervical opening once the cervix starts to dilate.) If the edge of the placenta is within two centimeters of the cervix but not bordering it, it's called a low-lying placenta.The location of your placenta will be checked during your mid-pregnancy ultrasound exam (usually done between 16 to 20 weeks) and again later if necessary.


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oison ivy rash is caused by contact with poison ivy, a plant that’s found on four continents. The sap of the poison ivy plant contains an oil called urushiol. This is the irritant that causes an allergic reaction and rash.


You don’t even have to come in direct contact with the plant to have a reaction. The oil can linger on your gardening equipment, golf clubs, or even your shoes. Brushing against the plant — or anything that’s touched it — can result in skin irritation, pain, and itching.


Here’s how to spot the danger, and what you can do if poison ivy gets too close.

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Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a slow-growing blood cancer in which your bone marrow makes too many red blood cells. These excess cells thicken your blood, slowing its flow. They also cause complications, such as blood clots, which can lead to a heart attack or stroke.


Polycythemia vera isn't common. It usually develops slowly, and you might have it for years without knowing. Often the condition is found during a blood test done for another reason.


Without treatment, polycythemia vera can be life-threatening. But proper medical care can help ease signs, symptoms and complications of this disease. Over time, in some cases there's a risk of progressing to more-serious blood cancers, such as myelofibrosis or acute leukemia.

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Poor or deficient color vision is an inability to see the difference between certain colors, but color is still seen. Many people commonly use the term "colorblind" for this condition. But true colorblindness — in which everything is seen in shades of black and white — is rare.


Poor color vision is usually inherited. Men are more likely to be born with poor color vision. Most people with poor color vision can't distinguish between certain shades of red and green. Less commonly, people with poor color vision can't distinguish between shades of blue and yellow.


Certain eye diseases and some medications also can cause poor color vision.


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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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Child development entails the biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence, as the individual progresses from dependency to increasing autonomy. It is a continuous process with a predictable sequence, yet having a unique course for every child. It does not progress at the same rate and each stage is affected by the preceding developmental experiences. Because these developmental changes may be strongly influenced by genetic factors and events during prenatal life, genetics and prenatal development are usually included as part of the study of child development. Related terms include developmental psychology, referring to development throughout the lifespan, and pediatrics, the branch of medicine relating to the care of children. Developmental change may occur as a result of genetically-controlled processes known as maturation,[1] or as a result of environmental factors and learning, but most commonly involves an interaction between the two. It may also occur as a result of human nature and our ability to learn from our environment.


There are various definitions of periods in a child's development, since each period is a continuum with individual differences regarding start and ending. Some age-related development periods and examples of defined intervals are: newborn (ages 0–4 weeks); infant (ages 4 weeks – 1 year); toddler (ages 1–3 years); preschooler (ages 4–6 years); school-aged child (ages 6–12 years); adolescent (ages 13–18).[2]


Promoting child development through parental training, among other factors, promotes excellent rates of child development.[3] Parents play a large role in a child's life, socialization, and development. Having multiple parents can add stability to the child's life and therefore encourage healthy development.[4] Another influential factor in a child's development is the quality of their care. Child care programs present a critical opportunity for the promotion of child development.


The optimal development of children is considered vital to society and so it is important to understand the social, cognitive, emotional, and educational development of children. Increased research and interest in this field has resulted in new theories and strategies, with specific regard to practice that promotes development within the school system. There are also some theories that seek to describe a sequence of states that compose child developmen

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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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Q fever, also called query fever, is a bacterial infection caused by the bacteria Coxiella burnetii. The bacteria are most commonly found in cattle, sheep, and goats around the world. Humans typically get Q fever when they breathe in dust that was contaminated by infected animals. Farmers, veterinarians, and people who work with these animals in labs are at the highest risk of being infected. The highest amounts of bacteria are found in the "birth products" (placenta, amniotic fluid) of infected animals. The disease may cause mild symptoms similar to the flu. However, many people have no symptoms at all. Mild forms of the disease may clear up in a few weeks without any treatment.

In rare cases, a more serious form of disease develops if the infection is chronic, which means it persists for six months (and there are some case reports indicating that it may persist for more than six months). A more serious form also can develop if the infection is recurrent, which means it comes back. People with heart valve problems or weak immune systems are at the highest risk of developing these types of Q fever. Chronic Q fever is very serious because it can damage a person’s vital organs, including the:

heart

liver

brain

lungs

More severe or chronic forms of Q fever can be treated with antibiotics. Those at risk for Q fever can prevent the disease by disinfecting contaminated areas and washing their hands thoroughly.


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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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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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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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Scarlet fever is a bacterial infection caused by group A Streptococcus bacteria. This illness usually occurs in a few people (about 10%) who have strep throat (streptococcal pharyngitis) and occasionally streptococcal skin infections or even wound infections. Scarlet fever is also known as scarlatina in the older articles; group A Streptococcus (for example, Streptococcus pyogenes) is often shortened to read as "group A strep" or group A beta-hemolytic streptococci (GABHS). Scarlet fever is mainly known for its sunburned-skin-colored sandpaper-like skin rash that is associated with fever.


Outbreaks occur. England reported a 50-year high number of individuals diagnosed with the disease (over 19,206) in 2016

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Schizoaffective disorder is a mental illness that involves persistent psychotic symptoms, like hallucinations or delusions, occurring together with mood problems of depressive, manic, or mixed episodes. The term schizoaffective was first used in 1933 by Jacob Kasanin and has been included in every edition of the mental health diagnostic manual, called the Diagnostic and Statistical Manual of Mental Disorders (DSM), since 1952. Statistics on how often this condition occurs range from 0.32% in the general United States population up to as much as 9% of psychiatrically hospitalized people. Schizoaffective disorder is thought to occur at least as often as schizophrenia and less often than 

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Selective IgA deficiency is one of the most common types of PI. These individuals lack IgA, but usually have normal amounts of other immunoglobulins (antibodies). Many people go undiagnosed because they are never sick enough to be seen by a doctor, while others may develop a variety of severe problems.


Selective IgA Deficiency

IgA protects the body at surfaces that come in contact with the environment. These sites are the mucosal surfaces—mouth, ears, sinuses, nose, throat, airways within the lungs, gastrointestinal tract, eyes, and genitals.


IgA antibodies are transported in secretions to these mucosal surfaces and play a role in protecting them from infection, which is why IgA is known as a secretory antibody. Because the area of a person's mucosal surfaces is equal to 1.5 tennis courts, the importance of IgA in protecting these surfaces cannot be overstated.


Although people with selective IgA deficiency do not produce IgA, they do produce all the other immunoglobulins. In addition, the other aspects of their immune systems function properly.


The causes of selective IgA deficiency remain unknown. It is likely there are a variety of causes that vary from person to person.


Low serum IgA, like absent serum IgA, is relatively common. Most people with low serum IgA have no apparent illness; others have symptoms similar to 


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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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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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Small vessel disease is a condition in which the walls of the small arteries in the heart are damaged. The condition causes signs and symptoms of heart disease, such as chest pain (angina).Small vessel disease is sometimes called coronary microvascular disease or small vessel heart disease. It's often diagnosed after a doctor finds little or no narrowing in the main arteries of your heart, despite your having symptoms that suggest heart disease.Small vessel disease is more common in women and in people who have diabetes or high blood pressure. The condition is treatable but can be difficult to detect.

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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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Synovial sarcoma is a type of soft-tissue sarcoma. It is a rare cancer. Only about 1 to 3 individuals in a million people are diagnosed with this disease each year. It can occur at any age, but it is more common among teenagers and young adults. Synovial sarcoma seems to have a slight preference for males, with 12 male patients for every 10 female patients. Despite its name, synovial sarcoma is not related to the synovial tissues that are a part of the joints. The disease starts most commonly in the legs or arms, but it can appear in any part of the body. On a pathology report, synovial sarcoma may be classified in different subtypes depending on what it looks like under the microscope or what specific gene mutation is involved. Synovial sarcoma is a high grade tumor. It spreads to distant sites in up to 50% of cases.


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The pulmonary veins are the four blood vessels (two on each side) that return oxygen-rich blood from the lungs to the left atrium (left upper chamber) of the heart. Total anomalous pulmonary venous return (TAPVR) is a rare congenital malformation in which all four pulmonary veins do not connect normally to the left atrium. Instead the four pulmonary veins drain abnormally to the right atrium (right upper chamber) by way of an abnormal (anomalous) connection.

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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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Transverse myelitis is an inflammation of the spinal cord, a major part of the central nervous system.  The spinal cord carries nerve signals to and from the brain through nerves that extend from each side of the spinal cord and connect to nerves elsewhere in the body.  The term myelitis refers to inflammation of the spinal cord; transverse refers to the pattern of changes in sensation—there is often a band-like sensation across the trunk of the body, with sensory changes below.Causes of transverse myelitis include infections, immune system disorders, and other disorders that may damage or destroy myelin, the fatty white insulating substance that covers nerve cell fibers.  Inflammation within the spinal cord interrupts communications between nerve fibers in the spinal cord and the rest of the body, affecting sensation and nerve signaling below the injury.  Symptoms include pain, sensory problems, weakness in the legs and possibly the arms, and bladder and bowel problems.  The symptoms may develop suddenly (over a period of hours) or over days or weeks.Transverse myelitis can affect people of any age, gender, or race.  It does not appear to be genetic or run in families.  A peak in incidence rates (the number of new cases per year) appears to occur between 10 and 19 years and 30 and 39 years.  It is estimated that about 1,400 new cases of transverse myelitis are diagnosed each year in the United States.Although some people recover from transverse myelitis with minor or no residual problems, the healing process may take months to years.  Others may suffer permanent impairments that affect their ability to perform ordinary tasks of daily living.  Some individuals will have only one episode of transverse myelitis; other individuals may have a recurrence, especially if an underlying illness caused the disorder.There is no cure for transverse myelitis.  Treatments to prevent or minimize permanent neurological deficits include corticosteroid and other medications that suppress the immune system, plasmapheresis (removal of proteins from the blood), or antiviral medications.

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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 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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This test measures the integrity of nerve tracts which conduct the electric impulses. It is used to assess the nature, severity and duration of the nerve lesion and in combination with EMG helps in predicting the chances of recovery after a nerve lesion.The nerves of interest are stimulated with a very low voltage electric current which causes mild tingling over the area stimulated. The test takes 20 min to 1 hour depending upon the number of nerves to be tested. It is very useful, in cases of carpal tunnel syndrome, diabetic neuropathy, traumatic neuropathy, plexopathy, varius vitamin deficiencies.

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This test is used to test the nerves and muscles in your entire lower extremity. Your doctor will usually order this test when he suspects that there may be some type of problem with the nerve supply to your foot and leg. Commonly the EMG/NCV test is used to diagnosis one of the following: Tarsal Tunnel Syndrome, Peripheral Neuropathy, Neuromuscular disorders, Nerve palsy or Paralysis, and Radioculopathy. Your doctor typically will refer you to either a hospital or a neurologist to have the test preformed.

The EMG portion of the test is used to record the electrical activity in your muscles. It can diagnose diseases of the nerves and muscles. It can detect conditions such as tarsal tunnel syndrome, inflamed muscles and pinched nerves. A tiny needle, called an electrode, is inserted directly into a specific muscle belly. The electrode then records the activity during the insertion, while the muscle is at rest, and while the muscle contracts. Nerve and muscle diseases alter the pattern of electrical activity in these muscles, which is record both audibly and on a computer screen. After the first muscle is tested, the electrode may be inserted into another muscle. Muscles chosen for the testing vary with the patient's symptoms and may be modified, depending on the results from the first muscles tested. Total testing time may range from just a few minutes to more than an hour, depending upon how many muscles are tested. After the exam, you may feel tenderness in the tested muscles. There is a slight risk of minor, localized inflammation in muscles during the test. This usually lasts only a few hours. Other common patient complaints are pain with insertion of the electrode.

Most of the time the Nerve Conduction Velocity Test will accompany the EMG Test. The NCV evaluates the health of the peripheral nerve by recording how fast electrical impulse travels through it. A peripheral nerve transmits information between the spinal cord and the muscles. You will be resting on a cart or bed and electrodes will be taped to your skin. A stimulator will be held against your skin, which sends out a small electrical charge along the nerve. You may feel a tingle or your muscles may twitch but this shock is not harmful. Each test will take only a few minutes. After the exam the electrodes will be removed and your skin cleaned. The time between the stimulation and response will be recorded to determine how quickly and thoroughly that the impulse is sent. A number of nervous system diseases may reduce the speed of this impulse. Each nerve test takes just a few minutes to an hour, depending upon how many nerves are being tested.

While the hospital or neurologist's office will give you instructions for the day of the examination, a few general preparations will help. Eat normally and take medication as you usually would. If you are taking a blood thinner, make sure you inform the testing facility and ask the ordering physician about the use of the medication and the timing of the test. Bath or shower the morning of the examination. Avoid bath oils or any skin lotions or emollients the day of the examination.


A typical EMG/NCV of the lower extremity takes approximately 45 minutes. This test is an important tool for diagnosing diseases of the nervous system, you can help ensure the best results if you relax and cooperate with the technicians. Make sure that you ask any questions that you have about the test before it is performed. Your physician will discuss the results with you. If you have any further questions regarding why this test was ordered for you, please ask your physician.



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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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A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through your peripheral nerves.Your peripheral nerves are located outside of your brain and along your spinal cord. These nerves help you control your muscles and experience the senses. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.The NVC test helps your doctor differentiate between an injury to the nerve fiber and an injury to the myelin sheath, the protective covering surrounding the nerve. It can also help your doctor tell the difference between a nerve disorder and a condition where a nerve injury has affected the muscles.Making these distinctions is important for proper diagnosis and determining your course of treatment.

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A nerve conduction velocity test (NCV) is an electrical test that is used to determine the adequacy of the conduction of the nerve impulse as it courses down a nerve. This test is used to detect signs of nerve injury. In this test, the nerve is electrically stimulated, and the electrical impulse 'down stream' from the stimulus is measured. This is usually done with surface patch electrodes (they are similar to those used for an electrocardiogram) that are placed on the skin over the nerve at various locations. One electrode stimulates the nerve with a very mild electrical impulse. The resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the speed of impulse transmission (nerve conduction velocity). A decreased speed of transmission indicates nerve disease or abnormal pressure on the nerve. A nerve conduction velocity test is often done at the same time as an electromyogram (EMG). An EMG is carried out in order to exclude or detect muscle conditions which may be present due to muscular or neurologic disease.


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The facial nerve conduction velocity was measured in 30 healthy subjects (60 sides) and in 51 patients with a unilateral Bell's palsy. The normal value was 47.8 +/- 5.1 m/s. Incomplete recovery was common in Bell's palsy when the velocity was below 30 m/s. Mild synkinesis was observed in only one patient when the nerve conduction velocity was above 30 m/s. When the degree of degeneration revealed by electroneuroneography did not exceed 60%, the conduction velocity was in the normal range. For degrees of degeneration in excess of this, the conduction velocity decreased in parallel with the increase in the degree of degeneration.


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A somatosensory evoked potential (SSEP) is an evoked potential caused by a physical stimulus (usually a small electric pulse). Electrodes positioned over particular areas of the body record responses of the SSEP, these are then observed as a reading on an electroencephalogram (EEG).  A SSEP can most commonly involve stimulation of the median nerve at the wrist, or the posterior tibial nerve at the ankle. This investigation therefore tests the pathway of the sensory nerves to the sensory areas of the brain, even though the stimuli are non-physiological.


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Somatosensory Evoked Potentials (SSEPs) are electric signals recorded from the scalp or spine following stimulation to the peripheral nerves. They are time-locked responses, representing the function of the ascending sensory pathways. Early in the 1960s Larson et al introduced the use of somatosensory evoked potentials to monitor neural structure during neurosurgical procedures. It was utilized as a supplement to the wake-up test during correctional spinal surgeries for spinal deformities such as scoliosis to provide warning of compromised spinal cord function to the spine surgeons, as reported by McCallum et al and Nash et al in the 1970s. Since then SSEP has become one of the earliest and primary tools for intraoperative neurophysiological monitoring.


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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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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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The spinal cord is made up of three bones: lumbar, dorsal, and cervical. The dorsal spine, the middle portion of the cord, comprises 12 vertebrae and forms the largest portion. A CT scan with a Virtualscopy test of the dorsal spine gives a 3D scanned image of the spine. It is useful in getting a clear picture of the condition of the bones and helps in detecting any abnormalities in the same. Back pain and multiple sclerosis are the most common symptoms that call for a CT scan test of the dorsal spine. It is a relatively painless procedure.

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Computed tomography (CT) of the abdomen and pelvis is a diagnostic imaging test used to help detect diseases of the small bowel, colon and other internal organs and is often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.


Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking, and allergies. You will be instructed not to eat or drink anything for a few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. These medications must be taken 12 hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. An IVP may provide enough information to allow your doctor to treat you with medication and avoid surgery.Inform your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodine-based contrast materials. Your doctor may instruct you to take a mild laxative the evening before the exam and to not eat or drink anything after midnight. Wear loose, comfortable clothing and leave jewelry at home. You may be asked to wear a gown.


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HE  MRI technician should be informed if you have any inner ear implants, artificial joints, a defibrillator or pacemaker, particular types of heart valves, vascular stents, brain aneurysm clips.

The staff will ask you to remove anything that contains metal, including jewelry, sunglasses or any electronic gadgets. All these interferes with the MRI machine’s ability to produce a clear image. Braces and dental fillings will typically not pose a problem, but pens, pins, and certain dental appliances can interfere. 

In the case of implants and pacemakers, those items can stop working properly due to an MRI’s magnetic field.

You will be asked to wear a hospital gown or clothing that doesn’t contain metal fasteners. 

Lastly if you’re pregnant , kindly inform the staff, the doctor may postponed the test if required.

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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 pelvis MRI (magnetic resonance imaging) scan is an imaging test that uses a machine with powerful magnets and radio waves to create pictures of the area between the hip bones. This part of the body is called the pelvic area. Structures inside and near the pelvis include the bladder, prostate and other male reproductive organs, female reproductive organs, lymph nodes, large bowel, small bowel, and pelvic bones. An MRI does not use radiation. Single MRI images are called slices. The images are stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.


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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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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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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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Protein C, a part of the natural anticoagulant system, is a vitamin K-dependent protein zymogen (molecular weight=62,000 da) that is synthesized in the liver and circulates at a plasma concentration of approximately 5 mcg/mL. Protein C is activated to activated protein C (APC) via proteolytic cleavage by thrombin bound to thrombomodulin, an endothelial cell surface membrane protein. APC downregulates the procoagulant system by proteolytically inactivating procoagulant factors Va and VIIIa. Protein S, another vitamin K-dependent coagulation protein, catalyzes APC inactivation of factors Va and VIIIa. APC interacts with and proteolyses factors V/Va and VIII/VIIIa at specific APC binding and cleavage sites, respectively. Resistance to activated protein C (APC resistance) is a term used to describe abnormal resistance of human plasma to the anticoagulant effects of human APC. APC resistance is characterized by a reduced anticoagulant response of patient plasma after adding a standard amount of APC. For this assay, the activated partial thromboplastin time clotting test fails to prolong significantly after the addition of APC.

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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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Angiotensin converting enzyme (ACE) participates in the renin cascade in response to hypovolemia. Its peptidase action on the decapeptide angiotensinogen I results in the hydrolysis of a terminal histidyl leucine dipeptide and the formation of the octapeptide angiotensin II, a potent vasoconstrictor that increases blood pressure.


The primary source of ACE is the endothelium of the lung. ACE activity is increased in sarcoidosis, a systemic granulomatous disease that commonly affects the lungs. In sarcoidosis, ACE is thought to be produced by epithelioid cells and macrophages of the granuloma.


Currently, it appears that ACE activity reflects the severity of sarcoidosis: 68% positivity in those with stage I sarcoidosis, 86% in stage II sarcoidosis, and 91% in stage III sarcoidosis. Serum ACE also appears to reflect the activity of the disease; there is a dramatic decrease in enzyme activity in some patients receiving prednisone.


Other conditions such as Gaucher disease, leprosy, untreated hyperthyroidism, psoriasis, premature infants with respiratory distress syndrome, adults with amyloidosis, and histoplasmosis have been associated with increased levels of ACE.

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The test system widely used currently for the determination of anti-HCV permits the detection of anti-HCV IgG alone. The data recently published by T. G. Wreghitt et al. confirm the probability of the presence of anti-HCV of both IgG and IgM classes in sera from hepatitis C patients. Anti-HCV IgM was detected by Ortho test with some modifications using an anti-M conjugate in the last stage of the experiment. Anti-HCV IgG were detected by regular Ortho test. A total of 46 patients with different forms of HCV infection and a control group were examined. According to the preliminary data, 18 patients were positive in the routine anti-HCV Ortho test. Among 18 anti-HCV-positive patients, nine had chronic HCV infection and the other 9 acute HCV infection. The distribution of IgM and IgG anti-HCV in the acute patients was as follows: 4 patients (44.5%) had approximately equal titres of IgG and IgM, 3 (33.5%) had predominantly IgG, 2 (22.2%) mainly IgM. A similar pattern was observed in the group with chronic HCV infection. Thus, 5 subjects (55.6%) showed approximately equal ratio of IgM and IgG anti-HCV, 2 (22.2%) had mostly IgM and the rest 2 mainly IgG. No anti-HCV in the control group was found. The control group consisted of 18 patients with chronic liver diseases without markers of HBV or HDV infection, 3 with HAV infection, 2 with HBV infection and 5 healthy subjects. The specificity of anti-HCV IgM test was confirmed by Chiron Western blot analysis using the same modification.(ABSTRACT TRUNCATED AT 250 WORDS).

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Hepatitis E virus (HEV) is the major etiologic agent of enterically transmiited non-A, non-B hepatitis worldwide and has a high case-fatality rate in pregnant women. Both IgM and IgG antibody to HEV (anti-HEV) are produced following infection. The titer of IgM anti-HEV declines rapidly during early convalescence; IgG anti-HEV persists and appears to provide at least short-term protection against disease.

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Hepatitis A virus (HAV) is endemic throughout the world, occurring most commonly, however, in areas of poor hygiene and low socioeconomic conditions. The virus is transmitted primarily by the fecal-oral route, and it is spread by close person-to-person contact and by food- and water-borne epidemics. Outbreaks frequently occur in overcrowded situations and in high-density institutions and centers, such as prisons and health care or day care centers. Viral spread by parenteral routes (eg, exposure to blood) is possible but rare, because infected individuals are viremic for a short period of time (usually <3 weeks). There is little or no evidence of transplacental transmission from mother to fetus or transmission to newborn during delivery.


Serological diagnosis of acute viral hepatitis A depends on the detection of specific anti-HAV IgM. Its presence in the patient's serum indicates a recent exposure to HAV. HAV-specific IgM antibody level becomes detectable in the blood by 4 weeks after infection, persisting at elevated levels for about 2 months before declining to undetectable levels by 6 months. They rarely persist beyond 12 months after infection.

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The activated partial thromboplastin time (APTT) assay is used as a screening test to evaluate the overall integrity of the intrinsic/common coagulation pathway and to monitor patients on heparin therapy.


This test reflects the activities of most of the coagulation factors in the intrinsic and common procoagulant pathway, but not the extrinsic procoagulant pathway, which includes factor VII and tissue factor, nor the activity of factor XIII (fibrin stabilizing factor).


Effective November 2016, APTT will no longer be used as the primary method for therapeutic heparin monitoring, for that purpose, order the heparin anti-Xa assay HEPTP / Heparin Anti-Xa Assay, Plasma.

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 Some fat in your liver is normal. But if it makes up more than 5%-10% of the organ's weight, you may have fatty liver disease. If you're a drinker, stop. That's one of the key causes of the condition.

There are two main types of fatty liver disease:-

Alcoholic liver disease (ALD)
Nonalcoholic fatty liver disease (NAFLD)

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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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Chikungunya virus (also known as CHIKV) is an alphavirus transmitted by the Aedes species of mosquitoes. Chikungunya means 'that which bends up' in the Makonde language (spoken in a border area between Mozambique and Tanzania where the first outbreak was described), which refers to the arthritis that the infection can cause. Fever and joint aches are the most common manifestations of infection, which may resemble other viral illnesses, including dengue. The disease is usually self-limited, but some cases may evolve into a chronic condition with debilitating arthritis.

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Although a fever technically is any body temperature above the normal of 98.6 F (37 C), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 F (38 C).

Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms. For that reason, low fevers should normally go untreated, although you may need to see your doctor to be sure if the fever is accompanied by any other troubling symptoms. As fevers range to 104 F and above, however, there can be unwanted consequences, particularly for children. These can include delirium and convulsions. A fever of this sort demands immediate home treatment and then medical attention. Home treatment possibilities include the use of aspirin or, in children, non-aspirin pain-killers such as acetaminophen, cool baths, or sponging to reduce the fever while seeking medical help. Fever may occur with almost any type of infection of illness. The temperature is measured with a thermometer.

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A small sore situated on the face or in the mouth that causes pain, burning, or itching before bursting and crusting over. The favorite locations are on the lips, chin or cheeks and in the nostrils. Less frequented sites are the gums or roof of the mouth (the palate).

Fever blisters are caused by herpes simplex virus type 1. It lies latent (dormant) in the body and is reawakened (reactivated) by factors such as stress, sunburn, or fever from a wide range of infectious diseases including colds. Recurrences are less common after age 35. Sunscreen (SPF 15 or more) on the lips prevents recurrences of herpes from sunburn.

The virus is highly contagious when fever blisters are present. It is spread by kissing. Children become infected by contact with someone who has a fever blister and then they spread the virus by rubbing their cold sore and touching other children. A person with fever blisters should be careful not to touch the blisters and spread the virus to new sites, such as the eyes or genitals.

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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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A vaginal swab test involves taking a sample of vaginal secretions with a device that looks like a cotton bud. The swab, with secretions attached, is then placed in a special container and sent to the microbiology laboratory for further analysis. When it reaches the laboratory the sample is then plated on a Petrie dish, which is a flat dish containing a special jelly. The dish is then placed in a special incubator that maintains a particular level of heat and humidity, which facilitates the growth of any bacteria that may be contained in the sample. The jelly in the Petrie dish is a nutrient material that allows any bacteria in the sample to colonise the surface of the jelly. This is the process that is referred to when we send a swab for culture. In other words the lab technician is attempting to make the bacteria reproduce and multiply by creating a favourable yet artificial environment. Having succeeded in creating the bacterial colonies on the Petrie dish various antibiotics are then added to the dish to determine which antibiotics are the most effective in eliminating the bacterial colonies from the dish. Therefore culture and sensitivity simply refers to the process whereby the bacteria in the sample are identified and then tested to determine which antibiotics are needed to eliminate them. “Culture and sensitivity” testing is widely used in microbiology for testing such diverse samples as various bodily discharges to urine samples.

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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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C-reactive protein (CRP) is an acute phase reactant, a protein made by the liver and released into the blood within a few hours after tissue injury, the start of an infection, or other cause of inflammation. Markedly increased levels are observed, for example, after trauma or a heart attack, with active or uncontrolled autoimmune disorders, and with serious bacterial infections like sepsis. The level of CRP can jump as much as a thousand-fold in response to inflammatory conditions, and its rise in the blood can precede pain, fever, or other clinical indicators. The test measures the amount of CRP in the blood and can be valuable in detecting inflammation due to acute conditions or in monitoring disease activity in chronic conditions.


The CRP test is not diagnostic, but it provides information to a health practitioner as to whether inflammation is present. This information can be used in conjunction with other factors such as signs and symptoms, physical exam, and other tests to determine if someone has an acute inflammatory condition or is experiencing a flare-up of a chronic inflammatory disease. The health practitioner may then follow up with further testing and treatment.


This standard CRP test is not to be confused with an hs-CRP test. These are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:


The standard CRP test measures markedly high levels of the protein to detect diseases that cause significant inflammation. It measures CRP in the range from 10 to 1000 mg/L.

The hs-CRP test accurately detects lower levels of the protein than the standard CRP test and is used to evaluate individuals for risk of cardiovascular disease. It measures CRP in the range from 0.5 to 10 mg/L.

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Cytomegalovirus (CMV) is a common virus that occurs widely throughout the population but rarely causes symptoms. In the United States, as many as 50-85% of adults have been infected with CMV. Most people are infected as children or as young adults and do not experience any significant symptoms or health problems.


CMV testing involves either a measurement of CMV antibodies, immune proteins produced in response to CMV exposure, or the detection of the virus itself. The virus can be identified during an active infection by culturing CMV or by detecting the virus's genetic material (its DNA) in a fluid or tissue sample.


CMV is found in many body fluids during an active infection, including saliva, urine, blood, breast milk, semen, vaginal secretions, and cerebrospinal fluid. It is easily transmitted to others through close physical contact or by contact with infected objects, such as diapers or toys. After the initial "primary" infection has resolved, CMV becomes dormant or latent, like other members of the herpes family. Cytomegalovirus remains in a person for the rest of the person's life without causing any symptoms unless the person's immune system is significantly weakened. If this happens, the virus can reactivate.


CMV can cause notable health problems in three situations:


In young adults, primary CMV infection may cause a flu-like or mononucleosis-type illness. This condition, which causes symptoms such as extreme fatigue, fever, chills, body aches and/or headaches, usually resolves within a few weeks. 

In infants, primary CMV infection may cause serious physical and developmental problems. This occurs when a woman is infected for the first time (primary infection) during pregnancy and then passes the infection to her developing baby across the placenta. Most newborns (about 90%) who are infected appear healthy at birth but may develop hearing or vision problems, pneumonia, seizures, and/or delayed mental development a few months later. A few babies may be stillborn, while others may have symptoms at birth such as jaundice, anemia, an enlarged spleen or liver, and a small head.

In those with weakened immune systems, CMV could cause serious illness and death. This includes those with HIV/AIDS, those who have had organ or bone marrow transplants, and those undergoing chemotherapy treatment for cancer. People with compromised immune systems who become infected for the first time (primary infection) might experience the most severe symptoms and their CMV infection may remain active. Those who have been exposed to CMV previously may reactivate their infection. This could affect their eyes (causing inflammation of the retina, which can lead to blindness), digestive tract (causing bloody diarrhea and abdominal pain), lungs (causing pneumonia with a non-productive cough and shortness of breath), and brain (causing encephalitis). There can also be spleen and liver involvement, and those who have had organ or bone marrow transplants may experience some degree of rejection. Active CMV also further depresses the immune system, allowing other secondary infections such as fungal infections, to occur.

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Epstein-Barr virus (EBV) is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection.


Epstein-Barr virus causes an infection that is very common. According to the Centers for Disease Control and Prevention (CDC), most people in the United States are infected by EBV at some point in their lives. The virus is very contagious and easily passed from person to person. It is present in the saliva of infected individuals and can be spread through close contact such as kissing and through sharing utensils or cups.


After initial exposure to EBV, there is a period of several weeks before associated symptoms may appear, called the incubation period. During the acute primary infection, the virus multiplies in number. This is followed by a decrease in viral numbers and resolution of symptoms, but the virus never completely goes away. Latent EBV remains in the person's body for the rest of that person's life and may reactivate but usually causes few problems unless the person's immune system is significantly weakened.


Most people are infected by EBV in childhood and experience few or no symptoms. However, when the initial infection occurs in adolescence, it can cause infectious mononucleosis, commonly called mono, a condition associated with fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and sometimes an enlarged liver. These symptoms occur in about 25% of infected teens and young adults and usually resolve within a month or two.


People with mono are typically diagnosed by their symptoms and the findings from a complete blood count (CBC) and a mono test (which tests for a heterophile antibody). About 25% of those with mono do not produce heterophile antibodies and will have a negative mono test; this is especially true with children. Tests for EBV antibodies can be used to determine whether or not the symptoms these people are experiencing are due to a current infection with the EBV virus.


EBV is the most common cause of mono. According to the CDC, examples of other causes of mono include cytomegalovirus (CMV), hepatitis A, hepatitis B or hepatitis C, rubella, and toxoplasmosis. Sometimes, it can be important to distinguish EBV from these other illnesses. For instance, it may be important to diagnose the cause of symptoms of a viral illness in a pregnant woman. Testing can help to distinguish a primary EBV infection, which has not been shown to affect a developing baby, from a CMV, herpes simplex virus, or toxoplasmosis infection, as these illnesses can cause complications during the pregnancy and may harm the fetus.


It can also be important to rule out EBV infection and to look for other causes of the symptoms. Those with strep throat, an infection caused by group A streptococcus, for instance, need to be identified and treated with antibiotics. A person may have strep throat instead of mono or may have both conditions at the same time.


Several tests for different types and classes of EBV antibodies are available. The antibodies are proteins produced by the body in an immune response to several different Epstein-Barr virus antigens. During a primary EBV infection, the level of each of these EBV antibodies rises and falls at various times as the infection progresses. Measurement of these antibodies in the blood can aid in diagnosis and typically provides the healthcare practitioner with information about the stage of infection and whether it is a current, recent, or past infection.

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Fibrinogen is a protein, a coagulation factor (factor I) that is essential for blood clot formation. Two types of tests are available to evaluate fibrinogen: a fibrinogen activity test evaluates how well fibrinogen functions in helping to form a blood clot while a fibrinogen antigen test measures the amount of fibrinogen in the blood.


Fibrinogen is produced by the liver and released into circulation along with several other coagulation factor proteins. Normally, when a body tissue or blood vessel wall is injured, a process called hemostasis begins to help stop the bleeding by forming a plug at the injury site. Small cell fragments called platelets adhere to and aggregate at the site, a coagulation cascade begins, and clotting factors are activated one after the other.


As the cascade nears completion, soluble fibrinogen is converted into insoluble fibrin threads. These threads crosslink together to form a fibrin net that stabilizes at the injury site. The fibrin net adheres to the site of injury along with the platelets to form a stable blood clot. This barrier prevents additional blood loss and remains in place until the injured area has healed.


For a stable clot to form there must be enough normally functioning platelets and coagulation factors. If there are dysfunctional factors or platelets, or too little or too much of them, it can lead to bleeding episodes and/or to formation of an in appropriate blood clot (thrombosis). Several laboratory tests, including fibrinogen tests, can be used to evaluate hemostasis.

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Hepatitis A is a highly contagious liver infection caused by the hepatitis A (HAV). It is one of several various causes of hepatitis, a condition characterized by inflammation and enlargement of the liver. This test detects antibodies in the blood that are produced by the immune system in response to a hepatitis A infection.


Hepatitis A is one of five "hepatitis viruses" identified so far, including B, C, D, and E, that are known to cause the disease. While hepatitis A can cause a severe, acute disease that typically lasts 1 to 2 months, it does not cause a chronic infection as do some of the other hepatitis viruses.


Hepatitis A is spread, most commonly, from person-to person through stool (fecal) contamination or by ingesting food or water contaminated by the stool of an infected person (a foodborne illness). Recognized risk factors for hepatitis A include close contact with an infected person, international travel, household or personal contact with a child who attends a child care center, household or personal contact with a newly arriving international adoptee, a recognized foodborne outbreak, men who have sex with men, and use of illegal drugs.


Although there are many causes of hepatitis, the symptoms remain the same. In hepatitis, the liver is damaged and unable to function normally. It cannot process toxins or waste products such as bilirubin for their removal from the body. During the course of the disease, bilirubin and liver enzyme levels in the blood can increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they do not identify the cause. Antibody tests for hepatitis viruses may help determine the cause.

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This test measures the actual amount of hepatitis B in a blood sample, which helps determine whether HBV is reproducing in the liver. In a person with detectable HBeAg, an HBV viral load greater than 20,000 international units per milliliter (IU/mL) of blood indicates that the virus is active and has the greatest potential to cause damage to the liver. Similarly, in a person with an HBeAg-negative chronic hepatitis B, an HBV viral load of greater than 2,000 IU/mL indicates that the virus is active and has the potential to cause damage to the liver. Generally speaking, if the HBV viral load is above these numbers, treatment is considered necessary. However, HBV treatment decisions are based on multiple factors, and your medical provider may make recommendations based on other input.

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An HCV antibody test is typically reported as "positive" or "negative."


Results of HCV viral load testing are reported as a number if virus is present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as "negative" or "not detected."


Interpretation of the HCV screening and follow-up tests is shown in the table below. In general, if the HCV antibody test is positive, then the individual tested is infected or has likely been infected at some time with hepatitis C. If the HCV RNA test is positive, then the person has a current infection. If no HCV viral RNA is detected, then the person either does not have an active infection or the virus is present in very low numbers.


For monitoring purposes, an HCV viral load (HCV RNA quantitative) can indicate whether or not treatment is effective. A high or increasing viral load may be a sign that treatment is not successful whereas a low, decreasing, or undetectable viral load may imply that the treatment is working.


Successful treatment causes a decrease of 99% or more in viral load soon after starting treatment (as early as 2-4 weeks) and usually leads to undetectable viral load after treatment is completed. According to guidelines from the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, an undetectable viral load in a treated person's blood 12 weeks after the end of the treatment means that the HCV infection has responded to therapy.

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The qualitative HCV RNA tests use either a process called polymerase chain reaction (PCR) or a process called transcription-mediated amplification (TMA). Either type of qualitative test will report whether the hepatitis C virus is present in the bloodstream or not. The result is reported as either "detected" or "not detected."

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Hepatitis E virus (HEV) causes an acute, usually self-limited infection. This small, non-enveloped RNA virus is from animal reservoir (eg, hogs) to humans via the fecal-oral route. HEV is endemic in Southeast and Central Asia, with several outbreaks observed in the Middle East, northern and western parts of Africa, and Mexico. In developed countries, HEV infection occurs mainly in persons who have traveled to disease-endemic areas. Transmission of HEV may also occur parenterally, and direct person-to-person transmission is rare. Clinically severe cases occur in young to middle-aged adults. Unusually high mortality (approximately 20%) occurs in patients infected during the third trimester of pregnancy. Although there is no carrier state associated with HEV, immunocompromised patients may have prolonged periods (eg, months) of viremia and virus shedding in the stool.


In immunocompetent patients, viremia and virus shedding in the stool occur in the preicteric phase, lasting up to 10 days into the clinical phase. After an incubation period ranging from 15 to 60 days, HEV-infected patients develop symptoms of hepatitis with appearance of anti-HEV IgM antibody in serum, followed by detectable anti-HEV IgG within a few days. Anti-HEV IgM may remain detectable up to 6 months after onset of symptoms, while anti-HEV IgG usually persists for many years after infection. Anti-HEV IgM is the serologic marker of choice for diagnosis of acute HEV infection.

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As part of your HIV care, your provider will order several laboratory tests. The results of these lab tests, along with your physical exam and other information you provide, will help you and your provider work together to develop the best plan to manage your HIV care so that you can get the virus under control, protect your health, and reduce the chance that you will pass the virus to others.Your healthcare provider will repeat some of these tests as part of your ongoing HIV care to continue to assess your health and how well your HIV treatment is working.


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This test looks for antibodies which the body develops in response to infection with the Human T-Cell Lymphotropic Virus (HTLV).  HTLV infects white blood cells which are important to the body’s immune system.  HTLV infection can be responsible for the development of a number of conditions including Leukemia, Lymphoma, and nervous system disorders.  The HTLV 1&2 Abs test detects and differentiates both type 1 and type 2 HTLV infections. An estimated 15-20 million people worldwide suffer from HTLV infections.  HTLV is typically spread through sexual contact and exposure to infected blood, especially through intravenous drug use.  Infected mothers can spread the infection to their infants during pregnancy or breast feeding.  After infection, HTLV will remain in the body for life.  Some people will develop HTLV related illnesses months or years after their initial exposure.  Most HTLV infections show no symptoms.  An infected person can spread the virus to others even if they are asymptomatic. 


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Despite the morbidity associated with anogenital condylomas and the mortality associated with anal, penile, and cervical carcinoma as a direct consequence of human papillomavirus (HPV), the US Centers for Disease Control and Prevention currently does not recommend routine screening for HPV in immuno competent men. However, findings of emerging research focusing on the high-risk populations of men who have sex with men and men who test positive for human immunodeficiency virus, in whom HPV infection is pervasive and persistent, suggest that these populations may benefit from screening. Therefore, HPV screening, including anal cytology, should be considered for these men in settings where appropriate follow-up, including high-resolution anoscopy, is available.

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Liver function tests help determine the health of your liver by measuring the levels of proteins, liver enzymes, or bilirubin in your blood.


A liver function test is often given in the following situations: to screen for liver infections, such as hepatitis C

to monitor the side effects of certain medications known to affect the liver

if you already have a liver disease, to monitor the disease and how well a particular treatment is working

to measure the degree of scarring (cirrhosis) on the liver

if you’re experiencing the symptoms of a liver disorder

if you’re planning on becoming pregnant

Many tests can be performed on the liver, but most of them don’t measure the overall function of the liver. Commonly used tests to check liver function are the alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, and bilirubin tests. The ALT and AST tests measure enzymes that your liver releases in response to damage or disease. The albumin and bilirubin tests measure how well the liver creates albumin, a protein, and how well it disposes of bilirubin, a waste product of the blood.

Having abnormal results on any of the liver function tests doesn’t necessarily mean you have liver disease or damage. Talk to your doctor about the results of your liver function test.

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Malaria antigen detection tests are a group of commercially available rapid diagnostic tests of the rapid antigen test type that allow quick diagnosis of malaria by people who are not otherwise skilled in traditional laboratory techniques for diagnosing malaria or in situations where such equipment is not available. There are currently over 20 such tests commercially available (WHO product testing 2008). The first malaria antigen suitable as target for such a test was a soluble glycolytic enzyme Glutamate dehydrogenase.[1][2][3] None of the rapid tests are currently as sensitive as a thick blood film, nor as cheap. A major drawback in the use of all current dipstick methods is that the result is essentially qualitative. In many endemic areas of tropical Africa, however, the quantitative assessment of parasitaemia is important, as a large percentage of the population will test positive in any qualitative assay.

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Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood.

Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly.  The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs.





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MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets. An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.


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The mumps virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, measles, respiratory syncytial virus, and metapneumovirus. Mumps is highly infectious among unvaccinated individuals and is typically transmitted through inhalation of infected respiratory droplets or secretions. Following an approximately 2-week incubation period, symptom onset is typically acute with a prodrome of low-grade fever, headache, and malaise.(1,2) Painful enlargement of the salivary glands, the hallmark of mumps, occurs in approximately 60% to 70% of infections and in 95% of patients with symptoms. Testicular pain (orchitis) occurs in approximately 15% to 30% of postpubertal men and abdominal pain (oophoritis) is found in 5% of postpubertal women.(1) Other complications include mumps-associated pancreatitis (<5% of cases) and central nervous system disease (meningitis <10% and encephalitis <1%).

Widespread routine immunization of infants with attenuated mumps virus has dramatically decreased the number of reported mumps cases in the United States. However, outbreaks continue to occur, indicating persistence of the virus in the general population. Laboratory diagnosis of mumps is typically accomplished by detection of IgM- and IgG-class antibodies to the mumps virus. However, due to the widespread mumps vaccination program, in clinically suspected cases of acute mumps infection, serologic testing should be supplemented with virus isolation in culture or detection of viral nucleic acid by PCR in throat, saliva, or urine specimens.


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Gingivitis: Gum disease with inflammation of the gums. On inspection, the gums will appear red and puffy, and will usually bleed during tooth-brushing or dental examination. Treatment is by improved cleaning, with more-frequent and longer brushing and flossing, and/or the use of electronic tooth-cleaning equipment. Antiseptic mouthwashes may also be recommended. See also acute membranous gingivitis

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The packed cell volume (PCV) is a measurement of the proportion of blood that is made up of cells. The value is expressed as a percentage or fraction of cells in blood. For example, a PCV of 40% means that there are 40 millilitres of cells in 100 millilitres of blood. 
Red blood cells account for nearly all the cells in the blood. The PCV rises when the number of red blood cells increases or when the total blood volume is reduced, as in dehydration. The PCV falls to less than normal, indicating anaemia, when your body decreases its production of red blood cells or increases its destruction of red blood cells.

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Hangovers can occur at any time of day, but are usually more common in the morning directly after a night of heavy drinking.

As well as physical symptoms, the person may experience elevated levels of anxiety, regret, shame, embarrassment, and depression. The severity of a hangover is closely linked to how much alcohol was consumed, and whether the sufferer had enough sleep; the less sleep, the worse the hangover.

It is impossible really to say how much alcohol can be safely consumed to avoid a hangover - it depends on the individual and other factors, such as how tired they were before they began drinking, whether they were already dehydrated before the drinking began, whether they drank plenty of water during their drinking session, and how much sleep they got afterward.

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Hay fever affects up to 30% of all people worldwide, including up to 10% of U.S. children under 17 years of age and 7.8% of U.S. adults. The medical cost of allergic rhinitis is approximately $3.4 billion, mostly due to the cost of prescription medications. These figures are probably an underestimate because many of those affected may attribute their discomfort to a chronic cold. Although childhood hay fever tends to be more common, this condition can occur at any age and usually occurs after years of repeated inhalation of allergic substances. The incidence of allergic disease has dramatically increased in the U.S. and other developed countries over recent decades.

"Hay fever" is a misnomer. Hay is not a usual cause of this problem, and it does not cause fever. Early descriptions of sneezing, nasal congestion, and eye irritation while harvesting field hay promoted this popular term. Allergic rhinitis is the correct term used to describe this allergic reaction, and many different substances cause the allergic symptoms noted in hay fever. Rhinitis means "inflammation of the nose" and is a derivative of rhino, meaning nose. Allergic rhinitis that occurs during a specific season is called "seasonal allergic rhinitis." When it occurs throughout the year, it is called "perennial allergic rhinitis." Rhinosinusitis is the medical term that refers to inflammation of the nasal lining as well as the lining tissues of the sinuses. This term is sometimes used because the two conditions frequently occur together.

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The oxygen-carrying pigment and predominant protein in the red blood cells. Hemoglobin forms an unstable, reversible bond with oxygen. In its oxygenated state it is called oxyhemoglobin and is bright red. In the reduced state it is called deoxyhemoglobin and is purple-blue.


Each hemoglobin molecule is made up of four heme groups surrounding a globin group. Heme contains iron and gives a red color to the molecule. Globin consists of two linked pairs of polypeptide chains. The development of each chain is controlled at a separate genetic locus. Changes in the amino acid sequence of these chains results in abnormal hemoglobins. For example, hemoglobin S is found in sickle-cell disease, a severe type of anemia in which the red cells become sickle-shaped when oxygen is in short supply.


When red blood cells die, the hemoglobin within them is released and broken up: the iron in hemoglobin is salvaged, transported to the bone marrow by a protein called transferrin and used again in the production of new red blood cells; the remainder of the hemoglobin becomes a chemical called bilirubin that is excreted into the bile which is secreted into the intestine, where it gives the feces their characteristic yellow-brown color.

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HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome, or AIDS, if not treated. Unlike some other viruses, the human body can’t get rid of HIV completely, even with treatment. So once you get HIV, you have it for life.

HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get other infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last stage of HIV infection.

No effective cure currently exists, but with proper medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.

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Hives (medically known as urticaria) appear on the skin as wheals that are red, very itchy, smoothly elevated areas of skin often with a blanched center. They appear in varying shapes and sizes, from a few millimeters to several centimeters in diameter anywhere on the body.

It is estimated that 20% of all people will develop urticaria at some point in their lives. Hives are more common in women than in men. One hallmark of hives are their tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours. An individual hive usually lasts no longer than 24 hours. An outbreak that looks impressive, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day. Very few skin diseases occur and then resolve so rapidly. Therefore, even if you have no evidence of hives to show the doctor when you get to the office for examination, the diagnosis can be established based upon the accurate recounting of your symptoms and signs. Because hives fluctuate so much and so fast, it is helpful to bring along a photograph of what the outbreak looked like at its most severe point.

Swelling deeper in the skin that may accompany hives is called angioedema. This swelling of the hands and feet, as well as the face (lips or eyelids), can be as dramatic as it is brief.

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Hoarseness is an abnormal change in the voice caused by a variety of conditions. The voice may have changes in pitch and volume, ranging from a deep, harsh voice to a weak, raspy voice.

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His is the medical term for a definite kind of vaginal discharge that is most common during pregnancy as well as at additional times during the reproductive years. If an individual has leukorrhea, it may be a sticky as well as thick vaginal discharge that is yellow, green or white. It may vary with the menstrual cycle of the woman as her hormone levels change.

Discharges from the vagina are normally a sign of vaginal yeast infections, bacterial vaginosis, or sexually transmitted diseases. Leukorrhea may or may not be an indication of the presence of an infection, and it is not normally accompanied by any other symptoms or signs, such as itching, pain, irritation or burning, or redness of the tissue. Only a qualified medical professional can advise a woman whether there is an infection.

If a woman has any type vaginal discharge which is unusual during pregnancy or at any other time, she should always consult with her primary care physician before using any over-the-counter therapy or home remedies.


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Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcom


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Liver cancer, also known as hepatic cancer, is a cancer which starts in the liver, rather than migrating to the liver from another organ or section of the body. In other words, it is a primary liver cancer.

Cancers that originate elsewhere and eventually reach the liver are known as liver metastasis or secondary liver cancers, and are most commonly from cancer of the gastrointestinal (GI) tract (colon cancer), lung cancer, renal cancer (cancer of the kidney), ovarian cancer and prostate cancer.

The liver, which is located below the right lung and under the ribcage is one of the largest organs of the human body. It is divided into the right and left lobes. Nutrient-rich blood is carried by the portal vein from the intestines to the liver, while oxygen-rich blood reaches the liver from the hepatic artery.

All vertebrates (animals with a spinal column) have a liver, as do some other animals. The liver has a range of functions, including detoxification (getting rid of toxins), synthesizing proteins, breaking down fats, and producing biochemicals that are essential for digestion. We cannot survive without a liver.

 

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A liver transplant is an operation that replaces a patient's diseased liver with a whole or partial healthy liver from another person. This article explains the current indications for liver transplantation, types of donor livers, the operation itself, and the immunosuppression that is required after transplantation.Liver transplantation surgically replaces a failing or diseased liver with one that is normal and healthy. At this time, transplantation is the only cure for liver insufficiency or liver failure because no device or machine reliably performs all of the functions of the liver. People who require liver transplants typically have one of the following conditions


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Liver

The liver is a large organ on the upper right side of your torso, opposite the stomach and behind the ribcage. One of its main functions is to make a substance called bile (composed mostly of bilirubin, bile salts, and cholesterol) that is required to digest food in the small intestine.


The liver is divided into two sections: a right lobe and a left lobe. Both lobes are made up of cells called hepatocytes. These cells produce bile and secrete it into the bile ducts, which carry bile to the gallbladder where it is stored until used by the small intestine.


Gallbladder and Bile Ducts

The gallbladder is a pear-shaped sac under the right lobe of the liver. Between meals, it stores and concentrates bile, which is produced at a constant rate by the liver. When it is not full of bile, the gallbladder is about 3 inches long and 1 inch wide at its thickest part.


After meals, the gallbladder releases bile into the duodenum to aid with digestion. The cystic duct carries bile from the gallbladder to the common bile duct, which empties into the duodenum. Entry of bile into the duodenum is regulated by layers of muscle called the sphincter of Oddi.


Between meals, the sphincter of Oddi closes and prevents bile from entering the duodenum. During and after meals, this sphincter opens and allows bile to enter the duodenum.


Pancreas

The pancreas is a long, thin gland that lies horizontally behind the bottom part of your stomach. It makes digestive enzymes that flow through the pancreatic duct to the small intestine. These enzymes, along with bile from the gallbladder, break down food for use as energy by the body. The pancreas also makes insulin and glucagon, hormones that help regulate blood glucose (sugar) levels.


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There is no such thing as a "bad memory", and anyone can improve their memory, as long as you are not suffering from memory loss as a medical condition. If you want to improve your memory, there are a number of things you can do, from eating blueberries to using a variety of mnemonic devices. If you're optimistic and dedicated, you'll be able to improve your memory, whether you want to win the World Memory Championships, ace your history test, or simply remember where you put your keys.

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Heavy menstrual bleeding (called menorrhagia by health care professionals) is defined as soaking a pad and/or tampon every hour or less during each menstrual cycle. For many women, heavy menstrual bleeding is a huge obstacle to their lifestyles. Have you ever had to reschedule an activity around your menstrual period? Then, you know the toll it can take. You may not know that heavy bleeding can be more than a schedule buster. The heavy bleeding can also lead to iron-deficient anemia, the most common health-related threat of menorrhagia. While most cases of anemia are easily treated with oral iron supplements, sometimes the bleeding is so severe a woman's entire volume of blood drops, leading to shortness of breath, severe fatigue and heart palpitations that require hospitalization.


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Making the right diagnosis, finding a mental health professional and obtaining health insurance coverage are the main challenges families face. Many insurers do not provide equal benefits for mental health services as they do for other general medical services. There are often long waiting lists to receive quality services. Patients who have a "dual diagnosis" of developmental and/or medical conditions along with their mental health condition seem to have the most difficulty finding appropriate services.Cincinnati Children's has compiled a list of Greater Cincinnati and national resources that provide mental health services.

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Defination

Bacterial vaginosis also is referred to as nonspecific vaginitis, is a vaginal condition that can produce vaginal discharge and results from an overgrowth of certain kinds of bacteria in the vagina. In the past, the condition was called Gardnerella vaginitis, after the bacteria that were thought to cause the condition. However, the newer name, bacterial vaginosis, reflects the fact that there are a number of species of bacteria that naturally live in the vaginal area and may grow to excess, rather than a true infection with foreign bacteria, such as occurs with many sexually-transmitted disease

Facts & Symptoms


Bacterial vaginosis (BV) is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina. It is not a true bacterial infection but rather an imbalance of the bacteria that are normally present in the vagina.
Bacterial vaginosis is not dangerous, but it can cause disturbing symptoms.
Most women do not experience symptoms of bacterial vaginosis, but when they do they are:

    vaginal discharge, and
    vaginal odor.

In diagnosing bacterial vaginosis, it is important to exclude other serious vaginal infections, such as the STDs gonorrhea and Chlamydia.
Treatment options for relief of bacterial vaginosis include prescription oral antibiotics and vaginal gels. Metronidazole (Flagyl) is one option for treating bacterial vaginosis.
Serious complications of bacterial vaginosis can occur during pregnancy, and recurrence is possible even after


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An ovarian cyst is a fluid-filled sac within the ovary. Often they cause no symptoms. Occasionally they may produce bloating, lower abdominal pain, or lower back pain. The majority of cysts are harmless. If the cyst either breaks open or causes twisting of the ovary, it may cause severe pain. This may result in vomiting or feeling faint.

Most ovarian cysts are related to ovulation, being either follicular cysts or corpus luteum cysts. Other types include cysts due to endometriosis, dermoid cysts, and cystadenomas. Many small cysts occur in both ovaries in polycystic ovarian syndrome. Pelvic inflammatory disease may also result in cysts. Rarely, cysts may be a form of ovarian cancer. Diagnosis is undertaken by pelvic examination with an ultrasound or other testing used to gather further details.

Often, cysts are simply observed over time. If they cause pain, medications such as paracetamol (acetaminophen) or ibuprofen may be used. Hormonal birth control may be used to prevent further cysts in those who are frequently affected. However, evidence does not support birth control as a treatment of current cysts. If they do not go away after several months, get larger, look unusual, or cause pain, they may be removed by surgery.
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eastern poison ivy/Toxicodendron rydbergii -- western poison ivy) typically grows as a vine or shrub, and it can be found throughout much of North America (except in the desert, Alaska, and Hawaii). It grows in open fields, wooded areas, on the roadside, and along riverbanks. It can also be found in urban areas, such as parks or backyards. Poison ivy plants typically have leaf arrangements that are clustered in groups of three leaflets (trifoiate), though this can vary. The color and shape of the leaves may also vary depending upon the exact species, the local environment, and the time of year. The plant may have yellow or green flowers, and white to green-yellow berries, depending on the season. Eastern poison ivy typically grows as a hairy ropelike vine, whereas western poison ivy tends to grow as a low shrub.

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Polycystic liver disease (PLD or PCLD) is a rare condition that causes cysts -- fluid-filled sacs -- to grow throughout the liver. A normal liver has a smooth, uniform appearance. A polycystic liver can look like a cluster of very large grapes. Cysts also can grow independently in different parts of the liver. The cysts, if they get too numerous or large, may cause discomfort and health complications. But most people with polycystic liver disease do not have symptoms and live a normal life.

Here are the facts about polycystic liver disease you need to better understand the condition.

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Polycystic ovary syndrome (PCOS) is a set of symptoms due to elevated androgens (male hormones) in women. Signs and symptoms of PCOS include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, difficulty getting pregnant, and patches of thick, darker, velvety skin. Associated conditions include type 2 diabetes, obesity, obstructive sleep apnea, heart disease, mood disorders, and endometrial cancer.

PCOS is due to a combination of genetic and environmental factors. Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts. Cysts may be detectable by ultrasound. Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and hyperprolactinemia.
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When the skin is in the process of recovering from an injury, whether the result of an accident, surgery, a burn, or acne, scarring will occur wherever multiple layers of the skin have been affected. Once a scar forms, it is permanent but may be made less visible or relocated surgically.
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Sensitive skin is a skin condition in which skin is prone to itching and irritation experienced as a subjective sensation when using cosmetics and toiletries. When questioned, over 50% of women in the UK and US, and 38% of men, report that they have sensitive skin.
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Skin rejuvenation helps rectify skin irregularities on the face and elsewhere on the body. La belle's Skin rejuvenation treatments have been developed considering the general needs and the various problems that could possibly affect the skin. We aim to help restore and promote the wellness of your skin and spirit. Our experts suggest the appropriate skin rejuvenation treatments after examining your skin type and identifying your requirement. Facial rejuvenation is a treatment aims to restore a youthful appearance to the human face cosmetically and can be carried out by surgical and/or non-surgical options

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Tinea versicolor is a condition characterized by a skin eruption on the trunk and proximal extremities. The majority of tinea versicolor is caused by the fungus Malassezia globosa, although Malassezia furfur is responsible for a small number of cases. These yeasts are normally found on the human skin and become troublesome only under certain circumstances, such as a warm and humid environment, although the exact conditions that cause initiation of the disease process are poorly understood.

The condition pityriasis versicolor was first identified in 1846. Versicolor comes from the Latin, from versāre to turn + color. It is also commonly referred to as Peter Elam's disease in many parts of South Asia.
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Tooth decay, also known as dental caries or cavities, is a breakdown of teeth due to acids made by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss, and infection or abscess formation.

The cause of caries is acid from bacteria dissolving the hard tissues of the teeth (enamel, dentin and cementum). The acid is produced from food debris or sugar on the tooth surface. Simple sugars in food are these bacteria's primary energy source and thus a diet high in simple sugar is a risk factor. If mineral breakdown is greater than build up from sources such as saliva, caries results. Risk factors include conditions that result in less saliva such as: diabetes mellitus, Sjogren's syndrome and some medications. Medications that decrease saliva production include antihistamines and antidepressants. Caries is also associated with poverty, poor cleaning of the mouth, and receding gums resulting in exposure of the roots of the teeth.
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Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms. Symptoms may vary from mild to severe and usually begin six to thirty days after exposure. Often there is a gradual onset of a high fever over several days. Weakness, abdominal pain, constipation, and headaches also commonly occur. Diarrhea is uncommon and vomiting is not usually severe. Some people develop a skin rash with rose colored spots. In severe cases there may be confusion. Without treatment symptoms may last weeks or months. Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others. Typhoid fever is a type of enteric fever along with paratyphoid fever.

The cause is the bacterium Salmonella typhi, also known as Salmonella enterica serotype Typhi, growing in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person. Risk factors include poor sanitation and poor hygiene. Those who travel to the developing world are also at risk and only humans can be infected. Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow. Culturing the bacterium can be difficult. Bone marrow testing is the most accurate. Symptoms are similar to that of many other infectious diseases. Typhus is a different disease.
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Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptom of active disease is abdominal pain and diarrhea mixed with blood. Weight loss, fever, and anemia may also occur. Often symptoms come on slowly and can range from mild to severe. Symptoms typically occur intermittently with periods of no symptoms between flares. Complications may include megacolon, inflammation of the eye, joints, or liver, and colon cancer.

The cause of UC is unknown. Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors. Rates tend to be higher in the developed world with some proposing this to be the result of less exposure to intestinal infections, or a Western diet and lifestyle. The removal of the appendix at an early age may be protective. Diagnosis is typically by colonoscopy with tissue biopsies. It is a kind of inflammatory bowel disease (IBD) along with Crohn's disease and microscopic colitis.
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Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection.


Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene.


None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition.

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Itching or irritation anywhere on the body can cause discomfort. But when it occurs in an area as sensitive as the vagina and vulva (the labia, clitoris, and vaginal opening), it can be especially uncomfortable. Most genital itching and irritation isn't a major concern. But because they can be symptoms of an infection, it's always a good idea to call your health care provider.

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Vaginitis, also known as vaginal infection and vulvovaginitis, is an inflammation of the vagina and possible vulva. It can result in discharge, itching and pain, and is often associated with an irritation or infection of the vulva. Infected women may also be asymptomatic.

It is usually due to infection. The three main kinds of vaginitis are bacterial vaginosis (BV), vaginal candidiasis, and trichomoniasis. A woman may have a combination of vaginal infections at one time. Testing for vaginal infections is not a part of routine pelvic exams. If there is discomfort in the vulvovaginal area, women can request their health care providers evaluate for the presence of an infection.
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Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux). Leg muscles pump the veins to return blood to the heart (the skeletal-muscle pump), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening (lipodermatosclerosis) and ulceration. Although life-threatening complications are uncommon, varicose veins may be confused with deep vein thrombosis, which may be life-threatening.

Non-surgical treatments include sclerotherapy, elastic stockings, leg elevation and exercise. The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments which seal the main leaking vein are available. Alternative techniques, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are available as well. Because most of the blood in the legs is returned by the deep veins, the superficial veins, which return only about 10% of the total blood of the legs, can usually be removed or ablated without serious harm.

Secondary varicose veins are those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis (DVT). Treatment options are usually support stockings, occasionally sclerotherapy and rarely, limited surgery.

Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. Many patients who suffer with varicose veins seek out the assistance of physicians who specialize in vein care or peripheral vascular disease. These physicians include vascular surgeons, phlebologists or interventional radiologists.
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Vertigo is a medical condition where a person feels as if they or the objects around them are moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties walking. It is typically worsened when the head is moved. Vertigo is the most common type of dizziness.

The most common diseases that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and labyrinthitis. Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears. Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed. Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin. Vertigo is a problem in a part of the vestibular system. Other causes of dizziness include presyncope, disequilibrium, and non-specific dizziness.

Benign paroxysmal positional vertigo is more likely in someone who gets repeated episodes of vertigo with movement and is otherwise normal between these episodes. The episodes of vertigo should last less than one minute. The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition. In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes. In labyrinthitis the onset of vertigo is sudden and the nystagmus occurs without movement. In this condition vertigo can last for days. More severe causes should also be considered. This is especially true if other problems such as weakness, headache, double vision, or numbness occur.

Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo. About 5% have vertigo in a given year. It becomes more common with age and affects women two to three times more often than men. Vertigo accounts for about 2–3% of emergency department visits in the developed world.
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Vomiting, also known as emesis and throwing up, among other terms, is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.

Vomiting can be caused by a wide variety of conditions; it may present as a specific response to ailments like gastritis or poisoning, or as a non-specific sequela of disorders ranging from brain tumors and elevated intracranial pressure to overexposure to ionizing radiation. The feeling that one is about to vomit is called nausea, which often precedes, but does not always lead to, vomiting. Antiemetics are sometimes necessary to suppress nausea and vomiting. In severe cases, where dehydration develops, intravenous fluid may be required. Self induced vomiting can be a component of an eating disorder, such as Bulimia Nervosa, and is itself now an eating disorder on its own, purging disorder.

Vomiting is different from regurgitation, although the two terms are often used interchangeably. Regurgitation is the return of undigested food back up the esophagus to the mouth, without the force and displeasure associated with vomiting. The causes of vomiting and regurgitation are generally different.
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Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Despite the name, nausea or vomiting can occur at any time during the day. Typically these symptoms occur between the 4th and 16th week of pregnancy. About 10% of women still have symptoms after the 20th week of pregnancy. A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.

The cause of morning sickness is unknown but may be related to changing levels of the hormone human chorionic gonadotrophin. Some have proposed that it may be useful from an evolutionary point of view. Diagnosis should only occur after other possible causes have been ruled out. Abdominal pain, fever, or headaches are typically not present in morning sickness.

Taking prenatal vitamins before pregnancy may decrease the risk. Specific treatment other than a bland diet may not be required for mild cases. If treatment is used the combination of doxylamine and pyridoxine is recommended initially. There is limited evidence that ginger may be useful. For severe cases that have not improved with other measures methylprednisolone may be tried. Tube feeding may be required in women who are losing weight.

Morning sickness affects about 70-80% of all pregnant women to some extent. About 60% of women have vomiting. Hyperemesis gravidarum occurs in about 1.6% of pregnancies. Morning sickness can negatively affect quality of life, result in decreased ability to work while pregnant, and result in health care expenses. Generally mild to moderate cases have no effect on the baby. Most severe cases also have normal outcomes. Some women choose to have an abortion due to the severity of symptoms. Complications such as Wernicke encephalopathy or esophageal rupture may occur but are very rare.
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A yawn is a reflex consisting of the simultaneous inhalation of air and the stretching of the eardrums, followed by an exhalation of breath.

Yawning (oscitation) most often occurs in adults immediately before and after sleep, during tedious activities and as a result of its contagious quality. It is commonly associated with tiredness, stress, sleepiness, or even boredom and hunger. In humans, yawning is often triggered by others yawning (e.g. seeing a person yawning, talking to someone on the phone who is yawning) and is a typical example of positive feedback. This "contagious" yawning has also been observed in chimpanzees, dogs, cats, birds, and reptiles, and can occur across species. Approximately 20 psychological reasons for yawning have been proposed by scholars, but there is little agreement about its main functions.

During a yawn, the tensor tympani muscle in the middle ear contracts, creating a rumbling noise from within the head. Yawning is sometimes accompanied, both in humans and animals, by an instinctive act of stretching several parts of the body, including arms, neck, shoulders and back.
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Ayurveda is a system of medicine with historical roots in the Indian subcontinent. Globalized and modernized practices derived from Ayurveda traditions are a type of complementary or alternative medicine. In countries beyond India, Ayurveda therapies and practices have been integrated in general wellness applications and in some cases in medical use.

The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the Gods to sages, and then to human physicians. In Sushruta Samhita (Sushruta's Compendium), Sushruta wrote that Dhanvantari, Hindu god of Ayurveda, incarnated himself as a king of Varanasi and taught medicine to a group of physicians, including Sushruta. Ayurveda therapies have varied and evolved over more than two millennia. Therapies are typically based on complex herbal compounds, minerals and metal substances (perhaps under the influence of early Indian alchemy or rasa shastra). Ancient Ayurveda texts also taught surgical techniques, including rhinoplasty, kidney stone extractions, sutures, and the extraction of foreign objects.

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A vitamin deficiency can cause a disease or syndrome known as an avitaminosis or hypovitaminosis. This usually refers to a long-term deficiency of a vitamin. When caused by inadequate nutrition it can be classed as a primary deficiency, and when due to an underlying disorder such as malabsorption it can be classed as a secondary deficiency. An underlying disorder may be metabolic as in a defect converting tryptophan to niacin. It can also be the result of lifestyle choices including smoking and alcohol consumption.

Examples are vitamin A deficiency, folate deficiency, (scurvy), vitamin D deficiency, vitamin E deficiency, and vitamin K deficiency. In the medical literature, any of these may also be called by names on the pattern of hypovitaminosis or avitaminosis + [letter of vitamin], for example, hypovitaminosis A, hypovitaminosis C, hypovitaminosis D.
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Have you ever felt your fingers and toes going numb? Most of us face this problem once in a while, but if this numbness becomes an everyday thing for you, you need help. Blood serves several important functions in the body. It provides oxygen and nutrients to every cell and organ in the body. It balances body temperature, providing warmth to the fingers, nose and toes.

Poor blood circulation is much more unpleasant than it sounds. It occurs when the blood flow becomes restricted to certain parts of the body like heart, legs, hands, toes, feet and fingers. In mild situations, poor blood circulation causes only discomfort. But if not handled in time, it can lead to several other serious health conditions. The health problems caused due to poor blood circulation include varicose veins, kidney issue and other blood restriction difficulties.

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Heart and blood vessel disease — also called heart disease — includes numerous problems, many of which are related to a process called atherosclerosis. Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can stop the blood flow. This can cause a heart attack or stroke.

A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die. Most people survive their first heart attack and return to their normal lives to enjoy many more years of productive activity. But having a heart attack does mean you have to make some changes. 

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A six-year study by the Centers for Disease Control and Prevention found three behaviors exerted enormous impact on mortality: not currently smoking, consuming a healthier diet, and moderately exercising at least 21 minutes a day. People with one of the three behaviors had a 40 percent lower risk of dying within that six-year period. Those with two out of three more than halved their chances of dying, and those with all three reduced their chances of dying in that time by 82 percent.

A similar study measured how much vitamin C subjects had in their bloodstreams, as vitamin C level was considered a good biomarker of plant food intake (and hence was used as a proxy for a healthy diet). The drop in mortality risk among those with healthier habits was equivalent to being 14 years younger. It’s like turning back the clock 14 years just by eating and living healthier.How else might we slow aging?The mitochondrial theory of aging suggests that free radical damage to our cells’ power source (mitochondria) leads to a loss of cellular energy and function over time. According to the theory, the resulting cellular damage is what essentially causes aging. Aging and disease have been thought of as the oxidation of the body; oxidant stress is thought to be why we all get wrinkles, why we lose some of our memory, why our organ systems break down as we get older.Basically, the theory goes, we’re rusting.

Eating antioxidant-rich foods may slow down this oxidant process. On average, plant foods may contain 64 times more antioxidants than animal foods. Including a variety of fruits, vegetables, herbs, and spices each meal continuously floods our body with antioxidants to help ward off stroke and other age-related diseases.Consuming fruits and veggies, and not smoking, has also been associated with longer protective telomeres, the caps on the tips of our chromosomes that keep DNA from unraveling. (Think of the plastic tips on the ends of our shoelaces.) Each time our cells divide, a bit of that cap is lost. Telomeres can start shortening as soon as we’re born, and when they’re gone, we’re gone. The food we eat may impact how fast we lose our telomeres: Consumption of refined grains, soda, meat, and dairy has been linked to shortened telomeres, while fruit, vegetable, and other antioxidant-rich plant food intake has been associated with longer ones.


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If you have ever experienced any pain in your neck or back, you’ve probably heard the term “pinched nerve.” In fact, if you have seen a doctor about neck or back pain that did not go away on its own after a few weeks, you’ve probably been diagnosed with a spinal pinched nerve. A pinched nerve is often the result of any type of degenerative spine condition that causes pain and other symptoms. Though this is a common occurrence for most people at some point in their lives, a pinched nerve can be difficult to treat because there are so many potential causes for nerve compression.


The best thing you can do when you start to develop pain that you believe comes from a pinched nerve is to schedule an appointment with your doctor. If diagnosed in time, you may be able to find pain relief with several weeks or months of conservative treatment. Take a moment to read below about what causes a pinched nerve and some warning signs you should be aware of to know whether or not you should see a doctor.

As part of the body’s nervous system, nerves branch out from the brain and spinal cord to carry instructions to every area of the body. Essentially, the nerves are like electrical wires that allow signals to travel from the brain to the spinal cord to the organs and extremities, and back again.

Nerves within the brain and spinal cord are part of the central nervous system, while nerves that run from the spine to other areas of the body are called peripheral nerves. The peripheral nerves originate as nerve roots that exit the spinal cord and then branch off to spread throughout the body. The nerves that travel to muscles allow the muscles to move. Nerves also pass to the skin, providing the ability to feel.


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MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets. An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.

Other names: CBC with differential

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MPV stands for mean platelet volume. Platelets are small blood cells that are essential for blood clotting, the process that helps you stop bleeding after an injury. An MPV blood test measures the average size of your platelets. The test can help diagnose bleeding disorders and diseases of the bone marrow.

Other names: Mean Platelet Volume

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Vitamin D is a nutrient that is essential for healthy bones and teeth. There are two forms of vitamin D that are important for nutrition: vitamin D2 and vitamin D3. Vitamin D2 mainly comes from fortified foods like breakfast cereals, milk, and other dairy items. Vitamin D3 is made by your own body when you are exposed to sunlight. It is also found in some foods, including eggs and fatty fish, such as salmon, tuna, and mackerel.

In your bloodstream, vitamin D2 and vitamin D3 are changed into a form of vitamin D called 25 hydroxyvitamin D, also known as 25(OH)D. A vitamin D blood test measures the level of 25(OH)D in your blood. Abnormal levels of vitamin D can indicate bone disorders, nutrition problems, organ damage, or other medical conditions.

Other names: 25-hydroxyvitamin D, 25(OH)D

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Vision rehabilitation is the process of treatment and education that helps individuals who are visually disabled attain maximum function, a sense of well being, a personally satisfying level of independence, and optimum quality of life. Function is maximized by evaluation, diagnosis and treatment including, but not limited to, the prescription of optical, non-optical, electronic and/or other treatments. The rehabilitation process includes the development of an individual rehabilitation plan specifying clinical therapy and/or instruction in compensatory approaches.

Vision rehabilitation may be necessitated by any condition, disease, or injury that causes a visual impairment which results in functional limitation or disability. In addition to the evaluation, diagnosis and management of visual impairment by an eye care physician (optometrist or ophthalmologist), vision rehabilitation may include, but is not limited to, optometric, medical, allied health, social, educational and psychological services.

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Vocational rehabilitation services are based on individual needs and defined as any goods or services an individual might need to be employable, such as assistive technology devices and services. For instance, a person who is blind would need screen reading software to access a computer and people with a cognitive or mental disability might need a talking electronic reminder device programmed to prompt them when it is time to perform certain tasks.

Vocational rehabilitation can be provided by private organizations, but is not typically funded under managed care arrangements. Thus, most people apply to state vocational rehabilitation agencies that are funded through federal and state monies. Typically, state agencies have offices in their state's major cities and towns. State VR agencies do not necessarily offer the same services or deliver services in the same way in every state, so individuals seeking services must learn how to access the VR program in their own state. The federal VR component is administered by the U.S. Department of Education Rehabilitation Services Administration and authorized by the Rehabilitation Act of 1973 as amended in the 1988 reauthorization.Most vocational rehabilitation services are free for eligible applicants; however, applicants may be asked to use other benefits, such as: insurance, Pell grants or other financial aid for training or higher education, to pay part of program costs.

Best practices in vocational rehabilitation include individual choice, person-centered planning, integrated setting, natural supports, rapid placement, and career development. The term integrated setting refers to placing individuals in usual employment situations rather than making placements into sheltered workshops or other segregated settings. Natural supports are the person's already existing support network, including family members, service providers, and friends, who can help the person reach a goal, such as the employment of their choice. Person-centered planning is a technique in which a plan for a person's future is developed by a team consisting of the person and his or her natural supports, and the team develops a practical plan based on the person's wishes and dreams. Each teammember agrees to perform certain tasks identified in the plan to help the person reach goals. Unfortunately, not all VR programs incorporate all of these best practices.


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As an O Negative blood donor you have a particularly unique opportunity to help people in emergency situations. O Negative blood cells are called “universal” meaning they can be transfused to almost any patient in need, and only 6.6% of the population has O Negative blood. In the event of an emergency, trauma patients and accident victims are given a fighting chance at life due to O Negative blood transfusion. You may hear that “O Negative blood is the type they carry on the medical helicopters”. This is often the case when there is no time to ask questions.

Additionally, O Negative red blood cells are safest for newborn infants with under-developed immune systems. Your commitment to regular and frequent donations is especially important to maintain sufficient supplies for our community. And, local patients are grateful for your “gift of life”. It is also important to remember that while donors of all blood types can receive O Negative blood, those with O Negative blood can generally only receive O Negative blood. In extreme emergencies when O Negative is in short supply, sometimes O Positive can be substituted. 1 in 15 people have O- blood (approximately 6.6% of the population).


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As an O Positive donor you are incredibly important to maintaining the blood supply in our community. O Positive is the most common blood type and therefore needed by so many patients.

Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply. We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 3 people have O+ blood (approximately 37.4% of the population).


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As an A Positive donor you are incredibly important to maintaining the blood supply in our community. A Positive is the second most common blood type and therefore just as many patients need this blood type.

Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply.  We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 3 people have A+ blood (approximately 35.7% of the population).


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As a B Positive donor, you are very important to maintaining the blood supply in our community. B+ is the third most common occurring blood type. Your regular and frequent blood donations are especially valued, and many in our area will be given a fighting chance at life because of your generous gift. Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply.  We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 12 people have B+ blood (approximately 8.5% of the population).


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As an AB blood donor, you have a unique opportunity to enhance your generous “gift of life”. People with AB Negative (.6% of the population) and AB Positive (3.4%) are potential universal plasma donors.  You may not know, but there is a special need for AB Plasma.In addition to being the most rare blood type, AB Plasma is universal and can be used for all patients regardless of their blood type. Plasma is used to treat clotting disorders, burn, and shock victims. Your plasma donation is especially important to maintaining sufficient supplies for our community, and with regular and frequent plasma donations you’ll be helping hundreds of patients in our area. Almost anyone who is a whole blood donor can donate plasma. You are eligible if you are at least 17 years old, weigh at least 110 pounds and are in generally good health.  You can donate plasma every 28 days.



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Only 6.3% of the population has A Negative blood. Because your blood is rare, it is important to maintain sufficient supplies for our community and local patients. Your regular and frequent blood donations are especially valued, and many in our area will be given a fighting chance at life because of your generous gift. 1 in 16 people have A- blood (approximately 6.3% of the population).


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As a B Negative blood donor, you are unique due to the rarity of your blood. Because your blood is rare, it is important to maintain sufficient supplies for our community and local patients. In fact, only 1 in 67 people have B- blood (approximately 1.5% of the population).Your regular and frequent blood donations are especially valued, and many in our area will be given a fighting chance at life because of your generous gift.


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Anaphylaxis is a rapidly developing and serious allergic reaction that can affect multiple body systems at the same time. Severe anaphylactic reactions can be fatal. Anaphylaxis is often triggered by substances that are injected or ingested and thereby gain access into the bloodstream. This can result in a reaction involving the skin, lungs, nose, throat, and gastrointestinal tract.

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Reactive arthritis is a type of arthritis that an infection in the body can trigger. Most commonly, a sexually transmitted infection or bacterial infection in the intestines triggers development of reactive arthritis.It’s considered to be an autoimmune disease of the spondyloarthritis group. The arthritis often doesn’t develop until after the infection has been successfully treatedPeople with reactive arthritis often experience symptoms in the larger joints of the lower extremity. Reactive arthritis was previously known as Reiter’s syndrome, a triad of arthritis, eye inflammation (conjunctivitis), and urinary tract inflammation (urethritis).The condition was previously thought to be uncommon. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), men develop reactive arthritis more often than women, but the diagnosis is more difficult in women. The average age of onset is 30 years old. Men also tend to experience more severe joint pain than women.


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Cervical cancer is a type of cancer that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina.


Various strains of the human papillomavirus (HPV), a sexually transmitted infection, play a role in causing most cervical cancer.


When exposed to HPV, a woman's immune system typically prevents the virus from doing harm. In a small group of women, however, the virus survives for years, contributing to the process that causes some cells on the surface of the cervix to become cancer cells.


You can reduce your risk of developing cervical cancer by having screening tests and receiving a vaccine that protects against HPV infection.

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Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs camera.gif as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).

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Seasonal affective disorder* is a form of depression also known as SAD, seasonal depression or winter depression. People with SAD experience mood changes and symptoms similar to depression. The symptoms usually occur during the fall and winter months when there is less sunlight and usually improve with the arrival of spring. The most difficult months for people with SAD in the U.S. tend to be January and February. While it is much less common, some people experience SAD in the summer.SAD is more than just “winter blues.” The symptoms can be distressing and overwhelming and can interfere with daily functioning. However, it can be treated. About 5 percent of adults in the U.S. experience SAD and it typically lasts about 40 percent of the year. It is more common among women than men.SAD has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter. As seasons change, people experience a shift in their biological internal clock or circadian rhythm that can cause them to be out of step with their daily schedule. SAD is more common in people living far from the equator where there are fewer daylight hours in the winter.


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Cirrhosis is a complication of many liver diseases characterized by abnormal structure and function of the liver. The diseases that lead to cirrhosis do so because they injure and kill liver cells, after which the inflammation and repair that is associated with the dying liver cells causes scar tissue to form. The liver cells that do not die multiply in an attempt to replace the cells that have died. This results in clusters of newly-formed liver cells (regenerative nodules) within the scar tissue. There are many causes of cirrhosis including chemicals (such as alcohol, fat, and certain medications), viruses, toxic metals (such as iron and copper that accumulate in the liver as a result of genetic diseases), and autoimmune liver disease in which the body's immune system attacks the liver.

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Dengue fever is a disease caused by a family of viruses transmitted by mosquitoes. It is an acute illness of sudden onset that usually follows a benign course with symptoms such as headache, fever, exhaustion, severe muscle and joint pain, swollen lymph nodes (lymphadenopathy), and rash. The presence of fever, itchy rash, and headache (the "dengue triad") is characteristic of dengue. Other signs of dengue fever include bleeding gums, severe pain behind the eyes, and red palms and soles.

Dengue (pronounced DENG-gay) can affect anyone but tends to be more severe in people with compromised immune systems. Because it is caused by one of five serotypes of the dengue virus, it is possible to get dengue fever multiple times. However, an attack of dengue produces immunity for a lifetime to that particular viral serotype to which the patient was exposed.

Dengue goes by other names, including "breakbone fever" or "dandy fever." Victims of dengue often have contortions due to the intense pain in the joints, muscles, and bones, hence the name breakbone fever. Slaves in the West Indies who contracted dengue were said to have dandy fever because of their postures and gait.

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West Nile fever is a viral infection typically spread by mosquitoes. In about 75% of infections people have few or no symptoms. About 20% of people develop a fever, headache, vomiting, or a rash

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Nonalcoholic fatty liver disease is an umbrella term for a range of liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of nonalcoholic fatty liver disease is too much fat stored in liver cells.

Nonalcoholic steatohepatitis, a potentially serious form of the disease, is marked by liver inflammation, which may progress to scarring and irreversible damage. This damage is similar to the damage caused by heavy alcohol use. At its most severe, nonalcoholic steatohepatitis can progress to cirrhosis and liver failureNonalcoholic fatty liver disease is increasingly common around the world, especially in Western nations. In the United States, it is the most common form of chronic liver disease, affecting an estimated 80 to 100 million people.

Nonalcoholic fatty liver disease occurs in every age group but especially in people in their 40s and 50s who are at high risk of heart disease because of such risk factors as obesity and type 2 diabetes. The condition is also closely linked to metabolic syndrome, which is a cluster of abnormalities including increased abdominal fat, poor ability to use the hormone insulin, high blood pressure and high blood levels of triglycerides, a type of fat.


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Hemochromatosis is a disease in which too much iron builds up in your body. Your body needs iron but too much of it is toxic. If you have hemochromatosis, you absorb more iron than you need. Your body has no natural way to get rid of the extra iron. It stores it in body tissues, especially the liver, heart, and pancreas. The extra iron can damage your organs. Without treatment, it can cause your organs to fail.There are two types of hemochromatosis. Primary hemochromatosis is an inherited disease. Secondary hemochromatosis is usually the result of something else, such as anemia, thalassemia, liver disease, or blood transfusions.

Many symptoms of hemochromatosis are similar to those of other diseases. Not everyone has symptoms. If you do, you may have joint pain, fatigue, general weakness, weight loss, and stomach pain.Your doctor will diagnose hemochromatosis based on your medical and family histories, a physical exam, and the results from tests and procedures. Treatments include removing blood (and iron) from your body, medicines, and changes in your diet.

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Liver blood tests are designed to show evidence that abnormalities, for example, inflammation, liver cell damage, has or is occurring within the liver.The blood tests most frequently used for liver disease are the aminotransferases (alanine aminotransferase or ALT and aspartate aminotransferase or AST).Normal levels of ALT ranges from about 7-56 units/liter, and 10-40units/liters for AST.Elevated levels of AST and ALT may signify the level of liver damage in a person.Common causes of elevated ALT and AST areheart failure.

Many drugs may cause elevated AST, and ALT and some medications can cause severe damage (for example, acetaminophen [Tylenol liver damage]).Less common causes of abnormal AST and ALT levels are wide ranging (for example, toxins, and autoimmune diseases)People with mild to moderate elevations of AST and ALT with no or few symptoms should follow-up with their doctor for potential underlying causes of elevated AST and/or ALT.Repeated test levels (monitoring) is useful in some patients (for example, viral-caused and Tylenol-caused elevations) to guide therapeutic treatments.Other liver enzymes, although not measured routinely, may add additional information about liver functions.

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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms. COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you notice any of these symptoms. Ask your doctor about taking a spirometry test.


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Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003. Infection with the SARS virus causes acute respiratory distress (severe breathing difficulty) and sometimes death.


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Women frequently ask what symptoms they can anticipate during menopause. In reality, each woman experiences menopause differently. Some women have changes in several areas of their lives. It is not always possible to tell if these changes are related to aging, menopause or both. While one woman is certain that insomnia is a menopause symptom for her, another feels joint aches are her primary menopause symptom. Doctors find it difficult to communicate to their patients about menopause and what could be a host of uncomfortable symptoms. For example, medical science cannot explain how declining hormone levels during menopause could cause joint pain. Menopause is not an illness, but a natural transition when a woman's reproductive ability ends. Yet many of the menopausal symptoms may mimic signs caused by diseases. When do women undergoing menopause need treatment in the first place? The same pattern of hot flashes in two women can have a very different psychological impact. For one woman, they can greatly disturb her daily functioning, while another may hardly be bothered.


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There are six basic types of nutrients that are considered essential to life: proteins, carbohydrates, fats, vitamins, minerals, and water. These nutrients are needed for your body to function properly, and your diet is the source of them. Vitamins and minerals are considered micronutrients because they are needed in smaller quantities than the macronutrients (protein, carbohydrates, and fat). Micronutrients do not provide calories. When your body does not absorb an adequate amount of any of the micronutrients, diseases can occur. It's important to understand what your nutritional needs are and how to achieve them.Vitamins are broken down into two categories: water-soluble and fat-soluble. Water-soluble vitamins dissolve in water. Leftover amounts are not stored and will leave your body through your urine. For this reason, you must consume them on a continuous basis. The water-soluble vitamins are the B vitamins and vitamin C. Fat-soluble vitamins dissolve in fat, not water. These vitamins need dietary fat in order to be better absorbed in the small intestines. They are then stored in the liver and fatty tissues (adipose tissues) and can accumulate to toxic levels when consumed in excess quantities. The fat-soluble vitamins are vitamins A, D, E, and K.Recommendations for essential nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Institute of Medicine of the National Academies. Dietary Reference Intakes is the general term for a set of reference values used for planning and assessing nutrient intake for healthy people. There are three important types of DRI reference values; Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). The RDA is set to meet the nutrient requirements for the average daily intake of nearly all healthy individuals in each age and gender group. When there is insufficient data to set an RDA for a nutrient, an AI is set. AIs meet or exceed the amount needed to maintain an adequate nutritional state in nearly everyone of a specific age and gender group. Some nutrients can cause health problems when consumed in excessive quantities. The UL was set to provide the maximum daily intake that is unlikely to result in adverse health effects. Numerous health conditions, however, can impact your nutritional needs. A registered dietitian or physician can help you better determine your needs based upon your overall health and condition.


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Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs).

Cervical spondylosis is very common and worsens with age. More than 85 percent of people older than age 60 are affected by cervical spondylosis.

Most people experience no symptoms from these problems. When symptoms do occur, nonsurgical treatments often are effective.

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Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

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