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{"text": "??????? - Abdominal aortic aneurysm - BD50.4Z\nAneurysms can develop anywhere along the aorta, but most aortic aneurysms occur in the part of the aorta that's in the belly area (abdomen). Several things can play a role in the development of an abdominal aortic aneurysm, including: Hardening of the arteries (atherosclerosis). Atherosclerosis occurs when fat and other substances build up on the lining of a blood vessel. High blood pressure. High blood pressure can damage and weaken the aorta's walls. Blood vessel diseases. These are diseases that cause blood vessels to become inflamed. Infection in the aorta. Rarely, a bacterial or fungal infection might cause an abdominal aortic aneurysms. Trauma. For example, being injured in a car accident can cause an abdominal aortic aneurysms. "}
{"text": "?????????????? - Abdominal aortic aneurysm - BD50.4Z\nTears in one or more of the layers of the wall of the aorta (aortic dissection) or a ruptured aneurysm are the main complications. A rupture can cause life-threatening internal bleeding. In general, the larger the aneurysm and the faster it grows, the greater the risk of rupture. Signs and symptoms that an aortic aneurysm has ruptured can include: Sudden, intense and persistent abdominal or back pain, which can be described as a tearing sensation, Low blood pressure, Fast pulse. Aortic aneurysms also increase the risk of developing blood clots in the area. If a blood clot breaks loose from the inside wall of an aneurysm and blocks a blood vessel elsewhere in your body, it can cause pain or block blood flow to the legs, toes, kidneys or abdominal organs. "}
{"text": "?????????? - Abdominal aortic aneurysm - BD50.4Z\nAbdominal aortic aneurysms are often found when a physical exam is done for another reason or during routine medical tests, such as an ultrasound of the heart or abdomen. To diagnose an abdominal aortic aneurysm, a doctor will examine you and review your medical and family history. If your doctor thinks that you may have an aortic aneurysm, imaging tests are done to confirm the diagnosis. Tests to diagnose an abdominal aortic aneurysm include: Abdominal ultrasound. This is the most common test to diagnose abdominal aortic aneurysms. An abdominal ultrasound is a painless test that uses sound waves to show how blood flows through the structures in the belly area, including the aorta. During an abdominal ultrasound, a technician gently presses an ultrasound wand (transducer) against the belly area, moving it back and forth. The device sends signals to a computer, which creates images. Abdominal Computerized tomography (CT) scan. This painless test uses X-rays to create cross-sectional images of the structures inside the belly area. It's used to create clear images of the aorta. An abdominal Computerized tomography (CT) scan can also detect the size and shape of an aneurysm. During a Computerized tomography (CT) scan, you lie on a table that slides into a doughnut-shaped machine. Sometimes, dye (contrast material) is given through a vein to make your blood vessels show up more clearly on the images.  Abdominal Magnetic resonance imaging (MRI). This imaging test uses a magnetic field and computer-generated radio waves to create detailed images of the structures inside your belly area. Sometimes, dye (contrast material) is given through a vein to make your blood vessels more visible. Screening for abdominal aortic aneurysm. Being male and smoking significantly increase the risk of abdominal aortic aneurysm. Screening recommendations vary, but in general: Men ages 65 to 75 who have ever smoked cigarettes should have a one-time screening using abdominal ultrasound. For men ages 65 to 75 who have never smoked, a doctor will decide on the need for an abdominal ultrasound based on other risk factors, such as a family history of aneurysm. There isn't enough evidence to determine whether women ages 65 to 75 who ever smoked cigarettes or have a family history of abdominal aortic aneurysm would benefit from abdominal aortic aneurysm screening. Ask your doctor if you need to have an ultrasound screening based on your risk factors. Women who have never smoked generally don't need to be screened for the condition. "}
{"text": "????????? - Abdominal aortic aneurysm - BD50.4Z\nAn abdominal aortic aneurysm is an enlarged area in the lower part of the major vessel that supplies blood to the body (aorta). The aorta runs from the heart through the center of the chest and abdomen. The aorta is the largest blood vessel in the body, so a ruptured abdominal aortic aneurysm can cause life-threatening bleeding. Depending on the size of the aneurysm and how fast it's growing, treatment varies from watchful waiting to emergency surgery. "}
{"text": "????????????? - Abdominal aortic aneurysm - BD50.4Z\nAbdominal aortic aneurysm risk factors include: Tobacco use. Smoking is the strongest risk factor for aortic aneurysms. Smoking can weaken the walls of the aorta, increasing the risk of aortic aneurysm and aneurysm rupture. The longer and more you smoke or chew tobacco, the greater the chances of developing an aortic aneurysm. Doctors recommend a one-time abdominal ultrasound to screen for an abdominal aortic aneurysm in men ages 65 to 75 who are current or former cigarette smokers. Age. Abdominal aortic aneurysms occur most often in people age 65 and older. Being male. Men develop abdominal aortic aneurysms much more often than women do. Being white. People who are white are at higher risk of abdominal aortic aneurysms. Family history. Having a family history of abdominal aortic aneurysms increases the risk of having the condition. Other aneurysms. Having an aneurysm in another large blood vessel, such as the artery behind the knee or the aorta in the chest (thoracic aortic aneurysm), might increase the risk of an abdominal aortic aneurysm. If you're at risk of an aortic aneurysm, your doctor might recommend other measures, such as medications to lower your blood pressure and relieve stress on weakened arteries. "}
{"text": "??????????? - Abdominal aortic aneurysm - BD50.4Z\nTo prevent an aortic aneurysm or keep an aortic aneurysm from worsening, do the following: Don't smoke or use tobacco products. Quit smoking or chewing tobacco and avoid secondhand smoke. If you need help quitting, talk to your doctor about medications and therapies that may help. Eat a healthy diet. Focus on eating a variety of fruits and vegetables, whole grains, poultry, fish, and low-fat dairy products. Avoid saturated and trans fats and limit salt. Keep your blood pressure and cholesterol under control. If your doctor has prescribed medications, take them as instructed. Get regular exercise. Try to get at least 150 minutes a week of moderate aerobic activity. If you haven't been active, start slowly and build up. Talk to your doctor about what kinds of activities are right for you. "}
{"text": "?????????? - Abdominal aortic aneurysm - BD50.4Z\nThe goal of abdominal aortic aneurysm treatment is to prevent an aneurysm from rupturing. Treatment may involve careful monitoring or surgery. Which treatment you have depends on the size of the aortic aneurysm and how fast it's growing. Medical monitoring. A doctor might recommend this option, also called watchful waiting, if the abdominal aortic aneurysm is small and isn't causing symptoms. Monitoring requires regular doctor's checkups and imaging tests to determine if the aneurysm is growing and to manage other conditions, such as high blood pressure, that could worsen the aneurysm. Typically, a person who has a small, symptomless abdominal aortic aneurysm needs an abdominal ultrasound at least six months after diagnosis and at regular follow-up appointments. Surgery and other procedures. Surgery to repair an abdominal aortic aneurysm is generally recommended if the aneurysm is 1.9 to 2.2 inches (4.8 to 5.6 centimeters) or larger, or if it's growing quickly. Also, a doctor might recommend abdominal aortic aneurysm repair surgery if you have symptoms such as stomach pain or you have a leaking, tender or painful aneurysm. The type of surgery performed depends on the size and location of the aneurysm, your age, and your overall health. Abdominal aortic aneurysm surgery options may include: Endovascular repair. This procedure is used most often to repair an abdominal aortic aneurysm. A surgeon inserts a thin, flexible tube (catheter) through an artery in the leg and gently guides it to the aorta. A metal mesh tube (graft) on the end of the catheter is placed at the site of the aneurysm, expanded and fastened in place. The graft strengthens the weakened section of the aorta to prevent rupture of the aneurysm. Endovascular surgery isn't an option for everyone with an abdominal aortic aneurysm. You and your doctor will discuss the best repair option for you. After endovascular surgery, you'll need regular imaging tests to ensure that the grafted area isn't leaking.  Open abdominal surgery. This involves removing the damaged part of the aorta and replacing it with a graft, which is sewn into place. Full recovery may take a month or more. Long-term survival rates are similar for both endovascular surgery and open surgery. Lifestyle and home remedies. For an abdominal aortic aneurysm, a doctor will likely suggest avoiding heavy lifting and vigorous physical activity to prevent extreme increases in blood pressure, which can put more pressure on an aneurysm. Emotional stress can raise blood pressure, so try to avoid conflict and stressful situations. If you're feeling stressed or anxious, let your doctor know so that together you can come up with the best treatment plan. "}
{"text": "????????? - Abdominal aortic aneurysm - BD50.4Z\nAbdominal aortic aneurysms often grow slowly without noticeable symptoms, making them difficult to detect. Some aneurysms never rupture. Many start small and stay small. Others grow larger over time, sometimes quickly. If you have an enlarging abdominal aortic aneurysm, you might notice: Deep, constant pain in the belly area or side of the belly (abdomen), Back pain, A pulse near the bellybutton. When to see a doctor. If you have pain, especially if pain is sudden and severe, seek immediate medical help. "}
{"text": "?????????? - Absence seizure - 8A68.1\nYour doctor will ask for a detailed description of the seizures and conduct a physical exam. Tests may include: Electroencephalography (EEG). This painless procedure measures waves of electrical activity in the brain. Brain waves are transmitted to the EEG machine via small electrodes attached to the scalp with paste or an elastic cap. Rapid breathing (hyperventilation) during an EEG study can trigger an absence seizure. During a seizure, the pattern on the EEG differs from the normal pattern.  Brain scans. In absence seizures, brain-imaging studies, such as magnetic resonance imaging (MRI), will be normal. But tests such as MRI can produce detailed images of the brain, which can help rule out other problems, such as a stroke or a brain tumor. Because your child will need to hold still for long periods, talk with your doctor about the possible use of sedation. "}
{"text": "????????? - Absence seizure - 8A68.1\nAbsence seizures involve brief, sudden lapses of consciousness. They're more common in children than in adults. Someone having an absence seizure may look like he or she is staring blankly into space for a few seconds. Then, there is a quick return to a normal level of alertness. This type of seizure usually doesn't lead to physical injury. Absence seizures usually can be controlled with anti-seizure medications. Some children who have them also develop other seizures. Many children outgrow absence seizures in their teens. "}
{"text": "????????????? - Absence seizure - 8A68.1\nCertain factors are common to children who have absence seizures, including: Age. Absence seizures are more common in children between the ages of 4 and 14. Sex. Absence seizures are more common in girls. Family members who have seizures. Nearly half of children with absence seizures have a close relative who has seizures. "}
{"text": "????????? - Absence seizure - 8A68.1\nAn indication of simple absence seizure is a vacant stare, which may be mistaken for a lapse in attention that lasts about 10 seconds, though it may last as long as 20 seconds, without any confusion, headache or drowsiness afterward. Signs and symptoms of absence seizures include: Sudden stop in motion without falling, Lip smacking, Eyelid flutters, Chewing motions, Finger rubbing, Small movements of both hands. Afterward, there's no memory of the incident. Some people have many episodes daily, which interfere with school or daily activities. A child may have absence seizures for some time before an adult notices the seizures, because they're so brief. A decline in a child's learning ability may be the first sign of this disorder. Teachers may comment about a child's inability to pay attention or that a child is often daydreaming. When to see a doctor. Contact your doctor: The first time you notice a seizure, If this is a new type of seizure, If the seizures continue to occur despite taking anti-seizure medication. Contact 911 or emergency services in your area: If you observe prolonged automatic behaviors lasting minutes to hours — activities such as eating or moving without awareness — or prolonged confusion, possible symptoms of a condition called absence status epilepticus, After any seizure lasting more than five minutes. "}
{"text": "?????????? - Absence seizure - 8A68.1\nYour doctor likely will start at the lowest dose of anti-seizure medication possible and increase the dosage as needed to control the seizures. Children may be able to taper off anti-seizure medications, under a doctor's supervision, after they've been seizure-free for two years. Drugs prescribed for absence seizure include: Ethosuximide (Zarontin). This is the drug most doctors start with for absence seizures. In most cases, seizures respond well to this drug. Possible side effects include nausea, vomiting, sleepiness, trouble sleeping, hyperactivity. Valproic acid (Depakene). Girls who continue to need medication into adulthood should discuss potential risks of valproic acid with their doctors. Valproic acid has been associated with higher risk of birth defects in babies, and doctors advise women against using it during pregnancy or while trying to conceive. Doctors may recommend the use of valproic acid in children who have both absence and grand mal (tonic-clonic) seizures.  Lamotrigine (Lamictal). Some studies show this drug to be less effective than ethosuximide or valproic acid, but it has fewer side effects. Side effects may include rash and nausea. Lifestyle and home remedies. Dietary therapy. Following a diet that's high in fat and low in carbohydrates, known as a ketogenic diet, can improve seizure control. This is used only if traditional medications fail to control the seizures. This diet isn't easy to maintain, but is successful at reducing seizures for some people. Variations on a high-fat, low-carbohydrate diet, such as the glycemic index and modified Atkins diets, though less effective, aren't as restrictive as the ketogenic diet and may also provide benefit. Additional options. Here are other steps you might take to help with seizure control: Take medication correctly. Don't adjust the dosage before talking to your doctor. If you feel your medication should be changed, discuss it with your doctor. Get enough sleep. Lack of sleep can trigger seizures. Be sure to get adequate rest every night. Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly if you have another seizure. Ask your doctor about driving or recreation restrictions. Someone with a seizure disorder will have to be seizure-free for reasonable lengths of time (intervals vary from state to state) before being able to drive. Don't bathe or swim unless someone else is nearby to help if needed. "}
{"text": "??????? - Absence seizure - 8A68.1\nMany children appear to have a genetic predisposition to absence seizures. In general, seizures are caused by abnormal electrical impulses from nerve cells (neurons) in the brain. The brain's nerve cells normally send electrical and chemical signals across the synapses that connect them. In people who have seizures, the brain's usual electrical activity is altered. During an absence seizure, these electrical signals repeat themselves over and over in a three-second pattern. People who have seizures may also have altered levels of the chemical messengers that help the nerve cells communicate with one another (neurotransmitters). "}
{"text": "?????????????? - Absence seizure - 8A68.1\nWhile most children outgrow absence seizures, some: Must take anti-seizure medications throughout life to prevent seizures, Eventually have full convulsions, such as generalized tonic-clonic seizures. Other complications can include: Learning difficulties, Behavior problems, Social isolation. "}
{"text": "?????????????? - Acanthosis nigricans - ED51.00\nPeople who have acanthosis nigricans are much more likely to develop type 2 diabetes. "}
{"text": "??????? - Acanthosis nigricans - ED51.00\nAcanthosis nigricans might be related to: Insulin resistance. Most people who have acanthosis nigricans have also become resistant to insulin. Insulin is a hormone secreted by the pancreas that allows the body to process sugar. Insulin resistance is what leads to type 2 diabetes. Insulin resistance is also related to polycystic ovarian syndrome and might be a factor in why acanthosis nigricans develops. Certain drugs and supplements. High-dose niacin, birth control pills, prednisone and other corticosteroids may cause acanthosis nigricans. Cancer. Some types of cancer cause acanthosis nigricans. These include lymphoma and cancers of the stomach, colon and liver. "}
{"text": "????????? - Acanthosis nigricans - ED51.00\nAcanthosis nigricans is a condition that causes areas of dark, thick velvety skin in body folds and creases. It typically affects the armpits, groin and neck. Acanthosis nigricans (ak-an-THOE-sis NIE-grih-kuns) tends to affect people with obesity. Rarely, the skin condition can be a sign of cancer in an internal organ, such as the stomach or liver. Treating the cause of acanthosis nigricans might restore the usual color and texture of the skin. "}
{"text": "?????????? - Acanthosis nigricans - ED51.00\nAcanthosis nigricans can be detected during a skin exam. To be sure of the diagnosis, your health care provider might take a skin sample (biopsy) to look at under a microscope. Or you may need other tests to find out what's causing your symptoms. "}
{"text": "????????? - Acanthosis nigricans - ED51.00\nThe main sign of acanthosis nigricans is dark, thick, velvety skin in body folds and creases. It often appears in the armpits, groin and back of the neck. It develops slowly. The affected skin might be itchy, have an odor and develop skin tags. When to see a doctor. Consult your health care provider if you notice changes in your skin — especially if the changes are sudden. You may have an underlying condition that needs treatment. "}
{"text": "????????????? - Acanthosis nigricans - ED51.00\nThe risk of acanthosis nigricans is higher in people who have obesity. The risk is also higher in people with a family history of the condition, especially in families where obesity and type 2 diabetes are also common. "}
{"text": "?????????? - Acanthosis nigricans - ED51.00\nThere's no specific treatment for acanthosis nigricans. Your care provider might suggest treatments to help with pain and odor, such as skin creams, special soaps, medications and laser therapy. Treating the underlying cause might help. Examples include: Lose weight. If your acanthosis nigricans is caused by obesity, nutritional counseling and losing weight may help. Stop medications. If your condition seems to be related to a medication or supplement that you use, your care provider may suggest that you stop using that substance. Have surgery. If acanthosis nigricans was triggered by a cancerous tumor, surgery to remove the tumor often clears up the skin symptoms. "}
{"text": "??????? - Achalasia - DA21.0\nThe exact cause of achalasia is poorly understood. Researchers suspect it may be caused by a loss of nerve cells in the esophagus. There are theories about what causes this, but viral infection or autoimmune responses have been suspected. Very rarely, achalasia may be caused by an inherited genetic disorder or infection. "}
{"text": "?????????? - Achalasia - DA21.0\nAchalasia can be overlooked or misdiagnosed because it has symptoms similar to other digestive disorders. To test for achalasia, your doctor is likely to recommend: Esophageal manometry. This test measures the rhythmic muscle contractions in your esophagus when you swallow, the coordination and force exerted by the esophagus muscles, and how well your lower esophageal sphincter relaxes or opens during a swallow. This test is the most helpful when determining which type of motility problem you might have. X-rays of your upper digestive system (esophagram). X-rays are taken after you drink a chalky liquid that coats and fills the inside lining of your digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine. You may also be asked to swallow a barium pill that can help to show a blockage of the esophagus. Upper endoscopy. Your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat, to examine the inside of your esophagus and stomach. Endoscopy can be used to define a partial blockage of the esophagus if your symptoms or results of a barium study indicate that possibility. Endoscopy can also be used to collect a sample of tissue (biopsy) to be tested for complications of reflux such as Barrett's esophagus. Read more about esophageal manometry. and upper endoscopy. "}
{"text": "????????? - Achalasia - DA21.0\nAchalasia symptoms generally appear gradually and worsen over time. Signs and symptoms may include: Inability to swallow (dysphagia), which may feel like food or drink is stuck in your throat, Regurgitating food or saliva, Heartburn, Belching, Chest pain that comes and goes, Coughing at night, Pneumonia (from aspiration of food into the lungs), Weight loss, Vomiting. "}
{"text": "????????? - Achalasia - DA21.0\nAchalasia is a rare disorder that makes it difficult for food and liquid to pass from the swallowing tube connecting your mouth and stomach (esophagus) into your stomach. Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in gastroesophageal reflux disease (GERD) the material comes from the stomach. There's no cure for achalasia. Once the esophagus is paralyzed, the muscle cannot work properly again. But symptoms can usually be managed with endoscopy, minimally invasive therapy or surgery. "}
{"text": "?????????? - Achalasia - DA21.0\nAchalasia treatment focuses on relaxing or stretching open the lower esophageal sphincter so that food and liquid can move more easily through your digestive tract. Specific treatment depends on your age, health condition and the severity of the achalasia. Nonsurgical treatment. Nonsurgical options include: Pneumatic dilation. A balloon is inserted by endoscopy into the center of the esophageal sphincter and inflated to enlarge the opening. This outpatient procedure may need to be repeated if the esophageal sphincter doesn't stay open. Nearly one-third of people treated with balloon dilation need repeat treatment within five years. This procedure requires sedation. Botox (botulinum toxin type A). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscopic needle. The injections may need to be repeated, and repeat injections may make it more difficult to perform surgery later if needed. Botox is generally recommended only for people who aren't good candidates for pneumatic dilation or surgery due to age or overall health. Botox injections typically do not last more than six months. A strong improvement from injection of Botox may help confirm a diagnosis of achalasia.  Medication. Your doctor might suggest muscle relaxants such as nitroglycerin (Nitrostat) or nifedipine (Procardia) before eating. These medications have limited treatment effect and severe side effects. Medications are generally considered only if you're not a candidate for pneumatic dilation or surgery, and Botox hasn't helped. This type of therapy is rarely indicated. Surgery. Surgical options for treating achalasia include: Heller myotomy. The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. The procedure can be done noninvasively (laparoscopic Heller myotomy). Some people who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD). To avoid future problems with gastroesophageal reflux disease (GERD), a procedure known as fundoplication might be performed at the same time as a Heller myotomy. In fundoplication, the surgeon wraps the top of your stomach around the lower esophagus to create an anti-reflux valve, preventing acid from coming back (GERD) into the esophagus. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. Peroral endoscopic myotomy (POEM). In the peroral endoscopic myotomy (POEM) procedure, the surgeon uses an endoscope inserted through your mouth and down your throat to create an incision in the inside lining of your esophagus. Then, as in a Heller myotomy, the surgeon cuts the muscle at the lower end of the esophageal sphincter. Peroral endoscopic myotomy (POEM) may also be combined with or followed by later fundoplication to help prevent gastroesophageal reflux disease (GERD). Some patients who have a peroral endoscopic myotomy (POEM) and develop gastroesophageal reflux disease (GERD) after the procedure are treated with daily oral medication. . "}
{"text": "??????? - Achilles tendinitis - FB40.Y\nAchilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes. The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury — particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs. "}
{"text": "?????????????? - Achilles tendinitis - FB40.Y\nAchilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair. "}
{"text": "????????? - Achilles tendinitis - FB40.Y\nAchilles tendinitis is an overuse injury of the Achilles (uh-KILL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It's also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends. Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor's supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair. "}
{"text": "?????????? - Achilles tendinitis - FB40.Y\nDuring the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range of motion and reflexes of your foot and ankle. Imaging tests. Your doctor may order one or more of the following tests to assess your condition: X-rays. While X-rays can't visualize soft tissues such as tendons, they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion, and color-Doppler ultrasound can evaluate blood flow around the tendon. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon. "}
{"text": "??????????? - Achilles tendinitis - FB40.Y\nWhile it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk: Increase your activity level gradually. If you're just beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training. Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest. Choose your shoes carefully. The shoes you wear while exercising should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don't support your feet, try arch supports in both shoes. Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis. Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to better handle the stresses they encounter with activity and exercise. Cross-train. Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and swimming. "}
{"text": "????????????? - Achilles tendinitis - FB40.Y\nA number of factors may increase your risk of Achilles tendinitis, including: Your sex. Achilles tendinitis occurs most commonly in men. Age. Achilles tendinitis is more common as you age. Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain. Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury. Medical conditions. People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis. Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis. "}
{"text": "????????? - Achilles tendinitis - FB40.Y\nThe pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting. You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity. When to see a doctor. If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon. "}
{"text": "?????????? - Achilles tendinitis - FB40.Y\nTendinitis usually responds well to self-care measures. But if your signs and symptoms are severe or persistent, your doctor might suggest other treatment options. Medications. If over-the-counter pain medications — such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) — aren't enough, your doctor might prescribe stronger medications to reduce inflammation and relieve pain. Physical therapy. A physical therapist might suggest some of the following treatment options: Exercises. Therapists often prescribe specific stretching and strengthening exercises to promote healing and strengthening of the Achilles tendon and its supporting structures. A special type of strengthening called \"eccentric\" strengthening, involving a slow let down of a weight after raising it, has been found to be especially helpful for persistent Achilles problems.  Orthotic devices. A shoe insert or wedge that slightly elevates your heel can relieve strain on the tendon and provide a cushion that lessens the amount of force exerted on your Achilles tendon. Surgery. If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon. Lifestyle and home remedies. Self-care strategies include the following steps, often known by the acronym R.I.C.E.: Rest. You may need to avoid exercise for several days or switch to an activity that doesn't strain the Achilles tendon, such as swimming. In severe cases, you may need to wear a walking boot and use crutches. Ice. To decrease pain or swelling, apply an ice pack to the tendon for about 15 minutes after exercising or when you experience pain. Compression. Wraps or compressive elastic bandages can help reduce swelling and reduce movement of the tendon. Elevation. Raise the affected foot above the level of your heart to reduce swelling. Sleep with your affected foot elevated at night. "}
{"text": "??????? - Achilles tendon rupture - NC96.02\nYour Achilles tendon helps you point your foot downward, rise on your toes and push off your foot as you walk. You rely on it virtually every time you walk and move your foot. Rupture usually occurs in the section of the tendon situated within 2 1/2 inches (about 6 centimeters) of the point where it attaches to the heel bone. This section might be prone to rupture because blood flow is poor, which also can impair its ability to heal. Ruptures often are caused by a sudden increase in the stress on your Achilles tendon. Common examples include: Increasing the intensity of sports participation, especially in sports that involve jumping, Falling from a height, Stepping into a hole. "}
{"text": "?????????? - Achilles tendon rupture - NC96.02\nDuring the physical exam, your doctor will inspect your lower leg for tenderness and swelling. Your doctor might be able to feel a gap in your tendon if it has ruptured completely. The doctor might ask you to kneel on a chair or lie on your stomach with your feet hanging over the end of the exam table. He or she might then squeeze your calf muscle to see if your foot will automatically flex. If it doesn't, you probably have ruptured your Achilles tendon. If there's a question about the extent of your Achilles tendon injury — whether it's completely or only partially ruptured — your doctor might order an ultrasound or MRI scan. These painless procedures create images of the tissues of your body. "}
{"text": "??????????? - Achilles tendon rupture - NC96.02\nTo reduce your chance of developing Achilles tendon problems, follow these tips: Stretch and strengthen calf muscles. Stretch your calf until you feel a noticeable pull but not pain. Don't bounce during a stretch. Calf-strengthening exercises can also help the muscle and tendon absorb more force and prevent injury. Vary your exercises. Alternate high-impact sports, such as running, with low-impact sports, such as walking, biking or swimming. Avoid activities that place excessive stress on your Achilles tendons, such as hill running and jumping activities. Choose running surfaces carefully. Avoid or limit running on hard or slippery surfaces. Dress properly for cold-weather training, and wear well-fitting athletic shoes with proper cushioning in the heels. Increase training intensity slowly. Achilles tendon injuries commonly occur after an abrupt increase in training intensity. Increase the distance, duration and frequency of your training by no more than 10 percent weekly. "}
{"text": "????????? - Achilles tendon rupture - NC96.02\nAchilles (uh-KILL-eez) tendon rupture is an injury that affects the back of your lower leg. It mainly occurs in people playing recreational sports, but it can happen to anyone. The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially. If your Achilles tendon ruptures, you might hear a pop, followed by an immediate sharp pain in the back of your ankle and lower leg that is likely to affect your ability to walk properly. Surgery is often performed to repair the rupture. For many people, however, nonsurgical treatment works just as well. "}
{"text": "????????????? - Achilles tendon rupture - NC96.02\nFactors that may increase your risk of Achilles tendon rupture include: Age. The peak age for Achilles tendon rupture is 30 to 40. Sex. Achilles tendon rupture is up to five times more likely to occur in men than in women. Recreational sports. Achilles tendon injuries occur more often during sports that involve running, jumping, and sudden starts and stops — such as soccer, basketball and tennis. Steroid injections. Doctors sometimes inject steroids into an ankle joint to reduce pain and inflammation. However, this medication can weaken nearby tendons and has been associated with Achilles tendon ruptures. Certain antibiotics. Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro) or levofloxacin (Levaquin), increase the risk of Achilles tendon rupture. Obesity. Excess weight puts more strain on the tendon. "}
{"text": "????????? - Achilles tendon rupture - NC96.02\nAlthough it's possible to have no signs or symptoms with an Achilles tendon rupture, most people have: The feeling of having been kicked in the calf, Pain, possibly severe, and swelling near the heel, An inability to bend the foot downward or \"push off\" the injured leg when walking, An inability to stand on the toes on the injured leg, A popping or snapping sound when the injury occurs. When to see your doctor. Seek medical advice immediately if you hear a pop in your heel, especially if you can't walk properly afterward. "}
{"text": "?????????? - Achilles tendon rupture - NC96.02\nTreatment for a ruptured Achilles tendon often depends on your age, activity level and the severity of your injury. In general, younger and more active people, particularly athletes, tend to choose surgery to repair a completely ruptured Achilles tendon, while older people are more likely to opt for nonsurgical treatment. Recent studies, however, have shown fairly equal effectiveness of both surgical and nonsurgical management. Nonsurgical treatment. This approach typically involves: Resting the tendon by using crutches, Applying ice to the area, Taking over-the-counter pain relievers, Keeping the ankle from moving for the first few weeks, usually with a walking boot with heel wedges or a cast, with the foot flexed down. Nonoperative treatment avoids the risks associated with surgery, such as infection. However, a nonsurgical approach might increase your chances of re-rupture and recovery can take longer, although recent studies indicate favorable outcomes in people treated nonsurgically if they start rehabilitation with weight bearing early. Surgery. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the torn tissue, the repair might be reinforced with other tendons. Complications can include infection and nerve damage. Minimally invasive procedures reduce infection rates over those of open procedures. Rehabilitation. After either treatment, you'll have physical therapy exercises to strengthen your leg muscles and Achilles tendon. Most people return to their former level of activity within four to six months. It's important to continue strength and stability training after that because some problems can persist for up to a year. A type of rehabilitation known as functional rehabilitation also focuses on coordination of body parts and how you move. The purpose is to return you to your highest level of performance, as an athlete or in your everyday life. One review study concluded that if you have access to functional rehabilitation, you might do just as well with nonsurgical treatment as with surgery. More study is needed. Rehabilitation after either surgical or nonsurgical management is also trending toward moving earlier and progressing faster. Studies are ongoing in this area also. "}
{"text": "??????? - Acne - 6B25.1\nFour main factors cause acne: Excess oil (sebum) production, Hair follicles clogged by oil and dead skin cells, Bacteria, Inflammation. Acne typically appears on your face, forehead, chest, upper back and shoulders because these areas of skin have the most oil (sebaceous) glands. Hair follicles are connected to oil glands. The follicle wall may bulge and produce a whitehead. Or the plug may be open to the surface and darken, causing a blackhead. A blackhead may look like dirt stuck in pores. But actually the pore is congested with bacteria and oil, which turns brown when it's exposed to the air. Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne. Certain things may trigger or worsen acne: Hormonal changes. Androgens are hormones that increase in boys and girls during puberty and cause the sebaceous glands to enlarge and make more sebum. Hormone changes during midlife, particularly in women, can lead to breakouts too. Certain medications. Examples include drugs containing corticosteroids, testosterone or lithium. Diet. Studies indicate that consuming certain foods — including carbohydrate-rich foods, such as bread, bagels and chips — may worsen acne. Further study is needed to examine whether people with acne would benefit from following specific dietary restrictions. Stress. Stress doesn't cause acne, but if you have acne already, stress may make it worse. Acne myths. These factors have little effect on acne: Chocolate and greasy foods. Eating chocolate or greasy food has little to no effect on acne. Hygiene. Acne isn't caused by dirty skin. In fact, scrubbing the skin too hard or cleansing with harsh soaps or chemicals irritates the skin and can make acne worse. Cosmetics. Cosmetics don't necessarily worsen acne, especially if you use oil-free makeup that doesn't clog pores (noncomedogenics) and remove makeup regularly. Nonoily cosmetics don't interfere with the effectiveness of acne drugs. "}
{"text": "?????????????? - Acne - 6B25.1\nPeople with darker skin types are more likely than are people with lighter skin to experience these acne complications: Scars. Pitted skin (acne scars) and thick scars (keloids) can remain long-term after acne has healed. Skin changes. After acne has cleared, the affected skin may be darker (hyperpigmented) or lighter (hypopigmented) than before the condition occurred. Risk factors. Risk factors for acne include: Age. People of all ages can get acne, but it's most common in teenagers. Hormonal changes. Such changes are common during puberty or pregnancy. Family history. Genetics plays a role in acne. If both of your parents had acne, you're likely to develop it too. Greasy or oily substances. You may develop acne where your skin comes into contact with oil or oily lotions and creams. Friction or pressure on your skin. This can be caused by items such as telephones, cellphones, helmets, tight collars and backpacks. "}
{"text": "????????? - Acne - 6B25.1\nAcne is a skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. It causes whiteheads, blackheads or pimples. Acne is most common among teenagers, though it affects people of all ages. Effective acne treatments are available, but acne can be persistent. The pimples and bumps heal slowly, and when one begins to go away, others seem to crop up. Depending on its severity, acne can cause emotional distress and scar the skin. The earlier you start treatment, the lower your risk of such problems. "}
{"text": "????????? - Acne - 6B25.1\nAcne signs vary depending on the severity of your condition: Whiteheads (closed plugged pores), Blackheads (open plugged pores), Small red, tender bumps (papules), Pimples (pustules), which are papules with pus at their tips Large, solid, painful lumps under the skin (nodules), Painful, pus-filled lumps under the skin (cystic lesions). Acne usually appears on the face, forehead, chest, upper back and shoulders. When to see a doctor. If self-care remedies don't clear your acne, see your primary care doctor. He or she can prescribe stronger medications. If acne persists or is severe, you may want to seek medical treatment from a doctor who specializes in the skin (dermatologist or pediatric dermatologist). For many women, acne can persist for decades, with flares common a week before menstruation. This type of acne tends to clear up without treatment in women who use contraceptives. In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention. The Food and Drug Administration (FDA) warns that some popular nonprescription acne lotions, cleansers and other skin products can cause a serious reaction. This type of reaction is quite rare, so don't confuse it with any redness, irritation or itchiness that occurs in areas where you've applied medications or products. Seek emergency medical help if after using a skin product you experience: Faintness, Difficulty breathing, Swelling of the eyes, face, lips or tongue, Tightness of the throat. "}
{"text": "?????????? - Acne - 6B25.1\nIf you've tried over-the-counter (nonprescription) acne products for several weeks and they haven't helped, ask your doctor about prescription-strength medications. A dermatologist can help you: Control your acne, Avoid scarring or other damage to your skin, Make scars less noticeable. Acne medications work by reducing oil production and swelling or by treating bacterial infection. With most prescription acne drugs, you may not see results for four to eight weeks. It can take many months or years for your acne to clear up completely. The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Topical medications and drugs you take by mouth (oral medication) are often used in combination. Treatment options for pregnant women are limited due to the risk of side effects. Talk with your doctor about the risks and benefits of medications and other treatments you are considering. And make follow-up appointments with your doctor every three to six months until your skin improves. Topical medications. The most common topical prescription medications for acne are: Retinoids and retinoid-like drugs. Drugs that contain retinoic acids or tretinoin are often useful for moderate acne. These come as creams, gels and lotions. Examples include tretinoin (Avita, Retin-A, others), adapalene (Differin) and tazarotene (Tazorac, Avage, others). You apply this medication in the evening, beginning with three times a week, then daily as your skin becomes used to it. It prevents plugging of hair follicles. Do not apply tretinoin at the same time as benzoyl peroxide. Topical retinoids increase your skin's sun sensitivity. They can also cause dry skin and redness, especially in people with brown or Black skin. Adapalene may be tolerated best.  Antibiotics. These work by killing excess skin bacteria and reducing redness and inflammation. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening. The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, others) and erythromycin with benzoyl peroxide (Benzamycin). Topical antibiotics alone aren't recommended. Azelaic acid and salicylic acid. Azelaic acid is a naturally occurring acid produced by a yeast. It has antibacterial properties. A 20% azelaic acid cream or gel seems to be as effective as many conventional acne treatments when used twice a day. Prescription azelaic acid (Azelex, Finacea) is an option during pregnancy and while breast-feeding. It can also be used to manage discoloration that occurs with some types of acne. Side effects include skin redness and minor skin irritation. Salicylic acid may help prevent plugged hair follicles and is available as both wash-off and leave-on products. Studies showing its effectiveness are limited. Side effects include skin discoloration and minor skin irritation.  Dapsone. Dapsone (Aczone) 5% gel twice daily is recommended for inflammatory acne, especially in women with acne. Side effects include redness and dryness. Evidence is not strong in support of using zinc, sulfur, nicotinamide, resorcinol, sulfacetamide sodium or aluminum chloride in topical treatments for acne. Oral medications. Antibiotics. For moderate to severe acne, you may need oral antibiotics to reduce bacteria. Usually the first choice for treating acne is a tetracycline (minocycline, doxycycline) or a macrolide (erythromycin, azithromycin). A macrolide might be an option for people who can't take tetracyclines, including pregnant women and children under 8 years old. Oral antibiotics should be used for the shortest time possible to prevent antibiotic resistance. And they should be combined with other drugs, such as benzoyl peroxide, to reduce the risk of developing antibiotic resistance. Severe side effects from the use of antibiotics to treat acne are uncommon. These drugs do increase your skin's sun sensitivity. Combined oral contraceptives. Four combined oral contraceptives are approved by the Food and Drug Administration (FDA) for acne therapy in women who also wish to use them for contraception. They are products that combine progestin and estrogen (Ortho Tri-Cyclen 21, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it for the first few weeks may help. Common side effects of combined oral contraceptives are weight gain, breast tenderness and nausea. These drugs are also associated with increased risk of cardiovascular problems, breast cancer and cervical cancer.  Anti-androgen agents. The drug spironolactone (Aldactone) may be considered for women and adolescent girls if oral antibiotics aren't helping. It works by blocking the effect of androgen hormones on the oil-producing glands. Possible side effects include breast tenderness and painful periods. Isotretinoin. Isotretinoin (Amnesteem, Claravis, others) is a derivative of vitamin A. It may be prescribed for people whose moderate or severe acne hasn't responded to other treatments. Potential side effects of oral isotretinoin include inflammatory bowel disease, depression and severe birth defects. All people receiving isotretinoin must participate in an Food and Drug Administration (FDA)-approved risk management program. And they'll need to see their doctors regularly to monitor for side effects. . Therapies. For some people, the following therapies might be helpful, either alone or in combination with medications. Light therapy. A variety of light-based therapies have been tried with some success. Most will require multiple visits to your doctor's office. Further study is needed to determine the ideal method, light source and dose. Chemical peel. This procedure uses repeated applications of a chemical solution, such as salicylic acid, glycolic acid or retinoic acid. This treatment is for mild acne. It might improve the appearance of the skin, though the change is not long lasting and repeat treatments are usually needed. Drainage and extraction. Your doctor may use special tools to gently remove whiteheads and blackheads (comedos) or cysts that haven't cleared up with topical medications. This technique temporarily improves the appearance of your skin, but it might also cause scarring. Steroid injection. Nodular and cystic lesions can be treated by injecting a steroid drug into them. This therapy has resulted in rapid improvement and decreased pain. Side effects may include skin thinning and discoloration in the treated area. Treating children. Most studies of acne drugs have involved people 12 years of age or older. Increasingly, younger children are getting acne as well. The Food and Drug Administration (FDA) has expanded the number of topical products approved for use in children. And guidelines from the American Academy of Dermatology indicate that topical benzoyl peroxide, adapalene and tretinoin in preadolescent children are effective and don't cause increased risk of side effects. If your child has acne, consider consulting a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child's growth and development. Alternative medicine. Some alternative and integrative medicine approaches might be helpful in reducing acne: Tea tree oil. Gels containing at least 5% tea tree oil may be as effective as lotions containing 5% benzoyl peroxide, although tea tree oil might work more slowly. Possible side effects include minor itching, burning, redness and dryness, which make it a poor choice for people with rosacea. Brewer's yeast. A strain of brewer's yeast called Hansen CBS seems to help decrease acne when taken orally. It may cause gas (flatulence). More research is needed to establish the potential effectiveness and long-term safety of these and other integrative approaches, such as biofeedback and ayurvedic compounds. Talk with your doctor about the pros and cons of specific treatments before you try them. Lifestyle and home remedies. You can try to avoid or control mild or moderate acne with nonprescription products, good basic skin care and other self-care techniques: Wash problem areas with a gentle cleanser. Twice a day, use your hands to wash your face with mild soap or a gentle cleanser (Cetaphil, Vanicream, others) and warm water. And be gentle if you're shaving affected skin. Avoid certain products, such as facial scrubs, astringents and masks. They tend to irritate the skin, which can worsen acne. Too much washing and scrubbing also can irritate the skin. Try over-the-counter acne products to dry excess oil and promote peeling. Look for products containing benzoyl peroxide and adapalene as the active ingredients. You might also try products containing salicylic acid, glycolic acid or alpha hydroxy acids. It may take a few weeks of using a product before you see any improvement. Creams are less irritating than gels or ointments. Nonprescription acne medications may cause initial side effects — such as redness, dryness and scaling — that often improve after the first month of using them.  Avoid irritants. Oily or greasy cosmetics, sunscreens, hairstyling products or acne concealers can worsen acne. Instead, use products labeled water-based or noncomedogenic, which means they are less likely to cause acne. Protect your skin from the sun. For some people, the sun worsens the discoloration that sometimes lingers after the acne has cleared. And some acne medications make you more susceptible to sunburn. Check with your doctor to see if your medication is one of these. If it is, stay out of the sun as much as possible. Regularly use a nonoily (noncomedogenic) moisturizer that includes a sunscreen. Avoid friction or pressure on your skin. Protect your acne-prone skin from contact with items such as phones, helmets, tight collars or straps, and backpacks. Avoid touching or picking acne-prone areas. Doing so can trigger more acne or lead to infection or scarring. Shower after strenuous activities. Oil and sweat on your skin can lead to breakouts. "}
{"text": "?????????????? - ACL injury - ND56.Z\nPeople who experience an anterior cruciate ligament (ACL) injury have a higher risk of developing osteoarthritis in the knee. Arthritis may occur even if you have surgery to reconstruct the ligament. Multiple factors likely influence the risk of arthritis, such as the severity of the original injury, the presence of related injuries in the knee joint or the level of activity after treatment. "}
{"text": "??????? - ACL injury - ND56.Z\nLigaments are strong bands of tissue that connect one bone to another. The anterior cruciate ligament (ACL), one of two ligaments that cross in the middle of the knee, connects your thighbone to your shinbone and helps stabilize your knee joint. anterior cruciate ligament (ACL) injuries often happen during sports and fitness activities that can put stress on the knee: Suddenly slowing down and changing direction (cutting), Pivoting with your foot firmly planted, Landing awkwardly from a jump, Stopping suddenly, Receiving a direct blow to the knee or having a collision, such as a football tackle. When the ligament is damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact. "}
{"text": "????????? - ACL injury - ND56.Z\nAn anterior cruciate ligament (ACL) injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia). anterior cruciate ligament (ACL) injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing. Many people hear a pop or feel a \"popping\" sensation in the knee when an anterior cruciate ligament (ACL) injury occurs. Your knee may swell, feel unstable and become too painful to bear weight. Depending on the severity of your anterior cruciate ligament (ACL) injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation. A proper training program may help reduce the risk of an anterior cruciate ligament (ACL) injury. "}
{"text": "?????????? - ACL injury - ND56.Z\nDuring the physical exam, your doctor will check your knee for swelling and tenderness — comparing your injured knee to your uninjured knee. He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. Often the diagnosis can be made on the basis of the physical exam alone, but you may need tests to rule out other causes and to determine the severity of the injury. These tests may include: X-rays. X-rays may be needed to rule out a bone fracture. However, X-rays don't show soft tissues, such as ligaments and tendons. Magnetic resonance imaging (MRI). An magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field to create images of both hard and soft tissues in your body. An magnetic resonance imaging (MRI) can show the extent of an anterior cruciate ligament (ACL) injury and signs of damage to other tissues in the knee, including the cartilage. Ultrasound. Using sound waves to visualize internal structures, ultrasound may be used to check for injuries in the ligaments, tendons and muscles of the knee. "}
{"text": "??????????? - ACL injury - ND56.Z\nProper training and exercise can help reduce the risk of anterior cruciate ligament (ACL) injury. A sports medicine physician, physical therapist, athletic trainer or other specialist in sports medicine can provide assessment, instruction and feedback that can help you reduce risks. Programs to reduce anterior cruciate ligament (ACL) injury include: Exercises to strengthen the core — including the hips, pelvis and lower abdomen — with a goal of training athletes to avoid moving the knee inward during a squat, Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength, Training and exercise emphasizing proper technique and knee position when jumping and landing from jumps, Training to improve technique when performing pivoting and cutting movements. Training to strengthen muscles of the legs, hips and core — as well as training to improve jumping and landing techniques and to prevent inward movement of the knee — may help to reduce the higher anterior cruciate ligament (ACL) injury risk in female athletes. Gear. Wear footwear and padding that is appropriate for your sport to help prevent injury. If you downhill ski, make sure your ski bindings are adjusted correctly by a trained professional so that your skis will release appropriately if you fall. Wearing a knee brace doesn't appear to prevent anterior cruciate ligament (ACL) injury or reduce the risk of recurring injury after surgery. "}
{"text": "????????????? - ACL injury - ND56.Z\nThere are a number of factors that increase your risk of an anterior cruciate ligament (ACL) injury, including: Being female — possibly due to differences in anatomy, muscle strength and hormonal influences, Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing, Poor conditioning, Using faulty movement patterns, such as moving the knees inward during a squat, Wearing footwear that doesn't fit properly, Using poorly maintained sports equipment, such as ski bindings that aren't adjusted properly, Playing on artificial turf. "}
{"text": "????????? - ACL injury - ND56.Z\nSigns and symptoms of an anterior cruciate ligament (ACL) injury usually include: A loud pop or a \"popping\" sensation in the knee, Severe pain and inability to continue activity, Rapid swelling, Loss of range of motion, A feeling of instability or \"giving way\" with weight bearing. When to see a doctor. Seek immediate care if any injury to your knee causes signs or symptoms of an anterior cruciate ligament (ACL) injury. The knee joint is a complex structure of bones, ligaments, tendons and other tissues that work together. It's important to get a prompt and accurate diagnosis to determine the severity of the injury and get proper treatment. "}
{"text": "?????????? - ACL injury - ND56.Z\nPrompt first-aid care can reduce pain and swelling immediately after an injury to your knee. Follow the rest, ice, compression, elevation (R.I.C.E.) model of self-care at home: Rest. General rest is necessary for healing and limits weight bearing on your knee. Ice. When you're awake, try to ice your knee at least every two hours for 20 minutes at a time. Compression. Wrap an elastic bandage or compression wrap around your knee. Elevation. Lie down with your knee propped up on pillows. Rehabilitation. Medical treatment for an anterior cruciate ligament (ACL) injury begins with several weeks of rehabilitative therapy. A physical therapist will teach you exercises that you will perform either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee. The goal of rehabilitation is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles. This course of physical therapy may successfully treat an anterior cruciate ligament (ACL) injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees. Surgery. Your doctor may recommend surgery if: You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting, More than one ligament or the fibrous cartilage in your knee also is injured, The injury is causing your knee to buckle during everyday activities. During anterior cruciate ligament (ACL) reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. This replacement tissue is called a graft. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor. After surgery you'll resume another course of rehabilitative therapy. Successful anterior cruciate ligament (ACL) reconstruction paired with rigorous rehabilitation can usually restore stability and function to your knee. There's no set time frame for athletes to return to play. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. A longer recovery period may reduce the risk of re-injury. In general, it takes as long as a year or more before athletes can safely return to play. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of anterior cruciate ligament (ACL) injury. "}
{"text": "??????? - Acoustic neuroma - 2A02.3&XA6LY7\nThe cause of acoustic neuromas can be linked to a problem with a gene on chromosome 22. Normally, this gene produces a tumor suppressor protein that helps control the growth of Schwann cells covering the nerves. Experts don't know what causes this problem with the gene. In most cases of acoustic neuroma, there is no known cause. This faulty gene is also inherited in neurofibromatosis type 2, a rare disorder that usually involves the growth of tumors on the hearing and balance nerves on both sides of your head (bilateral vestibular schwannomas). "}
{"text": "?????????????? - Acoustic neuroma - 2A02.3&XA6LY7\nAn acoustic neuroma may cause a variety of permanent complications, including: Hearing loss, Facial numbness and weakness, Difficulties with balance, Ringing in the ear. Large tumors may press on your brainstem, preventing the normal flow of fluid between your brain and spinal cord (cerebrospinal fluid). In this case, fluid can build up in your head (hydrocephalus), increasing the pressure inside your skull. "}
{"text": "????????? - Acoustic neuroma - 2A02.3&XA6LY7\nAcoustic neuroma, also known as vestibular schwannoma, is a noncancerous and usually slow-growing tumor that develops on the main (vestibular) nerve leading from your inner ear to your brain. Branches of this nerve directly influence your balance and hearing, and pressure from an acoustic neuroma can cause hearing loss, ringing in your ear and unsteadiness. Acoustic neuroma usually arises from the Schwann cells covering this nerve and grows slowly or not at all. Rarely, it may grow rapidly and become large enough to press against the brain and interfere with vital functions. Treatments for acoustic neuroma include regular monitoring, radiation and surgical removal. "}
{"text": "?????????? - Acoustic neuroma - 2A02.3&XA6LY7\nAcoustic neuroma is often difficult to diagnose in the early stages because signs and symptoms may be easy to miss and develop slowly over time. Common symptoms such as hearing loss are also associated with many other middle and inner ear problems. After asking questions about your symptoms, your doctor will conduct an ear exam. Your doctor may order the following tests: Hearing test (audiometry). In this test, conducted by a hearing specialist (audiologist), you hear sounds directed to one ear at a time. The audiologist presents a range of sounds of various tones and asks you to indicate each time you hear the sound. Each tone is repeated at faint levels to find out when you can barely hear. The audiologist may also present various words to determine your hearing ability.  Imaging. Magnetic resonance imaging (MRI) with contrast dye is usually used to diagnose acoustic neuroma. This imaging test can detect tumors as small as 1 to 2 millimeters in diameter. If magnetic resonance imaging (MRI) is unavailable or you can't have an magnetic resonance imaging (MRI) scan for some reason, computerized tomography (CT) may be used. However, computerized tomography (CT) scans may miss very small tumors. "}
{"text": "????????? - Acoustic neuroma - 2A02.3&XA6LY7\nSigns and symptoms of acoustic neuroma are often easy to miss and may take many years to develop. They usually happen because of the tumor's effects on the hearing and balance nerves. Pressure from the tumor on nearby nerves controlling facial muscles and sensation (facial and trigeminal nerves), nearby blood vessels, or brain structures may also cause problems. As the tumor grows, it may cause more noticeable or severe signs and symptoms. Common signs and symptoms of acoustic neuroma include: Hearing loss, usually gradually worsening over months to years — although in rare cases sudden — and occurring on only one side or more severe on one side, Ringing (tinnitus) in the affected ear, Unsteadiness or loss of balance, Dizziness (vertigo), Facial numbness and weakness or loss of muscle movement. In rare cases, an acoustic neuroma may grow large enough to compress the brainstem and become life-threatening. When to see your doctor. See your doctor if you notice hearing loss in one ear, ringing in your ear or trouble with your balance. Early diagnosis of an acoustic neuroma may help keep the tumor from growing large enough to cause serious consequences, such as total hearing loss. "}
{"text": "????????????? - Acoustic neuroma - 2A02.3&XA6LY7\nNeurofibromatosis type 2The only confirmed risk factor for acoustic neuroma is having a parent with the rare genetic disorder neurofibromatosis type 2. However, neurofibromatosis type 2 only accounts for about 5% of acoustic neuroma cases. A hallmark characteristic of neurofibromatosis type 2 is the development of noncancerous tumors on the hearing and balance nerves on both sides of the head, as well as on other nerves. Neurofibromatosis type 2 (NF2) is known as an autosomal dominant disorder, meaning that the mutation can be passed on by just one parent (dominant gene). Each child of an affected parent has a 50-50 chance of inheriting it. "}
{"text": "?????????? - Acoustic neuroma - 2A02.3&XA6LY7\nYour acoustic neuroma treatment may vary, depending on: The size and growth of the acoustic neuroma, Your overall health, Severity of symptoms. To treat acoustic neuroma, your doctor may suggest one or more of three potential options: monitoring, surgery or radiation therapy. Monitoring. If you have a small acoustic neuroma that isn't growing or is growing slowly and causes few or no signs or symptoms, you and your doctor may decide to monitor it. Monitoring may be recommended if you're an older adult or otherwise not a good candidate for more-aggressive treatment. Your doctor may recommend that you have regular imaging and hearing tests, usually every 6 to 12 months, to determine whether the tumor is growing and how quickly. If the scans show the tumor is growing or if the tumor causes progressive symptoms or other difficulties, you may need to undergo treatment. Surgery. You may need surgery to remove an acoustic neuroma, especially if the tumor is: Continuing to grow, Very large, Causing symptoms. Your surgeon may use one of several techniques for removing an acoustic neuroma, depending on the size of your tumor, hearing status and other factors. The goal of surgery is to remove the tumor and preserve the facial nerve to prevent facial paralysis. Removing the entire tumor may not be possible in certain cases — for example, if the tumor is too close to important parts of the brain or the facial nerve. Surgery for an acoustic neuroma is performed under general anesthesia and involves removing the tumor through the inner ear or through a window in your skull. Sometimes, surgical removal of the tumor may worsen symptoms if the hearing, balance, or facial nerves are irritated or damaged during the operation. Hearing may be lost on the side where the surgery is performed, and balance is usually affected temporarily. Complications may include: Leaking cerebrospinal fluid through the wound or nose, Hearing loss, Facial weakness or numbness, Ringing in the ear, Balance problems, Persistent headache, Rarely, infection of the cerebrospinal fluid (meningitis), Very rarely, stroke or brain bleeding. Radiation therapy. There are several types of radiation therapy used to treat acoustic neuroma: Stereotactic radiosurgery. Your doctor may recommend a type of radiation therapy known as stereotactic radiosurgery. It's often used if your tumor is small (less than 2.5 centimeters in diameter), you are an older adult or you cannot tolerate surgery for health reasons. Stereotactic radiosurgery, such as Gamma Knife radiosurgery, uses many tiny gamma rays to deliver a precisely targeted dose of radiation to a tumor without damaging the surrounding tissue or making an incision. The goal of stereotactic radiosurgery is to stop the growth of a tumor, preserve the facial nerve's function and possibly preserve hearing. It may take weeks, months or years before you notice the effects of radiosurgery. Your doctor will monitor your progress with follow-up imaging studies and hearing tests. Risks of radiosurgery include: Hearing loss. Ringing in the ear. Facial weakness or numbness. Balance problems. Continued tumor growth.  Hearing loss, Ringing in the ear, Facial weakness or numbness, Balance problems, Continued tumor growth, Stereotactic radiotherapy. Fractionated stereotactic radiotherapy (SRT) delivers a small dose of radiation to the tumor over several sessions. Stereotactic radiotherapy (SRT) is done to curb the growth of the tumor without damaging surrounding brain tissue. Proton beam therapy. This type of radiation therapy uses high-energy beams of positively charged particles called protons. Protons are delivered to the affected area in targeted doses to treat tumors and minimize radiation exposure to the surrounding area. Supportive therapy. In addition to treatment to remove or stop the growth of the tumor, your doctor may recommend supportive therapies to address symptoms or complications of an acoustic neuroma and its treatment, such as dizziness or balance problems. Cochlear implants or other treatments may also be recommended to treat hearing loss. "}
{"text": "??????? - Acromegaly - 5A60.0\nAcromegaly occurs when the pituitary gland produces too much growth hormone (GH) over a long period of time. The pituitary gland is a small gland at the base of your brain, behind the bridge of your nose. It produces growth hormone (GH) and a number of other hormones. Growth hormone (GH) plays an important role in managing your physical growth. When the pituitary gland releases growth hormone (GH) into your bloodstream, it triggers your liver to produce a hormone called insulin-like growth factor-1 (IGF-1) — sometimes also called insulin-like growth factor-I, or IGF-I. Insulin-like growth factor-1 (IGF-1) is what causes your bones and other tissues to grow. Too much growth hormone (GH) leads to too much insulin-like growth factor-1 (IGF-1), which can cause acromegaly signs, symptoms and complications. In adults, a tumor is the most common cause of too much growth hormone (GH) production: Pituitary tumors. Most acromegaly cases are caused by a noncancerous (benign) tumor (adenoma) of the pituitary gland. The tumor produces excessive amounts of growth hormone, causing many of the signs and symptoms of acromegaly. Some of the symptoms of acromegaly, such as headaches and impaired vision, are due to the tumor pressing on nearby brain tissues. Nonpituitary tumors. In a few people with acromegaly, tumors in other parts of the body, such as the lungs or pancreas, cause the disorder. Sometimes, these tumors secrete growth hormone (GH). In other cases, the tumors produce a hormone called growth hormone-releasing hormone (GH-RH), which signals the pituitary gland to make more growth hormone (GH). "}
{"text": "?????????????? - Acromegaly - 5A60.0\nIf left untreated, acromegaly can lead to major health problems. Complications may include: High blood pressure (hypertension), High cholesterol, Heart problems, particularly enlargement of the heart (cardiomyopathy), Osteoarthritis, Type 2 diabetes, Enlargement of the thyroid gland (goiter), Precancerous growths (polyps) on the lining of your colon, Sleep apnea, a condition in which breathing repeatedly stops and starts during sleep, Carpal tunnel syndrome, Increased risk of cancerous tumors, Spinal cord compression or fractures, Vision changes or vision loss. Early treatment of acromegaly can prevent these complications from developing or becoming worse. Untreated, acromegaly and its complications can lead to premature death. "}
{"text": "????????? - Acromegaly - 5A60.0\nAcromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood. When you have too much growth hormone, your bones increase in size. In childhood, this leads to increased height and is called gigantism. But in adulthood, a change in height doesn't occur. Instead, the increase in bone size is limited to the bones of your hands, feet and face, and is called acromegaly. Because acromegaly is uncommon and the physical changes occur slowly over many years, the condition sometimes takes a long time to recognize. Untreated, high levels of growth hormone can affect other parts of the body, in addition to your bones. This can lead to serious — sometimes even life-threatening — health problems. But treatment can reduce your risk of complications and significantly improve your symptoms, including the enlargement of your features. "}
{"text": "?????????? - Acromegaly - 5A60.0\nYour doctor will ask about your medical history and conduct a physical exam. Then he or she may recommend the following steps: IGF-1 measurement. After you've fasted overnight, your doctor will take a blood sample to measure the IGF-1 level in your blood. An elevated IGF-1 level suggests acromegaly. Growth hormone suppression test. This is the best method for confirming an acromegaly diagnosis. During this test, your GH blood level is measured both before and after you drink a preparation of sugar (glucose). In people who don't have acromegaly, the glucose drink typically causes the GH level to fall. But if you have acromegaly, your GH level will tend to stay high. Imaging. Your doctor may recommend an imaging test, such as magnetic resonance imaging (MRI), to help pinpoint the location and size of a tumor on your pituitary gland. If no pituitary tumors are seen, your doctor may order other imaging tests to look for nonpituitary tumors. "}
{"text": "????????? - Acromegaly - 5A60.0\nA common sign of acromegaly is enlarged hands and feet. For example, you may notice that you aren't able to put on rings that used to fit, and that your shoe size has progressively increased. Acromegaly may also cause gradual changes in your face's shape, such as a protruding lower jaw and brow bone, an enlarged nose, thickened lips, and wider spacing between your teeth. Because acromegaly tends to progress slowly, early signs may not be obvious for years. Sometimes, people notice the physical changes only by comparing old photos with newer ones. Overall, acromegaly signs and symptoms tend to vary from one person to another, and may include any of the following: Enlarged hands and feet, Enlarged facial features, including the facial bones, lips, nose and tongue, Coarse, oily, thickened skin, Excessive sweating and body odor, Small outgrowths of skin tissue (skin tags), Fatigue and joint or muscle weakness, Pain and limited joint mobility, A deepened, husky voice due to enlarged vocal cords and sinuses, Severe snoring due to obstruction of the upper airway, Vision problems, Headaches, which may be persistent or severe, Menstrual cycle irregularities in women, Erectile dysfunction in men, Loss of interest in sex. When to see a doctor. If you have signs and symptoms associated with acromegaly, contact your doctor for an exam. Acromegaly usually develops slowly. Even your family members may not notice the gradual physical changes that occur with this disorder at first. But early diagnosis is important so that you can start getting proper care. Acromegaly can lead to serious health problems if it's not treated. "}
{"text": "?????????? - Acromegaly - 5A60.0\nAcromegaly treatment varies by person. Your treatment plan will likely depend on the location and size of your tumor, the severity of your symptoms, and your age and overall health. To help lower your GH and IGF-1 levels, treatment options typically include surgery or radiation to remove or reduce the size of the tumor that is causing your symptoms, and medication to help normalize your hormone levels. If you're experiencing health problems as a result of acromegaly, your doctor may recommend additional treatments to help manage your complications. Surgery. Doctors can remove most pituitary tumors using a method called transsphenoidal surgery. During this procedure, your surgeon works through your nose to remove the tumor from your pituitary gland. If the tumor causing your symptoms isn't located on your pituitary gland, your doctor will recommend another type of surgery to remove the tumor. In many cases — especially if your tumor is small — removal of the tumor returns your GH levels to normal. If the tumor was putting pressure on the tissues around your pituitary gland, removing the tumor also helps relieve headaches and vision changes. In some cases, your surgeon may not be able to remove the entire tumor. If this is the case, you may still have elevated GH levels after surgery. Your doctor may recommend another surgery, medications or radiation treatments. Medications. Your doctor may recommend one of the following medications — or a combination of medications — to help your hormone levels return to normal: Drugs that reduce growth hormone production (somatostatin analogues). In the body, a brain hormone called somatostatin works against (inhibits) GH production. The drugs octreotide (Sandostatin) and lanreotide (Somatuline Depot) are man-made (synthetic) versions of somatostatin. Taking one of these drugs signals the pituitary gland to produce less GH, and may even reduce the size of a pituitary tumor. Typically, these drugs are injected into the muscles of your buttocks (gluteal muscles) once a month by a health care professional. Drugs to lower hormone levels (dopamine agonists). The oral medications cabergoline and bromocriptine (Parlodel) may help lower levels of GH and IGF-1 in some people. These drugs may also help decrease tumor size. To treat acromegaly, these medications usually need to be taken at high doses, which can increase the risk of side effects. Common side effects of these drugs include nausea, vomiting, stuffy nose, tiredness, dizziness, sleep problems and mood changes. Drug to block the action of GH (growth hormone antagonist). The medication pegvisomant (Somavert) blocks the effect of GH on the body's tissues. Pegvisomant may be particularly helpful for people who haven't had good success with other treatments. Given as a daily injection, this medication can help lower IGF-1 levels and relieve symptoms, but it doesn't lower GH levels or reduce tumor size. Radiation. If your surgeon wasn't able to remove the whole tumor during surgery, your doctor may recommend radiation treatment. Radiation therapy destroys any lingering tumor cells and slowly reduces GH levels. It may take years for this treatment to noticeably improve acromegaly symptoms. Radiation treatment often lowers levels of other pituitary hormones, too — not just GH. If you receive radiation treatment, you'll likely need regular follow-up visits with your doctor to make sure that your pituitary gland is working properly, and to check your hormone levels. This follow-up care may last for the rest of your life. Types of radiation therapy include: Conventional radiation therapy. This type of radiation therapy is usually given every weekday over a period of four to six weeks. You may not see the full effect of conventional radiation therapy for 10 or more years after treatment. Stereotactic radiosurgery. Stereotactic radiosurgery uses 3D imaging to deliver a high dose of radiation to the tumor cells, while limiting the amount of radiation to normal surrounding tissues. It can usually be delivered in a single dose. This type of radiation may bring GH levels back to normal within five to 10 years. "}
{"text": "?????????????? - Actinic keratosis - EK90.0\nIf treated early, actinic keratosis can be cleared up or removed. If left untreated, some of these spots might progress to squamous cell carcinoma — a type of cancer that usually isn't life-threatening if detected and treated early. "}
{"text": "??????? - Actinic keratosis - EK90.0\nAn actinic keratosis is caused by frequent or intense exposure to Ultraviolet (UV) rays from the sun or tanning beds. "}
{"text": "????????? - Actinic keratosis - EK90.0\nAn actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of sun exposure. It's often found on the face, lips, ears, forearms, scalp, neck or back of the hands. Also known as a solar keratosis, an actinic keratosis grows slowly and usually first appears in people over 40. You can reduce your risk of this skin condition by minimizing your sun exposure and protecting your skin from ultraviolet (UV) rays. Left untreated, the risk of actinic keratoses turning into a type of skin cancer called squamous cell carcinoma is about 5% to 10%. "}
{"text": "?????????? - Actinic keratosis - EK90.0\nYour doctor will likely be able to determine whether you have an actinic keratosis simply by examining your skin. If there's any doubt, your doctor may do other tests, such as a skin biopsy. During a skin biopsy, your doctor takes a small sample of your skin for analysis in a lab. A biopsy can usually be done in a doctor's office after a numbing injection. Even after treatment for actinic keratosis, your doctor might suggest that you have your skin checked at least once a year for signs of skin cancer. "}
{"text": "????????????? - Actinic keratosis - EK90.0\nAnyone can develop actinic keratoses. But you're at increased risk if you: Have red or blond hair and blue or light-colored eyes, Have a history of a lot of sun exposure or sunburn, Tend to freckle or burn when exposed to sunlight, Are older than 40, Live in a sunny place, Work outdoors, Have a weakened immune system. "}
{"text": "??????????? - Actinic keratosis - EK90.0\nSun safety is necessary to help prevent development and recurrence of actinic keratosis patches and spots. Take these steps to protect your skin from the sun: Limit your time in the sun. Especially avoid time in the sun between 10 a.m. and 2 p.m. And avoid staying in the sun so long that you get a sunburn or a suntan. Use sunscreen. Before spending time outdoors, even on cloudy days, apply a broad-spectrum water-resistant sunscreen with a sun protection factor (SPF) of at least 30, as the American Academy of Dermatology recommends. Use sunscreen on all exposed skin, and use lip balm with sunscreen on your lips. Apply sunscreen at least 15 minutes before going outside and reapply it every two hours — or more often if you're swimming or perspiring. Sunscreen is not recommended for babies under 6 months. Rather, keep them out of the sun if possible, or protect them with shade, hats, and clothing that covers the arms and legs.  Cover up. For extra protection from the sun, wear tightly woven clothing that covers your arms and legs. Also wear a broad-brimmed hat, which provides more protection than does a baseball cap or golf visor. Avoid tanning beds. The Ultraviolet (UV) exposure from a tanning bed can cause just as much skin damage as a tan acquired from the sun. Check your skin regularly and report changes to your doctor. Examine your skin regularly, looking for the development of new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp. Examine the tops and undersides of your arms and hands. "}
{"text": "?????????? - Actinic keratosis - EK90.0\nAn actinic keratosis sometimes disappears on its own but might return after more sun exposure. It's hard to tell which actinic keratoses will develop into skin cancer, so they're usually removed as a precaution. Medications. If you have several actinic keratoses, your doctor might prescribe a medicated cream or gel to remove them, such as fluorouracil (Carac, Fluoroplex, others), imiquimod (Aldara, Zyclara), ingenol mebutate or diclofenac (Solaraze). These products might cause redness, scaling or a burning sensation for a few weeks. Surgical and other procedures. Many methods are used to remove actinic keratosis, including: Freezing (cryotherapy). Actinic keratoses can be removed by freezing them with liquid nitrogen. Your doctor applies the substance to the affected skin, which causes blistering or peeling. As your skin heals, the damaged cells slough off, allowing new skin to appear. Cryotherapy is the most common treatment. It takes only a few minutes and can be done in your doctor's office. Side effects may include blisters, scarring, changes to skin texture, infection and changes in skin color of the affected area. Scraping (curettage). In this procedure, your doctor uses a device called a curet to scrape off damaged cells. Scraping may be followed by electrosurgery, in which the doctor uses a pencil-shaped instrument to cut and destroy the affected tissue with an electric current. This procedure requires local anesthesia. Side effects may include infection, scarring and changes in skin color of the affected area. Laser therapy. This technique is increasingly used to treat actinic keratosis. Your doctor uses an ablative laser device to destroy the patch, allowing new skin to appear. Side effects may include scarring and discoloration of the affected skin. Photodynamic therapy. Your doctor might apply a light-sensitive chemical solution to the affected skin and then expose it to a special light that will destroy the actinic keratosis. Side effects may include redness, swelling and a burning sensation during therapy. "}
{"text": "????????? - Actinic keratosis - EK90.0\nActinic keratoses vary in appearance. Signs and symptoms include: Rough, dry or scaly patch of skin, usually less than 1 inch (2.5 centimeters) in diameter, Flat to slightly raised patch or bump on the top layer of skin, In some cases, a hard, wartlike surface, Color variations, including pink, red or brown, Itching, burning, bleeding or crusting, New patches or bumps on sun-exposed areas of the head, neck, hands and forearms. When to see a doctor. It can be difficult to distinguish between noncancerous spots and cancerous ones. So it's best to have new skin changes evaluated by a doctor — especially if a scaly spot or patch persists, grows or bleeds. "}
{"text": "??????? - Acute coronary syndrome - BA4Z\nAcute coronary syndrome usually results from the buildup of fatty deposits (plaques) in and on the walls of coronary arteries, the blood vessels delivering oxygen and nutrients to heart muscles. When a plaque deposit ruptures or splits, a blood clot forms. This clot blocks the flow of blood to heart muscles. When the supply of oxygen to cells is too low, cells of the heart muscles can die. The death of cells — resulting in damage to muscle tissues — is a heart attack (myocardial infarction). Even when there is no cell death, the decrease in oxygen still results in heart muscles that don't work the way they should. This change may be temporary or permanent. When acute coronary syndrome doesn't result in cell death, it is called unstable angina. "}
{"text": "?????????? - Acute coronary syndrome - BA4Z\nIf you have signs or symptoms associated with acute coronary syndrome, an emergency room doctor will likely order several tests. Some tests may be done while your doctor is asking you questions about your symptoms or medical history. Tests include: Electrocardiogram (ECG). Electrodes attached to your skin measure the electrical activity in your heart. Abnormal or irregular impulses can mean your heart is not working properly due to a lack of oxygen. Certain patterns in electrical signals may show the general location of a blockage. The test may be repeated several times. Blood tests. Certain enzymes may be detected in the blood if cell death has resulted in damage to heart tissue. A positive result indicates a heart attack. The information from these two tests — as well as your signs and symptoms — is used to make a primary diagnosis of acute coronary syndrome. Your doctor can use the information to determine whether your condition can be classified as a heart attack or unstable angina. Other tests may be done to learn more about your condition, rule out other causes of symptoms, or to help your doctor personalize your diagnosis and treatment. Coronary angiogram. This procedure uses X-ray imaging to see your heart's blood vessels. A long, tiny tube (catheter) is threaded through an artery, usually in your arm or groin, to the arteries in your heart. A dye flows through the tube into your arteries. A series of X-rays show how the dye moves through your arteries, revealing any blockages or narrowing. The catheter may also be used for treatments. Echocardiogram. An echocardiogram uses sound waves, directed at your heart from a wand-like device, to produce a live image of your heart. An echocardiogram can help determine whether the heart is pumping correctly. Myocardial perfusion imaging. This test shows how well blood flows through your heart muscle. A tiny, safe amount of radioactive substance is injected into your blood. A specialized camera takes images of the substance's path through your heart. They show your doctor whether enough blood is flowing through heart muscles and where blood flow is reduced. Computerized tomography (CT) angiogram. A computerized tomography (CT) angiogram uses a specialized X-ray technology that can produce multiple images — cross-sectional 2-D slices — of your heart. These images can detect narrowed or blocked coronary arteries. Stress test. A stress test reveals how well your heart works when you exercise. In some cases, you may receive a medication to increase your heart rate rather than exercising. This test is done only when there are no signs of acute coronary syndrome or another life-threatening heart condition when you are at rest. During the stress test, an electrocardiogram (ECG), echocardiogram or myocardial perfusion imaging may be used to see how well your heart works. "}
{"text": "????????????? - Acute coronary syndrome - BA4Z\nThe risk factors for acute coronary syndrome are the same as those for other types of heart disease. Acute coronary syndrome risk factors include: Aging, High blood pressure, High blood cholesterol, Cigarette smoking, Lack of physical activity, Unhealthy diet, Obesity or overweight, Diabetes, Family history of chest pain, heart disease or stroke, History of high blood pressure, preeclampsia or diabetes during pregnancy, COVID-19 infection. "}
{"text": "????????? - Acute coronary syndrome - BA4Z\nAcute coronary syndrome is a term used to describe a range of conditions associated with sudden, reduced blood flow to the heart. One such condition is a heart attack (myocardial infarction) — when cell death results in damaged or destroyed heart tissue. Even when acute coronary syndrome causes no cell death, the reduced blood flow changes how your heart works and is a sign of a high risk of heart attack. Acute coronary syndrome often causes severe chest pain or discomfort. It is a medical emergency that requires prompt diagnosis and care. The goals of treatment include improving blood flow, treating complications and preventing future problems. "}
{"text": "?????????? - Acute coronary syndrome - BA4Z\nThe immediate goals of treatment for acute coronary syndrome are: Relieve pain and distress, Improve blood flow, Restore heart function as quickly and as best as possible. Long-term treatment goals are to improve overall heart function, manage risk factors and lower the risk of a heart attack. A combination of drugs and surgical procedures may be used to meet these goals. Medications. Depending on your diagnosis, medications for emergency or ongoing care (or both) may include the following: Thrombolytics (clot busters) help dissolve a blood clot that's blocking an artery. Nitroglycerin improves blood flow by temporarily widening blood vessels. Antiplatelet drugs help prevent blood clots from forming and include aspirin, clopidogrel (Plavix), prasugrel (Effient) and others. Beta blockers help relax your heart muscle and slow your heart rate. They decrease the demand on your heart and lower blood pressure. Examples include metoprolol (Lopressor, Toprol-XL) and nadolol (Corgard). Angiotensin-converting enzyme (ACE) inhibitors widen blood vessels and improve blood flow, allowing the heart to work better. They include lisinopril (Prinivil, Zestril), benazepril (Lotensin) and others. Angiotensin receptor blockers (ARBs) help control blood pressure and include irbesartan (Avapro), losartan (Cozaar) and several others. Statins lower the amount of cholesterol moving in the blood and may stabilize plaque deposits, making them less likely to rupture. Statins include atorvastatin (Lipitor), simvastatin (Zocor, Flolipid) and several others. Surgery and other procedures. Your doctor may recommend one of these procedures to restore blood flow to your heart muscles: Angioplasty and stenting. In this procedure, your doctor inserts a long, tiny tube (catheter) into the blocked or narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, opening the artery by compressing the plaque deposits against your artery walls. A mesh tube (stent) is usually left in the artery to help keep the artery open. Coronary bypass surgery. With this procedure, a surgeon takes a piece of blood vessel (graft) from another part of your body and creates a new route for blood that goes around (bypasses) a blocked coronary artery. Lifestyle and home remedies. Heart healthy lifestyle changes are an important part of heart attack prevention. Recommendations include the following: Don't smoke. If you smoke, quit. Talk to your doctor if you need help quitting. Also, avoid secondhand smoke. Eat a heart-healthy diet. Eat a diet with lots of fruits and vegetables, whole grains, and moderate amounts of low-fat dairy and lean meats. Be active. Get regular exercise and stay physically active. If you have not been exercising regularly, talk to your doctor about the best exercise to begin a healthy and safe routine. Check your cholesterol. Have your blood cholesterol levels checked regularly at your doctor's office. Avoid high-fat, high-cholesterol meat and dairy. If your doctor has prescribed a statin or other cholesterol-lowering medication, take it daily as directed by your doctor. Control your blood pressure. Have your blood pressure checked regularly as recommended by your doctor. Take blood pressure medicine daily as recommended. Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure, diabetes, heart disease and other conditions. Manage stress. To reduce your risk of a heart attack, reduce stress in your day-to-day activities. Rethink work habits and find healthy ways to minimize or deal with stressful events in your life. Talk to your doctor or a mental health care professional if you need help managing stress. Drink alcohol in moderation. If you drink alcohol, do so in moderation. Drinking more than one to two alcoholic drinks a day can raise blood pressure. "}
{"text": "????????? - Acute coronary syndrome - BA4Z\nThe signs and symptoms of acute coronary syndrome usually begin abruptly. They include: Chest pain (angina) or discomfort, often described as aching, pressure, tightness or burning, Pain spreading from the chest to the shoulders, arms, upper abdomen, back, neck or jaw, Nausea or vomiting, Indigestion, Shortness of breath (dyspnea), Sudden, heavy sweating (diaphoresis), Lightheadedness, dizziness or fainting, Unusual or unexplained fatigue, Feeling restless or apprehensive. Chest pain or discomfort is the most common symptom. However, signs and symptoms may vary significantly depending on your age, sex and other medical conditions. You're more likely to have signs and symptoms without chest pain or discomfort if you're a woman, older adult or have diabetes. When to see a doctor. Acute coronary syndrome is a medical emergency. Chest pain or discomfort can be a sign of any number of life-threatening conditions. Get emergency help for a prompt diagnosis and appropriate care. Do not drive yourself to the hospital. "}
{"text": "??????? - Acute flaccid myelitis (AFM) - 1C81\nAcute flaccid myelitis might be caused by an infection with a type of virus known as an enterovirus. Respiratory illnesses and fever from enteroviruses are common — especially in children. Most people recover. It's not clear why some people with an enterovirus infection develop acute flaccid myelitis. In the United States many viruses, including enteroviruses, circulate between August and November. This is when acute flaccid myelitis outbreaks tend to occur. The symptoms of acute flaccid myelitis can look similar to those of the viral disease polio. But none of the acute flaccid myelitis cases in the United States have been caused by poliovirus. "}
{"text": "?????????????? - Acute flaccid myelitis (AFM) - 1C81\nMuscle weakness caused by acute flaccid myelitis can continue for months to years. "}
{"text": "?????????? - Acute flaccid myelitis (AFM) - 1C81\nTo diagnose acute flaccid myelitis, the doctor starts with a thorough medical history and physical exam. The doctor might recommend: Examining the nervous system. The doctor examines the places on the body where you or your child has weakness, poor muscle tone and decreased reflexes. Magnetic resonance imaging (MRI). This imaging test allows the doctor to look at the brain and spinal cord. Lab tests. The doctor might take samples of the fluid around the brain and spinal cord (cerebrospinal fluid), respiratory fluid, blood, and stool for lab testing. A nerve check. This test can check how fast an electrical impulse moves through the nerves and the response of muscles to messages from the nerves. Acute flaccid myelitis can be hard to diagnose because it shares many of the same symptoms as other neurological diseases, such as Guillain-Barre syndrome. These tests can help distinguish acute flaccid myelitis from other conditions. "}
{"text": "????????? - Acute flaccid myelitis (AFM) - 1C81\nAcute flaccid myelitis (AFM) is a rare but serious condition that affects the spinal cord. It can cause sudden weakness in the arms or legs, loss of muscle tone, and loss of reflexes. The condition mainly affects young children. Most children have a mild respiratory illness or fever caused by a viral infection about one to four weeks before developing symptoms of acute flaccid myelitis. If you or your child develops symptoms of acute flaccid myelitis, seek immediate medical care. Symptoms can progress rapidly. Hospitalization is needed and sometimes a ventilator is required for breathing support. Since experts began tracking acute flaccid myelitis following initial clusters in 2014, outbreaks in the United States have occurred in 2016 and 2018. Outbreaks tend to occur between August and November. "}
{"text": "??????????? - Acute flaccid myelitis (AFM) - 1C81\nThere's no specific way to prevent acute flaccid myelitis. However, preventing a viral infection can help reduce the risk of developing acute flaccid myelitis. Take these steps to help protect yourself or your child from getting or spreading a viral infection: Wash your hands often with soap and water. Avoid touching your face with unwashed hands. Avoid close contact with people who are sick. Clean and disinfect frequently touched surfaces. Cover coughs and sneezes with a tissue or upper shirt sleeve. Keep sick children at home. "}
{"text": "????????????? - Acute flaccid myelitis (AFM) - 1C81\nAcute flaccid myelitis mainly affects young children. "}
{"text": "????????? - Acute flaccid myelitis (AFM) - 1C81\nThe most common signs and symptoms of acute flaccid myelitis include: Sudden arm or leg weakness, Sudden loss of muscle tone, Sudden loss of reflexes. Other possible signs and symptoms include: Difficulty moving the eyes or drooping eyelids, Facial droop or weakness, Difficulty with swallowing or slurred speech, Pain in the arms, legs, neck or back. Uncommon symptoms might include: Numbness or tingling, Inability to pass urine. Severe symptoms involve respiratory failure, due to the muscles involved in breathing becoming weak. It's also possible to experience life-threatening body temperature changes and blood pressure instability. When to see a doctor. If you or your child has any of the signs or symptoms listed above, seek medical care as soon as possible. "}
{"text": "?????????? - Acute flaccid myelitis (AFM) - 1C81\nCurrently, there is no specific treatment for acute flaccid myelitis. Treatment is aimed at managing symptoms. A doctor who specializes in treating brain and spinal cord illnesses (neurologist) might recommend physical or occupational therapy to help with arm or leg weakness. If physical therapy is started during the initial phase of the illness, it might improve long-term recovery. The doctor might also recommend treatment with immunoglobulin that contains healthy antibodies from healthy donors, drugs that lower inflammation in the body (corticosteroids) or antiviral drugs. Or the doctor might recommend a treatment that removes and replaces blood plasma (plasma exchange). However, it's not clear whether these treatments have any benefits. Sometimes nerve and muscle transfer surgeries are done to improve limb function. "}