{"instruction": "What is Flu?", "response": "What is Flu?: Flu is a respiratory infection caused by a number of viruses. The viruses pass through the air and enter your body through your nose or mouth. Between 5% and 20% of people in the U.S. get the flu each year. The flu can be serious or even deadly for elderly people, newborn babies, and people with certain chronic illnesses. Symptoms of the flu come on suddenly and are worse than those of the common cold. They may include - Body or muscle aches - Chills - Cough - Fever - Headache - Sore throat Is it a cold or the flu? Colds rarely cause a fever or headaches. Flu almost never causes an upset stomach. And \"stomach flu\" isn't really flu at all, but gastroenteritis. Most people with the flu recover on their own without medical care. People with mild cases of the flu should stay home and avoid contact with others, except to get medical care. If you get the flu, your health care provider may prescribe medicine to help your body fight the infection and lessen symptoms. The main way to keep from getting the flu is to get a yearly flu vaccine. Good hygiene, including hand washing, can also help. NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Flu?", "response": "What is Flu?: The flu is an infection of the nose, throat, and lungs. It spreads easily. This article discusses influenza types A and B. Another type of the flu is the swine flu (H1N1). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Flu?", "response": "What causes Flu?: The flu is caused by an influenza virus. Most people get the flu when they breathe in tiny airborne droplets from the coughs or sneezes of someone who has the flu. You can also catch the flu if you touch something with the virus on it, and then touch your mouth, nose, or eyes. People often confuse colds and flu. They are different, but you might have some of the same symptoms. Most people get a cold several times a year. On the contrary, people get the flu only once every few years. Sometimes, you can get a virus that makes you throw up or have diarrhea. Some people call this the \"stomach flu.\" This is a misleading name because this virus is not the actual flu. The flu mostly affects your nose, throat, and lungs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Flu?", "response": "Flu Shot (Summary): Summary Flu is a respiratory infection caused by a number of viruses. Most people with the flu get better on their own. But it can be serious. It can cause complications and sometimes even death. Getting the flu vaccine every year is the best way to lower your chance of getting the flu and spreading it to others. The flu vaccine causes antibodies to develop in your body about two weeks after you get it. These antibodies provide protection against infection with the viruses that are in the vaccine. There are different types of flu shots, including some especially for people 65 and older. Ask your health care provider which one is right for you. Everyone 6 months of age and older should get a flu vaccine every season. People with egg allergies should check with their doctors before getting a vaccine. Other exceptions are people who have - Had reactions to flu shots before - Guillain-Barre Syndrome - A fever Centers for Disease Control and Prevention. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Flu?", "response": "H1N1 Flu (Swine Flu) (Summary): Summary Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. In 2009 a strain of swine flu called H1N1 infected many people around the world. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. There are antiviral medicines you can take to prevent or treat swine flu. There is a vaccine available to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by - Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. - Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners. - Avoiding touching your eyes, nose or mouth. Germs spread this way. - Trying to avoid close contact with sick people. - Staying home from work or school if you are sick. Centers for Disease Control and Prevention. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Flu?", "response": "What are the symptoms of Flu?: Flu symptoms will often start quickly. You can start to feel sick about 1 to 7 days after you come in contact with the virus. Most of the time symptoms appear within 2 to 3 days. The flu spreads easily. It can affect a large group of people in a very short amount of time. For example, students and co-workers get sick within 2 or 3 weeks of the flu's arrival in a school or workplace. The first symptom is a fever between 102F (38C) and 106F (41.1C). An adult often has a lower fever than a child. Other common symptoms include: - Body aches - Chills - Dizziness - Flushed face - Headache - Lack of energy - Nausea and vomiting The fever, aches, and pains begin to go away on days 2 through 4. But new symptoms occur, including: - Dry cough - Increased symptoms that affect breathing - Runny nose (clear and watery) - Sneezing - Sore throat Most symptoms go away in 4 to 7 days. The cough and tired feeling may last for weeks. Sometimes, the fever comes back. Some people may not feel like eating. The flu can make asthma, breathing problems, and other long-term (chronic) illnesses and conditions worse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Flu?", "response": "Swine flu (H1N1 flu) (Symptoms): H1N1 flu signs and symptoms in humans are similar to those of other flu strains: - Fever (but not always) - Cough - Sore throat - Runny or stuffy nose - Watery, red eyes - Body aches - Headache - Fatigue - Diarrhea - Nausea and vomiting H1N1 flu symptoms develop about one to three days after you're exposed to the virus. When to see a doctor It's not necessary to see a doctor if you're generally healthy and develop flu signs and symptoms, such as fever, cough and body aches. Call your doctor, however, if you have flu symptoms and you're pregnant or you have a chronic disease, such as asthma, emphysema, diabetes or a heart condition, because you have a higher risk of complications from the flu. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Flu?", "response": "Symptoms and Causes of Diabetes (What are the symptoms of diabetes?): Symptoms of diabetes includeincreased thirst and urination increased hunger fatigue blurred vision numbness or tingling in the feet or hands sores that do not heal unexplained weight lossSymptoms of type 1 diabetes can start quickly, in a matter of weeks. Symptoms of type 2 diabetes often develop slowly—over the course of several years—and can be so mild that you might not even notice them. Many people with type 2 diabetes have no symptoms. Some people do not find out they have the disease until they have diabetes-related health problems, such as blurred vision or heart trouble. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Flu?", "response": "Influenza (flu) (Treatment): Usually, you'll need nothing more than bed rest and plenty of fluids to treat the flu. But in some cases, your doctor may prescribe an antiviral medication, such as oseltamivir (Tamiflu) or zanamivir (Relenza). If taken soon after you notice symptoms, these drugs may shorten your illness by a day or so and help prevent serious complications. Oseltamivir is an oral medication. Zanamivir is inhaled through a device similar to an asthma inhaler and shouldn't be used by anyone with respiratory problems, such as asthma and lung disease. Antiviral medication side effects may include nausea and vomiting. These side effects may be lessened if the drug is taken with food. Oseltamivir has also been associated with delirium and self-harm behaviors in teenagers. Some researchers recommend further study on both of these drugs because of uncertainty about their effects beyond a slight reduction in the time of illness. Some studies have suggested that these medications can also help reduce the severity of complications. The Centers for Disease Control and Prevention still recommends their use for some people. An additional concern is that some strains of influenza have become resistant to oseltamivir, amantadine and rimantadine (Flumadine), which are older antiviral drugs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Flu?", "response": "What are the treatments for Flu?: HOME CARE Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever. Providers sometimes suggest you to use both types of medicine. DO NOT use aspirin. A fever does not need to come all the way down to normal. Most people feel better when the temperature drops by 1 degree. Over-the-counter cold medicines may make some of your symptoms better. Cough drops or throat sprays will help with your sore throat. You will need a lot of rest. Drink plenty of liquids. DO NOT smoke or drink alcohol. ANTIVIRAL DRUGS Most people with milder symptoms feel better in 3 to 4 days. They do not need to see a provider or take antiviral medicines. Providers may give antiviral drugs to people who get very sick with the flu. You may need these medicines if you are more likely to have flu complications The health problems below may increase your risk of getting sicker with the flu: - Lung disease (including asthma) - Heart conditions (except high blood pressure) - Kidney, liver, nerve, and muscle conditions - Blood disorders (including sickle cell disease) - Diabetes - A weakened immune system due to diseases (such as AIDS), radiation therapy, or certain medicines, including chemotherapy and corticosteroids - Other long-term medical problem These medicines may shorten the time you have symptoms by about 1 day. They work better if you start taking them within 2 days of your first symptoms. Children at risk of a severe case of the flu may also need these medicines. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Flu?", "response": "Bird flu (avian influenza) (Treatment): Many influenza viruses have become resistant to the effects of a category of antiviral drugs that includes amantadine and rimantadine (Flumadine). Health officials recommend the use of oseltamivir (Tamiflu) or, if oseltamivir can't be used, zanamivir (Relenza). These drugs must be taken within two days after the appearance of symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Flu?", "response": "Influenza (flu) (Diagnosis): Your doctor will conduct a physical exam, look for signs and symptoms of influenza, and possibly order a test that detects influenza viruses. The most commonly used test is called a rapid influenza diagnostics test, which looks for substances (antigens) on a swab sample from the back of the nose or throat. These tests can provide results in 30 minutes or less. However, results vary greatly and are not always accurate. Your doctor may diagnose you with influenza based on symptoms, despite having a negative test result. More-sensitive flu tests are available in some specialized hospitals and labs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Flu?", "response": "How to diagnose Flu?: Most people do not need to see a health care provider when they have flu symptoms. This is because most people are not at risk for a severe case of the flu. If you are very sick with the flu, you may want to see your provider. People who are at high risk for flu complications may also want to see a provider if they get the flu. When many people in an area have flu, a provider can make a diagnosis after hearing about your symptoms. No further testing is needed. There is a test to detect the flu. It is done by swabbing the nose or throat. Most of the time, test results are available very fast. The test can help your provider prescribe the best treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Flu?", "response": "Bird flu (avian influenza) (Diagnosis): Laboratory tests Samples of fluids from your nose or throat can be tested for evidence of bird flu virus. These samples must be taken within the first few days after symptoms appear. Imaging tests X-rays may be useful in assessing the condition of your lungs, which can help determine the proper diagnosis and the best treatment options for your signs and symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Seasonal Affective Disorder ?", "response": "Seasonal affective disorder: Seasonal affective disorder (SAD) is a type of depression that occurs at a certain time of the year, usually in winter. SAD may begin during the teen years or in adulthood. Like other forms of depression, it occurs more often in women than in men. People who live in places with long winter nights are at high risk of developing SAD. A less common form of the disorder involves depression during the summer months. Symptoms usually build up slowly in the late autumn and winter months. Symptoms are often the same as with other forms of depression: - Hopelessness - Increased appetite with weight gain (weight loss is more common with other forms of depression) - Increased sleep (too little sleep is more common with other forms of depression) - Less energy and ability to concentrate - Loss of interest in work or other activities - Sluggish movements - Social withdrawal - Unhappiness and irritability SAD can sometimes become long-term depression. Bipolar disorder or thoughts of suicide are also possible. There is no test for SAD. Your health care provider can make a diagnosis by asking about your history of symptoms. Your provider may also perform a physical exam and blood tests to rule out other disorders that are similar to SAD. As with other types of depression, antidepressant medicines and talk therapy can be effective. MANAGING YOUR DEPRESSION AT HOME To manage your symptoms at home: - Get enough sleep. - Eat healthy foods. - Take medicines the right way. Ask your provider how to manage side effects. - Learn to watch for early signs that your depression is getting worse. Have a plan if it does get worse. - Try to exercise more often. Do activities that make you happy. DO NOT use alcohol or illegal drugs. These can make depression worse. They can also cause you to think about suicide. When you are struggling with depression, talk about how you are feeling with someone you trust. Try to be around people who are caring and positive. Volunteer or get involved in group activities. LIGHT THERAPY Your provider may prescribe light therapy. Light therapy uses a special lamp with a very bright light that mimics light from the sun: - Treatment is started in the fall or early winter, before the symptoms of SAD begin. - Follow your provider's instructions about how to use light therapy. One way that may be recommended is to sit a couple of feet (60 centimeters) away from the light box for about 30 minutes each day. This is often done in the early morning, to mimic sunrise. - Keep your eyes open, but do not look straight into the light source. If light therapy is going to help, symptoms of depression should improve within 3 to 4 weeks. Side effects of light therapy include: - Eye strain or headache - Mania (rarely) People who take medicines that make them more sensitive to light, such as certain psoriasis drugs, antibiotics, or antipsychotics, should not use light therapy. A checkup with your eye doctor is recommended before starting treatment. With no treatment, symptoms usually get better on their own with the change of seasons. Symptoms can improve more quickly with treatment. The outcome is usually good with treatment. But some people have SAD throughout their lives. Get medical help right away if you have thoughts of hurting yourself or anyone else. Updated by: Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Seasonal Affective Disorder ?", "response": "Seasonal affective disorder (SAD) (Causes): The specific cause of seasonal affective disorder remains unknown. Some factors that may come into play include: - Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. This decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression. - Serotonin levels. A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression. - Melatonin levels. The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Seasonal Affective Disorder ?", "response": "Seasonal affective disorder (SAD) (Risk factors): Seasonal affective disorder is diagnosed more often in women than in men. And SAD occurs more frequently in younger adults than in older adults. Factors that may increase your risk of seasonal affective disorder include: - Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression. - Having major depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions. - Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter and longer days during the summer months. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Seasonal Affective Disorder ?", "response": "What are the symptoms of Seasonal affective disorder?: Symptoms usually build up slowly in the late autumn and winter months. Symptoms are usually the same as with other forms of depression: - Hopelessness - Increased appetite with weight gain (weight loss is more common with other forms of depression) - Increased sleep (too little sleep is more common with other forms of depression) - Less energy and ability to concentrate - Loss of interest in work or other activities - Sluggish movements - Social withdrawal - Unhappiness and irritability SAD can sometimes become long-term depression. Bipolar disorder or thoughts of suicide are also possible. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Seasonal Affective Disorder ?", "response": "IMH » Seasonal Affective Disorder (Signs and Symptoms): Seasonal Affective Disorder (SAD) is not considered as a separate disorder. It is a type of depression displaying a recurring seasonal pattern. To be diagnosed with SAD, people must meet full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years. Seasonal depressions must be much more frequent than any non-seasonal depressions. Symptoms of Major Depression - Feeling depressed most of the day, nearly every day - Feeling hopeless or worthless - Having low energy - Losing interest in activities you once enjoyed - Having problems with sleep - Experiencing changes in your appetite or weight - Feeling sluggish or agitated - Having difficulty concentrating - Having frequent thoughts of death or suicide. Symptoms of the Winter Pattern of SAD include: - Having low energy - Hypersomnia - Overeating - Weight gain - Craving for carbohydrates - Social withdrawal (feel like “hibernating”) Symptoms of the less frequently occurring summer seasonal affective disorder include: - Poor appetite with associated weight loss - Insomnia - Agitation - Restlessness - Anxiety - Episodes of violent behavior. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Seasonal Affective Disorder ?", "response": "What are the treatments for Seasonal affective disorder?: As with other types of depression, antidepressant medicines and talk therapy can be effective. MANAGING YOUR DEPRESSION AT HOME To manage your symptoms at home: - Get enough sleep. - Eat healthy foods. - Take medicines the right way. Ask your provider how to manage side effects. - Learn to watch for early signs that your depression is getting worse. Have a plan if it does get worse. - Try to exercise more often. Do activities that make you happy. DO NOT use alcohol or illegal drugs. These can make depression worse. They can also cause you to think about suicide. When you are struggling with depression, talk about how you are feeling with someone you trust. Try to be around people who are caring and positive. Volunteer or get involved in group activities. LIGHT THERAPY Your provider may prescribe light therapy. Light therapy uses a special lamp with a very bright light that mimics light from the sun: - Treatment is started in the fall or early winter, before the symptoms of SAD begin. - Follow your provider's instructions about how to use light therapy. One way that may be recommended is to sit a couple of feet away from the light box for about 30 minutes each day. This is usually done in the early morning, to mimic sunrise. - Keep your eyes open, but do not look straight into the light source. If light therapy is going to help, symptoms of depression should improve within 3 to 4 weeks. Side effects of light therapy include: - Eye strain or headache - Mania (rarely) People who take medicines that make them more sensitive to light, such as certain psoriasis drugs, antibiotics, or antipsychotics, should not use light therapy. A checkup with your eye doctor is recommended before starting treatment. With no treatment, symptoms usually get better on their own with the change of seasons. Symptoms can improve more quickly with treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Seasonal Affective Disorder ?", "response": "Seasonal affective disorder (SAD) (Treatment): Treatment for seasonal affective disorder may include light therapy, medications and psychotherapy. If you have bipolar disorder, tell your doctor - this is critical to know when prescribing light therapy or an antidepressant. Both treatments can potentially trigger a manic episode. Light therapy In light therapy, also called phototherapy, you sit a few feet from a special light box so that you're exposed to bright light within the first hour of waking up each day. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks and causes few side effects. Research on light therapy is limited, but it appears to be effective for most people in relieving SAD symptoms. Before you purchase a light box, talk with your doctor about the best one for you, and familiarize yourself with the variety of features and options so that you buy a high-quality product that's safe and effective. Also ask your doctor about how and when to use the light box. Medications Some people with SAD benefit from antidepressant treatment, especially if symptoms are severe. An extended-release version of the antidepressant bupropion (Wellbutrin XL, Aplenzin) may help prevent depressive episodes in people with a history of SAD. Other antidepressants also may commonly be used to treat SAD. Your doctor may recommend starting treatment with an antidepressant before your symptoms typically begin each year. He or she may also recommend that you continue to take the antidepressant beyond the time your symptoms normally go away. Keep in mind that it may take several weeks to notice full benefits from an antidepressant. In addition, you may have to try different medications before you find one that works well for you and has the fewest side effects. Psychotherapy Psychotherapy, also called talk therapy, is another option to treat SAD. A type of psychotherapy known as cognitive behavioral therapy can help you: - Identify and change negative thoughts and behaviors that may be making you feel worse - Learn healthy ways to cope with SAD, especially with reducing avoidance behavior and scheduling activities - Learn how to manage stress Mind-body connection Examples of mind-body techniques that some people may choose to try to help cope with SAD include: - Relaxation techniques such as yoga or tai chi - Meditation - Guided imagery - Music or art therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Seasonal Affective Disorder ?", "response": "How to diagnose Seasonal affective disorder?: There is no test for SAD. Your health care provider can make a diagnosis by asking about your history of symptoms. Your provider may also perform a physical exam and blood tests to rule out other disorders that are similar to SAD. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Seasonal Affective Disorder ?", "response": "Seasonal affective disorder (SAD) (Diagnosis): Even with a thorough evaluation, it can sometimes be difficult for your doctor or mental health professional to diagnose seasonal affective disorder because other types of depression or other mental health conditions can cause similar symptoms. To help diagnose SAD, your doctor or mental health professional may do a thorough evaluation, which generally includes: - Physical exam. Your doctor may do a physical exam and ask in-depth questions about your health. In some cases, depression may be linked to an underlying physical health problem. - Lab tests. For example, your doctor may do a blood test called a complete blood count (CBC) or test your thyroid to make sure it's functioning properly. - Psychological evaluation. To check for signs of depression, your doctor or mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may fill out a questionnaire to help answer these questions. - DSM-5. Your mental health professional may use the criteria for seasonal depressive episodes listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Stroke?", "response": "What is Stroke?: There are two kinds of stroke. The most common kind of stroke is called ischemic stroke. It accounts for approximately 80 percent of all strokes. An ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind of stroke is called hemorrhagic stroke. A hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Stroke?", "response": "Stroke (What Is a Stroke?): A stroke happens when something changes how blood flows through the brain. Blood brings oxygen and nutrients to brain cells. If blood can't flow to a part of the brain, cells that do not receive enough oxygen suffer and eventually die. If brain cells are without oxygen for only a short time, they can sometimes get better. But brain cells that have died can't be brought back to life. So, someone who has had a stroke may have trouble speaking, thinking, or walking.There are two major types of stroke. The most common kind, ischemic, is caused by a blood clot or the narrowing of a blood vessel (an artery) leading to the brain. This keeps blood from flowing into other parts of the brain and keeps needed oxygen and nutrients from reaching brain cells. Blockages that cause ischemic strokes stem from three conditions:- Formation of a clot within a blood vessel of the brain or neck, called thrombosis - Movement of a clot from another part of the body, such as from the heart to the neck or brain, called an embolism - Severe narrowing of an artery (stenosis) in or leading to the brain, due to fatty deposits lining the blood vessel wallsIn the second major kind of stroke, hemorrhagic, a broken blood vessel causes bleeding in the brain. This break in the vessel also stops oxygen and nutrients from reaching brain cells.Sometimes the symptoms of a stroke last only a few minutes and then go away. That could be a transient ischemic attack (TIA), also called a mini-stroke. A TIA is a medical emergency. You should get medical help right away. If a TIA is not treated quickly, it could be followed within hours or days by a major disabling stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Stroke?", "response": "Stroke: A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. There are two forms of stroke: ischemic - blockage of a blood vessel supplying the brain, and hemorrhagic - bleeding into or around the brain. Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics. Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Stroke?", "response": "Ischemic Stroke (Summary): Summary A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually caused by a blood clot that blocks or plugs a blood vessel in the brain. This keeps blood from flowing to the brain. Within minutes, brain cells begin to die. Another cause is stenosis, or narrowing of the artery. This can happen because of atherosclerosis, a disease in which plaque builds up inside your arteries. Transient ischemic attacks (TIAs) occur when the blood supply to the brain is interrupted briefly. Having a TIA can mean you are at risk for having a more serious stroke. Symptoms of stroke are - Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) - Sudden confusion, trouble speaking or understanding speech - Sudden trouble seeing in one or both eyes - Sudden trouble walking, dizziness, loss of balance or coordination - Sudden severe headache with no known cause It is important to treat strokes as quickly as possible. Blood thinners may be used to stop a stroke while it is happening by quickly dissolving the blood clot. Post-stroke rehabilitation can help people overcome disabilities caused by stroke damage. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Stroke?", "response": "Stroke: A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. There are two forms of stroke: ischemic - blockage of a blood vessel supplying the brain, and hemorrhagic - bleeding into or around the brain. Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics. Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Stroke?", "response": "What causes Stroke?: Ischemic Stroke and Transient Ischemic Attack An ischemic stroke or transient ischemic attack (TIA) occurs if an artery that supplies oxygen-rich blood to the brain becomes blocked. Many medical conditions can increase the risk of ischemic stroke or TIA. For example, atherosclerosis (ath-er-o-skler-O-sis) is a disease in which a fatty substance called plaque builds up on the inner walls of the arteries. Plaque hardens and narrows the arteries, which limits the flow of blood to tissues and organs (such as the heart and brain). Plaque in an artery can crack or rupture (break open). Blood platelets (PLATE-lets), which are disc-shaped cell fragments, stick to the site of the plaque injury and clump together to form blood clots. These clots can partly or fully block an artery. Plaque can build up in any artery in the body, including arteries in the heart, brain, and neck. The two main arteries on each side of the neck are called the carotid (ka-ROT-id) arteries. These arteries supply oxygen-rich blood to the brain, face, scalp, and neck. When plaque builds up in the carotid arteries, the condition is called carotid artery disease. Carotid artery disease causes many of the ischemic strokes and TIAs that occur in the United States. An embolic stroke (a type of ischemic stroke) or TIA also can occur if a blood clot or piece of plaque breaks away from the wall of an artery. The clot or plaque can travel through the bloodstream and get stuck in one of the brains arteries. This stops blood flow through the artery and damages brain cells. Heart conditions and blood disorders also can cause blood clots that can lead to a stroke or TIA. For example, atrial fibrillation (A-tre-al fi-bri-LA-shun), or AF, is a common cause of embolic stroke. In AF, the upper chambers of the heart contract in a very fast and irregular way. As a result, some blood pools in the heart. The pooling increases the risk of blood clots forming in the heart chambers. An ischemic stroke or TIA also can occur because of lesions caused by atherosclerosis. These lesions may form in the small arteries of the brain, and they can block blood flow to the brain. Hemorrhagic Stroke Sudden bleeding in the brain can cause a hemorrhagic stroke. The bleeding causes swelling of the brain and increased pressure in the skull. The swelling and pressure damage brain cells and tissues. Examples of conditions that can cause a hemorrhagic stroke include high blood pressure, aneurysms, and arteriovenous (ar-TEER-e-o-VE-nus) malformations (AVMs). \"Blood pressure\" is the force of blood pushing against the walls of the arteries as the heart pumps blood. If blood pressure rises and stays high over time, it can damage the body in many ways. Aneurysms are balloon-like bulges in an artery that can stretch and burst. AVMs are tangles of faulty arteries and veins that can rupture within the brain. High blood pressure can increase the risk of hemorrhagic stroke in people who have aneurysms or AVMs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Stroke?", "response": "What are the symptoms of Stroke?: Warning signs are clues your body sends to tell you that your brain is not receiving enough oxygen. These are warning signs of a stroke, or brain attack: - sudden numbness or weakness of the face, arm, or leg, especially on one side of the body - sudden confusion, trouble speaking or understanding - sudden trouble seeing in one or both eyes - sudden trouble walking, dizziness, loss of balance or coordination - sudden severe headache with no known cause. sudden numbness or weakness of the face, arm, or leg, especially on one side of the body sudden confusion, trouble speaking or understanding sudden trouble seeing in one or both eyes sudden trouble walking, dizziness, loss of balance or coordination sudden severe headache with no known cause. If you observe one or more of these signs, don't wait. Call 911 right away!. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Stroke?", "response": "What are the symptoms of Stroke?: The signs and symptoms of a stroke often develop quickly. However, they can develop over hours or even days. The type of symptoms depends on the type of stroke and the area of the brain thats affected. How long symptoms last and how severe they are vary among different people. Signs and symptoms of a stroke may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache A transient ischemic attack (TIA) has the same signs and symptoms as a stroke. However, TIA symptoms usually last less than 12 hours (although they may last up to 24 hours). A TIA may occur only once in a persons lifetime or more often. At first, it may not be possible to tell whether someone is having a TIA or stroke. All stroke-like symptoms require medical care. If you think you or someone else is having a TIA or stroke, call 911 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts. Stroke Complications After youve had a stroke, you may develop other complications, such as: Blood clots and muscle weakness. Being immobile (unable to move around) for a long time can raise your risk of developing blood clots in the deep veins of the legs. Being immobile also can lead to muscle weakness and decreased muscle flexibility. Problems swallowing and pneumonia. If a stroke affects the muscles used for swallowing, you may have a hard time eating or drinking. You also may be at risk of inhaling food or drink into your lungs. If this happens, you may develop pneumonia. Loss of bladder control. Some strokes affect the muscles used to urinate. You may need a urinary catheter (a tube placed into the bladder) until you can urinate on your own. Use of these catheters can lead to urinary tract infections. Loss of bowel control or constipation also may occur after a stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Stroke?", "response": "What are the symptoms of Stroke?: Know the Signs Knowing the warning signs of stroke and controlling stroke's risk factors can lower your risk of death or disability. If you suffer a stroke, you may not realize it at first. The people around you might not know it, either. Your family, friends, or neighbors may think you are unaware or confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke and know how to act fast. Warning signs are clues your body sends to tell you that your brain is not receiving enough oxygen. If you observe one or more of the following signs of a stroke or \"brain attack,\" don't wait. Call 911 right away! Common Signs of Stroke These are warning signs of a stroke: - sudden numbness or weakness of the face, arm, or leg, especially on one side of the body - sudden confusion, trouble speaking or understanding - sudden trouble seeing in one or both eyes - sudden trouble walking, dizziness, loss of balance or coordination - sudden severe headache with no known cause. sudden numbness or weakness of the face, arm, or leg, especially on one side of the body sudden confusion, trouble speaking or understanding sudden trouble seeing in one or both eyes sudden trouble walking, dizziness, loss of balance or coordination sudden severe headache with no known cause. Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Don't Ignore \"Mini-Strokes\" Sometimes the warning signs of stroke may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks or TIAs, are sometimes called \"mini-strokes.\" Although brief, TIAs identify an underlying serious condition that isn't going away without medical help. Unfortunately, since they clear up, many people ignore them. Don't ignore them. Heeding them can save your life. Why It's Important To Act Fast Stroke is a medical emergency. Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save peoples lives and enhance their chances for successful recovery. Ischemic strokes, the most common type of strokes, can be treated with a drug called t-PA that dissolves blood clots obstructing blood flow to the brain. The window of opportunity to start treating stroke patients is three hours, but to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes. What Should You Do? Don't wait for the symptoms of stroke to improve or worsen. If you believe you are having a stroke, call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability and in greatly improving your chances for recovery. If you observe someone having a stroke if he or she suddenly loses the ability to speak, or move an arm or leg on one side, or experiences facial paralysis on one side call 911 immediately. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Stroke?", "response": "What are the treatments for Stroke?: Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Stroke?", "response": "Stroke (Treatment): A stroke is a medical emergency. Quick treatment is needed. Call 9-1-1 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. - If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. - To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: - Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) - Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol - Special procedures or surgery to relieve symptoms or prevent more strokes - Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Stroke?", "response": "What are the treatments for Stroke?: Medication or drug therapy is the most common treatment for stroke. The most popular kinds of drugs to prevent or treat stroke are antithrombotics -- which include antiplatelet agents and anticoagulants -- and thrombolytics. Antithrombotics prevent the formation of blood clots that can become stuck in an artery of the brain and cause strokes. - In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. In the case of stroke, doctors prescribe antiplatelet drugs mainly for prevention. The most widely known and used antiplatelet drug is aspirin. Other antiplatelet drugs include clopidogrel, ticlopidine, and dipyridamole. - Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Anticoagulants reduce the risk of stroke by reducing the clotting property of the blood. The most commonly used oral anticoagulants include warfarin, also known as Coumadin, dabigatran (Pradaxa) and rivaroxaban (Xarelto). Injectable anticoagulants include heparin, enoxaparin (Lovenox), and dalteparin (Fragmin). Thrombolytic drugs halt the stroke by dissolving the blood clot that is blocking blood flow to the brain. Ischemic strokes -- the most common kind -- can be treated with thrombolytic drugs. But a person needs to be at the hospital as soon as possible after symptoms start to be evaluated and receive treatment. A thrombolytic drug known as t-PA can be effective if a person receives it intravenously (in a vein) within 3 hours after his or her stroke symptoms have started. Because there is such a narrow time window for giving t-PA, it is important to note the time any stroke symptoms appear. Since thrombolytic drugs can increase bleeding, t-PA should be used only after the doctor is certain that the patient has suffered an ischemic and not a hemorrhagic stroke. Neuroprotectants are medications or other treatments that protect the brain from secondary injury caused by stroke. Although the FDA (Food and Drug Administration) has not approved any neuroprotectants for use in stroke at this time, many have been tested or are being tested in clinical trials. Cooling of the brain (hypothermia) is beneficial for improving neurological function after a cardiac arrest. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Stroke?", "response": "How to diagnose Stroke?: Doctors have several techniques and imaging tools to help diagnose stroke quickly and accurately. The first step in diagnosis is a short neurological examination, or an evaluation of the nervous system. When a possible stroke patient arrives at a hospital, a health care professional, usually a doctor or nurse, will ask the patient or a companion what happened and when the symptoms began. Blood tests, an electrocardiogram, and a brain scan such as computed tomography (CT) or magnetic resonance imaging (MRI) will often be done. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Stroke?", "response": "How to diagnose Stroke?: The doctor will do a physical exam to: - Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving. - Listen to the carotid arteries in the neck with a stethoscope for an abnormal sound, called a bruit, which is caused by abnormal blood flow. - Check for high blood pressure. You may have the following tests to help find the type, location, and cause of the stroke and rule out other problems: - Angiogram of the head to look for a blood vessel that is blocked or bleeding - Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed - Echocardiogram to see if the stroke could have been caused by a blood clot from the heart - Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain Other tests include: - Blood tests - Electrocardiogram (ECG) and heart rhythm monitoring. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Stroke?", "response": "Stroke (Diagnosing and Treating Stroke): A doctor will diagnose a stroke based on symptoms, medical history, and medical tests such as a CT scan. A CT scan is a test that lets doctors look closely at pictures of the brain.All strokes benefit from immediate medical treatment! But only people with ischemic stroke, the kind caused by a blood clot, can be helped by a drug called t-PA (tissue-plasminogen activator). This drug breaks up blood clots and can greatly lessen the damage caused by an ischemic stroke. Starting treatment with t-PA within 3 hours after an ischemic stroke is important to recovery. To be evaluated and receive treatment, patients need to get to the hospital within 60 minutes. Getting to a hospital right away allows time for a CT scan of the brain. This scan will show whether the clot-busting medicine is the right treatment choice.With stroke, treatment depends on the stage of the disease. There are three treatment stages for stroke: prevention, therapy immediately after stroke, and rehabilitation after stroke. Stroke therapies include medications, surgery, and rehabilitation.Medication or drug therapy is the most common treatment for stroke. The most popular kinds of drugs to prevent or treat stroke are antithrombotics--which include antiplatelet agents and anticoagulants--and thrombolytics. Thrombolytic drugs, like t-PA, halt the stroke by dissolving the blood clot that is blocking blood flow to the brain. Antithrombotics prevent the formation of blood clots that can become stuck in an artery of the brain and cause strokes.Surgery and vascular procedures can be used to prevent stroke, treat stroke, or repair damage to the blood vessels or malformations in and around the brain. These include angioplasty, stenting, and carotid endarterectomy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Breast Cancer?", "response": "Breast Cancer (Stages of Breast Cancer): - After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for breast cancer: - Stage 0 (carcinoma in situ) - Stage I - Stage II - Stage IIIA - Stage IIIB - Stage IIIC - Stage IV - The treatment of breast cancer depends partly on the stage of the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Breast Cancer?", "response": "What causes Breast cancer in men?: The cause of breast cancer is not clear. But there are risk factors that make breast cancer more likely in men: - Exposure to radiation - Higher estrogen levels due to factors such as heavy drinking, cirrhosis, obesity, and some medicines to treat prostate cancer - Heredity, such as a family history of breast cancer, mutated BRCA1 or BRCA2 gene, and certain genetic disorders, such as Klinefelter syndrome - Excess breast tissue (gynecomastia) - Age. Most men are diagnosed with breast cancer between ages 60 to 70. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Breast Cancer?", "response": "Familial breast cancer (Summary): Familial breast cancer is a cluster of breast cancer within a family. Most cases of breast cancer occur sporadically in people with little to no family history of the condition. Approximately 5-10% of breast cancer is considered \"hereditary\" and is thought to be caused by an inherited predisposition to breast cancer that is passed down through a family in an autosomal dominant manner. In some of these families, the underlying genetic cause is not known; however, many of these cases are caused by changes ( mutations ) in the BRCA1 , BRCA2, PTEN, TP53, CDH1, or STK11 genes (which are each associated with a unique hereditary cancer syndrome ). CHEK2 BRIP1 RAD51 ATM About 15-20% of women diagnosed with breast cancer have a significant family history of breast cancer (two or more first-degree or second-degree relatives with breast cancer) but have no identifiable mutation in a gene known to cause a hereditary predisposition to breast cancer. These clusters of breast cancer are likely due to a combination of gene(s) and other shared factors such as environment and lifestyle. [1] [2] [3] High-risk cancer screening and other preventative measures such as chemoprevention and/or prophylactic surgeries are typically recommended in women who have an increased risk for breast cancer based on their personal and/or family histories. [4]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Breast Cancer?", "response": "Breast cancer screening (Benefits and Risks of Screenings): When and how often to have a breast screening test is a choice you must make. Different expert groups do not fully agree on the best timing for screening. Before having a mammogram, talk to your provider about the pros and cons. Ask about: - Your risk for breast cancer. - Whether screening decreases your chance of dying from breast cancer. - Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it's discovered. Risks of screenings can include: - False-positive results. This occurs when a test shows cancer when there is none. This can lead to having more tests that also have risks. It can also cause anxiety. You may be more likely to have a false-positive result if you are younger, have a family history of breast cancer, have had breast biopsies in the past, or take hormones. - False-negative results. These are tests that come back normal even though there is cancer. Women who have false-negative results do not know they have breast cancer and delay treatment. - Exposure to radiation is a risk factor for breast cancer. Mammograms expose your breasts to radiation. - Overtreatment. Mammograms and MRIs may find slow-growing cancers. These are cancers that may not shorten your life. At this time, it is not possible to know which cancers will grow and spread, so when cancer is found it is usually treated. Treatment can cause serious side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Breast Cancer?", "response": "Breast cancer (Symptoms): Signs and symptoms of breast cancer may include: - A breast lump or thickening that feels different from the surrounding tissue - Change in the size, shape or appearance of a breast - Changes to the skin over the breast, such as dimpling - A newly inverted nipple - Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin - Redness or pitting of the skin over your breast, like the skin of an orange When to see a doctor If you find a lump or other change in your breast - even if a recent mammogram was normal - make an appointment with your doctor for prompt evaluation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Breast Cancer?", "response": "Breast cancer (Symptoms): Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don't have symptoms may be found earlier. As the cancer grows, symptoms may include: - Breast lump or lump in the armpit that is hard, has uneven edges, and usually does not hurt. - Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange. - Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus. In men, breast cancer symptoms include breast lump and breast pain and tenderness. Symptoms of advanced breast cancer may include: - Bone pain - Breast pain or discomfort - Skin ulcers - Swelling of the lymph nodes in the armpit (next to the breast with cancer) - Weight loss. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Breast Cancer?", "response": "Familial breast cancer (Symptoms): The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Breast carcinoma - Heterogeneous -. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Breast Cancer?", "response": "Breast Cancer (Treatment Option Overview): - There are different types of treatment for men with breast cancer. - Five types of standard treatment are used to treat men with breast cancer: - Surgery - Chemotherapy - Hormone therapy - Radiation therapy - Targeted therapy - Treatment for male breast cancer may cause side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Breast Cancer?", "response": "What are the treatments for Breast cancer in men?: Treatment options for breast cancer in men include: - Surgery to remove the breast, lymph nodes under the arm, the lining over chest muscles, and chest muscles, if needed - Radiation therapy after surgery to kill any remaining cancer cells and to target specific tumors - Chemotherapy to kill cancer cells that have spread to other parts of the body - Hormone therapy to block hormones that may help certain types of breast cancer grow During and after treatment, your provider may ask you to have more tests. This may include tests you had during diagnosis. The follow-up tests will show how the treatment is working. They will also show if the cancer comes back. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Breast Cancer?", "response": "Breast Cancer (Treatment Options by Stage): Early Stage Breast Cancer (Stage I and Stage II) Treatment of early-stage breast cancer (stage I and stage II) may include the following: - Modified radical mastectomy, if the breast cancer was diagnosed early in pregnancy. - Breast-conserving surgery followed by radiation therapy, if the breast cancer was diagnosed late in pregnancy. In pregnant women, radiation therapy is delayed until after the baby is born. - Modified radical mastectomy or breast-conserving surgery during pregnancy followed by chemotherapy after the first 3 months of pregnancy. Late Stage Breast Cancer (Stage III and Stage IV) Treatment of late-stage breast cancer (stage III and stage IV) may include the following: - Radiation therapy. - Chemotherapy. Radiation therapy and chemotherapy should not be given during the first 3 months of pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Breast Cancer?", "response": "Breast cancer (Diagnosis): Diagnosing breast cancer Tests and procedures used to diagnose breast cancer include: - Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities. - Mammogram. A mammogram is an X-ray of the breast. Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a screening mammogram, your doctor may recommend a diagnostic mammogram to further evaluate that abnormality. - Breast ultrasound. Ultrasound uses sound waves to produce images of structures deep within the body. Ultrasound may be used to determine whether a new breast lump is a solid mass or a fluid-filled cyst. - Removing a sample of breast cells for testing (biopsy). A biopsy is the only definitive way to make a diagnosis of breast cancer. During a biopsy, your doctor uses a specialized needle device guided by X-ray or another imaging test to extract a core of tissue from the suspicious area. Often, a small metal marker is left at the site within your breast so the area can be easily identified on future imaging tests. Biopsy samples are sent to a laboratory for analysis where experts determine whether the cells are cancerous. A biopsy sample is also analyzed to determine the type of cells involved in the breast cancer, the aggressiveness (grade) of the cancer, and whether the cancer cells have hormone receptors or other receptors that may influence your treatment options. - Breast magnetic resonance imaging (MRI). An MRI machine uses a magnet and radio waves to create pictures of the interior of your breast. Before a breast MRI, you receive an injection of dye. Unlike other types of imaging tests, an MRI doesn't use radiation to create the images. Other tests and procedures may be used depending on your situation. Staging breast cancer Once your doctor has diagnosed your breast cancer, he or she works to establish the extent (stage) of your cancer. Your cancer's stage helps determine your prognosis and the best treatment options. Complete information about your cancer's stage may not be available until after you undergo breast cancer surgery. Tests and procedures used to stage breast cancer may include: - Blood tests, such as a complete blood count - Mammogram of the other breast to look for signs of cancer - Breast MRI - Bone scan - Computerized tomography (CT) scan - Positron emission tomography (PET) scan Not all women will need all of these tests and procedures. Your doctor selects the appropriate tests based on your specific circumstances and taking into account new symptoms you may be experiencing. Breast cancer stages range from 0 to IV with 0 indicating cancer that is noninvasive or contained within the milk ducts. Stage IV breast cancer, also called metastatic breast cancer, indicates cancer that has spread to other areas of the body. Breast cancer staging also takes into account your cancer's grade; the presence of tumor markers, such as receptors for estrogen, progesterone and HER2; and proliferation factors. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Breast Cancer?", "response": "How to diagnose Breast cancer in men?: You health care provider will take your medical history and family medical history. You will have a physical exam and a breast exam. Your provider may order other tests, including: - A mammogram - Breast ultrasound - An MRI of the breast - An exam of any nipple discharge - A blood test to check for signs of cancer - If any of the tests suggest cancer, your provider will do a biopsy to check for cancer. If cancer is found, your provider will order other tests to find out: - How quickly the cancer might grow - How likely it is to spread - What treatments might be best - What are the chances that the cancer might come back The tests may include: - Chest X-ray, specifically to see if it has spread to the lungs - Bone scan - CT scan - PET scan - Sentinel lymph node biopsy to check if the cancer has spread to the lymph nodes The biopsy and other tests will be used to grade and stage the tumor. The results of those tests will help determine your treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Breast Cancer?", "response": "Recurrent breast cancer (Diagnosis): If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. Tests and procedures may include: - Imaging tests. What imaging tests you'll undergo will depend on your situation. Imaging tests may include a magnetic resonance imaging (MRI), computerized tomography (CT) scan, X-ray, bone scan or positron emission tomography (PET) scan. Not every person needs every test. Your doctor will determine which tests are most helpful in your particular situation. - Removing a sample of tissue for lab testing (biopsy). Your doctor may recommend a biopsy procedure to collect suspicious cells for testing. Working in a laboratory, a pathologist examines the cells and determines the types of cells involved. A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. Tests also show whether the cancer is sensitive to hormone treatment or targeted therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Heart Attack?", "response": "Heart attack - what to ask your doctor: A heart attack occurs when blood flow to a part of your heart is blocked for a period of time and a part of the heart muscle is damaged. It is also called a myocardial infarction (MI). Watch this video about: Coronary artery disease Angina is pain or pressure in the chest. It occurs when your heart muscle is not getting enough blood or oxygen. You may feel angina in your neck or jaw. Sometimes you may notice that you are short of breath. Below are some questions you may want to ask your health care provider to help you take care of yourself after a heart attack. What are the signs and symptoms that I am having angina? Will I always have the same symptoms? - What are the activities that can cause me to have angina? - How should I treat my chest pain or angina when it happens? - When should I call the doctor? - When should I call 911? How much activity is ok for me? - Can I walk around the house? Is it ok to go up and down stairs? When can I start light housework or cooking? How much can I lift or carry? How much sleep do I need? - Which activities are better to start with? Are there activities that are not safe for me? - Is it safe for me to exercise on my own? Should I exercise inside or outside? - How long and how hard can I exercise? Do I need to have a stress test? Do I need to go to a cardiac rehabilitation program? When can I return to work? Are there limits on what I can do at work? What should I do if I feel sad or very worried about my heart disease? How can I change the way I live to make my heart healthier? - What is a heart-healthy diet? Is it ok to ever eat something that is not heart healthy? How can I make heart-healthy choices when I go eat out? - Is it OK to drink alcohol? How much? - Is it OK to be around other people who are smoking? - Is my blood pressure normal? - What is my cholesterol? Do l need to take medicines for it? Is it OK to be sexually active? Is it safe to use sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) for erection problems? What medicines am I taking to treat angina? - Do they have any side effects? - What should I do if I miss a dose? - Is it ever safe to stop taking any of these medicines on my own? If I am taking a blood thinner such as aspirin, clopidogrel (Plavix), can I use medicines such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) for arthritis, headaches, or other pain problems? Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Heart Attack?", "response": "Heart attack (Causes): A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks. During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery. Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Heart Attack?", "response": "What causes Heart attack first aid?: A heart attack occurs when the blood flow that carries oxygen to the heart is blocked. The heart muscle becomes starved for oxygen and begins to die. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Heart Attack?", "response": "Heart attack (Symptoms): A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away. - DO NOT try to drive yourself to the hospital. - DO NOT WAIT. You are at greatest risk of sudden death in the early hours of a heart attack. Chest pain is the most common symptom of a heart attack. - You may feel the pain in only one part of your body OR - Pain may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back The pain can be severe or mild. It can feel like: - A tight band around the chest - Bad indigestion - Something heavy sitting on your chest - Squeezing or heavy pressure The pain most often lasts longer than 20 minutes. Rest and a medicine to relax the blood vessels (called nitroglycerin) may not completely relieve the pain of a heart attack. Symptoms may also go away and come back. Other symptoms of a heart attack can include: - Anxiety - Cough - Fainting - Lightheadedness, dizziness - Nausea and vomiting - Palpitations (feeling like your heart is beating too fast or irregularly) - Shortness of breath - Sweating, which may be very heavy Some people (the older adults, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms such as shortness of breath, fatigue, and weakness. A \"silent heart attack\" is a heart attack with no symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Heart Attack?", "response": "Heart Attack (Signs and Symptoms): Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies. In one study, for example, one-third of the patients who had heart attacks had no chest pain. These patients were more likely to be older, female, or diabetic. The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they've had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one. It is important for you to know the most common symptoms of a heart attack and also remember these facts: Heart attacks can start slowly and cause only mild pain or discomfort. Symptoms can be mild or more intense and sudden. Symptoms also may come and go over several hours. People who have high blood sugar (diabetes) may have no symptoms or very mild ones. The most common symptom, in both men and women, is chest pain or discomfort. Women are somewhat more likely to have shortness of breath, nausea and vomiting, unusual tiredness (sometimes for days), and pain in the back, shoulders, and jaw. Some people don't have symptoms at all. Heart attacks that occur without any symptoms or with very mild symptoms are called silent heart attacks. Most Common Symptoms The most common warning symptoms of a heart attack for both men and women are: Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest. The discomfort usually lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion. The feeling can be mild or severe. Upper body discomfort. You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button). Shortness of breath. This may be your only symptom, or it may occur before or along with chest pain or discomfort. It can occur when you are resting or doing a little bit of physical activity. The symptoms of angina (an-JI-nuh or AN-juh-nuh) can be similar to the symptoms of a heart attack. Angina is chest pain that occurs in people who have coronary heart disease, usually when they're active. Angina pain usually lasts for only a few minutes and goes away with rest. Chest pain or discomfort that doesn't go away or changes from its usual pattern (for example, occurs more often or while you're resting) can be a sign of a heart attack. All chest pain should be checked by a doctor. Other Common Signs and Symptoms Pay attention to these other possible symptoms of a heart attack: Breaking out in a cold sweat Feeling unusually tired for no reason, sometimes for days (especially if you are a woman) Nausea (feeling sick to the stomach) and vomiting Light-headedness or sudden dizziness Any sudden, new symptoms or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual) Not everyone having a heart attack has typical symptoms. If you've already had a heart attack, your symptoms may not be the same for another one. However, some people may have a pattern of symptoms that recur. The more signs and symptoms you have, the more likely it is that you're having a heart attack. Quick Action Can Save Your Life: Call 9–1–1 The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowly—sometimes within hours, days, or weeks of a heart attack. Any time you think you might be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 9–1–1 for emergency medical care, even if you are not sure whether you're having a heart attack. Here's why: Acting fast can save your life. An ambulance is the best and safest way to get to the hospital. Emergency medical services (EMS) personnel can check how you are doing and start life-saving medicines and other treatments right away. People who arrive by ambulance often receive faster treatment at the hospital. The 9–1–1 operator or EMS technician can give you advice. You might be told to crush or chew an aspirin if you're not allergic, unless there is a medical reason for you not to take one. Aspirin taken during a heart attack can limit the damage to your heart and save your life. Every minute matters. Never delay calling 9–1–1 to take aspirin or do anything else you think might help. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Heart Attack?", "response": "What are the treatments for Heart Attack?: There are many medicines that are used to treat a heart attack. - Clot-busters or thrombolytic drugs dissolve blood clots that are blocking blood flow to the heart. - Beta blockers decrease the workload on your heart by slowing your heart rate. - Angiotensin-converting enzyme (ACE) inhibitors lower your blood pressure and reduce the strain on your heart. - Nitrates, such as nitroglycerin relax blood vessels and relieve chest pain. - Anticoagulants thin the blood and prevent clots from forming in your arteries. - Antiplatelet medications, such as aspirin and clopidogrel, stop platelets from clumping together to form clots. These medications are given to people who have had a heart attack, have angina, or have had angioplasty. Clot-busters or thrombolytic drugs dissolve blood clots that are blocking blood flow to the heart. Beta blockers decrease the workload on your heart by slowing your heart rate. Angiotensin-converting enzyme (ACE) inhibitors lower your blood pressure and reduce the strain on your heart. Nitrates, such as nitroglycerin relax blood vessels and relieve chest pain. Anticoagulants thin the blood and prevent clots from forming in your arteries. Antiplatelet medications, such as aspirin and clopidogrel, stop platelets from clumping together to form clots. These medications are given to people who have had a heart attack, have angina, or have had angioplasty. Doctors may also prescribe medicines to relieve pain and anxiety, or to treat irregular heart rhythms which often occur during a heart attack. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Heart Attack?", "response": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Heart Attack?", "response": "How to diagnose Heart Attack?: Several tests are used to diagnose a heart attack. - An electrocardiogram, also called an EKG, measures the rate and regularity of your heartbeat. - Blood tests identify and measure markers in the blood that can show how much damage was done to your heart. These tests are often repeated at specific time periods to check for changes. - A nuclear heart scan uses radioactive tracers to show damage to heart chambers and major blood vessels. - Cardiac catheterization involves passing a thin flexible tube through an artery in your groin or arm to look at your coronary arteries. It allows your doctor to examine the blood flow in your heart's chambers. - Cardiac angiography is usually performed along with cardiac catheterization, using a dye injected through the cardiac catheter. The dye allows the doctor to see where there may be blockages in the coronary arteries. An electrocardiogram, also called an EKG, measures the rate and regularity of your heartbeat. Blood tests identify and measure markers in the blood that can show how much damage was done to your heart. These tests are often repeated at specific time periods to check for changes. A nuclear heart scan uses radioactive tracers to show damage to heart chambers and major blood vessels. Cardiac catheterization involves passing a thin flexible tube through an artery in your groin or arm to look at your coronary arteries. It allows your doctor to examine the blood flow in your heart's chambers. Cardiac angiography is usually performed along with cardiac catheterization, using a dye injected through the cardiac catheter. The dye allows the doctor to see where there may be blockages in the coronary arteries. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Heart Attack?", "response": "How to diagnose Heart Attack?: Your doctor will diagnose a heart attack based on your signs and symptoms, your medical and family histories, and test results. Diagnostic Tests EKG (Electrocardiogram) An EKG is a simple, painless test that detects and records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through each part of the heart. An EKG can show signs of heart damage due to coronary heart disease (CHD) and signs of a previous or current heart attack. Blood Tests During a heart attack, heart muscle cells die and release proteins into the bloodstream. Blood tests can measure the amount of these proteins in the bloodstream. Higher than normal levels of these proteins suggest a heart attack. Commonly used blood tests include troponin tests, CK or CKMB tests, and serum myoglobin tests. Blood tests often are repeated to check for changes over time. Coronary Angiography Coronary angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the insides of your coronary arteries. This test often is done during a heart attack to help find blockages in the coronary arteries. To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization (KATH-e-ter-ih-ZA-shun). A thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream. Special x rays are taken while the dye is flowing through the coronary arteries. The dye lets your doctor study the flow of blood through the heart and blood vessels. If your doctor finds a blockage, he or she may recommend a procedure calledpercutaneous (per-ku-TA-ne-us) coronary intervention (PCI), sometimes referred to ascoronary angioplasty(AN-jee-oh-plas-tee). This procedure can help restore blood flow through a blocked artery. Sometimes a small mesh tube called a stent is placed in the artery to help prevent blockages after the procedure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Heart Attack?", "response": "How to diagnose Heart Attack?: If You Have Symptoms, Call 9-1-1 Diagnosis and treatment of a heart attack can begin when emergency personnel arrive after you call 9-1-1. Do not put off calling 9-1-1 because you are not sure that you are having a heart attack. Call within 5 minutes of the start of symptoms. At the hospital emergency room, doctors will work fast to find out if you are having or have had a heart attack. They will consider your symptoms, medical and family history, and test results. Initial tests will be quickly followed by treatment if you are having a heart attack. Diagnostic Tests - an electrocardiogram - blood tests - nuclear heart scan - cardiac catheterization - and coronary angiography. an electrocardiogram blood tests nuclear heart scan cardiac catheterization and coronary angiography. The electrocardiogram, also known as ECG or EKG, is used to measure the rate and regularity of your heartbeat. Blood tests are also used in diagnosing a heart attack. When cells in the heart die, they release enzymes into the blood. They are called markers or biomarkers. Measuring the amount of these markers in the blood can show how much damage was done to your heart. Doctors often repeat these tests to check for changes. The nuclear heart scan uses radioactive tracers to outline the heart chambers and major blood vessels leading to and from the heart. A nuclear heart scan shows any damage to your heart muscle as well as how well blood flows to and from the heart. In cardiac catheterization, a thin, flexible tube is passed through an artery in your groin or arm to reach the coronary arteries. This test allows your doctor to - determine blood pressure and flow in the heart's chambers - collect blood samples from the heart, and - examine the arteries of the heart by x-ray. determine blood pressure and flow in the heart's chambers collect blood samples from the heart, and examine the arteries of the heart by x-ray. Coronary angiography is usually done with the cardiac catheterization. A dye that can be seen on an x-ray is injected through the catheter into the coronary arteries. It shows where there are blockages and how severe they are. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Dementia?", "response": "What is Dementia?: Dementia is the name for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do normal activities, such as getting dressed or eating. They may lose their ability to solve problems or control their emotions. Their personalities may change. They may become agitated or see things that are not there. Memory loss is a common symptom of dementia. However, memory loss by itself does not mean you have dementia. People with dementia have serious problems with two or more brain functions, such as memory and language. Although dementia is common in very elderly people, it is not part of normal aging. Many different diseases can cause dementia, including Alzheimer's disease and stroke. Drugs are available to treat some of these diseases. While these drugs cannot cure dementia or repair brain damage, they may improve symptoms or slow down the disease. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Dementia?", "response": "What is Dementia?: Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness. Some of the diseases that can cause symptoms of dementia are Alzheimers disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntingtons disease, and Creutzfeldt-Jakob disease. Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brains oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Dementia?", "response": "Dementia (WHAT IS DEMENTIA?): Dementia is the loss of cognitive functioning-thinking, remembering, and reasoning-and behavioral abilities to such an extent that it interferes with a person's daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person's functioning, to the most severe stage, when the person must depend completely on others for basic activities of living.Signs and symptoms of dementia result when once-healthy neurons (nerve cells) in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.While dementia is more common as people grow older (up to half of all people age 85 or older may have some form of dementia), it is not a normal part of aging. Many people live into their 90s and beyond without any signs of dementia. One type of dementia, frontotemporal disorders, is more common in middle-aged than older adults.Memory loss, though common, is not the only sign of dementia. For a person to have dementia, he or she must have:- Two or more core mental functions that are impaired. These functions include memory, language skills, visual perception, and the ability to focus and pay attention. These also include cognitive skills such as the ability to reason and solve problems. - A loss of brain function severe enough that a person cannot do normal, everyday tasksIn addition, some people with dementia cannot control their emotions. Their personalities may change. They can have delusions, which are strong beliefs without proof, such as the idea that someone is stealing from them. They also may hallucinate, seeing or otherwise experiencing things that are not real.The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia-a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer's disease and vascular dementia.Learn more about dementia from MedlinePlus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Dementia?", "response": "What causes Dementia?: Dementia usually occurs in older age. It is rare in people under age 60. The risk of dementia increases as a person gets older. Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer disease is the most common type of dementia. Another common type of dementia is vascular dementia. It is caused by many small strokes. Lewy body disease is a common cause of dementia in the elderly. People with this condition have abnormal protein structures in certain areas of the brain. The following medical conditions can also lead to dementia: - Huntington disease - Brain injury - Multiple sclerosis - Infections such as HIV/AIDS, syphilis,and Lyme disease - Parkinson disease - Pick disease - Progressive supranuclear palsy Some causes of dementia may be stopped or reversed if they are found soon enough, including: - Brain injury - Brain tumors - Chronic alcohol abuse - Changes in blood sugar, sodium, and calcium levels (dementia due to metabolic causes) - Low vitamin B12 level - Normal pressure hydrocephalus - Use of certain medicines, including cimetidine and some cholesterol drugs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Dementia?", "response": "Dementia (Definition): Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness. Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease. Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Dementia?", "response": "Frontotemporal dementia (Related Diseases): The following diseases are related to Frontotemporal dementia. If you have a question about any of these diseases, you can contact GARD. Pick's disease Primary progressive aphasia Semantic dementia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Dementia?", "response": "Dementia (Symptoms): Dementia symptoms vary depending on the cause, but common signs and symptoms include: Cognitive changes - Memory loss, which is usually noticed by a spouse or someone else - Difficulty communicating or finding words - Difficulty reasoning or problem-solving - Difficulty handling complex tasks - Difficulty with planning and organizing - Difficulty with coordination and motor functions - Confusion and disorientation Psychological changes - Personality changes - Depression - Anxiety - Inappropriate behavior - Paranoia - Agitation - Hallucinations When to see a doctor See a doctor if you or a loved one has memory problems or other dementia symptoms. Some treatable medical conditions can cause dementia symptoms, so it's important to determine the underlying cause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Dementia?", "response": "Dementia (Symptoms): Dementia symptoms include difficulty with many areas of mental function, including: - Emotional behavior or personality - Language - Memory - Perception - Thinking and judgment (cognitive skills) Dementia usually first appears as forgetfulness. Mild cognitive impairment (MCI) is the stage between normal forgetfulness due to aging and the development of dementia. People with MCI have mild problems with thinking and memory that do not interfere with daily activities. They often know about their forgetfulness. Not everyone with MCI develops dementia. Symptoms of MCI include: - Difficulty doing more than one task at a time - Difficulty solving problems or making decisions - Forgetting recent events or conversations - Taking longer to do more difficult mental activities Early symptoms of dementia can include: - Difficulty with tasks that take some thought, but that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines - Getting lost on familiar routes - Language problems, such as trouble with the names of familiar objects - Losing interest in things previously enjoyed, flat mood - Misplacing items - Personality changes and loss of social skills, which can lead to inappropriate behaviors As dementia becomes worse, symptoms are more obvious and interfere with the ability to take care of oneself. Symptoms may include: - Change in sleep patterns, often waking up at night - Difficulty with basic tasks, such as preparing meals, choosing proper clothing, or driving - Forgetting details about current events - Forgetting events in one's own life history, losing self-awareness - Having hallucinations, arguments, striking out, and violent behavior - Having delusions, depression, agitation - More difficulty reading or writing - Poor judgment and loss of ability to recognize danger - Using the wrong word, not pronouncing words correctly, speaking in confusing sentences - Withdrawing from social contact People with severe dementia can no longer: - Perform basic activities of daily living, such as eating, dressing, and bathing - Recognize family members - Understand language Other symptoms that may occur with dementia: - Problems controlling bowel movements or urine - Swallowing problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Dementia?", "response": "Vascular dementia (Symptoms): Symptoms of VaD may develop gradually or may progress after each small stroke. Symptoms may begin suddenly after each stroke. Some people with VaD may improve for short periods, but decline after having more silent strokes. Early symptoms of dementia can include: - Difficulty performing tasks that used to come easily, such as balancing a checkbook, playing games (such as bridge), and learning new information or routines - Getting lost on familiar routes - Language problems, such as trouble finding the name of familiar objects - Losing interest in things you previously enjoyed, flat mood - Misplacing items - Personality changes and loss of social skills As dementia worsens, symptoms are more obvious and the ability to take care of oneself declines. Symptoms may include: - Change in sleep patterns, often waking up at night - Difficulty doing basic tasks, such as preparing meals, choosing proper clothing, or driving - Forgetting details about current events - Forgetting events in your own life history, losing awareness of who you are - Having delusions, depression, or agitation - Having hallucinations, arguments, striking out, or violent behavior - Having more difficulty reading or writing - Having poor judgment and loss of ability to recognize danger - Using the wrong word, not pronouncing words correctly, or speaking in confusing sentences - Withdrawing from social contact Nervous system (neurologic) problems that occur with a stroke may also be present. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Dementia?", "response": "What are the treatments for Dementia?: Drugs to specifically treat Alzheimers disease and some other progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can improve symptoms and slow the progression of the disease. This may improve an individuals quality of life, ease the burden on caregivers, or delay admission to a nursing home. Many researchers are also examining whether these drugs may be useful for treating other types of dementia. Many people with dementia, particularly those in the early stages, may benefit from practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, people can sometimes be taught to use memory aids, such as mnemonics, computerized recall devices, or note taking. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Dementia?", "response": "What are the treatments for Dementia?: Treatment depends on the condition causing the dementia. Some people may need to stay in the hospital for a short time. Sometimes, dementia medicine can make a patient's confusion worse. Stopping or changing these medicines is part of the treatment. Certain mental exercises can help with dementia. Treating conditions that can lead to confusion often greatly improve mental function. Such conditions include: - Anemia - Congestive heart failure - Decreased blood oxygen (hypoxia) - Depression - Heart failure - Infections - Nutritional disorders - Thyroid disorders Medicines may be used to: - Slow the rate at which symptoms get worse, though improvement with these drugs may be small - Control problems with behavior, such as loss of judgment or confusion Someone with dementia will need support in the homeas the disease gets worse. Family members or other caregivers can help by helping the person cope with memory lossand behavior and sleep problems. It is important to make sure the homes of people who have dementia are safe for them. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Dementia?", "response": "Dementia (Treatment): Most types of dementia can't be cured, but there are ways to manage your symptoms. Medications The following are used to temporarily improve dementia symptoms. - Cholinesterase inhibitors. These medications - including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) - work by boosting levels of a chemical messenger involved in memory and judgment. Although primarily used to treat Alzheimer's disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson's disease dementia and Lewy body dementia. Side effects can include nausea, vomiting and diarrhea. - Memantine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor. A common side effect of memantine is dizziness. - Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation. Therapies Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as: - Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior; and prepare you for the dementia progression. - Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders. - Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Dementia?", "response": "How to diagnose Dementia?: A skilled health care provider can often diagnose dementia using the following: - Complete physical exam, including nervous system exam - Asking about the person's medical history and symptoms - Mental function tests (mental status examination) Other tests may be ordered to find out if other problems may be causing dementia or making it worse. These conditions include: - Anemia - Brain tumor - Chronic infection - Intoxication from medicines - Severe depression - Thyroid disease - Vitamin deficiency The following tests and procedures may be done: - B12 level - Blood ammonia levels - Blood chemistry (chem-20) - Blood gas analysis - Cerebrospinal fluid (CSF) analysis - Drug or alcohol levels (toxicology screen) - Electroencephalograph (EEG) - Head CT - Mental status test - MRI of head - Thyroid function tests, including thyroid stimulating hormone (TSH) - Thyroid stimulating hormone level - Urinalysis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Dementia?", "response": "Dementia (Diagnosis): Diagnosing dementia and determining what type it is can be challenging. A diagnosis of dementia requires that at least two core mental functions be impaired enough to interfere with daily living. They are memory, language skills, ability to focus and pay attention, ability to reason and problem-solve, and visual perception. Your doctor will review your medical history and symptoms and conduct a physical examination. He or she will likely ask someone close to you about your symptoms, as well. No single test can diagnose dementia, so doctors are likely to run a number of tests that can help pinpoint the problem. Cognitive and neuropsychological tests Doctors will evaluate your thinking (cognitive) function. A number of tests measure thinking skills such as memory, orientation, reasoning and judgment, language skills, and attention. Neurological evaluation Doctors evaluate your memory, language, visual perception, attention, problem-solving, movement, senses, balance, reflexes and other areas. Brain scans - CT or MRI. These scans can check for evidence of stroke or bleeding or tumor or hydrocephalus. - PET scans. These can show patterns of brain activity and if the amyloid protein, a hallmark of Alzheimer's disease, has been deposited in the brain. Laboratory tests Simple blood tests can detect physical problems that can affect brain function, such as vitamin B-12 deficiency or an underactive thyroid gland. Sometimes the spinal fluid is examined for infection, inflammation or markers of some degenerative diseases. Psychiatric evaluation A mental health professional can determine whether depression or another mental health condition is contributing to your symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Dementia?", "response": "Frontotemporal dementia (Diagnosis): Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. Orphanet lists international laboratories offering diagnostic testing for this condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is COPD?", "response": "What is COPD?: COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include - A cough that produces a lot of mucus - Shortness of breath, especially with physical activity - Wheezing - Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD. NIH: National Heart, Lung, and Blood Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is COPD?", "response": "What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The \"airways\" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band. - The walls between many of the air sacs are destroyed. - The walls of the airways become thick and inflamed or swollen. - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is COPD?", "response": "COPD: Español Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airways. Within the lungs, your bronchial tubes branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called capillaries run along the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, a waste product, called carbon dioxide (CO2) gas, moves from the capillaries into the air sacs. This process, called gas exchange, brings in oxygen for the body to use for vital functions and removes the CO2. The airways and air sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual and can become clogged. Normal Lungs and Lungs With COPD In the United States, the term COPD includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate. Outlook COPD is a major cause of disability, and it is the third leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older adults. The disease is not contagious, meaning it cannot be passed from person to person. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes COPD?", "response": "COPD (Summary): Summary COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include - A cough that produces a lot of mucus - Shortness of breath, especially with physical activity - Wheezing - Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD. NIH: National Heart, Lung, and Blood Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes COPD?", "response": "COPD (Causes): Long-term exposure to lung irritants that damage the lungs and the airways usually is the cause of COPD. In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Breathing in secondhand smoke, which is in the air from other people smoking; air pollution; or chemical fumes or dusts from the environment or workplace also can contribute to COPD. Rarely, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low blood levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you are exposed to smoke or other lung irritants. If you have alpha-1 antitrypsin deficiency and also smoke, COPD can worsen very quickly. Some people who have asthma can develop COPD. Asthma is a chronic lung disease that inflames and narrows the airways. Treatment usually can reverse the inflammation and narrowing that occurs in asthma. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes COPD?", "response": "COPD (Overview): Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke. People with COPD are at increased risk of developing heart disease, lung cancer and a variety of other conditions. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. Chronic bronchitis is inflammation of the lining of the bronchial tubes, which carry air to and from the air sacs (alveoli) of the lungs. It's characterized by daily cough and mucus (sputum) production. Emphysema is a condition in which the alveoli at the end of the smallest air passages (bronchioles) of the lungs are destroyed as a result of damaging exposure to cigarette smoke and other irritating gases and particulate matter. COPD is treatable. With proper management, most people with COPD can achieve good symptom control and quality of life, as well as reduced risk of other associated conditions. COPD care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of COPD?", "response": "COPD (Symptoms): COPD symptoms often don't appear until significant lung damage has occurred, and they usually worsen over time, particularly if smoking exposure continues. For chronic bronchitis, the main symptom is a daily cough and mucus (sputum) production at least three months a year for two consecutive years. Other signs and symptoms of COPD may include: - Shortness of breath, especially during physical activities - Wheezing - Chest tightness - Having to clear your throat first thing in the morning, due to excess mucus in your lungs - A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish - Blueness of the lips or fingernail beds (cyanosis) - Frequent respiratory infections - Lack of energy - Unintended weight loss (in later stages) - Swelling in ankles, feet or legs People with COPD are also likely to experience episodes called exacerbations, during which their symptoms become worse than usual day-to-day variation and persist for at least several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of COPD?", "response": "COPD (Signs and Symptoms): At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. Common signs and symptoms of COPD include: An ongoing cough or a cough that produces a lot of mucus; this is often called smoker's cough. Shortness of breath, especially with physical activity Wheezing or a whistling or squeaky sound when you breathe Chest tightness If you have COPD, you also may often have colds or other respiratory infections such as the flu, or influenza. Not everyone who has the symptoms described above has COPD. Likewise, not everyone who has COPD has these symptoms. Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. Your doctor can determine if you have COPD. If your symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs. Over time, symptoms may become severe enough to cause you to see a doctor. For example, you may become short of breath during physical exertion. The severity of your symptoms will depend on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. Severe COPD can cause other symptoms, such as swelling in your ankles, feet, or legs; weight loss; and lower muscle endurance. Some severe symptoms may require treatment in a hospital. You—or, if you are unable, family members or friends—should seek emergency care if you are experiencing the following: You are having a hard time catching your breath or talking. Your lips or fingernails turn blue or gray, a sign of a low oxygen level in your blood. People around you notice that you are not mentally alert. Your heartbeat is very fast. The recommended treatment for symptoms that are getting worse is not working. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of COPD?", "response": "What are the symptoms of COPD?: Common Symptoms The most common symptoms of COPD are - a cough that does not go away - coughing up lots of sputum (mucus). a cough that does not go away coughing up lots of sputum (mucus). These symptoms often start years before the flow of air in and out of the lungs is reduced. Not everyone who has a cough and sputum goes on to develop COPD. Other common symptoms of COPD include - shortness of breath while doing activities you used to be able to do - wheezing (a whistling sound when you breathe) - tightness in the chest. shortness of breath while doing activities you used to be able to do wheezing (a whistling sound when you breathe) tightness in the chest. Getting a Diagnosis Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. If your doctor thinks you may have COPD, he or she will examine you, listen to your lungs, and ask you questions about your medical history, and what lung irritants you may have been around for long periods of time. The Spirometry Test To confirm a diagnosis of COPD, your doctor will use a breathing test called spirometry. The test is easy and painless and shows how much air you can breathe out and measures how fast you can breathe it out. In a spirometry test, you breathe hard into a large hose connected to a machine called a spirometer. When you breathe out, the spirometer measures how much air your lungs can hold and how fast you can blow air out of your lungs. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Determining COPD Severity Based on this test, your doctor can determine if you have COPD and how severe it is. There are four levels of severity for COPD: - people at risk for COPD - people with mild COPD - people with moderate COPD - people with severe COPD. people at risk for COPD people with mild COPD people with moderate COPD people with severe COPD. People at risk for developing COPD have a normal breathing test and mild symptoms such as chronic cough and sputum (mucus) production. People with mild COPD have mild breathing limitation. Symptoms may include a chronic cough and sputum (mucus) production. At this stage, you may not be aware that airflow in your lungs is reduced. People with moderate COPD have a breathing test that shows worsening airflow blockages. Symptoms may be worse than with mild COPD and you may experience shortness of breath while working hard, walking fast, or doing brisk activity. At this stage, you would seek medical attention. People with severe COPD have a breathing test that shows severe limitation of the airflow. People with severe COPD will be short of breath after just a little activity. In very severe COPD, complications like respiratory failure or signs of heart failure may develop. At this stage, quality of life is impaired and worsening symptoms may be life-threatening. Other Tests Other tests are used to rule out other causes of the symptoms. - Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. Bronchodilator reversibility testing uses the spirometer and medications called bronchodilators to assess whether breathing problems may be caused by asthma. - A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. A chest X-ray or a chest CT scan may also be ordered by your doctor. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. - An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. An arterial blood gas test is another test that is used. This blood test shows the oxygen level in the blood to see how severe your COPD is and whether you need oxygen therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of COPD?", "response": "Chronic obstructive pulmonary disease (Treatment): There is no cure for COPD. But there are many things you can do to relieve symptoms and keep the disease from getting worse. If you smoke, now is the time to quit. This is the best way to slow lung damage. Medicines used to treat COPD include: - Inhalers (bronchodilators) COPD -- quick-relief drugs to help open the airways - Inhaled COPD -- control drugs or oral steroids to reduce lung inflammation - Anti-inflammatory drugs to reduce swelling in the airways - Certain long-term antibiotics In severe cases or during flare-ups, you may need to receive: - Steroids by mouth or through a vein (intravenously) - Bronchodilators through a nebulizer - Oxygen therapy - Assistance from a machine to help breathing by using a mask, BiPAP, or through the use of an endotracheal tube Your health care provider may prescribe antibiotics during symptom flare-ups, because an infection can make COPD worse. You may need oxygen therapy at home if you have a low level of oxygen in your blood. Pulmonary rehabilitation does not cure COPD. But it can teach you to breathe in a different way so you can stay active and feel better. LIVING WITH COPD You can do things every day to keep COPD from getting worse, protect your lungs, and stay healthy. Walk to build up strength: - Ask the provider or therapist how far to walk. - Slowly increase how far you walk. - Avoid talking if you get short of breath when you walk. - Use pursed lip breathing when you breathe out, to empty your lungs before the next breath. Things you can do to make it easier for yourself around the home include: - Avoid very cold air or very hot weather - Make sure no one smokes in your home - Reduce air pollution by not using the fireplace and getting rid of other irritants - Manage stress in your mood Eat healthy foods, including fish, poultry, and lean meat, as well as fruits and vegetables. If it is hard to keep your weight up, talk to a provider or dietitian about eating foods with more calories. Surgery may be used to treat COPD. Only a few people benefit from these surgical treatments: - Surgery to remove parts of the diseased lung, which can help less-diseased parts work better in some people with emphysema - Lung transplant for a small number of very severe cases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose COPD?", "response": "COPD (Diagnosis): COPD is commonly misdiagnosed - former smokers may sometimes be told they have COPD, when in reality they may have simple deconditioning or another less common lung condition. Likewise, many people who have COPD may not be diagnosed until the disease is advanced and interventions are less effective. To diagnose your condition, your doctor will review your signs and symptoms, discuss your family and medical history, and discuss any exposure you've had to lung irritants - especially cigarette smoke. Your doctor may order several tests to diagnose your condition. Tests may include: - Lung (pulmonary) function tests. Pulmonary function tests measure the amount of air you can inhale and exhale, and if your lungs are delivering enough oxygen to your blood. Spirometry is the most common lung function test. During this test, you'll be asked to blow into a large tube connected to a small machine called a spirometer. This machine measures how much air your lungs can hold and how fast you can blow the air out of your lungs. Spirometry can detect COPD even before you have symptoms of the disease. It can also be used to track the progression of disease and to monitor how well treatment is working. Spirometry often includes measurement of the effect of bronchodilator administration. Other lung function tests include measurement of lung volumes, diffusing capacity and pulse oximetry. - Chest X-ray. A chest X-ray can show emphysema, one of the main causes of COPD. An X-ray can also rule out other lung problems or heart failure. - CT scan. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer. - Arterial blood gas analysis. This blood test measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide. - Laboratory tests. Laboratory tests aren't used to diagnose COPD, but they may be used to determine the cause of your symptoms or rule out other conditions. For example, laboratory tests may be used to determine if you have the genetic disorder alpha-1-antitrypsin (AAt) deficiency, which may be the cause of some cases of COPD. This test may be done if you have a family history of COPD and develop COPD at a young age, such as under age 45. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose COPD?", "response": "COPD (Diagnosis): Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results. Your doctor may ask whether you smoke or have had contact with lung irritants, such as secondhand smoke, air pollution, chemical fumes, or dusts. If you have an ongoing cough, let your doctor know how long you've had it, how much you cough, and how much mucus comes up when you cough. Also, let your doctor know whether you have a family history of COPD. Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds. He or she also may recommend one or more tests to diagnose COPD. Pulmonary Function Tests Pulmonary function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. The main test for COPD is spirometry. Other lung function tests, such as a lung diffusion capacity test, also might be used. Read Pulmonary Function Tests for more information. Spirometry During this painless test, a technician will ask you to take a deep breath in. Then, you'll blow as hard as you can into a tube connected to a small machine. The machine is called a spirometer. The machine measures how much air you breathe out. It also measures how fast you can blow air out. Spirometry Your doctor may have you inhale, or breathe in, medicine that helps open your airways and then blow into the tube again. He or she can then compare your test results before and after taking the medicine. Spirometry can detect COPD before symptoms develop. Your doctor also might use the test results to find out how severe your COPD is and to help set your treatment goals. The test results also may help find out whether another condition, such as asthma or heart failure, is causing your symptoms. Other Tests Your doctor may recommend other tests, such as: A chest x ray or chest CT scan. These tests create pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. The pictures can show signs of COPD. They also may show whether another condition, such as heart failure, is causing your symptoms. An arterial blood gas test. This blood test measures the oxygen level in your blood using a sample of blood taken from an artery. The results from this test can show how severe your COPD is and whether you need oxygen therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Obesity?", "response": "What is Obesity?: Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Obesity?", "response": "What is Obesity?: Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active. Being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Obesity?", "response": "Health risks of obesity: Obesity is a medical condition in which a high amount of body fat increases the chance of developing medical problems. People with obesity have a higher chance of developing these health problems: - High blood glucose (sugar) or diabetes. - High blood pressure (hypertension). - High blood cholesterol and triglycerides (dyslipidemia or high blood fats). - Heart attacks due to coronary heart disease, heart failure, and stroke. - Bone and joint problems, more weight puts pressure on the bones and joints. This can lead to osteoarthritis, a disease that causes joint pain and stiffness. - Stopping breathing during sleep (sleep apnea). This can cause daytime fatigue or sleepiness, poor attention, and problems at work. - Gallstones and liver problems. - Some cancers Three things can be used to determine if a person's body fat gives them a higher chance of developing obesity-related diseases: - Body mass index (BMI) - Waist size - Other risk factors the person has (a risk factor is anything that increases your chance of getting a disease.) Body mass index (BMI) is calculated using height and weight. It is used to estimate body fat. Starting at 25.0, the higher your BMI, the greater is your risk of developing obesity-related health problems. These ranges of BMI are used to describe levels of risk: - Overweight (not obese), if BMI is 25.0 to 29.9 - Class 1 (low-risk) obesity, if BMI is 30.0 to 34.9 - Class 2 (moderate-risk) obesity, if BMI is 35.0 to 39.9 - Class 3 (high-risk) obesity, if BMI is equal to or greater than 40.0 Women with a waist size greater than 35 inches (89 centimeters) and men with a waist size greater than 40 inches (102 centimeters) have an increased risk of heart disease and type 2 diabetes. People with \"apple-shaped\" bodies (waist is bigger than the hips) also have an increased risk of these conditions. Having a risk factor does not mean that you will get the disease. But it does increase the chance that you will. Some risk factors, like age, race, or family history cannot be changed. The more risk factors you have, the more likely it is that you will develop the disease or health problem. Your risk of developing health problems such as heart disease, stroke, and kidney problems increases if you are obese and have these risk factors: - High blood pressure (hypertension) - High blood cholesterol or triglycerides - High blood glucose (sugar), a sign of type 2 diabetes These other risk factors for heart disease and stroke are not caused by obesity: - Having a family member under the age of 50 with heart disease - Being physically inactive or having a sedentary lifestyle - Smoking or using tobacco products of any kind You can control many of these risk factors by changing your lifestyle. If you have obesity, your doctor can help you begin a weight-loss program. A starting goal of losing 5 to 10% of your current weight will reduce your risk of developing obesity-related diseases. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in internal medicine and hospice and palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Obesity?", "response": "Obesity (Causes): Although there are genetic, behavioral and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, and other diseases and conditions. However, these disorders are rare and, in general, the principal causes of obesity are: - Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you use through exercise and normal daily activities. - Unhealthy diet and eating habits. Weight gain is inevitable if you regularly eat more calories than you burn. And most Americans' diets are too high in calories and are full of fast food and high-calorie beverages. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Obesity?", "response": "What causes Obesity?: Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Obesity?", "response": "Obesity (Risk factors): Obesity usually results from a combination of causes and contributing factors, including: - Genetics. Your genes may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy and how your body burns calories during exercise. - Family lifestyle. Obesity tends to run in families. If one or both of your parents are obese, your risk of being obese is increased. That's not just because of genetics. Family members tend to share similar eating and activity habits. - Inactivity. If you're not very active, you don't burn as many calories. With a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Having medical problems, such as arthritis, can lead to decreased activity, which contributes to weight gain. - Unhealthy diet. A diet that's high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain. - Medical problems. In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain. - Certain medications. Some medications can lead to weight gain if you don't compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers. - Social and economic issues. Research has linked social and economic factors to obesity. Avoiding obesity is difficult if you don't have safe areas to exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have money to buy healthier foods. In addition, the people you spend time with may influence your weight - you're more likely to become obese if you have obese friends or relatives. - Age. Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. This lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs, and can make it harder to keep off excess weight. If you don't consciously control what you eat and become more physically active as you age, you'll likely gain weight. - Pregnancy. During pregnancy, a woman's weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women. - Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain that the person becomes obese. In the long run, however, quitting smoking is still a greater benefit to your health than continuing to smoke. - Lack of sleep. Not getting enough sleep or getting too much sleep can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain. Even if you have one or more of these risk factors, it doesn't mean that you're destined to become obese. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Obesity?", "response": "Overweight and Obesity (Signs, Symptoms, and Complications): There are no specific symptoms of overweight and obesity. The signs of overweight and obesity include a high body mass index (BMI) and an unhealthy body fat distribution that can be estimated by measuring your waist circumference. Obesity can cause complications in many parts of your body. High body mass index (BMI) A high BMI is the most common sign of overweight and obesity. Unhealthy body fat distribution Another sign of overweight and obesity is having an unhealthy body fat distribution. Fatty tissue is found in different parts of your body and has many functions. Having an increased waist circumference suggests that you have increased amounts of fat in your abdomen. An increased waist circumference is a sign of obesity and can increase your risk for obesity-related complications. Read more Did you know that fatty tissue has different functions depending on its location in your body? Visceral fat is the fatty tissue inside of your abdomen and organs. While we do not know what causes the body to create and store visceral fat, it is known that this type of fat interferes with the body’s endocrine and immune systems and promotes chronic inflammation and contributes to obesity-related complications. Complications Obesity may cause the following complications: Metabolic Syndrome Type 2 diabetes High blood cholesterol and high triglyceride levels in the blood Diseases of the heart and blood vessels such as high blood pressure, atherosclerosis, heart attacks and stroke Respiratory problems such as obstructive sleep apnea , asthma, and obesity hypoventilation syndrome Back pain Non-alcoholic fatty liver disease (NAFLD) Osteoarthritis, a chronic inflammation that damages the cartilage and bone in or around the affected joint. It can cause mild or severe pain and usually affects weight-bearing joints in people who are obese. It is a major cause of knee replacement surgery in patients who are obese for a long time. Urinary incontinence, the unintentional leakage of urine. Chronic obesity can weaken pelvic muscles, making it harder to maintain bladder control. While it can happen to both sexes, it usually affects women as they age. Gallbladder disease Emotional health issues such as low self-esteem or depression. This may commonly occur in children. Cancers of the esophagus, pancreas, colon, rectum, kidney, endometrium, ovaries, gallbladder, breast, or liver. Read more Did you know inflammation is thought to play a role in the onset of certain obesity-related complications? Researchers now know more about visceral fat, which is deep in the abdomen of overweight and obese patients. Visceral fat releases factors that promote inflammation. Chronic obesity-related inflammation is thought to lead to insulin resistance and diabetes, changes in the liver or non-alcoholic fatty acid liver disease, and cancers. More research is needed to understand what triggers inflammation in some obese patients and to find new treatments. Look for Diagnosis will explain tests and procedures used to detect signs of overweight and obesity and help rule our other conditions that may be causing weight gain. Treatment will discuss treatment-related complications or side effects. Living With will explain how doctors use waist circumference to monitor for disease severity and check for complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Obesity?", "response": "What are the symptoms of Overweight and Obesity?: Weight gain usually happens over time. Most people know when they've gained weight. Some of the signs of overweight or obesity include: Clothes feeling tight and needing a larger size. The scale showing that you've gained weight. Having extra fat around the waist. A higher than normal body mass index and waist circumference. (For more information, go to \"How Are Overweight and Obesity Diagnosed?\"). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Obesity?", "response": "Obesity Hypoventilation Syndrome (Signs and Symptoms): Many of the signs and symptoms of obesity hypoventilation syndrome (OHS) are the same as those of obstructive sleep apnea. This is because many people who have OHS also have obstructive sleep apnea. One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses. Other symptoms include: Daytime sleepiness Morning headaches Memory, learning, or concentration problems Feeling irritable or depressed, or having mood swings or personality changes You also may have rapid, shallow breathing. During a physical exam, your doctor might hear abnormal heart sounds while listening to your heart with a stethoscope. He or she also might notice that the opening to your throat is small and your neck is larger than normal. Complications of Obesity Hypoventilation Syndrome When left untreated, OHS can cause serious problems, such as: Leg edema, which is swelling in the legs caused by fluid in the body's tissues. Pulmonary hypertension, which is increased pressure in the pulmonary arteries. These arteries carry blood from your heart to your lungs to pick up oxygen. Cor pulmonale, which is failure of the right side of the heart. Secondary erythrocytosis, which is a condition in which the body makes too many red blood cells. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Obesity?", "response": "What are the treatments for Obesity?: CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your health care provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1,100 calories per day) are not thought to be safe or to work very well. These types of diets often do not contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Obesity?", "response": "How to diagnose Obesity?: The health care provider will perform a physical exam and ask about your medical history, eating habits, and exercise routine. The two most common ways to assess your weight and measure health risks related to your weight are: - Body mass index (BMI) - Waist circumference (your waist measurement in inches) BMI is calculated using height and weight. You and your provider can use your BMI to estimate how much body fat you have. Your waist measurement is another way to estimate how much body fat you have. Extra weight around your middle or stomach area increases your risk for type 2 diabetes, heart disease, and stroke. People with \"apple-shaped\" bodies (meaning they tend to store fat around their waist and have a slim lower body) also have an increased risk for these diseases. Skin fold measurements may be taken to check your body fat percentage. Blood tests may be done to look for thyroid or hormone problems that could lead to weight gain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Obesity?", "response": "Obesity (Diagnosis): If your BMI is in the obese range, your health care provider will typically review your health history in detail, perform a physical exam and recommend some tests. These exams and tests generally include: - Taking your health history. Your doctor may review your weight history, weight-loss efforts, exercise habits, eating patterns, what other conditions you've had, medications, stress levels and other issues about your health. Your doctor may also review your family's health history to see if you may be predisposed to certain conditions. - A general physical exam. This includes also measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen. - Calculating your BMI. Your doctor will check your body mass index (BMI) to determine your level of obesity. This should be done at least once a year. Your BMI also helps determine your overall health risk and what treatment may be appropriate. - Measuring your waist circumference. Fat stored around your waist, sometimes called visceral fat or abdominal fat, may further increase your risk of diseases, such as diabetes and heart disease. Women with a waist measurement (circumference) of more than 35 inches (80 centimeters, or cm) and men with a waist measurement of more than 40 inches (102 cm) may have more health risks than do people with smaller waist measurements. Like the BMI measurement, your waist circumference should be checked at least once a year. - Checking for other health problems. If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure and diabetes. - Blood tests. What tests you have depend on your health, risk factors and any current symptoms you may be having. Tests may include a cholesterol test, liver function tests, a fasting glucose, a thyroid test and others. Your doctor may also recommend certain heart tests, such as an electrocardiogram. Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you already have. And this will guide treatment decisions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Obesity?", "response": "Overweight and Obesity (Diagnosis): Your doctor may diagnose overweight and obesity based on your medical history, physical exams that confirm you have a high body mass index (BMI) and possibly a high waist circumference, and tests to rule out other medical conditions. Confirming a high body mass index (BMI) To diagnose overweight and obesity, doctors measure BMI using calculations that depend on whether you are a child or an adult. Children: A healthy weight is usually when your child’s BMI is at the 5th percentile up to less than the 85th percentile based on growth charts for children who are the same age and sex. To figure out your child’s BMI, use the Center for Disease Control and Prevention (CDC) BMI Percentile Calculator for Child and Teen and compare the BMI with the table below. Adults: A healthy weight for adults is usually when your BMI is 18.5 to less than 25. To figure out your BMI, use the National Heart, Lung, and Blood Institute’s online BMI calculator and compare it with the table below. You can also download the BMI calculator app for iPhone and Android. Even if your BMI is in the healthy range, it is possible to be diagnosed as obese if you have a large waist circumference that suggests increased amounts of fat in your abdomen that can lead to complications. Medical history Your doctor will ask about your eating and physical activity habits, family history, and will see if you have other risk factors Your doctor may ask if you have any other signs or symptoms. This information can help determine if you have other conditions that may be causing you to be overweight or obese or if you have complications from being overweight or obese. Physical exam During your physical exam, your doctor will measure your weight and height to calculate your BMI. Your doctor may also measure your waist circumference to estimate the amount of unhealthy fat in your abdomen. In adults, a waist circumference over 35 inches for women who are not pregnant or 40 inches for men can help diagnose obesity and assess risk of future complications. If you are of South Asian or Central and South American descent, your doctor may use smaller waist circumference values to diagnose your obesity. People from these backgrounds often don’t show signs of a large waist circumference even though they may have unhealthy amounts of fat deep in their abdomens and may be diagnosed with obesity. Visit Assessing Your Weight for more information. Read Living With for more information about why it is important to monitor your waist circumference to assess your risk for complications. Tests to identify other medical conditions Your doctor may order some of the following tests to identify medical conditions that may be causing your overweight and obesity. Blood tests. Blood tests that check your thyroid hormone levels can help rule out hypothyroidism as a cause of your overweight or obesity. Cortisol and adrenocorticotropic hormone (ACTH) tests can rule out Cushing’s syndrome. Total testosterone and dehydroepiandrosterone sulphate (DHEAS) tests can help rule out polycystic ovary syndrome (PCOS). Pelvic ultrasound to examine the ovaries and detect cysts. This can rule out PCOS. Reminders Return to Risk Factors to review family history, lifestyle, or other environmental factors that increase your risk of developing overweight and obesity. Return to Signs, Symptoms, and Complications to review common signs and symptoms of overweight and obesity. Return to Screening and Prevention to review how to screen for overweight and obesity. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Alcohol Use Disorder?", "response": "How to diagnose Alcohol use disorder?: Your health care provider will: - Examine you - Ask about your medical and family history - Ask about your alcohol use, and if you have any of the symptoms listed above Your provider may order tests to check for health problems that are common in people who use alcohol. These tests may include: - Blood alcohol level (This shows if you have recently been drinking alcohol. It does not diagnose alcohol use disorder.) - Complete blood count - Liver function tests - Magnesium blood test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Alcohol Use Disorder?", "response": "Alcohol use disorder (Causes): Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder. Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Alcohol Use Disorder?", "response": "Alcohol use disorder (Risk factors): Risk factors for alcohol use disorder include: - Steady drinking over time. Drinking too much on a regular basis for an extended period or binge drinking on a regular basis can lead to alcohol-related problems or alcohol use disorder. - Age. People who begin drinking at an early age, and especially in a binge fashion, are at a higher risk of alcohol use disorder. Alcohol use may begin in the teens, but alcohol use disorder occurs more frequently in the 20s and 30s. However, it can begin at any age. - Family history. The risk of alcohol use disorder is higher for people who have a parent or other close relative who has problems with alcohol. This may be influenced by genetic factors. - Depression and other mental health problems. It's common for people with a mental health disorder such as anxiety, depression, schizophrenia or bipolar disorder to have problems with alcohol or other substances. - Social and cultural factors. Having friends or a close partner who drinks regularly could increase your risk of alcohol use disorder. The glamorous way that drinking is sometimes portrayed in the media also may send the message that it's OK to drink too much. For young people, the influence of parents, peers and other role models can impact risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Alcohol Use Disorder?", "response": "How to diagnose Alcohol use disorder?: Your health care provider will: - Examine you - Ask about your medical and family history - Ask about your alcohol use, and if you have any of the symptoms listed above Your provider may order tests to check for health problems that are common in people who use alcohol. These tests may include: - Blood alcohol level (This shows if you have recently been drinking alcohol. It does not diagnose alcohol use disorder.) - Complete blood count - Liver function tests - Magnesium blood test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Alcohol Use Disorder?", "response": "Alcohol use disorder (Symptoms): Alcohol use disorder can be mild, moderate or severe, based on the number of symptoms you experience. Signs and symptoms may include: - Being unable to limit the amount of alcohol you drink - Wanting to cut down on how much you drink or making unsuccessful attempts to do so - Spending a lot of time drinking, getting alcohol or recovering from alcohol use - Feeling a strong craving or urge to drink alcohol - Failing to fulfill major obligations at work, school or home due to repeated alcohol use - Continuing to drink alcohol even though you know it's causing physical, social or interpersonal problems - Giving up or reducing social and work activities and hobbies - Using alcohol in situations where it's not safe, such as when driving or swimming - Developing a tolerance to alcohol so you need more to feel its effect or you have a reduced effect from the same amount - Experiencing withdrawal symptoms - such as nausea, sweating and shaking - when you don't drink, or drinking to avoid these symptoms Alcohol use disorder can include periods of alcohol intoxication and symptoms of withdrawal. - Alcohol intoxication results as the amount of alcohol in your blood stream increases. The higher the blood alcohol concentration is, the more impaired you become. Alcohol intoxication causes behavior problems and mental changes. These may include inappropriate behavior, unstable moods, impaired judgment, slurred speech, impaired attention or memory, and poor coordination. You can also have periods called \"blackouts,\" where you don't remember events. Very high blood alcohol levels can lead to coma or even death. - Alcohol withdrawal can occur when alcohol use has been heavy and prolonged and is then stopped or greatly reduced. It can occur within several hours to four or five days later. Symptoms include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally seizures. Symptoms can be severe enough to impair your ability to function at work or in social situations. What is considered one drink? The National Institute on Alcohol Abuse and Alcoholism defines one standard drink as any one of these: - 12 ounces (355 milliliters) of regular beer (about 5 percent alcohol) - 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7 percent alcohol) - 5 ounces (148 milliliters) of unfortified wine (about 12 percent alcohol) - 1.5 ounces (44 milliliters) of 80-proof hard liquor (about 40 percent alcohol) When to see a doctor If you feel that you sometimes drink too much alcohol, or it's causing problems, or your family is concerned about your drinking, talk with your doctor. Other ways to get help include talking with a mental health provider or seeking help from a support group such as Alcoholics Anonymous or a similar type of self-help group. Because denial is common, you may not feel like you have a problem with drinking. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to relatives, friends or co-workers when they ask you to examine your drinking habits or to seek help. Consider talking with someone who has had a problem drinking, but has stopped. If your loved one needs help Many people with alcohol use disorder hesitate to get treatment because they don't recognize they have a problem. An intervention from loved ones can help some people recognize and accept that they need professional help. If you're concerned about someone who drinks too much, ask a professional experienced in alcohol treatment for advice on how to approach that person. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Alcohol Use Disorder?", "response": "Alcohol use disorder (Causes): Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder. Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Alcohol Use Disorder?", "response": "Alcohol use disorder (Alternative medicine): Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. But if used in addition to your treatment plan when recovering from alcohol use disorder, these techniques may be helpful: - Yoga. Yoga's series of postures and controlled breathing exercises may help you relax and manage stress. - Meditation. During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress. - Acupuncture. With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Alcohol Use Disorder?", "response": "What are the treatments for Alcohol use disorder?: Many people with an alcohol problem need to completely stop using alcohol. This is called abstinence. Having strong social and family support can help make it easier to quit drinking. Some people are able to just cut back on their drinking. So even if you do not give up alcohol altogether, you may be able to drink less. This can improve your health and relationships with others. It can also help you perform better at work or school. However, many people who drink too much find they cannot just cut back. Abstinence may be the only way to manage a drinking problem. DECIDING TO QUIT Like many people with an alcohol problem, you may not recognize that your drinking has gotten out of hand. An important first step is to be aware of how much you drink. It also helps to understand the health risks of alcohol. If you decide to quit drinking, talk with your health care provider. Treatment involves helping you realize how much your alcohol use is harming your life and the lives those around you. Depending on how much and how long you have been drinking, you may be at risk for alcohol withdrawal. Withdrawal can be very uncomfortable and even life-threatening. If you have been drinking a lot, you should cut back or stop drinking only under the care of a doctor. Talk with your provider about how to stop using alcohol. LONG-TERM SUPPORT Alcohol recovery or support programs can help you stop drinking completely. These programs usually offer: - Education about alcohol use and its effects - Counseling and therapy to discuss how to control your thoughts and behaviors - Physical health care For the best chance of success, you should live with people who support your efforts to avoid alcohol. Some programs offer housing options for people with alcohol problems. Depending on your needs and the programs that are available: - You may be treated in a special recovery center (inpatient) - You may attend a program while you live at home (outpatient) You may be prescribed medicines to help you quit. They are often used with long-term counseling or support groups. These medicines make it less likely that you will drink again or help limit the amount you drink. Drinking may mask depression or other mood or anxiety disorders. If you have a mood disorder, it may become more noticeable when you stop drinking. Your provider will treat any mental disorders in addition to your alcohol treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Alcohol Use Disorder?", "response": "Alcohol use disorder (Treatment): Treatment for alcohol use disorder can vary, depending on your needs. Treatment may involve a brief intervention, individual or group counseling, an outpatient program, or a residential inpatient stay. Working to stop the use of alcohol to improve quality of life is the main treatment goal. Treatment for alcohol use disorder may include: - Detox and withdrawal. Treatment may begin with a program of detoxification or detox - withdrawal that's medically managed - which generally takes two to seven days. You may need to take sedating medications to prevent withdrawal symptoms. Detox is usually done at an inpatient treatment center or a hospital. - Learning skills and establishing a treatment plan. This usually involves alcohol treatment specialists. It may include goal setting, behavior change techniques, use of self-help manuals, counseling and follow-up care at a treatment center. - Psychological counseling. Counseling and therapy for groups and individuals help you better understand your problem with alcohol and support recovery from the psychological aspects of alcohol use. You may benefit from couples or family therapy - family support can be an important part of the recovery process. - Oral medications. Naltrexone (Revia), a drug that blocks the good feelings alcohol causes, may prevent heavy drinking and reduce the urge to drink. Acamprosate (Campral) may help combat alcohol cravings once you stop drinking. Disulfiram (Antabuse) may help to prevent you from drinking, though it won't cure alcohol use disorder or remove the compulsion to drink. If you drink alcohol, the drug produces a physical reaction that may include flushing, nausea, vomiting and headaches. Unlike disulfiram, naltrexone and acamprosate don't make you feel sick after taking a drink. - Injected medication. Vivitrol, a version of the drug naltrexone, is injected once a month by a health care professional. Although similar medication can be taken in pill form, the injectable version of the drug may be easier for people recovering from alcohol use disorder to use consistently. - Continuing support. Aftercare programs and support groups help people recovering from alcohol use disorder to stop drinking, manage relapses and cope with necessary lifestyle changes. This may include medical or psychological care or attending a support group. - Treatment for psychological problems. Alcohol use disorder commonly occurs along with other mental health disorders. If you have depression, anxiety or another mental health condition, you may need talk therapy (psychotherapy), medications or other treatment. - Medical treatment for health conditions. Many alcohol-related health problems improve significantly once you stop drinking. But some health conditions may warrant continued treatment and follow-up. - Spiritual practice. People who are involved with some type of regular spiritual practice may find it easier to maintain recovery from alcohol use disorder or other addictions. For many people, gaining greater insight into their spiritual side is a key element in recovery. Residential treatment programs For a serious alcohol problem, you may need a stay at a residential treatment facility. Most residential treatment programs include individual and group therapy, support groups, educational lectures, family involvement and activity therapy. Residential treatment programs typically include licensed alcohol and drug counselors, social workers, nurses, doctors and others with expertise and experience in treating alcohol use disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Alcohol Use Disorder?", "response": "Alcohol use disorder (Alternative medicine): Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. But if used in addition to your treatment plan when recovering from alcohol use disorder, these techniques may be helpful: - Yoga. Yoga's series of postures and controlled breathing exercises may help you relax and manage stress. - Meditation. During meditation, you focus your attention and eliminate the stream of jumbled thoughts that may be crowding your mind and causing stress. - Acupuncture. With acupuncture, hair-thin needles are inserted under the skin. Acupuncture may help reduce anxiety and depression. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Alcohol Use Disorder?", "response": "How to diagnose Alcohol use disorder?: Your health care provider will: - Examine you - Ask about your medical and family history - Ask about your alcohol use, and if you have any of the symptoms listed above Your provider may order tests to check for health problems that are common in people who use alcohol. These tests may include: - Blood alcohol level (This shows if you have recently been drinking alcohol. It does not diagnose alcohol use disorder.) - Complete blood count - Liver function tests - Magnesium blood test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Alcohol Use Disorder?", "response": "Alcohol use disorder (Diagnosis): You're likely to start by seeing your primary care doctor. If your doctor suspects you have a problem with alcohol, he or she may refer you to a mental health provider. To assess your problem with alcohol, your health care provider will likely: - Ask you several questions related to your drinking habits. The health care provider may ask for permission to speak with family members or friends. However, confidentiality laws prevent your health care provider from giving out any information about you without your consent. - Perform a physical exam. Your health care provider may do a physical exam and ask questions about your health. There are many physical signs that indicate complications of alcohol use. - Lab tests and imaging tests. While there are no specific tests to diagnose alcohol use disorder, certain patterns of lab test abnormalities may strongly suggest it. And you may need tests to identify health problems that may be linked to your alcohol use. Damage to your organs may be seen on tests. - Complete a psychological evaluation. This evaluation includes questions about your symptoms, thoughts, feelings and behavior patterns. You may need to fill out a questionnaire to help answer these questions. - Use the DSM-5 criteria. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, is often used by mental health providers to diagnose mental health conditions and by insurance companies to reimburse for treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Alcohol Use Disorder?", "response": "Alcohol use disorder (Causes): Genetic, psychological, social and environmental factors can impact how drinking alcohol affects your body and behavior. Theories suggest that for certain people drinking has a different and stronger impact that can lead to alcohol use disorder. Over time, drinking too much alcohol may change the normal function of the areas of your brain associated with the experience of pleasure, judgment and the ability to exercise control over your behavior. This may result in craving alcohol to try to restore good feelings or reduce negative ones. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Parkinson's Disease?", "response": "Parkinson disease - discharge (Resources): The American Parkinson Disease Association -- www.apdaparkinson.org The National Parkinson Foundation -- www.parkinson.org. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Parkinson's Disease?", "response": "Parkinson disease - discharge (Other Care): Having Parkinson disease may make you feel sad or depressed at times. Talk to friends or family about this. Ask your doctor about seeing a professional to help you with these feelings. Keep up to date with your vaccinations. Get a flu shot every year. Ask your doctor if you need a pneumonia shot. Ask your doctor if it is safe for you to drive. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Parkinson's Disease?", "response": "Parkinson disease - resources (Summary): The following organizations are good resources for information on Parkinson disease: - The Michael J. Fox Foundation -- www.michaeljfox.org - National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/Disorders/All-Disorders/Parkinsons-Disease-Information-Page - National Parkinson Foundation -- www.parkinson.org - Parkinson's Disease Foundation -- www.pdf.org - US National Library of Medicine, Genetics Home Reference -- ghr.nlm.nih.gov/condition/parkinson-disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Parkinson's Disease?", "response": "Parkinson disease (Symptoms): A number of disorders can cause symptoms similar to those of Parkinson disease. People with symptoms that resemble Parkinson disease but that result from other causes are sometimes said to have parkinsonism. Some of these disorders are listed below. [1] Postencephalitic parkinsonism Drug-induced parkinsonism Toxin -induced parkinsonism Arteriosclerotic parkinsonism Parkinsonism- dementia complex of Guam Post-traumatic parkinsonism Essential tremor Normal pressure hydrocephalus Progressive supranuclear palsy Corticobasal degeneration Multiple system atrophy Dementia with Lewy bodies More information on each of these conditions is available in the National Institute of Neurological Disorders and Stroke (NINDS) publication, Parkinsonian symptoms may also appear in patients with other, clearly distinct neurological disorders such as Wilson disease, Huntington disease, Alzheimer disease, spinocerebellar ataxias, and Creutzfeldt-Jakob disease. Each of these disorders has specific features that help to distinguish them from Parkinson disease.[1] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Dysautonomia Occasional Hallucinations Occasional Bradykinesia - Constipation - Dementia - Depressivity - Dysarthria - Dysphagia - Dystonia - Insidious onset - Lewy bodies - Mask-like facies - Neuronal loss in central nervous system - Parkinsonism - Personality changes - Postural instability - Progressive - Resting tremor - Rigidity - Short stepped shuffling gait - Sleep disturbance - Sporadic - Substantia nigra gliosis - Urinary urgency - Weak voice - View complete list of signs and symptoms... If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Parkinson's Disease?", "response": "Parkinson disease - discharge (Resources): The American Parkinson Disease Association -- www.apdaparkinson.org The National Parkinson Foundation -- www.parkinson.org. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Parkinson's Disease?", "response": "Parkinson disease - resources (Summary): The following organizations are good resources for information on Parkinson disease: - The Michael J. Fox Foundation -- www.michaeljfox.org - National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/Disorders/All-Disorders/Parkinsons-Disease-Information-Page - National Parkinson Foundation -- www.parkinson.org - Parkinson's Disease Foundation -- www.pdf.org - US National Library of Medicine, Genetics Home Reference -- ghr.nlm.nih.gov/condition/parkinson-disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Parkinson's Disease?", "response": "Parkinson disease (Treatment): There is no cure for Parkinson disease, but treatment can help control your symptoms. MEDICINE Your provider will prescribe medicines to help control your shaking and movement symptoms. At certain times during the day, the medicine may wear off and symptoms can return. If this happens, your provider may need to change any of the following: - Type of medicine - Dose - Amount of time between doses - The way you take the medicine You may also need to take medicines to help with: - Mood and thinking problems - Pain relief - Sleep problems - Drooling (botulinum toxin is often used) Parkinson medicines can cause severe side effects, including: - Confusion - Seeing or hearing things that are not there (hallucinations) - Nausea, vomiting, or diarrhea - Feeling lightheaded or fainting - Behaviors that are hard to control, such as gambling - Delirium Tell your provider right away if you have these side effects. Never change or stop taking any medicines without talking with your provider. Stopping some medicines for Parkinson disease may lead to a severe reaction. Work with your provider to find a treatment plan that works for you. As the disease gets worse, symptoms such as stooped posture, frozen movements, and speech problems may not respond to the medicines. SURGERY Surgery may be an option for some people. Surgery does not cure Parkinson disease, but it may help ease symptoms. Types of surgery include: - Deep brain stimulation. This involves placing electric stimulators in areas of the brain that control movement. - Surgery to destroy brain tissue that causes Parkinson symptoms. - Stem cell transplant and other procedures are being studied. LIFESTYLE Certain lifestyle changes may help you cope with Parkinson disease: - Stay healthy by eating nutritious foods and not smoking. - Make changes in what you eat or drink if you have swallowing problems. - Use speech therapy to help you adjust to changes in your swallowing and speech. - Stay active as much as possible when you feel good. DO NOT overdo it when your energy is low. - Rest as needed during the day and avoid stress. - Use physical therapy and occupational therapy to help you stay independent and reduce the risk of falls. - Place handrails throughout your house to help prevent falls. Place them in bathrooms and along stairways. - Use assistive devices, when needed, to make movement easier. These devices may include special eating utensils, wheelchairs, bed lifts, shower chairs, and walkers. - Talk to a social worker or other counseling service to help you and your family cope with the disorder. These services can also help you get outside help, such as Meals on Wheels. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Parkinson's Disease?", "response": "Parkinson disease type 3 (Treatment): FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal Medline Plus Health Information. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Parkinson's Disease?", "response": "Parkinson disease - discharge (Resources): The American Parkinson Disease Association -- www.apdaparkinson.org The National Parkinson Foundation -- www.parkinson.org. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Parkinson's Disease?", "response": "How to diagnose Parkinson disease?: Your health care provider may be able to diagnose Parkinson disease based on your symptoms and a physical exam. But the symptoms can be hard to pin down, particularly in older adults. Symptoms are easier to recognize as the illness gets worse. The examination may show: - Difficulty starting or finishing a movement - Jerky, stiff movements - Muscle loss - Shaking (tremors) - Changes in your heart rate - Normal muscle reflexes Your doctor may do some tests to rule out other conditions that can cause similar symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Parkinson's Disease?", "response": "Parkinson disease (Diagnosis): There are currently no blood or laboratory tests that have been proven to help diagnose sporadic cases of Parkinson disease. The diagnosis is generally made after careful evaluation of medical history, current symptoms, and exclusion of other conditions. [1] The clinical findings of tremor, rigidity, and bradykinesia are highly suggestive of Parkinson disease. The genetic cause of some forms of Parkinson disease has been identified. In those cases, genetic testing may be utilized to identify affected family members. [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Parkinson's Disease?", "response": "Parkinson disease - discharge (Resources): The American Parkinson Disease Association -- www.apdaparkinson.org The National Parkinson Foundation -- www.parkinson.org. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Epilepsy?", "response": "What is Epilepsy?: Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Epilepsy?", "response": "Epilepsy: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Epilepsy?", "response": "Epilepsy (Overview): Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Treatment with medications or sometimes surgery can control seizures for the majority of people with epilepsy. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age. Epilepsy care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Epilepsy?", "response": "What is Epilepsy?: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activityfrom illness to brain damage to abnormal brain developmentcan lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Epilepsy?", "response": "Epilepsy - children (Prevention): There is no known way to prevent epilepsy. Proper diet and sleep may decrease the chances of seizures in children with epilepsy. Reduce the risk of head injury during risky activities. This can decrease the likelihood of a brain injury that leads to seizures and epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Epilepsy?", "response": "What are the symptoms of Epilepsy - overview?: Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness. The type of seizure depends on the part of the brain that is affected. Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura. Your doctor can tell you more about the specific type of seizure you may have: - Absence (petit mal) seizure (staring spells) - Generalized tonic-clonic (grand mal) seizure (involves the entire body, including aura, rigid muscles, and loss of alertness) - Partial (focal) seizure (can involve any of the symptoms described above, depending on where in the brain the seizure starts). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Epilepsy?", "response": "Epilepsy (Symptoms): Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process your brain coordinates. Seizure signs and symptoms may include: - Temporary confusion - A staring spell - Uncontrollable jerking movements of the arms and legs - Loss of consciousness or awareness - Psychic symptoms such as fear, anxiety or deja vu Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins. Focal seizures When seizures appear to result from abnormal activity in just one area of your brain, they're called focal (partial) seizures. These seizures fall into two categories: - Focal seizures without loss of consciousness. Once called simple partial seizures, these seizures don't cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights. - Focal seizures with impaired awareness. Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles. Symptoms of focal seizures may be confused with other neurological disorders, such as migraine, narcolepsy or mental illness. A thorough examination and testing are needed to distinguish epilepsy from other disorders. Generalized seizures Seizures that appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist. - Absence seizures. Absence seizures, previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking. These seizures may occur in clusters and cause a brief loss of awareness. - Tonic seizures. Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back, arms and legs and may cause you to fall to the ground. - Atonic seizures. Atonic seizures, also known as drop seizures, cause a loss of muscle control, which may cause you to suddenly collapse or fall down. - Clonic seizures. Clonic seizures are associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms. - Myoclonic seizures. Myoclonic seizures usually appear as sudden brief jerks or twitches of your arms and legs. - Tonic-clonic seizures. Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. When to see a doctor Seek immediate medical help if any of the following occurs: - The seizure lasts more than five minutes. - Breathing or consciousness doesn't return after the seizure stops. - A second seizure follows immediately. - You have a high fever. - You're experiencing heat exhaustion. - You're pregnant. - You have diabetes. - You've injured yourself during the seizure. If you experience a seizure for the first time, seek medical advice. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Epilepsy?", "response": "Epilepsy - children (Symptoms): Symptoms vary from child to child. Some children may simply stare. Others may shake violently and lose alertness. The movements or symptoms of a seizure may depend on the part of the brain that is affected. Your child's health care provider can tell you more about the specific type of seizure your child may have: - Absence (petit mal) seizure: Staring spells - Generalized tonic-clonic (grand mal) seizure: Involves the entire body, including aura, rigid muscles, and loss of alertness - Partial (focal) seizure: Can involve any of the symptoms described above, depending on where in the brain the seizure starts Most of the time, the seizure is similar to the one before it. Some children have a strange sensation before a seizure. Sensations may be tingling, smelling an odor that is not actually there, feeling fear or anxiety for no reason or having a sense of déjà vu (feeling that something has happened before). This is called an aura. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Epilepsy?", "response": "Epilepsy (Treatment): Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Epilepsy?", "response": "Epilepsy (Summary): Summary Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Epilepsy?", "response": "Epilepsy - overview (Exams and Tests): The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: - Wear an EEG recorder for days or weeks as you go about your everyday life. - Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Epilepsy?", "response": "Epilepsy (Diagnosis): To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Epilepsy?", "response": "Epilepsy - children (Exams and Tests): The provider will: - Ask about your child's medical and family history in detail - Ask about the seizure episode - Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: - Wear an EEG recorder for few days during day-to-day activities - Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Anemia?", "response": "What is Anemia?: Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different types of anemia include: - Anemia due to B12 deficiency - Anemia due to folate deficiency - Anemia due to iron deficiency - Anemia of chronic disease - Hemolytic anemia - Idiopathic aplastic anemia - Megaloblastic anemia - Pernicious anemia - Sickle cell anemia - Thalassemia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Anemia?", "response": "What is Anemia?: Espaol Anemia (uh-NEE-me-uh) is a condition in which your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). Hemoglobin is an iron-rich protein that gives blood its red color. This protein helps red blood cells carry oxygen from the lungs to the rest of the body. If you have anemia, your body doesn't get enough oxygen-rich blood. As a result, you may feel tired or weak. You also may have other symptoms, such as shortness of breath, dizziness, or headaches. Severe or long-lasting anemia can damage your heart, brain, and other organs in your body. Very severe anemia may even cause death. Overview Blood is made up of many parts, including red blood cells, white blood cells, platelets (PLATE-lets), and plasma (the fluid portion of blood). Red blood cells are disc-shaped and look like doughnuts without holes in the center. They carry oxygen and remove carbon dioxide (a waste product) from your body. These cells are made in the bone marrowa sponge-like tissue inside the bones. White blood cells and platelets (PLATE-lets) also are made in the bone marrow. White blood cells help fight infection. Platelets stick together to seal small cuts or breaks on the blood vessel walls and stop bleeding. With some types of anemia, you may have low numbers of all three types of blood cells. Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction. These causes might be the result of diseases, conditions, or other factors. Outlook Many types of anemia can be mild, short term, and easily treated. You can even prevent some types with a healthy diet. Other types can be treated with dietary supplements. However, certain types of anemia can be severe, long lasting, and even life threatening if not diagnosed and treated. If you have signs or symptoms of anemia, see your doctor to find out whether you have the condition. Treatment will depend on the cause of the anemia and how severe it is. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Anemia?", "response": "What causes Anemia?: Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells. Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin (epo) made in your kidneys signals your bone marrow to make more red blood cells. Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their color. People with anemia do not have enough hemoglobin. The body needs certain vitamins, minerals, and nutrients to make enough red blood cells. Iron, vitamin B12, and folic acid are three of the most important ones. The body may not have enough of these nutrients due to: - Changes in the lining of the stomach or intestines affect how well nutrients are absorbed (for example, celiac disease) - Poor diet - Slow blood loss (for example, from heavy menstrual periods or stomach ulcers) - Surgery that removes part of the stomach or intestines Possible causes of anemia include: - Certain medicines - Destruction of red blood cells earlier than normal (which may be caused by immune system problems) - Long-term (chronic) diseases such as chronic kidney disease, cancer, ulcerative colitis, or rheumatoid arthritis - Some forms of anemia, such as thalassemia or sickle cell anemia, which can be inherited - Pregnancy - Problems with bone marrow such as lymphoma, leukemia, myelodysplasia, multiple myeloma, or aplastic anemia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Anemia?", "response": "What causes Anemia?: The three main causes of anemia are: Blood loss Lack of red blood cell production High rates of red blood cell destruction For some people, the condition is caused by more than one of these factors. Blood Loss Blood loss is the most common cause of anemia, especially iron-deficiency anemia. Blood loss can be short term or persist over time. Heavy menstrual periods or bleeding in the digestive or urinary tract can cause blood loss. Surgery, trauma, or cancer also can cause blood loss. If a lot of blood is lost, the body may lose enough red blood cells to cause anemia. Lack of Red Blood Cell Production Both acquired and inherited conditions and factors can prevent your body from making enough red blood cells. \"Acquired\" means you aren't born with the condition, but you develop it. \"Inherited\" means your parents passed the gene for the condition on to you. Acquired conditions and factors that can lead to anemia include poor diet, abnormal hormone levels, some chronic (ongoing) diseases, and pregnancy. Aplastic anemia also can prevent your body from making enough red blood cells. This condition can be acquired or inherited. Diet A diet that lacks iron, folic acid (folate), or vitamin B12 can prevent your body from making enough red blood cells. Your body also needs small amounts of vitamin C, riboflavin, and copper to make red blood cells. Conditions that make it hard for your body to absorb nutrients also can prevent your body from making enough red blood cells. Hormones Your body needs the hormone erythropoietin (eh-rith-ro-POY-eh-tin) to make red blood cells. This hormone stimulates the bone marrow to make these cells. A low level of this hormone can lead to anemia. Diseases and Disease Treatments Chronic diseases, like kidney disease and cancer, can make it hard for your body to make enough red blood cells. Some cancer treatments may damage the bone marrow or damage the red blood cells' ability to carry oxygen. If the bone marrow is damaged, it can't make red blood cells fast enough to replace the ones that die or are destroyed. People who have HIV/AIDS may develop anemia due to infections or medicines used to treat their diseases. Pregnancy Anemia can occur during pregnancy due to low levels of iron and folic acid and changes in the blood. During the first 6 months of pregnancy, the fluid portion of a woman's blood (the plasma) increases faster than the number of red blood cells. This dilutes the blood and can lead to anemia. Aplastic Anemia Some infants are born without the ability to make enough red blood cells. This condition is called aplastic anemia. Infants and children who have aplastic anemia often need blood transfusions to increase the number of red blood cells in their blood. Acquired conditions or factors, such as certain medicines, toxins, and infectious diseases, also can cause aplastic anemia. High Rates of Red Blood Cell Destruction Both acquired and inherited conditions and factors can cause your body to destroy too many red blood cells. One example of an acquired condition is an enlarged or diseased spleen. The spleen is an organ that removes wornout red blood cells from the body. If the spleen is enlarged or diseased, it may remove more red blood cells than normal, causing anemia. Examples of inherited conditions that can cause your body to destroy too many red blood cells include sickle cell anemia, thalassemias, and lack of certain enzymes. These conditions create defects in the red blood cells that cause them to die faster than healthy red blood cells. Hemolytic anemia is another example of a condition in which your body destroys too many red blood cells. Inherited or acquired conditions or factors can cause hemolytic anemia. Examples include immune disorders, infections, certain medicines, or reactions to blood transfusions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Anemia?", "response": "Fanconi anemia (Causes): Fanconi anemia is due to an abnormal gene that damages cells, which keeps them from repairing damaged DNA. To inherit Fanconi anemia, a person must get 1 copy of the abnormal gene from each parent. The condition is most often diagnosed in children between 2 and 15 years old. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Anemia?", "response": "What are the symptoms of Anemia?: You may have no symptoms if the anemia is mild or if the problem develops slowly. Symptoms that may occur first include: - Feeling grumpy - Feeling weak or tired more often than usual, or with exercise - Headaches - Problems concentrating or thinking If the anemia gets worse, symptoms may include: - Blue color to the whites of the eyes - Brittle nails - Desire to eat ice or other non-food things (pica syndrome) - Light-headedness when you stand up - Pale skin color - Shortness of breath with mild activity or even at rest - Sore tongue. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Anemia?", "response": "Anemia (Signs and Symptoms): The most common symptom of anemia is fatigue (feeling tired or weak). If you have anemia, you may find it hard to find the energy to do normal activities. Other signs and symptoms of anemia include: Shortness of breath Dizziness Headache Coldness in the hands and feet Pale skin Chest pain These signs and symptoms can occur because your heart has to work harder to pump oxygen-rich blood through your body. Mild to moderate anemia may cause very mild symptoms or none at all. Complications of Anemia Some people who have anemia may have arrhythmias (ah-RITH-me-ahs). Arrhythmias are problems with the rate or rhythm of the heartbeat. Over time, arrhythmias can damage your heart and possibly lead to heart failure. Anemia also can damage other organs in your body because your blood can't get enough oxygen to them. Anemia can weaken people who have cancer or HIV/AIDS. This can make their treatments not work as well. Anemia also can cause many other health problems. People who have kidney disease and anemia are more likely to have heart problems. With some types of anemia, too little fluid intake or too much loss of fluid in the blood and body can occur. Severe loss of fluid can be life threatening. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Anemia?", "response": "Aplastic anemia (Symptoms): The symptoms of aplastic anemia vary depending on how severe it is and how low blood counts are. Signs and symptoms may include: [2] [3] [4] Low numbers of red blood cells (anemia): May cause paleness (pallor), headache, palpitations, rapid heart rate Low numbers of platelets ( thrombocytopenia ): May result in gum bleeding, nosebleeds or bleeding in the internal organs and skin bruises. Low white blood cells (neutropenia): May present infections, recurrent infections, mouth sores. The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Aplastic anemia - Bone marrow hypocellularity -. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Anemia?", "response": "What are the treatments for Anemia?: Treatment should be directed at the cause of the anemia, and may include: - Blood transfusions - Corticosteroids or other medicines that suppress the immune system - Erythropoietin, a medicine that helps your bone marrow make more blood cells - Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Anemia?", "response": "Anemia (Treatment): Anemia treatment depends on the cause. - Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and making changes to your diet. If the underlying cause of iron deficiency is loss of blood - other than from menstruation - the source of the bleeding must be located and stopped. This may involve surgery. - Vitamin deficiency anemias. Treatment for folic acid and B-12 deficiency involves dietary supplements and increasing these nutrients in your diet. If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you may need vitamin B-12 shots. At first, you may receive the shots every other day. Eventually, you'll need shots just once a month, which may continue for life, depending on your situation. - Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by your kidneys, may help stimulate red blood cell production and ease fatigue. - Aplastic anemia. Treatment for this anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells. - Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation. - Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells. Depending on the severity of your anemia, a blood transfusion or plasmapheresis may be necessary. Plasmapheresis is a type of blood-filtering procedure. In certain cases, removal of the spleen can be helpful. - Sickle cell anemia. Treatment for this anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also may recommend blood transfusions, folic acid supplements and antibiotics. A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia. - Thalassemia. This anemia may be treated with blood transfusions, folic acid supplements, medication, removal of the spleen (splenectomy), or a blood and bone marrow stem cell transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Anemia?", "response": "How to diagnose Anemia?: The doctor will perform a physical examination, and may find: - A heart murmur - Low blood pressure, especially when you stand up - Pale skin - Rapid heart rate Some types of anemia may cause other findings on a physical exam. Blood tests used to diagnose some common types of anemia may include: - Blood levels of iron, vitamin B12, folic acid, and other vitamins and minerals - Red blood count and hemoglobin level - Reticulocyte count Other tests may be done to find medical problems that can cause anemia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Anemia?", "response": "Anemia (Diagnosis): To diagnose anemia, your doctor may ask you about your medical and family history, perform a physical exam, and run the following tests: - Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia your doctor will be interested in the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in your blood. Normal adult hematocrit values vary from one medical practice to another but are generally between 40 and 52 percent for men and 35 and 47 percent for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women. - A test to determine the size and shape of your red blood cells. Some of your red blood cells may also be examined for unusual size, shape and color. Additional diagnostic tests If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of ulcers, benign polyps in the colon, colon cancer, tumors or kidney problems. Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Anemia?", "response": "How to diagnose Anemia?: Your doctor will diagnose anemia based on your medical and family histories, a physical exam, and results from tests and procedures. Because anemia doesn't always cause symptoms, your doctor may find out you have it while checking for another condition. Medical and Family Histories Your doctor may ask whether you have any of the common signs or symptoms of anemia. He or she also may ask whether you've had an illness or condition that could cause anemia. Let your doctor know about any medicines you take, what you typically eat (your diet), and whether you have family members who have anemia or a history of it. Physical Exam Your doctor will do a physical exam to find out how severe your anemia is and to check for possible causes. He or she may: Listen to your heart for a rapid or irregular heartbeat Listen to your lungs for rapid or uneven breathing Feel your abdomen to check the size of your liver and spleen Your doctor also may do a pelvic or rectal exam to check for common sources of blood loss. Diagnostic Tests and Procedures You may have various blood tests and other tests or procedures to find out what type of anemia you have and how severe it is. Complete Blood Count Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many parts of your blood. The test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia. The normal range of these levels might be lower in certain racial and ethnic populations. Your doctor can explain your test results to you. The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results might be a sign of anemia, another blood disorder, an infection, or another condition. Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells and a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal. Other Tests and Procedures If the CBC results show that you have anemia, you may need other tests, such as: Hemoglobin electrophoresis (e-lek-tro-FOR-e-sis). This test looks at the different types of hemoglobin in your blood. The test can help diagnose the type of anemia you have. A reticulocyte (re-TIK-u-lo-site) count. This test measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. Tests for the level of iron in your blood and body. These tests include serum iron and serum ferritin tests. Transferrin level and total iron-binding capacity tests also measure iron levels. Because anemia has many causes, you also might be tested for conditions such as kidney failure, lead poisoning (in children), and vitamin deficiencies (lack of vitamins, such as B12 and folic acid). If your doctor thinks that you have anemia due to internal bleeding, he or she may suggest several tests to look for the source of the bleeding. A test to check the stool for blood might be done in your doctor's office or at home. Your doctor can give you a kit to help you get a sample at home. He or she will tell you to bring the sample back to the office or send it to a laboratory. If blood is found in the stool, you may have other tests to find the source of the bleeding. One such test is endoscopy (en-DOS-ko-pe). For this test, a tube with a tiny camera is used to view the lining of the digestive tract. Your doctor also may want to do bone marrow tests. These tests show whether your bone marrow is healthy and making enough blood cells. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Sickle Cell Anemia?", "response": "How to diagnose Sickle cell anemia?: Tests commonly done diagnose and monitor patients with sickle cell anemia include: - Bilirubin - Blood oxygen saturation - Complete blood count (CBC) - Hemoglobin electrophoresis - Serum creatinine - Serum potassium - Sickle cell test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Sickle Cell Anemia?", "response": "Sickle cell anemia (Causes): Sickle cell anemia is caused by a mutation in the gene that tells your body to make the red, iron-rich compound that gives blood its red color (hemoglobin). Hemoglobin allows red blood cells to carry oxygen from your lungs to all parts of your body. In sickle cell anemia, the abnormal hemoglobin causes red blood cells to become rigid, sticky and misshapen. The sickle cell gene is passed from generation to generation in a pattern of inheritance called autosomal recessive inheritance. This means that both the mother and the father must pass on the defective form of the gene for a child to be affected. If only one parent passes the sickle cell gene to the child, that child will have the sickle cell trait. With one normal hemoglobin gene and one defective form of the gene, people with the sickle cell trait make both normal hemoglobin and sickle cell hemoglobin. Their blood might contain some sickle cells, but they generally don't have symptoms. But they are carriers of the disease, which means they can pass the gene to their children. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Sickle Cell Anemia?", "response": "How to diagnose Sickle cell anemia?: Tests commonly done diagnose and monitor patients with sickle cell anemia include: - Bilirubin - Blood oxygen saturation - Complete blood count (CBC) - Hemoglobin electrophoresis - Serum creatinine - Serum potassium - Sickle cell test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Sickle Cell Anemia?", "response": "What are the symptoms of Sickle cell anemia?: Symptoms usually do not occur until after the age of 4 months. Almost all people with sickle cell anemia have painful episodes called crises. These can last from hours to days. Crises can cause pain in the lower back, leg, joints, and chest. Some people have one episode every few years. Others have many episodes each year. The crises can be severe enough to require a hospital stay. When the anemia becomes more severe, symptoms may include: - Fatigue - Paleness - Rapid heart rate - Shortness of breath - Yellowing of the eyes and skin (jaundice) Younger children with sickle cell anemia have attacks of abdominal pain. The following symptoms may occur because small blood vessels become blocked by the abnormal cells: - Painful and prolonged erection (priapism) - Poor eyesight or blindness - Problems with thinking or confusion caused by small strokes - Ulcers on the lower legs (in adolescents and adults) Over time, the spleen stops working. As a result, people with sickle cell anemia may have symptoms of infections such as: - Bone infection (osteomyelitis) - Gallbladder infection (cholecystitis) - Lung infection (pneumonia) - Urinary tract infection Other signs and symptoms include: - Delayed growth and puberty - Painful joints caused by arthritis - Heart failure due to too much iron (from blood transfusions). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Sickle Cell Anemia?", "response": "Sickle cell anemia (Symptoms): Signs and symptoms of sickle cell anemia, which vary from person to person and change over time, include: - Anemia. Sickle cells break apart easily and die, leaving you without enough red blood cells. Red blood cells usually live for about 120 days before they need to be replaced. But sickle cells usually die in 10 to 20 days, leaving a shortage of red blood cells (anemia). Without enough red blood cells, your body can't get the oxygen it needs to feel energized, causing fatigue. - Episodes of pain. Periodic episodes of pain, called crises, are a major symptom of sickle cell anemia. Pain develops when sickle-shaped red blood cells block blood flow through tiny blood vessels to your chest, abdomen and joints. Pain can also occur in your bones. The pain varies in intensity and can last for a few hours to a few weeks. Some people have only a few pain episodes. Others have a dozen or more crises a year. If a crisis is severe enough, you might need to be hospitalized. Some adolescents and adults with sickle cell anemia also have chronic pain, which can result from bone and joint damage, ulcers and other causes. - Painful swelling of hands and feet. The swelling is caused by sickle-shaped red blood cells blocking blood flow to the hands and feet. - Frequent infections. Sickle cells can damage an organ that fights infection (spleen), leaving you more vulnerable to infections. Doctors commonly give infants and children with sickle cell anemia vaccinations and antibiotics to prevent potentially life-threatening infections, such as pneumonia. - Delayed growth. Red blood cells provide your body with the oxygen and nutrients you need for growth. A shortage of healthy red blood cells can slow growth in infants and children and delay puberty in teenagers. - Vision problems. Tiny blood vessels that supply your eyes may become plugged with sickle cells. This can damage the retina - the portion of the eye that processes visual images, leading to vision problems. When to see a doctor Although sickle cell anemia is usually diagnosed in infancy, if you or your child develops any of the following problems, see your doctor right away or seek emergency medical care: - Unexplained episodes of severe pain, such as pain in the abdomen, chest, bones or joints. - Swelling in the hands or feet. - Abdominal swelling, especially if the area is tender to the touch. - Fever. People with sickle cell anemia have an increased risk of infection, and fever can be the first sign of an infection. - Pale skin or nail beds. - Yellow tint to the skin or whites of the eyes. - Signs or symptoms of stroke. If you notice one-sided paralysis or weakness in the face, arms or legs; confusion; trouble walking or talking; sudden vision problems or unexplained numbness; or a headache, call 911 or your local emergency number right away. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Sickle Cell Anemia?", "response": "Sickle cell anemia - resources (Summary): The following organizations are good resources for information on sickle cell anemia: - American Sickle Cell Anemia Association -- www.ascaa.org - US National Library of Medicine -- ghr.nlm.nih.gov/condition/sickle-cell-disease - National Heart, Lung, and Blood Institute -- www.nhlbi.nih.gov/health/health-topics/topics/sca/ - Sickle Cell Disease Association of America -- www.sicklecelldisease.org - Centers for Disease Control and Prevention -- www.cdc.gov/ncbddd/sicklecell. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Sickle Cell Anemia?", "response": "What are the treatments for Sickle cell anemia?: The goal of treatment is to manage and control symptoms, and to limit the number of crises. People with sickle cell disease need ongoing treatment, even when not having a crisis. People with this condition should take folic acid supplements. Folic acid helps make newred blood cells. Treatment for a sickle cell crisis includes: - Blood transfusions (may also be given regularly to prevent stroke) - Pain medicines - Plenty of fluids Other treatments for sickle cell anemia may include: - Hydroxyurea (Hydrea), which helps reduce the number of pain episodes (including chest pain and breathing problems) in some people - Antibiotics, which help prevent bacterial infections that are common in children with sickle cell disease - Medicines that reduce the amount of iron in the body. Treatments that may be needed to manage complications of sickle cell anemia include: - Dialysis or kidney transplant for kidney disease - Counseling forpsychological complications - Gallbladder removal inpeople with gallstone disease - Hip replacement for avascular necrosis of the hip - Surgery for eye problems - Treatment for overuse or abuse of narcotic pain medicines - Wound care for leg ulcers Bone marrow or stem cell transplants can cure sickle cell anemia, but this treatment is not an option for most people. Sickle cell anemia patients often cannot find well-matched stem cell donors. People with sickle cell disease should have the following vaccinations to lower the risk of infection: - Haemophilus influenzae vaccine (Hib) - Pneumococcal conjugate vaccine (PCV) - Pneumococcal polysaccharide vaccine (PPV). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Sickle Cell Anemia?", "response": "Sickle cell anemia (Diagnosis): A blood test can check for hemoglobin S - the defective form of hemoglobin that underlies sickle cell anemia. In the United States, this blood test is part of routine newborn screening done at the hospital. But older children and adults can be tested, too. In adults, a blood sample is drawn from a vein in the arm. In young children and babies, the blood sample is usually collected from a finger or heel. The sample is then sent to a laboratory, where it's screened for hemoglobin S. If the screening test is negative, there is no sickle cell gene present. If the screening test is positive, further tests will be done to determine whether one or two sickle cell genes are present. Additional tests If you or your child has sickle cell anemia, a blood test to check for a low red blood cell count (anemia) will be done. Your doctor might suggest additional tests to check for possible complications of the disease. If you or your child carries the sickle cell gene, you'll likely be referred to a genetic counselor. Tests to detect sickle cell genes before birth Sickle cell disease can be diagnosed in an unborn baby by sampling some of the fluid surrounding the baby in the mother's womb (amniotic fluid) to look for the sickle cell gene. If you or your partner has been diagnosed with sickle cell anemia or sickle cell trait, ask your doctor about whether you should consider this screening. Ask for a referral to a genetic counselor who can help you understand the risk to your baby. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Sickle Cell Anemia?", "response": "How to diagnose Sickle cell anemia?: Tests commonly done diagnose and monitor patients with sickle cell anemia include: - Bilirubin - Blood oxygen saturation - Complete blood count (CBC) - Hemoglobin electrophoresis - Serum creatinine - Serum potassium - Sickle cell test. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Gonorrhea?", "response": "Gonorrhea (More About Gonorrhea): Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Gonorrhea?", "response": "Gonorrhea: Gonorrhea is a sexually transmitted infection (STI). It is usually spread by having vaginal, oral, or anal sex. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Antibiotics can treat gonorrhea. If left untreated, it can cause serious health problems, including problems getting pregnant. Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.1 Gonorrhea is spread through: Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria. Signs and symptoms in the genital area can include: Signs and symptoms in other parts of the body include: Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. There are two ways that a doctor or nurse tests for gonorrhea: A Pap test is not used to detect gonorrhea. Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible. For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated. Gonorrhea that is not treated can cause serious health problems in women:3 Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible. If you have gonorrhea: For pregnant women, untreated gonorrhea raises the risk of: Babies born to infected mothers are at risk for: Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection. The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps: The steps work best when used together. No single step can protect you from every single type of STI. Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea. For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Gonorrhea?", "response": "Gonorrhea: Gonorrhea is a sexually transmitted disease that can infect both men and women. Caused by the Neisseria gonorrhoeae bacterium, gonorrhea can cause infections in the genitals, rectum and throat. Although treatable, drug-resistant forms of gonorrhea are increasing. If left untreated, gonorrhea can lead to pelvic inflammatory disease, ectopic pregnancy, infertility, and increased risk of HIV infection. Gonorrhea can also be passed from mother to child and cause blindness or life-threatening infections in the infant. NIAID supports a comprehensive, multidisciplinary program of research on Neissesria gonorrhoeae (gonococci). Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases Scientists have determined the complete genetic code, or sequence (genetic blueprint), of the N. gonorrhoeae genome. They are using this information to help us better understand how the bacterium causes disease and becomes resistant to antibiotics. NIAID also supports research to develop topical microbicides (antimicrobial preparations that can be appled inside the vagina) to prevent gonococcal infections. Another important area of gonorrhea research concerns antibiotic (drug) resistance. This is particularly important because strains of N. gonorhoeae that are resistant to recommended antibiotic treatments have been increasing and are becoming widespread in the United States. These events add urgency to conduct research on and develop new antibiotics and to prevent antibiotic resistance from spreading. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Gonorrhea?", "response": "Gonorrhea: Gonorrhea is a sexually transmitted infection (STI). It is usually spread by having vaginal, oral, or anal sex. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Antibiotics can treat gonorrhea. If left untreated, it can cause serious health problems, including problems getting pregnant. Gonorrhea is an STI that is caused by the bacteria Neisseria gonorrhoeae. It is an especially serious problem for women because it can damage the female reproductive organs. In 2014, gonorrhea affected more than 162,000 women in the United States.1 Gonorrhea most often affects women ages 15 to 24. But, gonorrhea is becoming more common in older women too.1 Gonorrhea is spread through: Most women with gonorrhea do not have any signs or symptoms. If you do get symptoms, they are often mild and can be mistaken for a bladder or vaginal infection. Signs or symptoms of gonorrhea depend on where you are first infected by the gonorrhea bacteria. Signs and symptoms in the genital area can include: Signs and symptoms in other parts of the body include: Gonorrhea can cause serious health problems, even if you do not have any signs or symptoms. You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. There are two ways that a doctor or nurse tests for gonorrhea: A Pap test is not used to detect gonorrhea. Your doctor or nurse will give you antibiotics to treat gonorrhea. The antibiotics are usually a pill you swallow. Although antibiotics can cure gonorrhea, they cannot fix any permanent damage done to your body. For this reason, it is important to get tested and to take the antibiotics as soon as possible. For the antibiotics to work, you must finish all of the antibiotics that your doctor gives you, even if the symptoms go away. Do not share your antibiotics for gonorrhea with anyone. If symptoms do not go away after treatment, see your doctor or nurse. It is possible to get gonorrhea again if you have sex with someone who has gonorrhea. Tell your recent sex partner(s) so they can be tested and treated. Gonorrhea that is not treated can cause serious health problems in women:3 Gonorrhea is easy to treat. But you need to get tested and treated as soon as possible. If you have gonorrhea: For pregnant women, untreated gonorrhea raises the risk of: Babies born to infected mothers are at risk for: Treatment of gonorrhea as soon as it is found in pregnant women will lower the risk of these problems for both mother and baby. Your baby will get antibiotics if you have gonorrhea or if your baby has a gonorrheal eye infection. The best way to prevent gonorrhea or any STI is to not have vaginal, oral, or anal sex. If you do have sex, lower your risk of getting an STI with the following steps: The steps work best when used together. No single step can protect you from every single type of STI. Yes. It is possible to get gonorrhea, or any other STI, if you are a woman who has sex only with women. Talk to your partner about her sexual history before having sex, and ask your doctor about getting tested if you have signs or symptoms of gonorrhea. For more information about gonorrhea, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Gonorrhea?", "response": "Gonorrhea: Gonorrhea is a sexually transmitted disease that can infect both men and women. Caused by the Neisseria gonorrhoeae bacterium, gonorrhea can cause infections in the genitals, rectum and throat. Although treatable, drug-resistant forms of gonorrhea are increasing. If left untreated, gonorrhea can lead to pelvic inflammatory disease, ectopic pregnancy, infertility, and increased risk of HIV infection. Gonorrhea can also be passed from mother to child and cause blindness or life-threatening infections in the infant. NIAID supports a comprehensive, multidisciplinary program of research on Neissesria gonorrhoeae (gonococci). Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases Scientists have determined the complete genetic code, or sequence (genetic blueprint), of the N. gonorrhoeae genome. They are using this information to help us better understand how the bacterium causes disease and becomes resistant to antibiotics. NIAID also supports research to develop topical microbicides (antimicrobial preparations that can be appled inside the vagina) to prevent gonococcal infections. Another important area of gonorrhea research concerns antibiotic (drug) resistance. This is particularly important because strains of N. gonorhoeae that are resistant to recommended antibiotic treatments have been increasing and are becoming widespread in the United States. These events add urgency to conduct research on and develop new antibiotics and to prevent antibiotic resistance from spreading. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Gonorrhea?", "response": "What are the symptoms of Gonorrhea?: Symptoms of gonorrhea most often appear 2 to 5 days after infection. However, it may take up to a month for symptoms to appear in men. Some people do not have symptoms. They may not know that they have caught the infection, so do not seek treatment. This increases the risk of complications and the chances of passing the infection on to another person. Symptoms in men include: - Burning and pain while urinating - Need to urinate urgently or more often - Discharge from the penis (white, yellow, or green in color) - Red or swollen opening of penis (urethra) - Tender or swollen testicles - Sore throat (gonococcal pharyngitis) Symptoms in women can be very mild. They can be mistaken for another type of infection. They include: - Burning and pain while urinating - Sore throat - Painful sexual intercourse - Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area) - Fever (if the infection spreads to the fallopian tubes and stomach area) If the infection spreads to the bloodstream, symptoms include: - Fever - Rash - Arthritis-like symptoms - Abnormal vaginal discharge with greenish, yellow or foul smelling discharge. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Gonorrhea?", "response": "Gonorrhea (Symptoms): In many cases, gonorrhea infection causes no symptoms. When symptoms do appear, gonorrhea infection can affect multiple sites in your body, but it commonly appears in the genital tract. Gonorrhea affecting the genital tract Signs and symptoms of gonorrhea infection in men include: - Painful urination - Pus-like discharge from the tip of the penis - Pain or swelling in one testicle Signs and symptoms of gonorrhea infection in women include: - Increased vaginal discharge - Painful urination - Vaginal bleeding between periods, such as after vaginal intercourse - Painful intercourse - Abdominal or pelvic pain Gonorrhea at other sites in the body Gonorrhea can also affect these parts of the body: - Rectum. Signs and symptoms include anal itching, pus-like discharge from the rectum, spots of bright red blood on toilet tissue and having to strain during bowel movements. - Eyes. Gonorrhea that affects your eyes may cause eye pain, sensitivity to light, and pus-like discharge from one or both eyes. - Throat. Signs and symptoms of a throat infection may include a sore throat and swollen lymph nodes in the neck. - Joints. If one or more joints become infected by bacteria (septic arthritis), the affected joints may be warm, red, swollen and extremely painful, especially when you move an affected joint. When to see your doctor Make an appointment with your doctor if you notice any troubling signs or symptoms, such as a burning sensation when you urinate or a pus-like discharge from your penis, vagina or rectum. Also make an appointment with your doctor if your partner has been diagnosed with gonorrhea. You may not experience signs or symptoms that prompt you to seek medical attention. But without treatment, you can reinfect your partner even after he or she has been treated for gonorrhea. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Gonorrhea?", "response": "Gonorrhea (More About Gonorrhea): Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Gonorrhea?", "response": "Gonorrhea (Treatment): Gonorrhea treatment in adults Adults with gonorrhea are treated with antibiotics. Due to emerging strains of drug-resistant Neisseria gonorrhoeae, the Centers for Disease Control and Prevention recommends that uncomplicated gonorrhea be treated only with the antibiotic ceftriaxone - given as an injection - in combination with either azithromycin (Zithromax, Zmax) or doxycycline (Monodox, Vibramycin, others) - two antibiotics that are taken orally. Some research indicates that oral gemifloxacin (Factive) or injectable gentamicin, combined with oral azithromycin, is highly successful in treating gonorrhea. This treatment may be helpful in treating people who are allergic to cephalosporin antibiotics, such as ceftriaxone. Gonorrhea treatment for partners Your partner also should undergo testing and treatment for gonorrhea, even if he or she has no signs or symptoms. Your partner receives the same treatment you do. Even if you've been treated for gonorrhea, you can be reinfected if your partner isn't treated. Gonorrhea treatment for babies Babies born to mothers with gonorrhea receive a medication in their eyes soon after birth to prevent infection. If an eye infection develops, babies can be treated with antibiotics. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Gonorrhea?", "response": "What are the treatments for Gonorrhea?: A number of different antibiotics may be used for treating this type of infection. - You may receive one large dose of oral antibiotics or take a smaller dose for seven days. - You may be given an antibiotic injection or shot, and then perhaps be sent home with antibiotic pills. - More severe cases of PID (pelvic inflammatory disease) may require you to stay in the hospital. Antibiotics are first given by IV. - Never treat yourself without being seen by your doctor first. Your health care provider will determine the best treatment. About half of the women with gonorrhea are also infected with chlamydia. Chlamydia is treated at the same time as a gonorrhea infection. You will need a follow-up visit 7 days after if your symptoms include joint pain, skin rash, or more severe pelvic or belly pain. Tests will be done to make sure the infection is gone. Sexual partners must be tested and treated to prevent passing the infection back and forth. You and your partner must finish all of the antibiotics. Use condoms until you both have finished taking your antibiotics. All sexual contacts of the person with gonorrhea should be contacted and tested. This helps prevent further spread of the infection. - In some places you may be able to take information and medicines to your sexual partner yourself. - In other places, the health department will contact your partner. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Gonorrhea?", "response": "How to diagnose Gonorrhea?: Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. - Rarely they are taken from joint fluid or blood - Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours. If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Gonorrhea?", "response": "Gonorrhea (Diagnosis): To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is HIV/AIDS?", "response": "HIV/AIDS (What Is HIV? What Is AIDS?): HIV (human immunodeficiency virus) is a virus that damages and weakens the body's immune system-the system your body uses to fight off infection and disease. Having HIV puts a person in danger of experiencing other life-threatening infections and certain cancers.When the body cannot fight off infections and some other diseases anymore, HIV can lead to a serious illness called AIDS (acquired immunodeficiency syndrome). When someone has AIDS, they are more likely to get infections, and more vulnerable to unusual forms of cancers and other serious diseases. But, with early and uninterrupted treatment, it is possible that a person with HIV will never develop AIDS.If you think you may have HIV, you should get tested. Everyone age 13 to 64 should be tested at least once for HIV. If you are over 64 and are at risk for HIV, talk with your doctor. Your doctor can help determine how often you should be tested and help find ways to reduce your risk.There are drugs that, when taken consistently, can help suppress the amount of HIV in your blood to undetectable levels, improving your health overall and making it harder to pass HIV on to your sexual partners. To get the best results, it is important to start treatment as soon as possible. If you are unsure about your HIV status, get tested. Always protect yourself and your partners when having sex or using needles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is HIV/AIDS?", "response": "HIV/AIDS: HIV, or human immunodeficiency virus, is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). HIV attacks the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell that is vital to fighting off infection. The destruction of these cells leaves people living with HIV vulnerable to other infections, diseases and other complications. As the leading U.S. government institute for HIV/AIDS research, NIAID is committed to conducting the research necessary to successfully end the fight against HIV/AIDS. Nearly 37 million people are living with HIV around the world. In the United States, 1.2 million people are living with HIV, of whom 13 percent are unaware of their diagnosis. Although progress has been made in the global fight against HIV/AIDS, the epidemic continues in the United States and the international community. Globally, AIDS-related deaths have dropped by 45 percent since their peak in 2004. Yet the rate of HIV transmission remains unacceptably high, with 2.1 million new infections occurring worldwide in 2015 alone. NIAID-supported investigators are conducting an abundance of research on all areas of HIV infection, including developing and testing preventive HIV vaccines, prevention strategies, and new treatments for HIV infection and AIDS-associated opportunistic infections. Through laboratories and clinics on the National Institutes of Health campus in Bethesda, Maryland, and a vast network of supported research at universities, medical centers, and clinical trial sites around the globe, NIAID is working to better understand HIV and how it causes disease, find new tools to prevent HIV infection including a preventive vaccine, develop new and more effective treatments for people living with HIV, and hopefully, find a cure. Preventing new HIV infections is a key step toward ending the HIV pandemic as we know it. NIAID-supported researchers have worked since the early days of AIDS in the 1980s to identify prevention tools to keep people healthy. Today, an array of prevention methods are available for use in combination or on their own, and scientists continue to work to develop and improve cutting-edge tools and techniques that can work to prevent HIV in diverse populations around the world. Historically, vaccination has been the best method for protecting people from infectious diseases. While an array of techniques are available for preventing HIV infection, the development of a safe and effective HIV vaccine remains key to realizing a durable end to the HIV/AIDS pandemic. NIAID-supported scientists are working toward an HIV vaccine from two complementary angles: an empirical approach that quickly moves vaccine candidates into human testing, and a theoretical approach that designs vaccine candidates based on an understanding of the immune response to HIV infection. One of NIAID’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS, turning what was once a uniformly fatal disease into a manageable chronic condition for many. NIAID is working to find new and more effective therapeutic products, drug classes, and combinations as well as safe and effective treatments for dangerous related co-infections and complications. NIAID is exploring therapies that suppress the amount of HIV to such low levels that an HIV-infected person would no longer need treatment because his or her immune system could keep the remaining virus in check, creating in essence a “functional cure.”. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes HIV/AIDS?", "response": "What causes HIV/AIDS?: The virus is spread (transmitted) person-to-person in any of the following ways: - Through sexual contact - Through blood -- by blood transfusions (now extremely rare in the U.S.) or more often by needle sharing - From mother to child -- a pregnant woman can spread the virus to her fetus through their shared blood circulation, or a nursing mother can pass it to her baby through her breast milk The virus is NOT spread by: - Casual contact, such as hugging - Mosquitoes - Participating in sports - Touching items that were touched by a person infected with the virus HIV and blood or organ donation: - HIV is not spread to a person who donates blood or organs. People who donate organs are never in direct contact with the people who receive them. Likewise, a person who donates blood is never in contact with the person receiving it. In all of these procedures, sterile needles and instruments are used. - But HIV can be spread to a person receiving blood or organs from an infected donor. To reduce this risk, blood banks and organ donor programs check (screen) donors, blood, and tissues thoroughly. People at high risk of getting HIV include: - Drug users who inject and then share needles - Infants born to mothers with HIV who did not receive HIV treatment during pregnancy - People who have unprotected sex, especially with people who have other high-risk behaviors, are HIV-positive, or have AIDS - People who received blood transfusions or clotting products between 1977 and 1985, before screening for the virus became standard practice - Sexual partners of those who engage in high-risk activities (such as injection drug use or anal sex) After HIV infects the body, the virus can be found in many different fluids and tissues in the body. - Only blood, semen, fluids from the vagina, and breast milk have been shown to transmit infection to others. - The virus may also be found in saliva, tears, and spinal fluid. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes HIV/AIDS?", "response": "HIV/AIDS (Overview): HIV, or human immunodeficiency virus, is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). HIV attacks the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell that is vital to fighting off infection. The destruction of these cells leaves people living with HIV vulnerable to other infections, diseases and other complications. As the leading U.S. government institute for HIV/AIDS research, NIAID is committed to conducting the research necessary to successfully end the fight against HIV/AIDS. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes HIV/AIDS?", "response": "HIV/AIDS (Overview): Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight the organisms that cause disease. HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS. There's no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of HIV/AIDS?", "response": "HIV/AIDS (What Are the Symptoms of HIV?): Many people do not notice symptoms when they first acquire HIV. It can take as little as a few weeks for minor, flu-like symptoms to show up, or more than 10 years for more serious symptoms to appear, or any time in between. Signs of early HIV infection include flu-like symptoms such as headache, muscle aches, swollen glands, sore throat, fevers, chills, and sweating, and can also include a rash or mouth ulcers. Symptoms of later-stage HIV or AIDS include swollen glands, lack of energy, loss of appetite, weight loss, chronic or recurrent diarrhea, repeated yeast infections, short-term memory loss, and blotchy lesions on the skin, inside the mouth, eyelids, nose, or genital area. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of HIV/AIDS?", "response": "HIV/AIDS (Symptoms): The symptoms of HIV and AIDS vary, depending on the phase of infection. Primary infection (Acute HIV) Most people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible signs and symptoms include: - Fever - Headache - Muscle aches and joint pain - Rash - Sore throat and painful mouth sores - Swollen lymph glands, mainly on the neck These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage. Clinical latent infection (Chronic HIV) In some people, persistent swelling of lymph nodes occurs during this stage. Otherwise, there are no specific signs and symptoms. HIV remains in the body and in infected white blood cells. This stage of HIV infection generally lasts around 10 years if you're not receiving antiretroviral therapy. But sometimes, even with this treatment, it lasts for decades. Some people develop more severe disease much sooner. Symptomatic HIV infection As the virus continues to multiply and destroy your immune cells - the cells in your body that help fight off germs - you may develop mild infections or chronic signs and symptoms such as: - Fever - Fatigue - Swollen lymph nodes - often one of the first signs of HIV infection - Diarrhea - Weight loss - Oral yeast infection (thrush) - Shingles (herpes zoster) Progression to AIDS Thanks to better antiviral treatments, most people with HIV in the U.S. today don't develop AIDS. Untreated, HIV typically turns into AIDS in about 10 years. When AIDS occurs, your immune system has been severely damaged. You'll be more likely to develop opportunistic infections or opportunistic cancers - diseases that wouldn't usually trouble a person with a healthy immune system. The signs and symptoms of some of these infections may include: - Soaking night sweats - Recurring fever - Chronic diarrhea - Persistent white spots or unusual lesions on your tongue or in your mouth - Persistent, unexplained fatigue - Weight loss - Skin rashes or bumps When to see a doctor If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of HIV/AIDS?", "response": "HIV/AIDS (Overview): HIV, or human immunodeficiency virus, is the virus that causes AIDS (Acquired Immunodeficiency Syndrome). HIV attacks the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell that is vital to fighting off infection. The destruction of these cells leaves people living with HIV vulnerable to other infections, diseases and other complications. As the leading U.S. government institute for HIV/AIDS research, NIAID is committed to conducting the research necessary to successfully end the fight against HIV/AIDS. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of HIV/AIDS?", "response": "HIV/AIDS (Treatment): There's no cure for HIV/AIDS, but many different drugs are available to control the virus. Such treatment is called antiretroviral therapy, or ART. Each class of drug blocks the virus in different ways. ART is now recommended for everyone, regardless of CD4 T cell counts. It's recommended to combine three drugs from two classes to avoid creating drug-resistant strains of HIV. The classes of anti-HIV drugs include: - Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune). - Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) are faulty versions of the building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine/tenofovir (Truvada), Descovy (tenofovir alafenamide/emtricitabine), and lamivudine-zidovudine (Combivir). - Protease inhibitors (PIs) inactivate HIV protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and indinavir (Crixivan). - Entry or fusion inhibitors Tblock HIV's entry into CD4 T cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry). - Integrase inhibitors work by disabling a protein called integrase, which HIV uses to insert its genetic material into CD4 T cells. Examples include raltegravir (Isentress) and dolutegravir (Tivicay). When to start treatment Everyone with HIV infection, regardless of CD4 T cell count, should be offered antiviral medication. HIV therapy is particularly important for the following situations: - You have severe symptoms. - You have an opportunistic infection. - Your CD4 T cell count is under 350. - You're pregnant. - You have HIV-related kidney disease. - You're being treated for hepatitis B or C. Treatment can be difficult HIV treatment plans may involve taking several pills at specific times every day for the rest of your life. Each medication comes with its own unique set of side effects. It's critical to have regular follow-up appointments with your doctor to monitor your health and treatment. Some of the treatment side effects are: - Nausea, vomiting or diarrhea - Heart disease - Weakened bones or bone loss - Breakdown of muscle tissue (rhabdomyolysis) - Abnormal cholesterol levels - Higher blood sugar Treatment for age-related diseases Some health issues that are a natural part of aging may be more difficult to manage if you have HIV. Some medications that are common for age-related heart, bone or metabolic conditions, for example, may not interact well with anti-HIV medications. It's important to talk to your doctor about your other health conditions and the medications you are taking. Treatment response Your doctor will monitor your viral load and CD4 T cell counts to determine your response to HIV treatment. CD4 T cell counts should be checked every three to six months. Viral load should be tested at the start of treatment and then every three to four months during therapy. Treatment should lower your viral load so that it's undetectable. That doesn't mean your HIV is gone. It just means that the test isn't sensitive enough to detect it. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of HIV/AIDS?", "response": "HIV/AIDS (Finding a Cure): NIAID is exploring therapies that suppress the amount of HIV to such low levels that an HIV-infected person would no longer need treatment because his or her immune system could keep the remaining virus in check, creating in essence a “functional cure.”. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of HIV/AIDS?", "response": "HIV/AIDS (Treatment): One of NIAID’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS, turning what was once a uniformly fatal disease into a manageable chronic condition for many. NIAID is working to find new and more effective therapeutic products, drug classes, and combinations as well as safe and effective treatments for dangerous related co-infections and complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose HIV/AIDS?", "response": "HIV/AIDS (Diagnosis): HIV is most commonly diagnosed by testing your blood or saliva for antibodies to the virus. Unfortunately, it takes time for your body to develop these antibodies - usually up to 12 weeks. A quicker test checks for HIV antigen, a protein produced by the virus immediately after infection. It can confirm a diagnosis soon after infection and allow the person to take swifter steps to prevent the spread of the virus to others. Home testing At least two Food and Drug Administration-approved home test kits for HIV are available. Depending on which you choose, you'll need a drop of dried blood or sample of saliva. If the test is positive, you'll need to see your doctor to confirm the diagnosis and discuss your treatment options. If the test is negative, it needs to be repeated in a few months to confirm the results. Tests to stage disease and treatment If you receive a diagnosis of HIV/AIDS, several tests can help your doctor determine the stage of your disease and the best treatment. These tests include: - CD4 T cell count. CD4 T cells are white blood cells that are specifically targeted and destroyed by HIV. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 T cell count dips below 200. - Viral load (HIV RNA). This test measures the amount of virus in your blood. A higher viral load has been linked to a worse outcome. - Drug resistance. Some strains of HIV are resistant to medications. This test helps your doctor determine if your specific form of the virus has resistance and guides treatment decisions. Tests for complications Your doctor might also order lab tests to check for other infections or complications, including: - Tuberculosis - Hepatitis - Toxoplasmosis - Sexually transmitted infections - Liver or kidney damage - Urinary tract infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose HIV/AIDS?", "response": "How to diagnose HIV/AIDS?: DIAGNOSTIC TESTS These are tests that are done to check if you've been infected with the virus. In general, testing is a 2-step process: - Screening test -- There are several kinds of tests. Some are blood tests, others are mouth fluid tests. They check for antibodies to the HIV virus, HIV antigen, or both. Some screening tests can give results in 30 minutes or less. - Follow-up test -- This is also called a confirmatory test. It is often done when the screening test is positive. Home tests are available to test for HIV. If you plan to use one, checkto make sureit's approved by the FDA. Follow instructions on the packaging to ensure the results are as accurate as possible. The Centers for Disease Control and Prevention (CDC) recommends that everyone ages 15 to 65 have a screening test for HIV. People with risky behaviors should be tested regularly. Pregnant women should also have a screening test. TESTS AFTER BEING DIAGNOSED WITH HIV People with AIDS usually have regular blood tests to check their CD4 cell count: - CD4 cells are the blood cells that HIV attacks. They are also called T4 cells or \"helper T cells.\" - As HIV damages the immune system, the CD4 count drops. A normal CD4 count is from 500 to 1,500 cells/mm3 of blood. - People usually develop symptoms when their CD4 count drops below 350. More serious complications occur when the CD4 count drops to 200. When the count is below 200, the person is said to have AIDS. Other tests include: - HIV RNA level, or viral load, to check how much HIV is in the blood - A resistance test to see if the virus has any resistance to the medicines used to treat HIV - Complete blood count, blood chemistry, and urine test - Tests for other sexually transmitted infections - TB test - Pap smear to check for cervical cancer - Anal pap smear to check for cancer of the anus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Ectopic Pregnancy?", "response": "Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother. In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include: - Birth defect in the fallopian tubes - Scarring after a ruptured appendix - Endometriosis - Having had an ectopic pregnancy in the past - Scarring from past infections or surgery of the female organs The following also increase risk of an ectopic pregnancy: - Age over 35 - Getting pregnant while having an intrauterine device (IUD) - Having your tubes tied. This is more likely 2 or more years after the procedure - Having had surgery to untie tubes to become pregnant - Having had many sexual partners - Some infertility treatments Sometimes, the cause is unknown. Hormones may play a role. The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix. An ectopic pregnancy can occur even if you use birth control. You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy. Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. One out of three women who have had 1 ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again. The likelihood of a successful pregnancy after an ectopic pregnancy depends on: - The woman's age - Whether she has already had children - Why the first ectopic pregnancy occurred Call your provider if you have: - Abnormal vaginal bleeding - Lower abdominal or pelvic pain Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include: - Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection - Getting early diagnosis and treatment of all infections caused by sexual relations (STDs) - Stopping smoking Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Ectopic Pregnancy?", "response": "How to diagnose Ectopic pregnancy?: The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone (quantitative HCG blood test) can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your doctor may suspect an ectopic pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ectopic Pregnancy?", "response": "Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother. In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include: - Birth defect in the fallopian tubes - Scarring after a ruptured appendix - Endometriosis - Having had an ectopic pregnancy in the past - Scarring from past infections or surgery of the female organs The following also increase risk of an ectopic pregnancy: - Age over 35 - Getting pregnant while having an intrauterine device (IUD) - Having your tubes tied. This is more likely 2 or more years after the procedure - Having had surgery to untie tubes to become pregnant - Having had many sexual partners - Some infertility treatments Sometimes, the cause is unknown. Hormones may play a role. The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix. An ectopic pregnancy can occur even if you use birth control. You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy. Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. One out of three women who have had 1 ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again. The likelihood of a successful pregnancy after an ectopic pregnancy depends on: - The woman's age - Whether she has already had children - Why the first ectopic pregnancy occurred Call your provider if you have: - Abnormal vaginal bleeding - Lower abdominal or pelvic pain Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include: - Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection - Getting early diagnosis and treatment of all infections caused by sexual relations (STDs) - Stopping smoking Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ectopic Pregnancy?", "response": "How to diagnose Ectopic pregnancy?: The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone (quantitative HCG blood test) can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your doctor may suspect an ectopic pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ectopic Pregnancy?", "response": "What are the symptoms of Ectopic pregnancy?: You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ectopic Pregnancy?", "response": "Ectopic pregnancy (Symptoms): At first, an ectopic pregnancy might not cause any signs or symptoms. In other cases, early signs and symptoms of an ectopic pregnancy might be the same as those of any pregnancy - a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can't continue as normal. Light vaginal bleeding with abdominal or pelvic pain is often the first warning sign of an ectopic pregnancy. If blood leaks from the fallopian tube, it's also possible to feel shoulder pain or an urge to have a bowel movement - depending on where the blood pools or which nerves are irritated. If the fallopian tube ruptures, heavy bleeding inside the abdomen is likely - followed by lightheadedness, fainting and shock. When to see a doctor Seek emergency medical help if you experience any signs or symptoms of an ectopic pregnancy, including: - Severe abdominal or pelvic pain accompanied by vaginal bleeding - Extreme lightheadedness or fainting - Shoulder pain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ectopic Pregnancy?", "response": "Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother. In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include: - Birth defect in the fallopian tubes - Scarring after a ruptured appendix - Endometriosis - Having had an ectopic pregnancy in the past - Scarring from past infections or surgery of the female organs The following also increase risk of an ectopic pregnancy: - Age over 35 - Getting pregnant while having an intrauterine device (IUD) - Having your tubes tied. This is more likely 2 or more years after the procedure - Having had surgery to untie tubes to become pregnant - Having had many sexual partners - Some infertility treatments Sometimes, the cause is unknown. Hormones may play a role. The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix. An ectopic pregnancy can occur even if you use birth control. You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy. Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. One out of three women who have had 1 ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again. The likelihood of a successful pregnancy after an ectopic pregnancy depends on: - The woman's age - Whether she has already had children - Why the first ectopic pregnancy occurred Call your provider if you have: - Abnormal vaginal bleeding - Lower abdominal or pelvic pain Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include: - Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection - Getting early diagnosis and treatment of all infections caused by sexual relations (STDs) - Stopping smoking Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ectopic Pregnancy?", "response": "Ectopic pregnancy (Treatment): A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue needs to be removed. If the ectopic pregnancy is detected early, an injection of the drug methotrexate is sometimes used to stop cell growth and dissolve existing cells. It's imperative that the diagnosis of ectopic pregnancy is certain before this treatment is undertaken. After the injection, your doctor will monitor your blood for the pregnancy hormone human chorionic gonadotropin (HCG). If the HCG level remains high, you might need another injection of methotrexate. In other cases, ectopic pregnancy is usually treated with laparoscopic surgery. In this procedure, a small incision is made in the abdomen, near or in the navel. Then your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the area. Other instruments can be inserted into the tube or through other small incisions to remove the ectopic tissue and repair the fallopian tube. If the fallopian tube is significantly damaged, it might need to be removed. If the ectopic pregnancy is causing heavy bleeding or the fallopian tube has ruptured, you might need emergency surgery through an abdominal incision (laparotomy). In some cases, the fallopian tube can be repaired. Typically, however, a ruptured tube must be removed. Your doctor will monitor your HCG levels after surgery to be sure all of the ectopic tissue was removed. If HCG levels don't come down quickly, an injection of methotrexate may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ectopic Pregnancy?", "response": "What are the treatments for Ectopic pregnancy?: Ectopic pregnancy is life-threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock, an emergency condition. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ectopic Pregnancy?", "response": "Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother. In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include: - Birth defect in the fallopian tubes - Scarring after a ruptured appendix - Endometriosis - Having had an ectopic pregnancy in the past - Scarring from past infections or surgery of the female organs The following also increase risk of an ectopic pregnancy: - Age over 35 - Getting pregnant while having an intrauterine device (IUD) - Having your tubes tied. This is more likely 2 or more years after the procedure - Having had surgery to untie tubes to become pregnant - Having had many sexual partners - Some infertility treatments Sometimes, the cause is unknown. Hormones may play a role. The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix. An ectopic pregnancy can occur even if you use birth control. You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy. Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. One out of three women who have had 1 ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again. The likelihood of a successful pregnancy after an ectopic pregnancy depends on: - The woman's age - Whether she has already had children - Why the first ectopic pregnancy occurred Call your provider if you have: - Abnormal vaginal bleeding - Lower abdominal or pelvic pain Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include: - Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection - Getting early diagnosis and treatment of all infections caused by sexual relations (STDs) - Stopping smoking Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ectopic Pregnancy?", "response": "How to diagnose Ectopic pregnancy?: The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone (quantitative HCG blood test) can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your doctor may suspect an ectopic pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ectopic Pregnancy?", "response": "Ectopic pregnancy (Diagnosis): If your doctor suspects an ectopic pregnancy, he or she might do a pelvic exam to check for pain, tenderness, or a mass in the fallopian tube or ovary. A physical exam alone usually isn't enough to diagnose an ectopic pregnancy, however. The diagnosis is typically confirmed with blood tests and imaging studies, such as an ultrasound. With a standard ultrasound, high-frequency sound waves are directed at the tissues in the abdominal area. During early pregnancy, however, the uterus and fallopian tubes are closer to the vagina than to the abdominal surface. The ultrasound will likely be done using a wandlike device placed in your vagina (transvaginal ultrasound). Sometimes it's too soon to detect a pregnancy through ultrasound. If the diagnosis is in question, your doctor might monitor your condition with blood tests until the ectopic pregnancy can be confirmed or ruled out through ultrasound - usually by four to five weeks after conception. In an emergency situation - if you're bleeding heavily, for example - an ectopic pregnancy might be diagnosed and treated surgically. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ectopic Pregnancy?", "response": "Ectopic pregnancy: An ectopic pregnancy is a pregnancy that occurs outside the womb (uterus). It is life-threatening to the mother. In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg is blocked or slowed through the tubes, it can lead to an ectopic pregnancy. Things that may cause this problem include: - Birth defect in the fallopian tubes - Scarring after a ruptured appendix - Endometriosis - Having had an ectopic pregnancy in the past - Scarring from past infections or surgery of the female organs The following also increase risk of an ectopic pregnancy: - Age over 35 - Getting pregnant while having an intrauterine device (IUD) - Having your tubes tied. This is more likely 2 or more years after the procedure - Having had surgery to untie tubes to become pregnant - Having had many sexual partners - Some infertility treatments Sometimes, the cause is unknown. Hormones may play a role. The most common site for an ectopic pregnancy is within 1 of the 2 fallopian tubes. In rare cases, ectopic pregnancies can occur in the ovary, abdomen, or cervix. An ectopic pregnancy can occur even if you use birth control. You may have early pregnancy symptoms, such as breast tenderness or nausea. Other symptoms may include: - Abnormal vaginal bleeding - Low back pain - Mild cramping on one side of the pelvis - No periods - Pain in the lower belly or pelvic area If the area around the abnormal pregnancy ruptures and bleeds, symptoms may get worse. They may include: - Fainting or feeling faint - Intense pressure in the rectum - Low blood pressure - Pain in the shoulder area - Severe, sharp, and sudden pain in the lower abdomen The health care provider will do a pelvic exam. The exam may show tenderness in the pelvic area. A pregnancy test and vaginal ultrasound will be done. HCG is a hormone normally produced during pregnancy. Checking the blood level of this hormone can diagnose pregnancy. If the blood level of HCG is not rising fast enough, your provider may suspect an ectopic pregnancy. Ectopic pregnancy is life threatening. The pregnancy cannot continue to birth (term). The developing cells must be removed to save the mother's life. If the ectopic pregnancy has not ruptured, treatment may include: - Surgery - Medicine that ends the pregnancy, along with close monitoring by your doctor You will need emergency medical help if the area of the ectopic pregnancy breaks open (ruptures). Rupture can lead to bleeding and shock. Treatment for shock may include: - Blood transfusion - Fluids given through a vein - Keeping warm - Oxygen - Raising the legs If there is a rupture, surgery is done to stop blood loss and remove the pregnancy. In some cases, the doctor may have to remove the fallopian tube. One out of three women who have had 1 ectopic pregnancy are later able to have a baby. Another ectopic pregnancy is more likely to occur. Some women do not become pregnant again. The likelihood of a successful pregnancy after an ectopic pregnancy depends on: - The woman's age - Whether she has already had children - Why the first ectopic pregnancy occurred Call your provider if you have: - Abnormal vaginal bleeding - Lower abdominal or pelvic pain Most forms of ectopic pregnancy that occur outside the fallopian tubes are probably not preventable. You may be able to reduce your risk by avoiding conditions that may scar the fallopian tubes. These steps include: - Practicing safer sex by taking steps before and during sex, which can prevent you from getting an infection - Getting early diagnosis and treatment of all infections caused by sexual relations (STDs) - Stopping smoking Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Appendicitis?", "response": "Appendicitis: Appendicitis is inflammation of the appendix. The appendix is a small pouch attached to the large intestine. Appendicitis is a very common cause of emergency surgery. The problem most often occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor. The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, older people, and women of childbearing age. The first symptom is often pain around the belly button or mid upper abdomen. Pain may be minor at first, but becomes more sharp and severe. You may also have a loss of appetite, nausea, vomiting, and a low-grade fever. The pain tends to move into the right lower part of your belly. The pain tends to focus at a spot directly above the appendix called McBurney point. This most often occurs 12 to 24 hours after the illness starts. Your pain may be worse when you walk, cough, or make sudden movements. Later symptoms include: - Chills and shaking - Hard stools - Diarrhea - Fever - Nausea and vomiting Your health care provider may suspect appendicitis based on the symptoms you describe. Your provider will do a physical exam. - If you have appendicitis, your pain will increase when your lower right belly area is pressed. - If your appendix has ruptured, touching the belly area may cause a lot of pain and lead you to tighten your muscles. - A rectal exam may find tenderness on the right side of your rectum. A blood test will often show a high white blood cell count. Imaging tests may also help diagnose appendicitis. Imaging tests include: - CT scan of the abdomen - Ultrasound of the abdomen Most of the time, a surgeon will remove your appendix as soon as you are diagnosed. If a CT scan shows that you have an abscess, you may be treated with antibiotics first. You will have your appendix removed after the infection and swelling have gone away. The tests used to diagnose appendicitis are not perfect. As a result, the operation may show that your appendix is normal. In that case, the surgeon will remove your appendix and explore the rest of your abdomen for other causes of your pain. Most people recover quickly after surgery if the appendix is removed before it ruptures. If your appendix ruptures before surgery, recovery may take longer. You are also more likely to develop problems, such as: - An abscess - Blockage of the intestine - Infection inside the abdomen (peritonitis) - Infection of the wound after surgery Call your provider if you have abdominal pain in the lower-right portion of your belly, or other symptoms of appendicitis. Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Appendicitis?", "response": "Appendicitis (Summary): Summary The appendix is a small, tube-like organ attached to the first part of the large intestine. It is located in the lower right part of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis. The main symptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include - Swelling in the abdomen - Loss of appetite - Nausea and vomiting - Constipation or diarrhea - Inability to pass gas - Low fever Not everyone with appendicitis has all these symptoms. Appendicitis is a medical emergency. Treatment almost always involves removing the appendix. Anyone can get appendicitis, but it is more common among people 10 to 30 years old. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Appendicitis?", "response": "Appendicitis (Symptoms and Causes): The most common symptom of appendicitis is pain in your abdomen.If you have appendicitis, you’ll most often have pain in your abdomen thatbegins near your belly button and then moves lower and to your right gets worse in a matter of hours gets worse when you move around, take deep breaths, cough, or sneeze is severe and often described as different from any pain you’ve felt before occurs suddenly and may even wake you up if you’re sleeping occurs before other symptomsOther symptoms of appendicitis may includeloss of appetite nausea vomiting constipation or diarrhea an inability to pass gas a low-grade fever swelling in your abdomen the feeling that having a bowel movement will relieve discomfortSymptoms can be different for each person and can seem like the following conditions that also cause pain in the abdomen:abdominal adhesions constipation inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, long-lasting disorders that cause irritation and ulcers in the GI tract intestinal obstruction pelvic inflammatory disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Appendicitis?", "response": "Appendicitis: Appendicitis is inflammation of the appendix. The appendix is a small pouch attached to the large intestine. Appendicitis is a very common cause of emergency surgery. The problem most often occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor. The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, older people, and women of childbearing age. The first symptom is often pain around the belly button or mid upper abdomen. Pain may be minor at first, but becomes more sharp and severe. You may also have a loss of appetite, nausea, vomiting, and a low-grade fever. The pain tends to move into the right lower part of your belly. The pain tends to focus at a spot directly above the appendix called McBurney point. This most often occurs 12 to 24 hours after the illness starts. Your pain may be worse when you walk, cough, or make sudden movements. Later symptoms include: - Chills and shaking - Hard stools - Diarrhea - Fever - Nausea and vomiting Your health care provider may suspect appendicitis based on the symptoms you describe. Your provider will do a physical exam. - If you have appendicitis, your pain will increase when your lower right belly area is pressed. - If your appendix has ruptured, touching the belly area may cause a lot of pain and lead you to tighten your muscles. - A rectal exam may find tenderness on the right side of your rectum. A blood test will often show a high white blood cell count. Imaging tests may also help diagnose appendicitis. Imaging tests include: - CT scan of the abdomen - Ultrasound of the abdomen Most of the time, a surgeon will remove your appendix as soon as you are diagnosed. If a CT scan shows that you have an abscess, you may be treated with antibiotics first. You will have your appendix removed after the infection and swelling have gone away. The tests used to diagnose appendicitis are not perfect. As a result, the operation may show that your appendix is normal. In that case, the surgeon will remove your appendix and explore the rest of your abdomen for other causes of your pain. Most people recover quickly after surgery if the appendix is removed before it ruptures. If your appendix ruptures before surgery, recovery may take longer. You are also more likely to develop problems, such as: - An abscess - Blockage of the intestine - Infection inside the abdomen (peritonitis) - Infection of the wound after surgery Call your provider if you have abdominal pain in the lower-right portion of your belly, or other symptoms of appendicitis. Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Appendicitis?", "response": "Appendicitis (Symptoms): The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, older people, and women of childbearing age. The first symptom is often pain around the belly button or mid upper abdomen. Pain may be minor at first, but becomes more sharp and severe. You may also have a loss of appetite, nausea, vomiting, and a low-grade fever. The pain tends to move into the right lower part of your belly. The pain tends to focus at a spot directly above the appendix called McBurney point. This most often occurs 12 to 24 hours after the illness starts. Your pain may be worse when you walk, cough, or make sudden movements. Later symptoms include: - Chills and shaking - Hard stools - Diarrhea - Fever - Nausea and vomiting. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Appendicitis?", "response": "Appendicitis (Symptoms): Signs and symptoms of appendicitis may include: - Sudden pain that begins on the right side of the lower abdomen - Sudden pain that begins around your navel and often shifts to your lower right abdomen - Pain that worsens if you cough, walk or make other jarring movements - Nausea and vomiting - Loss of appetite - Low-grade fever that may worsen as the illness progresses - Constipation or diarrhea - Abdominal bloating The site of your pain may vary, depending on your age and the position of your appendix. When you're pregnant, the pain may seem to come from your upper abdomen because your appendix is higher during pregnancy. When to see a doctor Make an appointment with a doctor if you or your child has worrisome signs or symptoms. Severe abdominal pain requires immediate medical attention. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Appendicitis?", "response": "Appendicitis (Symptoms and Causes): The most common symptom of appendicitis is pain in your abdomen.If you have appendicitis, you’ll most often have pain in your abdomen thatbegins near your belly button and then moves lower and to your right gets worse in a matter of hours gets worse when you move around, take deep breaths, cough, or sneeze is severe and often described as different from any pain you’ve felt before occurs suddenly and may even wake you up if you’re sleeping occurs before other symptomsOther symptoms of appendicitis may includeloss of appetite nausea vomiting constipation or diarrhea an inability to pass gas a low-grade fever swelling in your abdomen the feeling that having a bowel movement will relieve discomfortSymptoms can be different for each person and can seem like the following conditions that also cause pain in the abdomen:abdominal adhesions constipation inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, long-lasting disorders that cause irritation and ulcers in the GI tract intestinal obstruction pelvic inflammatory disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Appendicitis?", "response": "What are the treatments for Appendicitis?: Most of the time, a surgeon will remove your appendix as soon as you are diagnosed. If a CT scan shows that you have an abscess, you may be treated with antibiotics first. You will have your appendix removed after the infection and swelling have gone away. The tests used to diagnose appendicitis are not perfect. As a result, the operation may show that your appendix is normal. In that case, the surgeonwill remove your appendix and explore the rest of your abdomen for other causes of your pain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Appendicitis?", "response": "Appendicitis (Treatment): Doctors typically treat appendicitis with surgery to remove the appendix. Surgeons perform the surgery in a hospital with general anesthesia. Your doctor will recommend surgery if you have continuous abdominal pain and fever, or signs of a burst appendix and infection. Prompt surgery decreases the chance that your appendix will burst.Health care professionals call the surgery to remove the appendix an appendectomy. A surgeon performs the surgery using one of the following methods:Laparoscopic surgery. During laparoscopic surgery, surgeons use several smaller incisions and special surgical tools that they feed through the incisions to remove your appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time. Laparotomy. Surgeons use laparotomy to remove the appendix through a single incision in the lower right area of your abdomen.After surgery, most patients completely recover from appendicitis and don’t need to make changes to their diet, exercise, or lifestyle. Surgeons recommend that you limit physical activity for the first 10 to 14 days after a laparotomy and for the first 3 to 5 days after laparoscopic surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Appendicitis?", "response": "Appendicitis (Treatment): Appendicitis treatment usually involves surgery to remove the inflamed appendix. Before surgery you may be given a dose of antibiotics to prevent infection. Surgery to remove the appendix (appendectomy) Appendectomy can be performed as open surgery using one abdominal incision about 2 to 4 inches (5 to 10 centimeters) long (laparotomy). Or the surgery can be done through a few small abdominal incisions (laparoscopic surgery). During a laparoscopic appendectomy, the surgeon inserts special surgical tools and a video camera into your abdomen to remove your appendix. In general, laparoscopic surgery allows you to recover faster and heal with less pain and scarring. It may be better for people who are elderly or obese. But laparoscopic surgery isn't appropriate for everyone. If your appendix has ruptured and infection has spread beyond the appendix or you have an abscess, you may need an open appendectomy, which allows your surgeon to clean the abdominal cavity. Expect to spend one or two days in the hospital after your appendectomy. Draining an abscess before appendix surgery If your appendix has burst and an abscess has formed around it, the abscess may be drained by placing a tube through your skin into the abscess. Appendectomy can be performed several weeks later after controlling the infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Appendicitis?", "response": "Appendicitis (Exams and Tests): Your health care provider may suspect appendicitis based on the symptoms you describe. Your provider will do a physical exam. - If you have appendicitis, your pain will increase when your lower right belly area is pressed. - If your appendix has ruptured, touching the belly area may cause a lot of pain and lead you to tighten your muscles. - A rectal exam may find tenderness on the right side of your rectum. A blood test will often show a high white blood cell count. Imaging tests may also help diagnose appendicitis. Imaging tests include: - CT scan of the abdomen - Ultrasound of the abdomen. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Appendicitis?", "response": "Appendicitis (Diagnosis): To help diagnose appendicitis, your doctor will likely take a history of your signs and symptoms and examine your abdomen. Tests and procedures used to diagnose appendicitis include: - Physical exam to assess your pain. Your doctor may apply gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, signaling that the adjacent peritoneum is inflamed. Your doctor also may look for abdominal rigidity and a tendency for you to stiffen your abdominal muscles in response to pressure over the inflamed appendix (guarding). Your doctor may use a lubricated, gloved finger to examine your lower rectum (digital rectal exam). Women of childbearing age may be given a pelvic exam to check for possible gynecological problems that could be causing the pain. - Blood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection. - Urine test. Your doctor may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn't causing your pain. - Imaging tests. Your doctor may also recommend an abdominal X-ray, an abdominal ultrasound or a computerized tomography (CT) scan to help confirm appendicitis or find other causes for your pain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Appendicitis?", "response": "Appendicitis (Diagnosis): Most often, health care professionals suspect the diagnosis of appendicitis based on your symptoms, your medical history, and a physical exam. A doctor can confirm the diagnosis with an ultrasound, x-ray, or MRI exam.A health care professional will ask specific questions about your symptoms and health history to help rule out other health problems. The health care professional will want to knowwhen your abdominal pain began the exact location and severity of your pain when your other symptoms appeared your other medical conditions, previous illnesses, and surgical procedures whether you use medicines, alcohol, or illegal drugsHealth care professionals need specific details about the pain in your abdomen to diagnose appendicitis correctly. A health care professional will assess your pain by touching or applying pressure to specific areas of your abdomen.The following responses to touch or pressure may indicate that you have appendicitis:Rovsing's sign Psoas sign Obturator sign Guarding Rebound tenderness Digital rectal exam Pelvic examDoctors use lab tests to help confirm the diagnosis of appendicitis or find other causes of abdominal pain.Blood tests. A health care professional draws your blood for a blood test at a doctor’s office or a commercial facility. The health care professional sends the blood sample to a lab for testing. Blood tests can show a high white blood cell count, a sign of infection. Blood tests also may show dehydration or fluid and electrolyte imbalances.Urinalysis. Urinalysis is testing of a urine sample. You will provide a urine sample in a special container in a doctor’s office, a commercial facility, or a hospital. Health care professionals can test the urine in the same location or send it to a lab for testing. Doctors use urinalysis to rule out a urinary tract infection or a kidney stone.Pregnancy test. For women, health care professionals also may order blood or urine samples to check for pregnancy.Doctors use imaging tests to confirm the diagnosis of appendicitis or find other causes of pain in the abdomen.Abdominal ultrasound. In an ultrasound, a health care professional uses a device, called a transducer, to bounce safe, painless sound waves off of your organs to create an image of their structure. He or she can move the transducer to different angles to examine different organs.In an abdominal ultrasound, a health care professional applies a gel to your abdomen and moves a hand-held transducer over your skin. A health care professional performs this procedure in a doctor’s office, an outpatient center, or a hospital, and you don’t need anesthesia.A radiologist reviews the images, which can show signs ofa blockage in your appendiceal lumen a burst appendix inflammation other sources of abdominal painHealth care professionals use an ultrasound as the first imaging test for possible appendicitis in infants, children, young adults, and pregnant women.Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of your body’s internal organs and soft tissues without using x-rays.A health care professional performs the procedure in an outpatient center or a hospital. A radiologist reviews the images. Patients don’t need anesthesia, although a health care professional may give light sedation, taken by mouth, to children and people with a fear of small spaces. A health care professional may inject a special dye, called contrast medium, into your body.In most cases, you’ll lie on a table that slides into a tunnel-shaped device. The tunnel may be open ended or closed at one end.An MRI can show signs ofa blockage in your appendiceal lumen a burst appendix inflammation other sources of abdominal painWhen diagnosing appendicitis and other sources of abdominal pain, doctors can use an MRI as a safe, reliable alternative to a computerized tomography (CT) scan.2CT scan. CT scans use x-rays and computer technology to create images.A health care professional may give you a solution to drink and an injection of contrast medium. You’ll lie on a table that slides into a tunnel-shaped device that takes the x-rays. X-ray technicians perform CT scans in an outpatient center or a hospital. Radiologists review the images.Patients don’t need anesthesia, although health care professionals may give children a sedative to help them fall asleep for the test.A CT scan of the abdomen can show signs of inflammation, such asan enlarged or a burst appendix an appendiceal abscess a blockage in your appendiceal lumenWomen of childbearing age should have a pregnancy test before having a CT scan. The radiation from CT scans can be harmful to a developing fetus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Ear Infections?", "response": "Ear Infections in Children (What are the symptoms of an ear infection?): There are three main types of ear infections. Each has a different combination of symptoms. - Acute otitis media (AOM) is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the ear—commonly called an earache. Your child might also have a fever. - Otitis media with effusion (OME) sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument. - Chronic otitis media with effusion (COME) happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Ear Infections?", "response": "Ear Infections in Children (How can I tell if my child has an ear infection?): Most ear infections happen to children before they’ve learned how to talk. If your child isn’t old enough to say “My ear hurts,” here are a few things to look for: - Tugging or pulling at the ear(s) - Fussiness and crying - Trouble sleeping - Fever (especially in infants and younger children) - Fluid draining from the ear - Clumsiness or problems with balance - Trouble hearing or responding to quiet sounds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ear Infections?", "response": "Ear Infections in Children (How can I tell if my child has an ear infection?): Most ear infections happen to children before they’ve learned how to talk. If your child isn’t old enough to say “My ear hurts,” here are a few things to look for: - Tugging or pulling at the ear(s) - Fussiness and crying - Trouble sleeping - Fever (especially in infants and younger children) - Fluid draining from the ear - Clumsiness or problems with balance - Trouble hearing or responding to quiet sounds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ear Infections?", "response": "Ear Infections in Children (Why are children more likely than adults to get ear infections?): There are several reasons why children are more likely than adults to get ear infections. Eustachian tubes are smaller and more level in children than they are in adults. This makes it difficult for fluid to drain out of the ear, even under normal conditions. If the eustachian tubes are swollen or blocked with mucus due to a cold or other respiratory illness, fluid may not be able to drain. A child’s immune system isn’t as effective as an adult’s because it’s still developing. This makes it harder for children to fight infections. As part of the immune system, the adenoids respond to bacteria passing through the nose and mouth. Sometimes bacteria get trapped in the adenoids, causing a chronic infection that can then pass on to the eustachian tubes and the middle ear. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ear Infections?", "response": "Ear Infections in Children (What are the symptoms of an ear infection?): There are three main types of ear infections. Each has a different combination of symptoms. - Acute otitis media (AOM) is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the ear—commonly called an earache. Your child might also have a fever. - Otitis media with effusion (OME) sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument. - Chronic otitis media with effusion (COME) happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ear Infections?", "response": "Ear Infections in Children (How can I tell if my child has an ear infection?): Most ear infections happen to children before they’ve learned how to talk. If your child isn’t old enough to say “My ear hurts,” here are a few things to look for: - Tugging or pulling at the ear(s) - Fussiness and crying - Trouble sleeping - Fever (especially in infants and younger children) - Fluid draining from the ear - Clumsiness or problems with balance - Trouble hearing or responding to quiet sounds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ear Infections?", "response": "Ear Infections in Children (What are the symptoms of an ear infection?): There are three main types of ear infections. Each has a different combination of symptoms. - Acute otitis media (AOM) is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum. This causes pain in the ear—commonly called an earache. Your child might also have a fever. - Otitis media with effusion (OME) sometimes happens after an ear infection has run its course and fluid stays trapped behind the eardrum. A child with OME may have no symptoms, but a doctor will be able to see the fluid behind the eardrum with a special instrument. - Chronic otitis media with effusion (COME) happens when fluid remains in the middle ear for a long time or returns over and over again, even though there is no infection. COME makes it harder for children to fight new infections and also can affect their hearing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ear Infections?", "response": "What are Ear Infections?: Ear infections are the most common reason parents bring their child to a doctor. Three out of four children will have at least one ear infection by their third birthday. Adults can also get ear infections, but they are less common. The infection usually affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid. If your child isn't old enough to say \"My ear hurts,\" here are a few things to look for - Tugging at ears - Crying more than usual - Fluid draining from the ear - Trouble sleeping - Balance difficulties - Hearing problems Your health care provider will diagnose an ear infection by looking inside the ear with an instrument called an otoscope. Often, ear infections go away on their own. Your health care provider may recommend pain relievers. Severe infections and infections in young babies may require antibiotics. Children who get infections often may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears so that the child can hear again. NIH: National Institute on Deafness and Other Communication Disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ear Infections?", "response": "What are the treatments for Ear infection - acute?: Some ear infections clear on their own without antibiotics. Often, treating the pain and allowing the body time to heal itself is all that is needed: - Apply a warm cloth or warm water bottle to the affected ear. - Use over-the-counter pain relief drops for ears. Or, ask the provider about prescription eardrops to relieve pain. - Take over-the-counter medicines such as ibuprofen or acetaminophen for pain or fever. Do NOT give aspirin to children. All children younger than 6 months with a fever or symptoms of an ear infection should see a provider. Children who are older than 6 months may be watched at home if they do NOT have: - A fever higher than 102F (38.9C) - More severe pain or other symptoms - Other medical problems If there is no improvement or if symptoms get worse, schedule an appointment with the provider to determine whether antibiotics are needed. ANTIBIOTICS A virus or bacteria can cause ear infections. Antibiotics will not help an infection that is caused by a virus. Most providers don't prescribe antibiotics for every ear infection. However, all children younger than 6 months with an ear infection are treated with antibiotics. Your health care provider is more likely to prescribe antibiotics if your child: - Is under age 2 - Has a fever - Appears sick - Does not improve in 24 to 48 hours If antibiotics are prescribed, it is important to take them every day and to take all of the medicine. Do NOT stop the medicine when symptoms go away. If the antibiotics do not seem to be working within 48 to 72 hours, contact your provider. You may need to switch to a different antibiotic. Side effects of antibiotics may include nausea, vomiting, and diarrhea. Although rare, serious allergic reactions may also occur. Some children have repeat ear infections that seem to go away between episodes. They may receive a smaller, daily dose of antibiotics to prevent new infections. SURGERY If an infection does not go away with the usual medical treatment, or if a child has many ear infections over a short period of time, the provider may recommend ear tubes: - A tiny tube is inserted into the eardrum, keeping open a small hole that allows air to get in so fluids can drain more easily. - Usually the tubes fall out by themselves. Those that don't fall out may be removed in the provider's office. If the adenoids are enlarged, removing them with surgery may be considered if ear infections continue to occur. Removing tonsils does not seem to help prevent ear infections. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ear Infections?", "response": "Ear Infections in Children (How is an acute middle ear infection treated?): Many doctors will prescribe an antibiotic, such as amoxicillin, to be taken over seven to 10 days. Your doctor also may recommend over-the-counter pain relievers such as acetaminophen or ibuprofen, or eardrops, to help with fever and pain. (Because aspirin is considered a major preventable risk factor for Reye’s syndrome, a child who has a fever or other flu-like symptoms should not be given aspirin unless instructed to by your doctor.) If your doctor isn’t able to make a definite diagnosis of OM and your child doesn’t have severe ear pain or a fever, your doctor might ask you to wait a day or two to see if the earache goes away. The American Academy of Pediatrics issued guidelines in 2013 that encourage doctors to observe and closely follow these children with ear infections that can’t be definitively diagnosed, especially those between the ages of 6 months to 2 years. If there’s no improvement within 48 to 72 hours from when symptoms began, the guidelines recommend doctors start antibiotic therapy. Sometimes ear pain isn’t caused by infection, and some ear infections may get better without antibiotics. Using antibiotics cautiously and with good reason helps prevent the development of bacteria that become resistant to antibiotics. If your doctor prescribes an antibiotic, it’s important to make sure your child takes it exactly as prescribed and for the full amount of time. Even though your child may seem better in a few days, the infection still hasn’t completely cleared from the ear. Stopping the medicine too soon could allow the infection to come back. It’s also important to return for your child’s follow-up visit, so that the doctor can check if the infection is gone. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ear Infections?", "response": "Ear infection (middle ear) (Diagnosis): Your doctor can usually diagnose an ear infection or another condition based on the symptoms you describe and an exam. The doctor will likely use a lighted instrument (an otoscope) to look at the ears, throat and nasal passage. He or she will also likely listen to your child breathe with a stethoscope. Pneumatic otoscope An instrument called a pneumatic otoscope is often the only specialized tool a doctor needs to make a diagnosis of an ear infection. This instrument enables the doctor to look in the ear and judge whether there is fluid behind the eardrum. With the pneumatic otoscope, the doctor gently puffs air against the eardrum. Normally, this puff of air would cause the eardrum to move. If the middle ear is filled with fluid, your doctor will observe little to no movement of the eardrum. Additional tests Your doctor may perform other diagnostic tests if there is any doubt about a diagnosis, if the condition hasn't responded to previous treatments, or if there are other persistent or serious problems. - Tympanometry. This test measures the movement of the eardrum. The device, which seals off the ear canal, adjusts air pressure in the canal, thereby causing the eardrum to move. The device quantifies how well the eardrum moves and provides an indirect measure of pressure within the middle ear. - Acoustic reflectometry. This test measures how much sound emitted from a device is reflected back from the eardrum - an indirect measure of fluids in the middle ear. Normally, the eardrum absorbs most of the sound. However, the more pressure there is from fluid in the middle ear, the more sound the eardrum will reflect. - Tympanocentesis. Rarely, a doctor may use a tiny tube that pierces the eardrum to drain fluid from the middle ear - a procedure called tympanocentesis. Tests to determine the infectious agent in the fluid may be beneficial if an infection hasn't responded well to previous treatments. - Other tests. If your child has had persistent ear infections or persistent fluid buildup in the middle ear, your doctor may refer you to a hearing specialist (audiologist), speech therapist or developmental therapist for tests of hearing, speech skills, language comprehension or developmental abilities. What a diagnosis means - Acute otitis media. The diagnosis of \"ear infection\" is generally shorthand for acute otitis media. Your doctor likely makes this diagnosis if he or she observes signs of fluid in the middle ear, if there are signs or symptoms of an infection, and if the onset of symptoms was relatively sudden. - Otitis media with effusion. If the diagnosis is otitis media with effusion, the doctor has found evidence of fluid in the middle ear, but there are presently no signs or symptoms of infection. - Chronic suppurative otitis media. If the doctor makes a diagnosis of chronic suppurative otitis media, he or she has found that a persistent ear infection resulted in tearing or perforation of the eardrum. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ear Infections?", "response": "Ear Infections in Children (How can I tell if my child has an ear infection?): Most ear infections happen to children before they’ve learned how to talk. If your child isn’t old enough to say “My ear hurts,” here are a few things to look for: - Tugging or pulling at the ear(s) - Fussiness and crying - Trouble sleeping - Fever (especially in infants and younger children) - Fluid draining from the ear - Clumsiness or problems with balance - Trouble hearing or responding to quiet sounds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ear Infections?", "response": "What are Ear Infections?: Ear infections are the most common reason parents bring their child to a doctor. Three out of four children will have at least one ear infection by their third birthday. Adults can also get ear infections, but they are less common. The infection usually affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid. If your child isn't old enough to say \"My ear hurts,\" here are a few things to look for - Tugging at ears - Crying more than usual - Fluid draining from the ear - Trouble sleeping - Balance difficulties - Hearing problems Your health care provider will diagnose an ear infection by looking inside the ear with an instrument called an otoscope. Often, ear infections go away on their own. Your health care provider may recommend pain relievers. Severe infections and infections in young babies may require antibiotics. Children who get infections often may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears so that the child can hear again. NIH: National Institute on Deafness and Other Communication Disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Cervical Cancer?", "response": "Cervical cancer (Who gets cervical cancer?): Each year, about 12,000 women in the United States get cervical cancer. Cervical cancer happens most often in women 30 years or older, but all women are at risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Cervical Cancer?", "response": "Cervical cancer (Causes): Cervical cancer begins when healthy cells acquire a genetic change (mutation) that causes them to turn into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from a tumor to spread (metastasize) elsewhere in the body. It isn't clear what causes cervical cancer, but it's certain that HPV plays a role. HPV is very common, and most women with the virus never develop cervical cancer. This means other factors - such as your environment or your lifestyle choices - also determine whether you'll develop cervical cancer. The type of cervical cancer that you have helps determine your prognosis and treatment. The main types of cervical cancer are: - Squamous cell carcinoma. This type of cervical cancer begins in the thin, flat cells (squamous cells) lining the outer part of the cervix, which projects into the vagina. Most cervical cancers are squamous cell carcinomas. - Adenocarcinoma. This type of cervical cancer begins in the column-shaped glandular cells that line the cervical canal. Sometimes, both types of cells are involved in cervical cancer. Very rarely, cancer occurs in other cells in the cervix. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Cervical Cancer?", "response": "Cervical cancer (Causes): Worldwide, cervical cancer is the third most common type of cancer in women. It is much less common in the United States because of the routine use of Pap smears. Cervical cancer starts in the cells on the surface of the cervix. There are 2 types of cells on the surface of the cervix, squamous and columnar. Most cervical cancers are from squamous cells. Cervical cancer usually develops slowly. It starts as a precancerous condition called dysplasia. This condition can be detected by a Pap smear and is 100% treatable. It can take years for dysplasia to develop into cervical cancer. Most women who are diagnosed with cervical cancer today have not had regular Pap smears, or they have not followed up on abnormal Pap smear results. Almost all cervical cancers are caused by HPV (human papillomavirus). HPV is a common virus that is spread through sexual intercourse. There are many different types (strains) of HPV. Some strains lead to cervical cancer. Other strains can cause genital warts. Others do not cause any problems at all. A woman's sexual habits and patterns can increase her risk of developing cervical cancer. Risky sexual practices include: - Having sex at an early age - Having multiple sexual partners - Having a partner or many partners who take part in high-risk sexual activities Other risk factors for cervical cancer include: - Not getting the HPV vaccine - Being economically disadvantaged - Having a mother who took the drug diethylstilbestrol (DES) during pregnancy in the early 1960s to prevent miscarriage - Having a weakened immune system. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Cervical Cancer?", "response": "Cervical cancer: Cervical cancer is cancer that starts in the cervix, the lower, narrow part of the uterus (womb). Most cervical cancers are caused by the human papillomavirus (HPV). Cervical cancer is the easiest gynecological cancer to prevent with regular screening tests and vaccination. It is also very curable when found and treated early. Learn more about cervical cancer at the National Cancer Institute. Cervical cancer is cancer that starts in the cervix, the lower, narrow part of the uterus. It happens when the body's cervical cells divide very fast and grow out of control. These extra cells form a tumor. Each year, about 12,000 women in the United States get cervical cancer. Cervical cancer happens most often in women 30 years or older, but all women are at risk. Most cases of cervical cancer are caused by a high-risk type of HPV. HPV is a virus that is passed from person to person through genital contact, such as vaginal, anal, or oral sex. If the HPV infection does not go away on its own, it may cause cervical cancer over time. Other things may increase the risk of developing cancer following a high-risk HPV infection. These other things include: You may not notice any signs or symptoms of cervical cancer. Signs of advanced cervical cancer may include bleeding or discharge from the vagina. These symptoms may not be caused by cervical cancer, but the only way to be sure is to see your doctor. Women should start getting screened at age 21. You can get a Pap test to look for changes in cervical cells that could become cancer-ous if not treated. If the Pap test finds major changes in the cells of the cervix, your doctor may suggest more tests to look for cancer. Women between the ages of 30 and 65 can also get an HPV test with your Pap test to see if you have HPV. The Pap test and the HPV test look for different things. A Pap test checks the cervix for abnormal cell changes that, if not found and treated, can lead to cervical cancer. Your doctor takes cells from your cervix to examine under a microscope. How often you need a Pap test depends on your age and health history. Talk with your doctor about what is best for you. Learn more about Pap tests on our Pap test page. An HPV test looks for HPV on a woman's cervix. Certain types of HPV can lead to cervical cancer. Your doctor will swab the cervix for cells. An HPV test is not the same as the HPV vaccine. According to the U.S. Preventive Services Task Force (USPSTF), women ages 30 to 65 can combine the HPV test with a Pap test every 5 years. The USPSTF does not recommend the HPV test for women under age 30. Learn more about HPV and the HPV test on our HPV page. How often you need to be screened depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines: If you had a hysterectomy, you should follow these guidelines: You can lower your risk of getting cervical cancer with the following steps. The steps work best when used together. No single step can protect you from cervical cancer. The best ways to prevent cervical cancer include: HPV vaccines are approved for girls and young women from 9 through 26. Experts recommend that all girls get an HPV vaccine before any sexual activity, by the time they are 11 or 12. The Gardasil 9 HPV vaccine gives the most protection against cervical cancer for girls and women. Some girls younger than 15 may be able to get just two doses of the HPV vaccine, but others may need three doses of the HPV vaccine. The HPV vaccine is not recommended for pregnant women. Talk to your doctor to find out how many doses are best for you. Yes. You can still benefit from the HPV vaccine if you have already had sexual contact before getting all three doses. This only applies if you have not been infected with the HPV types included in the vaccine. For more information about cervical cancer, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Cervical Cancer?", "response": "Cervical cancer (What are the symptoms of cervical cancer?): You may not notice any signs or symptoms of cervical cancer. Signs of advanced cervical cancer may include bleeding or discharge from the vagina. These symptoms may not be caused by cervical cancer, but the only way to be sure is to see your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Cervical Cancer?", "response": "Cervical cancer (Symptoms): Early-stage cervical cancer generally produces no signs or symptoms. Signs and symptoms of more-advanced cervical cancer include: - Vaginal bleeding after intercourse, between periods or after menopause - Watery, bloody vaginal discharge that may be heavy and have a foul odor - Pelvic pain or pain during intercourse Make an appointment with your doctor if you have any signs or symptoms that concern you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Cervical Cancer?", "response": "Cervical cancer (Symptoms): Most of the time, early cervical cancer has no symptoms. Symptoms that may occur include: - Abnormal vaginal bleeding between periods, after intercourse, or after menopause - Vaginal discharge that does not stop, and may be pale, watery, pink, brown, bloody, or foul-smelling - Periods that become heavier and last longer than usual Cervical cancer may spread to the bladder, intestines, lungs, and liver. Often, there are no problems until the cancer is advanced and has spread. Symptoms of advanced cervical cancer may include: - Back pain - Bone pain or fractures - Fatigue - Leaking of urine or feces from the vagina - Leg pain - Loss of appetite - Pelvic pain - Single swollen leg - Weight loss. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Cervical Cancer?", "response": "Cervical Cancer (Treatment Option Overview): - There are different types of treatment for patients with cervical cancer. - Four types of standard treatment are used: - Surgery - Radiation therapy - Chemotherapy - Targeted therapy - New types of treatment are being tested in clinical trials. - Treatment for cervical cancer may cause side effects. - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Cervical Cancer?", "response": "Cervical cancer (Treatment): Treatment of cervical cancer depends on: - The stage of the cancer - The size and shape of the tumor - The woman's age and general health - Her desire to have children in the future Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why routine Pap smears are so important to prevent cervical cancer. There are surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future. Types of surgery for early cervical cancer include: - Loop electrosurgical excision procedure (LEEP): Uses electricity to remove abnormal tissue - Cryotherapy: Freezes abnormal cells - Laser therapy: Uses light to burn abnormal tissue A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have had repeated LEEP procedures. Treatment for more advanced cervical cancer may include: - Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina. - Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed. Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned. Chemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Cervical Cancer?", "response": "Cervical cancer (Treatment): Treatment for cervical cancer depends on several factors, such as the stage of the cancer, other health problems you may have and your preferences. Surgery, radiation, chemotherapy or a combination of the three may be used. Surgery Early-stage cervical cancer is typically treated with surgery to remove the uterus (hysterectomy). A hysterectomy can cure early-stage cervical cancer and prevent recurrence. But removing the uterus makes it impossible to become pregnant. Your doctor may recommend: - Simple hysterectomy. The cervix and uterus are removed along with the cancer. Simple hysterectomy is usually an option only in very early-stage cervical cancer. - Radical hysterectomy. The cervix, uterus, part of the vagina and lymph nodes in the area are removed with the cancer. Minimally invasive surgery may be an option for early-stage cervical cancer. Surgery that preserves the possibility of becoming pregnant also may be an option, if you have very early-stage cervical cancer without lymph node involvement. Radiation Radiation therapy uses high-powered energy beams, such as X-rays or protons, to kill cancer cells. Radiation therapy may be used alone or with chemotherapy before surgery to shrink a tumor or after surgery to kill any remaining cancer cells. Radiation therapy can be given: - Externally, by directing a radiation beam at the affected area of the body (external beam radiation therapy) - Internally, by placing a device filled with radioactive material inside your vagina, usually for only a few minutes (brachytherapy) - Both externally and internally Premenopausal women may stop menstruating and begin menopause as a result of radiation therapy. If you might want to get pregnant after radiation treatment, ask your doctor about ways to preserve your eggs before treatment starts. Chemotherapy Chemotherapy uses medications, usually injected into a vein, to kill cancer cells. Low doses of chemotherapy are often combined with radiation therapy, since chemotherapy may enhance the effects of the radiation. Higher doses of chemotherapy are used to control advanced cervical cancer that may not be curable. Follow-up care After you complete treatment, your doctor will recommend regular checkups. Ask your doctor how often you should have follow-up exams. Supportive (palliative) care Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Cervical Cancer?", "response": "How to diagnose Cervical cancer?: Precancerous changes of the cervix and cervical cancer cannot be seen with the naked eye. Special tests and tools are needed to spot such conditions: - A Pap smear screens for precancers and cancer, but does not make a final diagnosis. - The human papillomavirus (HPV) DNA test may be done along with a Pap test. Or it may be used after a woman has had an abnormal Pap test result. It may also be used as a main test. - If abnormal changes are found, the cervix is usually examined under magnification. This procedure is called colposcopy. Pieces of tissue are removed (biopsied) during this procedure. This tissue is then sent to a lab for examination. - A procedure called cone biopsy may also be done. If cervical cancer is diagnosed, the health care provider will order more tests. These help determine how far the cancer has spread. This is called staging. Tests may include: - Chest x-ray - CT scan of the pelvis - Cystoscopy - Intravenous pyelogram (IVP) - MRI of the pelvis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Cervical Cancer?", "response": "Cervical cancer (Diagnosis): Screening Cervical cancer that is detected early is more likely to be treated successfully. Most guidelines suggest that women begin screening for cervical cancer and precancerous changes at age 21. Screening tests include: - Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities. A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer. - HPV DNA test. The HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer. This test may be an option for women age 30 and older, or for younger women with an abnormal Pap test. Diagnosis If cervical cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells. During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use: - Punch biopsy, which involves using a sharp tool to pinch off small samples of cervical tissue. - Endocervical curettage, which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix. If the punch biopsy or endocervical curettage is worrisome, your doctor may perform one of the following tests: - Electrical wire loop, which uses a thin, low-voltage electrical wire to obtain a small tissue sample. Generally this is done under local anesthesia in the office. - Cone biopsy, which is a procedure that allows your doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia. Staging If your doctor determines that you have cervical cancer, you'll have further tests to determine the extent (stage) of your cancer. Your cancer's stage is a key factor in deciding on your treatment. Staging exams include: - Imaging tests. Tests such as X-rays, CT scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) help your doctor determine whether your cancer has spread beyond your cervix. - Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder and rectum. Stages of cervical cancer include: - Stage I. Cancer is confined to the cervix. - Stage II. Cancer is present in the cervix and upper portion of the vagina. - Stage III. Cancer has moved to the lower portion of the vagina or internally to the pelvic side wall. - Stage IV. Cancer has spread to nearby organs, such as the bladder or rectum, or it has spread to other areas of the body, such as the lungs, liver or bones. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Ovarian Cancer?", "response": "Ovarian cancer: Ovarian cancer is cancer that begins in the ovaries. The ovaries make female hormones and produce a woman's eggs. Ovarian cancer is a serious cancer that is more common in older women. Treatment is most effective when the cancer is found early. Screening for ovarian cancer is not recommended for most women. Learn more about ovarian cancer at the National Cancer Institute. Ovarian cancer forms in tissues of the ovary. (An ovary is one of a pair of female reproductive glands in which the ova, or eggs, are formed.) Tumors in the ovaries can be benign, which means they are not cancer, or they can be malignant, which means they are cancer. Cancers that start in the ovaries can spread to other parts of the body. This is called metastasis. Cancer that starts in the ovaries and spreads to other parts of the body is still called ovarian cancer. Around one in every 60 women in the United States will develop ovarian cancer. Most ovarian cancers are diagnosed in women over 60, but this disease can also affect younger women. Among women in the United States, ovarian cancer is rare. Most ovarian cancers are diagnosed among women ages 55 to 64, but ovarian cancer can also affect younger women. Women with a high risk of ovarian cancer are those with a harmful mutation on the BRCA1 or BRCA2 genes. These mutations can be found with a blood test. Women with a family or personal history of breast or ovarian cancer also have a higher risk of ovarian cancer. If you have family members in multiple generations with breast cancer or ovarian cancer, see your doctor to learn more about your risk of ovarian cancer. Research shows that certain steps, such as surgery to remove the ovaries and the fallopian tubes, may help prevent ovarian cancer in women who are at high risk. The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early, because its symptoms are also the symptoms of many other illnesses. The following may be symptoms of ovarian cancer if they continue or get worse over time: If you have any of these symptoms, talk to your doctor. He or she can determine if the cause is cancer or something else. Your doctor also may ask you to visit a gynecologic oncologist. This is a doctor who focuses on cancers of the female pelvis. The U.S. Preventive Services Task Force (USPSTF) recommends against screening women who are not at high risk for ovarian cancer. The USPSTF found that testing for ovarian cancer may do more harm than good. Current testing methods, like pelvic exams, ultrasound, and blood tests, can lead to \"false positives\" (results that say a woman has ovarian cancer when she really does not have ovarian cancer). These incorrect results can lead to surgeries that are not needed and that can be risky. Some women, like those who are at high risk, can talk to their doctor about their risk and what they can do to help prevent ovarian cancer. For more information about ovarian cancer, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ovarian Cancer?", "response": "Ovarian cancer (Causes): It's not clear what causes ovarian cancer, though doctors have identified factors that can increase the risk of the disease. In general, cancer begins when a cell develops errors (mutations) in its DNA. The mutations tell the cell to grow and multiply quickly, creating a mass (tumor) of abnormal cells. The abnormal cells continue living when healthy cells would die. They can invade nearby tissues and break off from an initial tumor to spread elsewhere in the body (metastasize). Types of ovarian cancer The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include: - Epithelial tumors, which begin in the thin layer of tissue that covers the outside of the ovaries. About 90 percent of ovarian cancers are epithelial tumors. - Stromal tumors, which begin in the ovarian tissue that contains hormone-producing cells. These tumors are usually diagnosed at an earlier stage than other ovarian tumors. About 7 percent of ovarian tumors are stromal. - Germ cell tumors, which begin in the egg-producing cells. These rare ovarian cancers tend to occur in younger women. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ovarian Cancer?", "response": "Ovarian cancer (Risk factors): Factors that can increase your risk of ovarian cancer include: - Older age. Ovarian cancer can occur at any age but is most common in women ages 50 to 60 years. - Inherited gene mutations. A small percentage of ovarian cancers are caused by gene mutations you inherit from your parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes also increase the risk of breast cancer. Other gene mutations, including those associated with Lynch syndrome, are known to increase the risk of ovarian cancer. - Family history of ovarian cancer. People with two or more close relatives with ovarian cancer have an increased risk of the disease. - Estrogen hormone replacement therapy, especially with long-term use and in large doses. - Age when menstruation started and ended. Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Ovarian Cancer?", "response": "Ovarian cancer: Ovarian cancer is cancer that begins in the ovaries. The ovaries make female hormones and produce a woman's eggs. Ovarian cancer is a serious cancer that is more common in older women. Treatment is most effective when the cancer is found early. Screening for ovarian cancer is not recommended for most women. Learn more about ovarian cancer at the National Cancer Institute. Ovarian cancer forms in tissues of the ovary. (An ovary is one of a pair of female reproductive glands in which the ova, or eggs, are formed.) Tumors in the ovaries can be benign, which means they are not cancer, or they can be malignant, which means they are cancer. Cancers that start in the ovaries can spread to other parts of the body. This is called metastasis. Cancer that starts in the ovaries and spreads to other parts of the body is still called ovarian cancer. Around one in every 60 women in the United States will develop ovarian cancer. Most ovarian cancers are diagnosed in women over 60, but this disease can also affect younger women. Among women in the United States, ovarian cancer is rare. Most ovarian cancers are diagnosed among women ages 55 to 64, but ovarian cancer can also affect younger women. Women with a high risk of ovarian cancer are those with a harmful mutation on the BRCA1 or BRCA2 genes. These mutations can be found with a blood test. Women with a family or personal history of breast or ovarian cancer also have a higher risk of ovarian cancer. If you have family members in multiple generations with breast cancer or ovarian cancer, see your doctor to learn more about your risk of ovarian cancer. Research shows that certain steps, such as surgery to remove the ovaries and the fallopian tubes, may help prevent ovarian cancer in women who are at high risk. The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early, because its symptoms are also the symptoms of many other illnesses. The following may be symptoms of ovarian cancer if they continue or get worse over time: If you have any of these symptoms, talk to your doctor. He or she can determine if the cause is cancer or something else. Your doctor also may ask you to visit a gynecologic oncologist. This is a doctor who focuses on cancers of the female pelvis. The U.S. Preventive Services Task Force (USPSTF) recommends against screening women who are not at high risk for ovarian cancer. The USPSTF found that testing for ovarian cancer may do more harm than good. Current testing methods, like pelvic exams, ultrasound, and blood tests, can lead to \"false positives\" (results that say a woman has ovarian cancer when she really does not have ovarian cancer). These incorrect results can lead to surgeries that are not needed and that can be risky. Some women, like those who are at high risk, can talk to their doctor about their risk and what they can do to help prevent ovarian cancer. For more information about ovarian cancer, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ovarian Cancer?", "response": "Ovarian cancer (Symptoms): Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions. Signs and symptoms of ovarian cancer may include: - Abdominal bloating or swelling - Quickly feeling full when eating - Weight loss - Discomfort in the pelvis area - Changes in bowel habits, such as constipation - A frequent need to urinate When to see a doctor Make an appointment with your doctor if you have any signs or symptoms that worry you. If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ovarian Cancer?", "response": "Ovarian cancer (Symptoms): Many people with early ovarian cancer have no signs or symptoms of the condition. When present, symptoms are often nonspecific and blamed on other, more common conditions. Some people with ovarian cancer may experience the following: [2] [6] Bloating Difficulty eating or early satiety Pelvic or lower abdominal pain Back pain Abnormal vaginal bleeding Digestive symptoms such as nausea and vomiting; constipation; indigestion; and/or acid reflux Weight loss or weight gain Increased urinary frequency or urgency Tiredness Shortness of breath The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Abnormality of metabolism/homeostasis - Autosomal dominant inheritance - Breast carcinoma - Dysgerminoma - Ovarian papillary adenocarcinoma -. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Ovarian Cancer?", "response": "Ovarian cancer (What are the symptoms of ovarian cancer?): The following may be symptoms of ovarian cancer if they continue or get worse over time: If you have any of these symptoms, talk to your doctor. He or she can determine if the cause is cancer or something else. Your doctor also may ask you to visit a gynecologic oncologist. This is a doctor who focuses on cancers of the female pelvis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ovarian Cancer?", "response": "Ovarian cancer (Treatment): The best treatment options for ovarian cancer depend on many factors including the subtype and stage of the condition. In general, treatment may include a combination of the following:[3][4][5] Surgery to remove the ovaries, the fallopian tubes, the uterus, and/or other structures in the belly (pelvis). Chemotherapy Radiation therapy Targeted therapy (such as monoclonal antibody therapy) Unfortunately, research suggests that there are no benefits of ovarian cancer screening (using a CA-125 blood test and transvaginal ultrasound), even in women who are at an elevated risk due to their personal and/or family histories.[8] Women who are at a high-risk for ovarian cancer may, therefore, want to discuss other preventative measures, such as prophylactic surgery, with their healthcare provider. In women with a known hereditary cancer syndrome , management should also include screening for the other component cancers. Please click on the following links for more information regarding the treatment and management of each condition: Hereditary Breast and Ovarian Cancer Lynch syndrome Peutz-Jeghers syndrome FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ovarian Cancer?", "response": "Ovarian, Fallopian Tube, and Primary Peritoneal Cancer (Treatment Options by Stage): Early Ovarian Epithelial and Fallopian Tube Cancer Treatment of early ovarian epithelial cancer or fallopian tube cancer may include the following: - Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and checked under a microscope for cancer cells. Chemotherapy may be given after surgery. - Unilateral salpingo-oophorectomy may be done in certain women who wish to have children. Chemotherapy may be given after surgery. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Advanced Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment of advanced ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer may include the following: - Hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. Lymph nodes and other tissues in the pelvis and abdomen are removed and checked under a microscope to look for cancer cells. Surgery is followed by one of the following: - Intravenous chemotherapy. - Intraperitoneal chemotherapy. - Chemotherapy and targeted therapy (bevacizumab, olaparib, or niraparib). - Chemotherapy followed by hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. - Chemotherapy alone for patients who cannot have surgery. - A clinical trial of intraperitoneal radiation therapy, immunotherapy (vaccine therapy), or targeted therapy. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Ovarian Cancer?", "response": "Ovarian cancer (Treatment): Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy. Surgery Operations to remove ovarian cancer include: - Surgery to remove one ovary. For very early stage cancer that hasn't spread beyond one ovary, surgery may involve removing the affected ovary and its fallopian tube. This procedure may preserve your ability to have children. - Surgery to remove both ovaries. If cancer is present in both your ovaries, but there are no signs of additional cancer, your surgeon may remove both ovaries and both fallopian tubes. This procedure leaves your uterus intact, so you may still be able to become pregnant using your own frozen embryos or eggs or with eggs from a donor. - Surgery to remove both ovaries and the uterus. If your cancer is more extensive or if you don't wish to preserve your ability to have children, your surgeon will remove the ovaries, the fallopian tubes, the uterus, nearby lymph nodes and a fold of fatty abdominal tissue (omentum). - Surgery for advanced cancer. If your cancer is advanced, your doctor may recommend chemotherapy followed by surgery to remove as much of the cancer as possible. Chemotherapy Chemotherapy is a drug treatment that uses chemicals to kill fast-growing cells in the body, including cancer cells. Chemotherapy drugs can be injected into a vein or taken by mouth. Sometimes the drugs are injected directly into the abdomen (intraperitoneal chemotherapy). Chemotherapy is often used after surgery to kill any cancer cells that might remain. It can also be used before surgery. Targeted therapy Targeted therapy uses medications that target the specific vulnerabilities present within your cancer cells. Targeted therapy drugs are usually reserved for treating ovarian cancer that returns after initial treatment or cancer that resists other treatments. Your doctor may test your cancer cells to determine which targeted therapy is most likely to have an effect on your cancer. Targeted therapy is an active area of cancer research. Many clinical trials are testing new targeted therapies. Supportive (palliative) care Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery and chemotherapy. When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ovarian Cancer?", "response": "Ovarian cancer (Diagnosis): If ovarian cancer is suspected based on the presence of certain signs and symptoms, the following tests and procedures may be recommended: [2] [6] Physical evaluation and pelvic exam to check for signs of ovarian cancer (i.e. lumps or swelling) and to examine the size, shape and location of the ovaries Ultrasound and other imaging studies to look for abnormal growths Blood tests such as a CA-125 assay which may be elevated in people with ovarian cancer A biopsy of the tumor is the only way to confirm a diagnosis of ovarian cancer The National Cancer Institute offers more detailed information regarding the tests used to diagnose ovarian cancer. To access this resource, please click here. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to diagnose Ovarian Cancer?", "response": "Ovarian cancer (Diagnosis): Tests and procedures used to diagnose ovarian cancer include: - Pelvic exam. During a pelvic exam, your doctor inserts gloved fingers into your vagina and simultaneously presses a hand on your abdomen in order to feel (palpate) your pelvic organs. The doctor also visually examines your external genitalia, vagina and cervix. - Imaging tests. Tests, such as ultrasound or CT scans of your abdomen and pelvis, may help determine the size, shape and structure of your ovaries. - Blood tests. Blood tests might include organ function tests that can help determine your overall health. Your doctor might also test your blood for tumor markers that indicate ovarian cancer. For example, a cancer antigen (CA) 125 test can detect a protein that's often found on the surface of ovarian cancer cells. These tests can't tell your doctor whether you have cancer, but may give clues about your diagnosis and prognosis. - Surgery. Sometimes your doctor can't be certain of your diagnosis until you undergo surgery to remove an ovary and have it tested for signs of cancer. Once it's confirmed that you have ovarian cancer, your doctor will use information from your tests and procedures to assign your cancer a stage. The stages of ovarian cancer are indicated using Roman numerals ranging from I to IV, with the lowest stage indicating that the cancer is confined to the ovaries. By stage IV, the cancer has spread to distant areas of the body. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Prostate Cancer?", "response": "Familial prostate cancer: Familial prostate cancer is a cluster of prostate cancer within a family. Most cases of prostate cancer occur sporadically in people with no family history of the condition. However, approximately 5% to 10% of prostate cancer cases are believed to be primarily caused by a genetic predisposition to the condition. [1] In many families, the underlying genetic cause is unknown; however, some of these cases are caused by changes ( mutations ) in the BRCA1 , BRCA2, HOXB13, or several other genes . Other cases are likely due to a combination of gene(s) and other shared factors such as environment and lifestyle. [2] High-risk cancer screening at an earlier age is typically recommended in men who have an increased risk for prostate cancer based on personal and/or family histories. The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Neoplasm - Prostate cancer - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Prostate Cancer?", "response": "Prostate Cancer (Stages of Prostate Cancer): - After prostate cancer has been diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. - There are three ways that cancer spreads in the body. - Cancer may spread from where it began to other parts of the body. - The following stages are used for prostate cancer: - Stage I - Stage II - Stage III - Stage IV. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Prostate Cancer?", "response": "Cryotherapy for prostate cancer (Summary): Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells. The goal of cryosurgery is to destroy the entire prostate gland and possibly surrounding tissue. Cryosurgery is generally not used as a first treatment for prostate cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Prostate Cancer?", "response": "Prostate cancer - resources (Summary): The following organizations are good resources for information on prostate cancer: - American Cancer Society -- www.cancer.org/cancer/prostatecancer/index - National Cancer Institute -- www.cancer.gov/cancertopics/types/prostate - Prostate Cancer Foundation -- www.pcf.org - U.S. Centers for Disease Control and Prevention -- www.cdc.gov/cancer/prostate - U.S. National Library of Medicine Genetics Home Reference -- ghr.nlm.nih.gov/condition/prostate-cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What causes Prostate Cancer?", "response": "How to diagnose Prostate Cancer?: Doctors use tests to detect prostate abnormalities, but tests cannot show whether abnormalities are cancer or another, less serious condition. The results from these tests will help the doctor decide whether to check the patient further for signs of cancer. The most common test is a blood test for prostate specific antigen or PSA -- a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, an enlarged prostate, or infection in the prostate. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Prostate Cancer?", "response": "Prostate cancer (Symptoms): With early prostate cancer, there are often no symptoms. The PSA blood test may done to screen men for prostate cancer. Often, PSA level rises before there are any symptoms. The symptoms listed below can occur with prostate cancer as it grows larger in the prostate. These symptoms can also be caused by other prostate problems: - Delayed or slowed start of urinary stream - Dribbling or leakage of urine, most often after urinating - Slow urinary stream - Straining when urinating, or not being able to empty all of the urine - Blood in the urine or semen When the cancer has spread, there may be bone pain or tenderness, most often in the lower back and pelvic bones. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Prostate Cancer?", "response": "What are the symptoms of Prostate Cancer?: - a need to urinate frequently, especially at night - difficulty starting urination or holding back urine - inability to urinate - weak or interrupted flow of urine a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine If prostate cancer develops and is not treated, it can cause these symptoms: - painful or burning urination - difficulty in having an erection - painful ejaculation - blood in urine or semen - pain or stiffness in the lower back, hips, or upper thighs painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen pain or stiffness in the lower back, hips, or upper thighs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the symptoms of Prostate Cancer?", "response": "Prostate Cancer (Overview): The prostate gland makes fluid that forms part of semen. The prostate lies just below the bladder in front of the rectum. It surrounds the urethra (the tube that carries urine and semen through the penis and out of the body). Prostate cancer is the most common cancer in men in the United States, after skin cancer. It is the second leading cause of death from cancer in men. Prostate cancer occurs more often in African-American men than in white men. African-American men with prostate cancer are more likely to die from the disease than white men with prostate cancer. Almost all prostate cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids). Prostate cancer often has no early symptoms. Advanced prostate cancer can cause men to urinate more often or have a weaker flow of urine, but these symptoms can also be caused by benign prostate conditions. Prostate cancer usually grows very slowly. Most men with prostate cancer are older than 65 years and do not die from the disease. Finding and treating prostate cancer before symptoms occur may not improve health or help you live longer. Talk to your doctor about your risk of prostate cancer and whether you need screening tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Prostate Cancer?", "response": "Familial prostate cancer (Treatment): FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What are the treatments of Prostate Cancer?", "response": "Cryotherapy for prostate cancer (When Cryosurgery is Used to Treat Prostate Cancer): This therapy is not as commonly used and is not as well accepted as other treatments for prostate cancer. Doctors do not know for certain how well cryosurgery works over time. There is not enough data to compare it with standard prostatectomy, radiation treatment, or brachytherapy. It can only treat prostate cancer that has not spread beyond the prostate. Men who cannot have surgery because of their age or other health problems may have cryosurgery instead. It also may be used if cancer comes back after other treatments. It is generally not helpful for men with very large prostate glands. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Noonan syndrome. What are the references with noonan syndrome and polycystic renal disease", "response": "Noonan syndrome: Noonan syndrome is a disease that can be passed down through families (inherited). It causes many parts of the body to develop abnormally. Noonan syndrome is linked to defects in several genes. In general, certain proteins involved in growth and development become overactive as a result of these gene changes. Noonan syndrome is an autosomal dominant condition. This means only one parent has to pass down the nonworking gene for the child to have the syndrome. However, some cases may not be inherited. Symptoms include: - Delayed puberty - Down-slanting or wide-set eyes - Hearing loss (varies) - Low-set or abnormally shaped ears - Mild intellectual disability (only in about 25% of cases) - Sagging eyelids (ptosis) - Short stature - Small penis - Undescended testicles - Unusual chest shape (most often a sunken chest called pectus excavatum) - Webbed and short-appearing neck The health care provider will perform a physical exam. This may show signs of heart problems the infant had from birth. These may include pulmonary stenosis and atrial septal defect. Tests depend on the symptoms, but may include: - Platelet count - Blood clotting factor test - EKG, chest x-ray, or echocardiogram - Hearing tests - Growth hormone levels Genetic testing can help diagnose this syndrome. There is no specific treatment. Your provider will suggest treatment to relieve or manage symptoms. Growth hormone has been used successfully to treat short height in some persons with Noonan syndrome. The Noonan Syndrome Foundation is a place where people dealing with this condition can find information and resources. Complications may include: - Abnormal bleeding or bruising - Buildup of fluid in tissues of body (lymphedema, cystic hygroma) - Failure to thrive in infants - Leukemia and other cancers - Low self-esteem - Infertility in males if both testes are undescended - Problems with the structure of the heart - Short height - Social problems due to physical symptoms This condition may be found during early infant exams. A geneticist is often needed to diagnose Noonan syndrome. Couples with a family history of Noonan syndrome may want to consider genetic counseling before having children. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Gluten information. Re:NDC# 0115-0672-50 Zolmitriptan tabkets 5mg. I have celiac disease & need to know if these contain gluten, Thank you!", "response": "What other information should I know about Zolmitriptan?: Keep all appointments with your doctor. Your blood pressure should be checked regularly. You should keep a headache diary by writing down when you have headaches and when you take zolmitriptan. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "amphetamine salts 20 mg. are they gluten free", "response": "Dextroamphetamine and Amphetamine (Brand names of combination products): - Adderall® (containing Amphetamine, Dextroamphetamine) - Adderall® XR (containing Amphetamine, Dextroamphetamine) - Biphetamine® (containing Amphetamine, Dextroamphetamine)¶. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "amphetamine salts 20 mg. are they gluten free", "response": "Amphetamine (Why is this medication prescribed?): Amphetamine (Adzenys XR, Dyanavel XR, Evekeo) is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in adults and children. Amphetamine (Evekeo) is used to treat narcolepsy (a sleep disorder that causes excessive daytime sleepiness and sudden attacks of sleep). Amphetamine (Evekeo) is also used for a limited period of time (a few weeks) along with a reduced calorie diet and an exercise plan for weight loss in obese people unable to lose weight. Amphetamine is in a class of medications called central nervous system stimulants. It works by changing the amounts of certain natural substances in the brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "amphetamine salts 20 mg. are they gluten free", "response": "Amphetamine (What other information should I know?): Keep all appointments with your doctor. Your doctor may order certain tests to check your body's response to amphetamine and your blood pressure. Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking amphetamine. This prescription is not refillable. Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vdrl positive. vdrl positive patients please tell me what are he doing . Diagnosis and precaution.", "response": "VDRL test (What Abnormal Results Mean): A positive test result may mean you have syphilis. If the test is positive, the next step is to confirm the results with an FTA-ABS test, which is a more specific syphilis test. The VDRL test's ability to detect syphilis depends on the stage of the disease. The test's sensitivity to detect syphilis nears 100% during the middle stages; it is less sensitive during the earlier and later stages. Some conditions may cause a false-positive test, including: - HIV - Lyme disease - Certain types of pneumonia - Malaria - Systemic lupus erythematosus The body does not always produce antibodies specifically in response to the syphilis bacteria, so this test is not always accurate. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vdrl positive. vdrl positive patients please tell me what are he doing . Diagnosis and precaution.", "response": "VDRL test: The VDRL test is a screening test for syphilis. It measures substances (proteins), called antibodies, that your body may produce if you have come in contact with the bacteria that cause syphilis. The test is most often done using a blood sample. It can also be done using a sample of spinal fluid. This article discusses the blood test. A blood sample is needed. When the needle is inserted to draw blood, some people may feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away. This test is used to screen for syphilis. The bacteria that cause syphilis is called Treponema pallidum. Your health care provider may order this test if you have signs and symptoms of a sexually transmitted illness (STI). Syphilis screening is a routine part of prenatal care during pregnancy. Several states also require screening for syphilis prior to obtaining a marriage license. This test is similar to the newer rapid plasma reagin (RPR) test. A negative test is normal. It means that no antibodies to syphilis have been seen in your blood sample. The screening test is most likely to be positive in the secondary and latent stages of syphilis. This test may give a false-negative result during early- and late-stage syphilis. This test must be confirmed with another blood test to make the diagnosis of syphilis. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results. A positive test result may mean you have syphilis. If the test is positive, the next step is to confirm the results with an FTA-ABS test, which is a more specific syphilis test. The VDRL test's ability to detect syphilis depends on the stage of the disease. The test's sensitivity to detect syphilis nears 100% during the middle stages; it is less sensitive during the earlier and later stages. Some conditions may cause a false-positive test, including: - HIV - Lyme disease - Certain types of pneumonia - Malaria - Systemic lupus erythematosus The body does not always produce antibodies specifically in response to the syphilis bacteria, so this test is not always accurate. Veins and arteries vary in size from one person to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others. Other risks associated with having blood drawn are slight, but may include: - Excessive bleeding - Fainting or feeling lightheaded - Hematoma (blood accumulating under the skin) - Infection (a slight risk any time the skin is broken) Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vdrl positive. vdrl positive patients please tell me what are he doing . Diagnosis and precaution.", "response": "CSF-VDRL test (Why the Test is Performed): The CSF-VDRL test is done to diagnose syphilis in the brain or spinal cord. Brain and spinal cord involvement is often a sign of late-stage syphilis. Blood screening tests (VDRL and RPR) are better at detecting middle-stage (secondary) syphilis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much glucagon. How much glucose is in my GlucaGen HypoKit ? Just curious, I know that there is enough because I have used it. Thank you very much", "response": "How should Glucagon be used and what is the dosage?: Glucagon is usually given by injection beneath the skin, in the muscle, or in the vein. It comes as a powder and liquid that will need to be mixed just before administering the dose. Instructions for mixing and giving the injection are in the package. Glucagon should be administered as soon as possible after discovering that the patient is unconscious from low blood sugar. After the injection, the patient should be turned onto the side to prevent choking if they vomit. Once the glucagon has been given, contact your doctor. It is very important that all patients have a household member who knows the symptoms of low blood sugar and how to administer glucagon. If you have low blood sugar often, keep a glucagon kit with you at all times. You should be able to recognize some of the signs and symptoms of low blood sugar (i.e., shakiness, dizziness or lightheadedness, sweating, confusion, nervousness or irritability, sudden changes in behavior or mood, headache, numbness or tingling around the mouth, weakness, pale skin, sudden hunger, clumsy or jerky movements). Try to eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, before it is necessary to administer glucagon. Follow the directions on your prescription label carefully, and ask your pharmacist or doctor to explain any part you or your household members do not understand. Use glucagon exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much glucagon. How much glucose is in my GlucaGen HypoKit ? Just curious, I know that there is enough because I have used it. Thank you very much", "response": "Low Blood Glucose (Hypoglycemia): Someone will need to give you a glucagon injection if you have severe hypoglycemia. An injection of glucagon will quickly raise your blood glucose level. Talk with your health care provider about when and how to use a glucagon emergency kit. If you have an emergency kit, check the date on the package to make sure it hasn’t expired.If you are likely to have severe hypoglycemia, teach your family, friends, and coworkers when and how to give you a glucagon injection. Also, tell your family, friends, and coworkers to call 911 right away after giving you a glucagon injection or if you don’t have a glucagon emergency kit with you.If you have hypoglycemia often or have had severe hypoglycemia, you should wear a medical alert bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that hypoglycemia can cause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much glucagon. How much glucose is in my GlucaGen HypoKit ? Just curious, I know that there is enough because I have used it. Thank you very much", "response": "Continuous Glucose Monitoring: A CGM is one part of the “artificial pancreas” systems that are beginning to reach people with diabetes.The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has played an important role in developing artificial pancreas technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots. A single system monitors blood glucose levels around the clock and provides insulin or both insulin and a second hormone, glucagon, automatically. The system can also be monitored remotely, for example by parents or medical staff.In 2016, the U.S. Food and Drug Administration approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night through a CGM, and automatically gives you the right amount of basal insulin, a long-acting insulin, through a separate insulin pump. You will still need to test your blood with a glucose meter a few times a day. And you'll manually adjust the amount of insulin the pump delivers at mealtimes and when you need a correction dose.The hybrid closed-loop system may free you from some of the daily tasks needed to keep your blood glucose stable—or help you sleep through the night without the need to wake and test your glucose or take medicine. Talk with your health care provider about whether this system might be right for you.The NIDDK has funded – and continues to fund – several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ANESTHESIA EFFECT ON FXTAS PERSONS.. Does Anesthesia given during a operation severely hurt, or damage a brain for FXTAS patient? The operation would be for hip replacement! Thank you very much", "response": "General anesthesia (Before the Procedure): Tell your provider: - If you could be pregnant - What medicines you are taking, even drugs or herbs you bought without a prescription During the days before the surgery: - An anesthesiologist will take a complete medical history to determine the type and amount of the anesthesia you need. This includes asking you about any allergies, health conditions, medicines, and history of anesthesia. - Several days to a week before surgery, you may be asked to stop taking blood thinning drugs, such as aspirin, ibuprofen (Advil, Motrin), and warfarin (Coumadin, Jantoven). - Ask your provider which drugs you should still take on the day of your surgery. - Always try to stop smoking. Your doctor can help. On the day of your surgery: - You will likely be asked not to drink or eat anything after midnight the night before the surgery. This is to prevent you from vomiting while you are under the effect of the anesthesia. Vomiting can cause food in the stomach to be inhaled into the lungs. This can lead to breathing problems. - Take the drugs that your provider told you to take with a small sip of water. - Arrive at the hospital on time. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ANESTHESIA EFFECT ON FXTAS PERSONS.. Does Anesthesia given during a operation severely hurt, or damage a brain for FXTAS patient? The operation would be for hip replacement! Thank you very much", "response": "Fragile X-Associated Tremor and Ataxia Syndrome (FXTAS) (How is a change in a gene related to FXTAS?): People with FXTAS have a change or mutation in the FMR1 gene found on the X chromosome. In the gene, the information for making a protein has two parts: the introduction, and the instructions for making the protein itself. Researchers call the introduction the promoter because of how it helps to start the process of building the protein. The promoter part of the FMR1 gene includes many repeats—repeated instances of a specific DNA sequence called the CGG sequence. A normal FMR1 gene has between 6 and 40 repeats in the promoter; the average is 30 repeats. People with between 55 and 200 repeats have a premutation of the gene. The premutation causes the gene to not work properly, but it does not cause intellectual and developmental disability (IDD). FXTAS occurs in some people who have the premutation. The premutation is also related to fragile X-associated primary ovarian insufficiency (FXPOI). People with 200 or more repeats in the promoter part of the gene have a full mutation, meaning the gene might not work at all. People with a full mutation often have fragile X syndrome, the most common inherited form of IDD. Individuals with the full mutation are not at risk for FXTAS. Inheriting FXTAS Anyone with the FMR1 gene mutation can pass it to their children. However, a person who inherits the gene may not develop FXTAS. Males will pass it down to all of their daughters and not their sons. Females have a 50/50 chance to pass it along to both their sons and daughters. In addition, parents can have children with a condition associated with fragile X even if the parents do not have that condition themselves. Read more about how FMR1 changes as it is passed from parent to child. « Condition Information What causes it? ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ANESTHESIA EFFECT ON FXTAS PERSONS.. Does Anesthesia given during a operation severely hurt, or damage a brain for FXTAS patient? The operation would be for hip replacement! Thank you very much", "response": "Anesthesia - what to ask your doctor - child: Your child is scheduled to have a surgery or procedure. You will need to talk with your child's doctor about the type of anesthesia that will be best for your child. Below are some questions you may want to ask. BEFORE ANESTHESIA Which type of anesthesia is best for my child and the procedure that my child is having? - General anesthesia - Spinal or epidural anesthesia - Conscious sedation When does my child need to stop eating or drinking before the anesthesia? What if my child is breastfeeding? When do my child and I need to get to the hospital on the day of the surgery? Is the rest of our family allowed to be there too? If my child is taking the following medicines, what should I do? - Aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve), other arthritis drugs, vitamin E, warfarin (Coumadin), and any other drugs that make it hard for the child's blood to clot - Vitamins, minerals, herbs, or other supplements - Medicines for heart problems, lung problems, diabetes, allergies, or seizures - Other medicines the child is supposed to take everyday If my child has asthma, diabetes, seizures, heart disease, or any other medical problems, do I need to do anything special before my child has anesthesia? Can my child take a tour of the surgery and recovery areas of the hospital before the surgery? DURING ANESTHESIA - Will my child be awake or aware of what is happening? - Will my child feel any pain? - Will someone be watching to make sure my child is ok? - How long may I stay with my child? AFTER ANESTHESIA - How soon will my child wake up? - When can I see my child? - How soon before my child can get up and move around? - How long will my child need to stay? - Will my child have any pain? - Will my child have an upset stomach? - If my child had spinal or epidural anesthesia, will my child have a headache afterwards? - What if I have more questions after the surgery? Who can I contact? Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "DVT. Can a birth control called Ocella cause DVT? My daughter experiences pains cramping,redness and swelling in her thigh and also really bad huge blood clots during her menstrual cycles after she was prescribed Osella for birth control. Also these syntoms worsened after she gave birth. This has been happening for a year now should she see discuss this with her doctor right away?", "response": "Pulmonary Embolism (Summary): Summary A pulmonary embolism is a sudden blockage in a lung artery. The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung. Pulmonary embolism is a serious condition that can cause - Permanent damage to the affected lung - Low oxygen levels in your blood - Damage to other organs in your body from not getting enough oxygen If a clot is large, or if there are many clots, pulmonary embolism can cause death. Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg. The goal of treatment is to break up clots and help keep other clots from forming. NIH: National Heart, Lung, and Blood Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "DVT. Can a birth control called Ocella cause DVT? My daughter experiences pains cramping,redness and swelling in her thigh and also really bad huge blood clots during her menstrual cycles after she was prescribed Osella for birth control. Also these syntoms worsened after she gave birth. This has been happening for a year now should she see discuss this with her doctor right away?", "response": "Blood Clots (Summary): Summary Normally, if you get hurt, your body forms a blood clot to stop the bleeding. After the bleeding stops and healing takes place, your body usually breaks down and removes the clot. But some people get too many clots or their blood clots abnormally. Many conditions can cause the blood to clot too much or prevent blood clots from dissolving properly. Risk factors for excessive blood clotting include - Certain genetic disorders - Atherosclerosis - Diabetes - Atrial fibrillation - Overweight, obesity, and metabolic syndrome - Some medicines - Smoking - Staying in one position for a long time, such as being in the hospital or taking a long car or plane ride - Cancer and cancer treatments Blood clots can form in, or travel to, the blood vessels in the brain, heart, kidneys, lungs, and limbs. A clot in the veins deep in the limbs is called deep vein thrombosis (DVT). DVT usually affects the deep veins of the legs. If a blood clot in a deep vein breaks off and travels through the bloodstream to the lungs and blocks blood flow, it is called a pulmonary embolism. Other complications of blood clots include stroke, heart attack, kidney problems, kidney failure, and pregnancy-related problems. Treatments for blood clots include blood thinners and other medicines. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "DVT. Can a birth control called Ocella cause DVT? My daughter experiences pains cramping,redness and swelling in her thigh and also really bad huge blood clots during her menstrual cycles after she was prescribed Osella for birth control. Also these syntoms worsened after she gave birth. This has been happening for a year now should she see discuss this with her doctor right away?", "response": "Lupus anticoagulants and antiphospholipid antibodies (Outlook (Prognosis)): Most of the time, outcome is good with proper treatment. Some people may have blood clots that are hard to control with treatments. Symptoms may recur. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "medication question. I have had a bad UTI for 3 months I have taken cipro 7 times uti returns days after I oomplete I need a new prescription but the doctors here can figure out what to give me as I am allergic to penicillin and allergic to dairy products wich is a filler in many drugs. Please please give me some idea of what I can get my dr; to prescribe", "response": "Gastric bypass surgery - discharge (Drugs): You may need to take some medicines when you go home. - You may need to give yourself shots underneath the skin of a blood-thinning drug for 2 or more weeks. Your provider will show you how. - You may need to take medicine to prevent gallstones. - You will need to take certain vitamins that your body may not absorb well from your food. Two of these are vitamin B-12 and vitamin D. - You may need to take calcium and iron supplements as well. Aspirin, ibuprofen (Advil, Motrin), and some other drugs may harm the lining of your stomach or even cause ulcers. Talk with your provider before you take these drugs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "medication question. I have had a bad UTI for 3 months I have taken cipro 7 times uti returns days after I oomplete I need a new prescription but the doctors here can figure out what to give me as I am allergic to penicillin and allergic to dairy products wich is a filler in many drugs. Please please give me some idea of what I can get my dr; to prescribe", "response": "Medicines and medication management (What Are Medicines? What Are Drugs?): Medicines, often referred to as drugs, can be:- Prescriptions. What you can get only with a doctor's order (for example, pills to lower your cholesterol or an asthma inhaler) - Over-the-counter pills, liquids, or creams. What you buy without a prescription (for example, pills for headaches or chew tablets for heartburn) - Vitamins, eye drops, or dietary supplements.Make sure your doctor knows about ALL the medicines you take. This includes those prescribed by other doctors, as well as vitamins, supplements, herbal remedies, and over-the-counter drugs you use every now and then. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "medication question. I have had a bad UTI for 3 months I have taken cipro 7 times uti returns days after I oomplete I need a new prescription but the doctors here can figure out what to give me as I am allergic to penicillin and allergic to dairy products wich is a filler in many drugs. Please please give me some idea of what I can get my dr; to prescribe", "response": "Who should get Penicillin G Procaine Injection and why is it prescribed?: Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to treat gonorrhea (a sexually transmitted disease) or early in the treatment of certain serious infections. Penicillin G procaine injection is in a class of medications called penicillins. It works by killing bacteria that cause infections. Antibiotics such as penicillin G procaine injection will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "infection. can a streptococcus infection cause an invasive disease like wegeners or the symptoms of wegeners?", "response": "Rheumatic fever (Summary): Rheumatic fever is a disease that may develop after an infection with group A streptococcus bacteria (such as strep throat or scarlet fever). It can cause severe illness in the heart, joints, skin, and brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "infection. can a streptococcus infection cause an invasive disease like wegeners or the symptoms of wegeners?", "response": "Ecthyma (Causes): Ecthyma is most often caused by the streptococcus bacteria. Sometimes, staphylococcus bacteria cause this skin infection on its own or in combination with streptococcus. The infection may start in skin that has been injured due to a scratch, rash, or insect bite. The infection often develops on the legs. People with diabetes or a weakened immune system are more prone to ecthyma. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "infection. can a streptococcus infection cause an invasive disease like wegeners or the symptoms of wegeners?", "response": "PANDAS (Summary): PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus. It is used to describe a condition in children whose symptoms of obsessive-compulsive disorder (OCD) or a tic disorder (i.e. Tourette syndrome) are worsened by group A streptococcal (GAS) infections. The underlying cause of PANDAS is unclear, but studies suggest that a strep infection causes an abnormal immune response resulting in neuropsychiatric symptoms. The association between PANDAS and GAS is controversial because the cause has not been proven. Management is centered on providing antibiotics for GAS infection, and medication or behavioral therapy for neuropsychiatric symptoms. [1] [2]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes and pain control. How can I narrow my search to find information regarding pain(joint) medication suitable to use with a person who has diabetes type 2.", "response": "Diabetes type 2 - meal planning (Review Date 4/15/2017): Updated by: Robert Hurd, MD, Professor of Endocrinology and Health Care Ethics, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes and pain control. How can I narrow my search to find information regarding pain(joint) medication suitable to use with a person who has diabetes type 2.", "response": "Type 2 diabetes - what to ask your doctor (Summary): Type 2 diabetes is a lifelong disease that causes a high level of sugar (glucose) in your blood. It can damage your organs. It can also lead to a heart attack or stroke and cause many other health problems. You can do many things to control your symptoms, prevent damage due to diabetes, and make your life better. Below are questions you may want to ask your health care provider to help you take care of your diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes and pain control. How can I narrow my search to find information regarding pain(joint) medication suitable to use with a person who has diabetes type 2.", "response": "Diabetes (Treatment): Type 2 diabetes may be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes. Treating either type 1 diabetes or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Macular Degeneration. I am a non-smoker , retired military veteran who was subjected to working conditions where the majority of fellow workers were smokers. Could or does second hand smoke contribute or is a cause for getting Early AMD. I was diagnosed with early AMD in 1982 when ventilation of work spaces was nearly non existent. My genetic profile does not include any previous conditions except that I am Caucasian.", "response": "Dry macular degeneration (Risk factors): Factors that may increase your risk of macular degeneration include: - Age. This disease is most common in people over 65. - Family history and genetics. This disease has a hereditary component. Researchers have identified several genes that are related to developing the condition. - Race. Macular degeneration is more common in whites than it is in other people. - Smoking. Smoking cigarettes or being regularly exposed to smoke significantly increases your risk of macular degeneration. - Obesity. Research indicates that being obese may increase your chance that early or intermediate macular degeneration will progress to the more severe form of the disease. - Cardiovascular disease. If you have had diseases that affected your heart and blood vessels, you may be at higher risk of macular degeneration. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Macular Degeneration. I am a non-smoker , retired military veteran who was subjected to working conditions where the majority of fellow workers were smokers. Could or does second hand smoke contribute or is a cause for getting Early AMD. I was diagnosed with early AMD in 1982 when ventilation of work spaces was nearly non existent. My genetic profile does not include any previous conditions except that I am Caucasian.", "response": "Macular degeneration - age-related (Prevention): Although there is no known way to prevent macular degeneration, leading a healthy lifestyle can reduce your risk of developing AMD: - Do not smoke - Maintain a healthy diet that is high in fruits and vegetables and low in animal fat - Exercise regularly - Maintain a healthy weight See your eye care professional regularly for dilated eye exams. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "molar pregnancy.. is conception a requirement of a molar pregnancy. if so, when ?", "response": "Molar pregnancy (Causes): A molar pregnancy is caused by an abnormally fertilized egg. Human cells normally contain 23 pairs of chromosomes. One chromosome in each pair comes from the father, the other from the mother. In a complete molar pregnancy, an empty egg is fertilized by one or two sperm, and all of the genetic material is from the father. In this situation, the chromosomes from the mother's egg are lost or inactivated and the father's chromosomes are duplicated. In a partial or incomplete molar pregnancy, the mother's chromosomes remain but the father provides two sets of chromosomes. As a result, the embryo has 69 chromosomes instead of 46. This most often occurs when two sperm fertilize an egg, resulting in an extra copy of the father's genetic material. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "molar pregnancy.. is conception a requirement of a molar pregnancy. if so, when ?", "response": "Hydatidiform mole: Hydatidiform mole (HM) is a rare mass or growth that forms inside the womb (uterus) at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD). HM, or molar pregnancy, results from abnormal fertilization of the oocyte (egg). It results in an abnormal fetus. The placenta grows normally with little or no growth of the fetal tissue. The placental tissue forms a mass in the uterus. On ultrasound this mass often has a grape-like appearance, as it contains many small cysts. Chance of mole formation is higher in older women. A history of mole in earlier years is also a risk factor. Molar pregnancy can be of 2 types: - Partial molar pregnancy. There is an abnormal placenta and some fetal development. - Complete molar pregnancy. There is an abnormal placenta and no fetus. There is no way to prevent formation of these masses. Symptoms of a molar pregnancy may include: - Abnormal growth of the uterus, either bigger or smaller than usual - Severe nausea and vomiting - Vaginal bleeding during the first 3 months of pregnancy - Symptoms of hyperthyroidism, including heat intolerance, loose stools, rapid heart rate, restlessness or nervousness, warm and moist skin, trembling hands, or unexplained weight loss - Symptoms similar to preeclampsia that occur in the first trimester or early second trimester, including high blood pressure and swelling in the feet, ankles, and legs (this is almost always a sign of a hydatidiform mole, because preeclampsia is extremely rare this early in a normal pregnancy) Your health care provider will perform a pelvic exam, which may show signs similar to a normal pregnancy. However, the size of the womb may be abnormal and there may be no heart sounds from the baby. Also, there may be some vaginal bleeding. A pregnancy ultrasound will show a snowstorm appearance with an abnormal placenta, with or without some development of a baby. Tests done may include: - hCG (quantitative levels) blood test - Abdominal or vaginal ultrasound of the pelvis - Chest x-ray - CT or MRI of the abdomen (imaging tests) - Complete blood count (CBC) - Blood clotting tests - Kidney and liver function tests If your provider suspects a molar pregnancy, removal of the abnormal tissue with a dilation and curettage (D and C) will most likely be suggested. D and C may also be done using suction. This is called suction aspiration (The method uses a suction cup to remove contents from the uterus). Sometimes a partial molar pregnancy can continue. A woman may choose to continue her pregnancy in the hope of having a successful birth and delivery. However, these are very high-risk pregnancies. Risks may include bleeding, problems with blood pressure, and premature delivery (having the baby before it is fully developed). In rare cases, the fetus is genetically normal. Women need to completely discuss the risks with their provider before continuing the pregnancy. A hysterectomy (surgery to remove the uterus) may be an option for older women who DO NOT wish to become pregnant in the future. After treatment, your hCG level will be followed. It is important to avoid another pregnancy and to use a reliable contraceptive for 6 to 12 months after treatment for a molar pregnancy. This time allows for accurate testing to be sure that the abnormal tissue does not grow back. Women who get pregnant too soon after a molar pregnancy are at high risk of having another molar pregnancy. Most HMs are noncancerous (benign). Treatment is usually successful. Close follow-up by your provider is important to ensure that signs of the molar pregnancy are gone and pregnancy hormone levels return to normal. In some cases of complete HM, moles can become invasive. These moles can grow deep into the uterine wall and cause bleeding or other complications. In very few cases of complete HM, moles develop into a choriocarcinoma. This is a fast-growing cancer. It is usually successfully treated with chemotherapy, but can be life threatening. Complications of molar pregnancy may include: - Change to invasive molar disease or choriocarcinoma - Preeclampsia - Thyroid problems - Molar pregnancy that continues or comes back Complications from surgery to remove a molar pregnancy may include: - Excessive bleeding, possibly requiring a blood transfusion - Side effects of anesthesia Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms and diagnosis. My son is being tested now to see if he has hnpp and after reading about the disease, it occurred to me that all my trouble with my hands could have been this and not arthritis. I have had both hands operated on several times, with some success, but continue with swelling in my hands and feet/ankles and soreness and stiffness. Would it be easy to think a patient has arthritis?", "response": "Rheumatoid arthritis (Diagnosis): Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she may also check your reflexes and muscle strength. Blood tests People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Imaging tests Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms and diagnosis. My son is being tested now to see if he has hnpp and after reading about the disease, it occurred to me that all my trouble with my hands could have been this and not arthritis. I have had both hands operated on several times, with some success, but continue with swelling in my hands and feet/ankles and soreness and stiffness. Would it be easy to think a patient has arthritis?", "response": "Reactive arthritis (Diagnosis): During the physical exam, your doctor is likely to check your joints for signs and symptoms of inflammation, such as swelling, warmth and tenderness, and test range of motion in your spine and affected joints. Your doctor might also check your eyes for inflammation and your skin for rashes. Blood tests Your doctor might recommend that a sample of your blood be tested for: - Evidence of past or current infection - Signs of inflammation - Antibodies associated with other types of arthritis - A genetic marker linked to reactive arthritis Joint fluid tests Your doctor might use a needle to withdraw a sample of fluid from within an affected joint. This fluid will be tested for: - White blood cell count. An increased number of white blood cells might indicate inflammation or an infection. - Infections. Bacteria in your joint fluid might indicate septic arthritis, which can result in severe joint damage. - Crystals. Uric acid crystals in your joint fluid might indicate gout. This very painful type of arthritis often affects the big toe. Imaging tests X-rays of your low back, pelvis and joints can indicate whether you have any of the characteristic signs of reactive arthritis. X-rays can also rule out other types of arthritis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms and diagnosis. My son is being tested now to see if he has hnpp and after reading about the disease, it occurred to me that all my trouble with my hands could have been this and not arthritis. I have had both hands operated on several times, with some success, but continue with swelling in my hands and feet/ankles and soreness and stiffness. Would it be easy to think a patient has arthritis?", "response": "rheumatoid arthritis (Description): Rheumatoid arthritis is a disease that causes chronic abnormal inflammation, primarily affecting the joints. The most common signs and symptoms are pain, swelling, and stiffness of the joints. Small joints in the hands and feet are involved most often, although larger joints (such as the shoulders, hips, and knees) may become involved later in the disease. Joints are typically affected in a symmetrical pattern; for example, if joints in the hand are affected, both hands tend to be involved. People with rheumatoid arthritis often report that their joint pain and stiffness is worse when getting out of bed in the morning or after a long rest. Rheumatoid arthritis can also cause inflammation of other tissues and organs, including the eyes, lungs, and blood vessels. Additional signs and symptoms of the condition can include a loss of energy, a low fever, weight loss, and a shortage of red blood cells (anemia). Some affected individuals develop rheumatoid nodules, which are firm lumps of noncancerous tissue that can grow under the skin and elsewhere in the body. The signs and symptoms of rheumatoid arthritis usually appear in mid- to late adulthood. Many affected people have episodes of symptoms (flares) followed by periods with no symptoms (remissions) for the rest of their lives. In severe cases, affected individuals have continuous health problems related to the disease for many years. The abnormal inflammation can lead to severe joint damage, which limits movement and can cause significant disability. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vasculitis. Yes my wife has been dianosed with giant cell vasculitis Our doctors are not clear about this so im asking for help From you . She has vomited something like coffee grounds and swelling in her feet and legs is really bad.migranes and face swelling to.no blood clots but nothing to go on so please help if u can thank u", "response": "Vasculitis (Treatment): Treatment of vasculitis generally depends on the type of vasculitis, the organs affected and the severity in each individual. [1] The main goal of treatment is to reduce inflammation in the affected blood vessels. Individuals with mild vasculitis may only need over-the-counter pain medications, while those with severe vasculitis are often treated with prescription medications including corticosteroids and/or cytotoxic medicines that reduce or stop the immune response causing the inflammation. [1] Commonly used medications have included methotrexate, prednisone and/or cyclophosphamide. [2] In rare cases, surgery may be needed. Other treatments may be used for certain types of vasculitis (for example, high-dose aspirin and immune globulin for Kawasaki syndrome). [1] A study by U. Specks et al. published in August of 2013 in the New England Journal of Medicine found that a medication called rituximab is as effective as cyclophosphamide and glucocorticoids for ANCA-associated vasculitis; the authors reported that rituximab also requires a shorter treatment duration. For the patients in this study, administration of rituximab once a week for 4 weeks, followed by placebo, was as effective in the treatment of severe ANCA-associated vasculitis as conventional immunosuppressive therapy administered for 18 months. [3] See the NIH's news release \" Therapy for severe vasculitis shows long-term effectiveness\" for more information about this study. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vasculitis. Yes my wife has been dianosed with giant cell vasculitis Our doctors are not clear about this so im asking for help From you . She has vomited something like coffee grounds and swelling in her feet and legs is really bad.migranes and face swelling to.no blood clots but nothing to go on so please help if u can thank u", "response": "Vasculitis (Treatment): Treatment focuses on controlling the inflammation with medications and resolving any underlying disease that triggered your vasculitis. For your vasculitis, you may go through two treatment phases - first stopping the inflammation and then preventing relapse (maintenance therapy). Both phases involve prescription drugs. Which drugs and how long you need to take them depend on the type of vasculitis, the organs involved and how serious your condition is. Some people have initial success with treatment, then experience flare-ups later. Others may never see their vasculitis completely go away and need ongoing treatment. Medications Your doctor may prescribe a corticosteroid drug, such as prednisone or methylprednisolone (Medrol), to help control inflammation. Side effects of corticosteroids can be severe, especially if you take them for a long time. Possible side effects include weight gain, diabetes and bone thinning (osteoporosis). If a corticosteroid is needed for long-term (maintenance) therapy, you'll likely receive the lowest dose possible. Other medications may be prescribed with corticosteroids to control the inflammation so that the dosage of corticosteroids can be tapered more quickly. These medications are sometimes called steroid-sparing and may includemethotrexate (Trexall), azathioprine (Imuran, Azasan), mycophenolate (Cellcept) or cyclophosphamide. The specific medication that you'll need depends on the type and severity of vasculitis you have, which organs are involved, and any other medical problems that you have. Biologic therapies such as rituximab (Rituxan) or tocilizumab (Actemra) may be recommended, depending on the type of vasculitis you have. Surgery Sometimes, vasculitis causes a balloonlike bulge (aneurysm) to form in the wall of a blood vessel. This bulge may need surgery. Blocked arteries also may require surgical treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "vasculitis. Yes my wife has been dianosed with giant cell vasculitis Our doctors are not clear about this so im asking for help From you . She has vomited something like coffee grounds and swelling in her feet and legs is really bad.migranes and face swelling to.no blood clots but nothing to go on so please help if u can thank u", "response": "Vasculitis: The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 52759 Disease definition Vasculitis represents a clinically heterogenous group of diseases of multifactorial etiology characterized by inflammation of either large-sized vessels (large-vessel vasculitis, e.g. Giant- cell arteritis and Takayasu arteritis; see these terms), medium-sized vessels (medium-vessel vasculitis e.g. polyarteritis nodosa and Kawasaki disease; see these terms), or small-sized vessels (small-vessel vasculitis, e.g. granulomatosis with polyangiitis, microscopic polyangiitis, immunoglobulin A vasculitis, and cutaneous leukocytoclastic angiitis; see these terms). Vasculitis occurs at any age, may be acute or chronic, and manifests with general symptoms such as fever, weight loss and fatigue, as well as more specific clinical signs depending on the type of vessels and organs affected. The degree of severity is variable, ranging from life or sight threatening disease (e.g. Behçet disease, see this term) to relatively minor skin disease. Visit the Orphanet disease page for more resources. Treatment of vasculitis generally depends on the type of vasculitis, the organs affected and the severity in each individual. [1] The main goal of treatment is to reduce inflammation in the affected blood vessels. Individuals with mild vasculitis may only need over-the-counter pain medications, while those with severe vasculitis are often treated with prescription medications including corticosteroids and/or cytotoxic medicines that reduce or stop the immune response causing the inflammation. [1] Commonly used medications have included methotrexate, prednisone and/or cyclophosphamide. [2] In rare cases, surgery may be needed. Other treatments may be used for certain types of vasculitis (for example, high-dose aspirin and immune globulin for Kawasaki syndrome). [1] A study by U. Specks et al. published in August of 2013 in the New England Journal of Medicine found that a medication called rituximab is as effective as cyclophosphamide and glucocorticoids for ANCA-associated vasculitis; the authors reported that rituximab also requires a shorter treatment duration. For the patients in this study, administration of rituximab once a week for 4 weeks, followed by placebo, was as effective in the treatment of severe ANCA-associated vasculitis as conventional immunosuppressive therapy administered for 18 months. [3] See the NIH's news release \" Therapy for severe vasculitis shows long-term effectiveness\" for more information about this study. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can't find an answer. I was diagnosed with Fibromyalgia with chronic pain along with some other things and my blood work showed that I was missing a chromosone. How would I find out if I have a genetic for of Fibromyalgia?", "response": "Fibromyalgia (What causes it?): Doctors don’t know the exact cause of fibromyalgia. Researchers continue to study fibromyalgia and think the following events may contribute to the cause of the disorder: - Stressful or traumatic events, such as car accidents. - Repetitive injuries. - Illness. - Certain diseases. Sometimes, fibromyalgia can develop on its own. Fibromyalgia tends to run in families and some scientists think that a gene or genes could make you more likely to develop fibromyalgia. The genes could make you react strongly to things that other people would not find painful. Doctors don’t know the exact cause of fibromyalgia. Researchers continue to study fibromyalgia and think the following events may contribute to the cause of the disorder: - Stressful or traumatic events, such as car accidents. - Repetitive injuries. - Illness. - Certain diseases. Sometimes, fibromyalgia can develop on its own. Fibromyalgia tends to run in families and some scientists think that a gene or genes could make you more likely to develop fibromyalgia. The genes could make you react strongly to things that other people would not find painful. Doctors don’t know the exact cause of fibromyalgia. Researchers continue to study fibromyalgia and think the following events may contribute to the cause of the disorder: - Stressful or traumatic events, such as car accidents. - Repetitive injuries. - Illness. - Certain diseases. Sometimes, fibromyalgia can develop on its own. Fibromyalgia tends to run in families and some scientists think that a gene or genes could make you more likely to develop fibromyalgia. The genes could make you react strongly to things that other people would not find painful. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can't find an answer. I was diagnosed with Fibromyalgia with chronic pain along with some other things and my blood work showed that I was missing a chromosone. How would I find out if I have a genetic for of Fibromyalgia?", "response": "Fibromyalgia (Who treats it?): Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "cant use site.. I want to find a doctor who specializes in burning mouth syndrome and that could be in many specialities, I cannot understand how to do this on your website.", "response": "Burning mouth syndrome (Risk factors): Burning mouth syndrome is uncommon. However, your risk may be greater if: - You're a woman - You're postmenopausal - You're over the age of 50 Burning mouth syndrome usually begins spontaneously, with no known triggering factor. However, certain factors may increase your risk of developing burning mouth syndrome, including: - Recent illness - Previous dental procedures - Wearing dentures - Allergic reactions to food - Medications - Traumatic life events - Stress - Anxiety - Depression. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "cant use site.. I want to find a doctor who specializes in burning mouth syndrome and that could be in many specialities, I cannot understand how to do this on your website.", "response": "Do I need to see a doctor for Waardenburg syndrome?: Genetic counseling may be helpful if you have a family history of Waardenburg syndrome and plan to have children. Call for a hearing test if you or your child has deafness or decreased hearing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "estradiol 75g patch. Can I stop using the patch only been on it 4.5 months", "response": "Ethinyl Estradiol and Norelgestromin Transdermal Patch (Why is this medication prescribed?): Ethinyl estradiol and norelgestromin transdermal system (patch) is used to prevent pregnancy. Norelgestromin is a progestin and ethinyl estradiol is an estrogen. Estrogen and progestin are two female sex hormones. Ethinyl estradiol and norelgestromin contraceptive patch works by preventing ovulation (the release of eggs from the ovaries) and by changing the cervical mucus and the lining of the uterus. The contraceptive patch is a very effective method of birth control, but it does not prevent the spread of human immunodeficiency virus (HIV; the virus that causes acquired immunodeficiency syndrome [AIDS]) and other sexually transmitted diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "estradiol 75g patch. Can I stop using the patch only been on it 4.5 months", "response": "Who should get Estradiol Transdermal Patch and why is it prescribed?: Most brands of estradiol transdermal patches are used to treat hot flushes (hot flashes; sudden strong feelings of heat and sweating) and/or vaginal dryness, itching, and burning in women who are experiencing menopause (change of life; the end of monthly menstrual periods). Transdermal estradiol is also used to prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who are experiencing or have experienced menopause. Women who need to use transdermal estradiol for more than one of these reasons can benefit most from the medication. Women whose only bothersome symptoms are vaginal dryness, itching, or burning may benefit more from an estrogen product that is applied topically to the vagina. Women who only need a medication to prevent osteoporosis may benefit more from a different medication that does not contain estrogen. Most brands of estradiol transdermal patches are also sometimes used as a source of estrogen in young women who do not produce enough estrogen naturally. Estradiol is in a class of medications called estrogen hormones. It works by replacing estrogen that is normally produced by the body. Menostar brand patches contain less estrogen than other brands of estradiol transdermal patches. Menostar patches are used only to prevent osteoporosis in women who are experiencing or have experienced menopause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Wax.. I sometimes drop Peroxide into the ear and let it bubble for a couple of minutes, then use warm water to flush it out. is there harm?", "response": "Ear wax (Treatment): Most cases of ear wax blockage can be treated at home. The following remedies can be used to soften wax in the ear: - Baby oil - Commercial drops - Glycerin - Mineral oil - Water Another method is to wash out the wax. - Use body-temperature water (cooler or warmer water may cause brief but severe dizziness or vertigo). - Hold your head upright and straighten the ear canal by holding the outside ear and gently pulling upward. - Use a syringe (you can buy one at the store) to gently direct a small stream of water against the ear canal wall next to the wax plug. - Tip your head to allow the water to drain. You may need to repeat irrigation several times. To avoid damaging your ear or causing an infection: - Never irrigate the ear if the eardrum may have a hole in it. - Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik). After the wax is removed, dry the ear thoroughly. You may use a few drops of alcohol in the ear or a hair dryer set on low to help dry the ear. You may clean the outer ear canal by using a cloth or paper tissue wrapped around your finger. Mineral oil can be used to moisturize the ear and prevent the wax from drying. Do not clean your ears too often or too hard. Ear wax also helps protect your ears. Never try to clean the ear by putting any object, such as a cotton swab, into the ear canal. If you cannot remove the wax plug or you have discomfort, consult a health care provider, who may remove the wax by: - Repeating the irrigation attempts - Suctioning the ear canal - Using a small device called a curette - Using a microscope to help. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Wax.. I sometimes drop Peroxide into the ear and let it bubble for a couple of minutes, then use warm water to flush it out. is there harm?", "response": "Ear wax: The ear canal is lined with hair follicles. The ear canal also has glands that produce a waxy oil called cerumen. The wax will most often make its way to the opening of the ear. There it will fall out or be removed by washing. Wax can build up and block the ear canal. Wax blockage is one of the most common causes of hearing loss. Ear wax protects the ear by: - Trapping and preventing dust, bacteria, and other germs and small objects from entering and damaging the ear - Protecting the delicate skin of the ear canal from getting irritated when water is in the canal In some people, the glands produce more wax than can be easily removed from the ear. This extra wax may harden in the ear canal and block the ear. When you try to clean the ear, you may instead push wax deeper and block the ear canal. Some of the common symptoms are: - Earache - Fullness in the ear or a sensation that the ear is plugged - Noises in the ear (tinnitus) - Partial hearing loss, may get worse Most cases of ear wax blockage can be treated at home. The following remedies can be used to soften wax in the ear: - Baby oil - Commercial drops - Glycerin - Mineral oil - Water Another method is to wash out the wax. - Use body-temperature water (cooler or warmer water may cause brief but severe dizziness or vertigo). - Hold your head upright and straighten the ear canal by holding the outside ear and gently pulling upward. - Use a syringe (you can buy one at the store) to gently direct a small stream of water against the ear canal wall next to the wax plug. - Tip your head to allow the water to drain. You may need to repeat irrigation several times. To avoid damaging your ear or causing an infection: - Never irrigate the ear if the eardrum may have a hole in it. - Do not irrigate the ear with a jet irrigator designed for cleaning teeth (such as a WaterPik). After the wax is removed, dry the ear thoroughly. You may use a few drops of alcohol in the ear or a hair dryer set on low to help dry the ear. You may clean the outer ear canal by using a cloth or paper tissue wrapped around your finger. Mineral oil can be used to moisturize the ear and prevent the wax from drying. Do not clean your ears too often or too hard. Ear wax also helps protect your ears. Never try to clean the ear by putting any object, such as a cotton swab, into the ear canal. If you cannot remove the wax plug or you have discomfort, consult a health care provider, who may remove the wax by: - Repeating the irrigation attempts - Suctioning the ear canal - Using a small device called a curette - Using a microscope to help The ear may become blocked with wax again in the future. Hearing loss is often temporary. In most cases, hearing returns completely after the blockage is removed. Rarely, trying to remove ear wax may cause an infection in the ear canal. This can also damage the eardrum. See your provider if your ears are blocked with wax and you are unable to remove the wax. Also call if you have an ear wax blockage and you develop new symptoms, such as: - Drainage from the ear - Ear pain - Fever - Hearing loss that continues after you clean the wax Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Wax.. I sometimes drop Peroxide into the ear and let it bubble for a couple of minutes, then use warm water to flush it out. is there harm?", "response": "Ear wax (Review Date 5/21/2016): Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Sevoflurane. I work in a hospital, and a question recently came up regarding the stability of Sevoflurane once it has been opened. Does Sevoflurane expire within a particular timeframe or is the product still effective until the expiration date listed on the bottle?", "response": "Healthy Eating (Product Dates): You might see one of three types of product dates on some foods you buy:- \"Sell by\" tells how long the store can sell foods like meat, poultry, eggs, or milk products-buy it before this date - \"Use by\" tells how long the food will be at peak quality-if you buy or use it after that date, some foods might not be safe any longer - \"Best if used by\" (or \"best if used before\") tells how long the food has the best flavor or quality-it is not a purchase or safety date. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Sevoflurane. I work in a hospital, and a question recently came up regarding the stability of Sevoflurane once it has been opened. Does Sevoflurane expire within a particular timeframe or is the product still effective until the expiration date listed on the bottle?", "response": "Breast milk - pumping and storing (Giving Your Baby a Bottle): Wait until your baby is 3 to 4 weeks old to try a bottle. This gives you and your baby time to get good at breastfeeding first. Your baby has to learn to suck from a bottle. Here are ways to help your baby learn to take a bottle. - Give your baby a bottle while your baby is still calm, before hunger starts. - Have someone else give your baby the bottle. This way, your baby is not confused why you are not breastfeeding. - Leave the room when someone is giving your baby a bottle. Your baby can smell you and will wonder why you are not breastfeeding. Start bottle feeding about 2 weeks before you go back to work so your baby has time to get used to it. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Sevoflurane. I work in a hospital, and a question recently came up regarding the stability of Sevoflurane once it has been opened. Does Sevoflurane expire within a particular timeframe or is the product still effective until the expiration date listed on the bottle?", "response": "Breast milk - pumping and storing (Nursing and Bottle Feeding): If you are nursing as well as bottle feeding: - Nurse your baby before leaving for work in the morning and right when you get home. - Expect your baby to nurse more often in the evenings and weekends when you are home. Feed on-demand when you are with your baby. - Have your child care provider give your baby bottles of breast milk when you are at work. - The American Academy of Pediatrics recommends that you exclusively give breast milk to your baby for the first 6 months. This means not giving any other food, drinks, or formula. - If you use formula, still breastfeed and give as much breast milk as you can. The more breast milk your baby gets, the better. Supplementing with too much formula will decrease your milk supply. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ODD. Would like to learn more about condition on ODD", "response": "Schizotypal personality disorder (Symptoms): SPD should not be confused with schizophrenia. People with SPD can have odd beliefs and behaviors, but unlike people with schizophrenia, they are not disconnected from reality and usually DO NOT hallucinate. They also DO NOT have delusions. People with SPD may be very disturbed. They may also have unusual preoccupations and fears, such as fear of being monitored by government agencies. More commonly, people with this disorder behave oddly and have unusual beliefs (such as aliens). They cling to these beliefs so strongly that they have difficulty forming and keeping close relationships. People with SPD may also have depression. A second personality disorder, such as paranoid personality disorder, is also common. Common signs of SPD include: - Discomfort in social situations - Inappropriate displays of feelings - No close friends - Odd behavior or appearance - Odd beliefs, fantasies, or preoccupations - Odd speech. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ODD. Would like to learn more about condition on ODD", "response": "Resources (Review Date 12/10/2016): Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ODD. Would like to learn more about condition on ODD", "response": "Klinefelter Syndrome (KS) (Is there a cure?): Currently, there is no way to remove chromosomes from cells to \"cure\" the XXY condition. But many symptoms can be successfully treated, minimizing the impact the condition has on length and quality of life. Most adult XXY men have full independence and have friends, families, and normal social relationships. They live about as long as other men, on average. « How is it diagnosed? Other FAQs ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Beckwith-Wieddeman Syndrome.. Beckwith-Wieddeman Syndrome. I would like to request further knowledge on this specific disorder.", "response": "Beckwith-Wiedemann syndrome (Inheritance Pattern): In about 85 percent of cases of Beckwith-Wiedemann syndrome, only one person in a family has been diagnosed with the condition. However, parents of one child with Beckwith-Wiedemann syndrome may be at risk of having other children with the disorder. This risk depends on the genetic cause of the condition. Another 10 to 15 percent of people with Beckwith-Wiedemann syndrome are part of families with more than one affected family member. In most of these families, the condition appears to have an autosomal dominant pattern of inheritance. Autosomal dominant inheritance means that one copy of an altered gene in each cell is typically sufficient to cause the disorder. In most of these cases, individuals with Beckwith-Wiedemann syndrome inherit the genetic change from their mothers. Occasionally, a person who inherits the altered gene will not have any of the characteristic signs and symptoms of the condition. Rarely, Beckwith-Wiedemann syndrome results from changes in the structure of chromosome 11. Some of these chromosomal abnormalities are inherited from a parent, while others occur as random events during the formation of reproductive cells (eggs and sperm) or in the earliest stages of development before birth. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Beckwith-Wieddeman Syndrome.. Beckwith-Wieddeman Syndrome. I would like to request further knowledge on this specific disorder.", "response": "CDKN1C gene (Beckwith-Wiedemann syndrome): Beckwith-Wiedemann syndrome is a condition that causes overgrowth and has other signs and symptoms that affect many parts of the body. At least half of all cases of Beckwith-Wiedemann syndrome result from changes in methylation of the IC2 region. Specifically, the maternally inherited copy of the IC2 region has too few methyl groups attached (hypomethylation). This abnormality disrupts the regulation of several genes that are normally controlled by IC2, including CDKN1C. Because this gene normally restrains cell growth and division, a reduction in its activity leads to overgrowth and the other features of Beckwith-Wiedemann syndrome. In a few cases, Beckwith-Wiedemann syndrome has been caused by deletions of a small amount of DNA from the maternally inherited copy of the IC2 region. Like abnormal methylation, these deletions disrupt the activity of several genes, including CDKN1C. Beckwith-Wiedemann syndrome can also result from mutations within the maternally inherited copy of the CDKN1C gene. More than two dozen such mutations have been identified. Some of these genetic changes lead to an abnormally short, nonfunctional version of the CDKN1C protein, while others alter single protein building blocks (amino acids) or delete a small number of amino acids from the protein. All of these mutations are described as \"loss-of-function\" because they alter the structure of the CDKN1C protein such that it can no longer control growth effectively. The resulting problems with growth regulation lead to overgrowth and the other features of Beckwith-Wiedemann syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Beckwith-Wieddeman Syndrome.. Beckwith-Wieddeman Syndrome. I would like to request further knowledge on this specific disorder.", "response": "What is Beckwith-Wiedemann syndrome?: Beckwith-Wiedemann syndrome is a condition that affects many parts of the body. It is classified as an overgrowth syndrome, which means that affected infants are considerably larger than normal (macrosomia) and tend to be taller than their peers during childhood. Growth begins to slow by about age 8, and adults with this condition are not unusually tall. In some children with Beckwith-Wiedemann syndrome, specific parts of the body on one side or the other may grow abnormally large, leading to an asymmetric or uneven appearance. This unusual growth pattern, which is known as hemihyperplasia, usually becomes less apparent over time. The signs and symptoms of Beckwith-Wiedemann syndrome vary among affected individuals. Some children with this condition are born with an opening in the wall of the abdomen (an omphalocele) that allows the abdominal organs to protrude through the belly-button. Other abdominal wall defects, such as a soft out-pouching around the belly-button (an umbilical hernia), are also common. Some infants with Beckwith-Wiedemann syndrome have an abnormally large tongue (macroglossia), which may interfere with breathing, swallowing, and speaking. Other major features of this condition include abnormally large abdominal organs (visceromegaly), creases or pits in the skin near the ears, low blood sugar (hypoglycemia) in infancy, and kidney abnormalities. Children with Beckwith-Wiedemann syndrome are at an increased risk of developing several types of cancerous and noncancerous tumors, particularly a form of kidney cancer called Wilms tumor and a form of liver cancer called hepatoblastoma. Tumors develop in about 10 percent of people with this condition and almost always appear in childhood. Most children and adults with Beckwith-Wiedemann syndrome do not have serious medical problems associated with the condition. Their life expectancy is usually normal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CITROBACTOR FREUNDII.. CITROBACTOR FREUNDII. Does ciprofaxin work well? Is there a better drug if so what.", "response": "Retroperitoneal fibrosis (Treatment): Corticosteroids are tried first. Some health care providers also prescribe a drug called tamoxifen. If corticosteroid treatment does not work, a biopsy should be done to confirm the diagnosis. Other medicines to suppress the immune system can be prescribed. When medicine does not work, surgery and stents (draining tubes) are needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CITROBACTOR FREUNDII.. CITROBACTOR FREUNDII. Does ciprofaxin work well? Is there a better drug if so what.", "response": "Crigler-Najjar syndrome (Treatment): Light treatment (phototherapy) is needed throughout a person's life. In infants, this is done using bilirubin lights (bili or 'blue' lights). Phototherapy does not work as well after age 4, because thickened skin blocks the light. A liver transplant can be done in some people with type I disease. Blood transfusions may help control the amount of bilirubin in blood. Calcium compounds are sometimes used to remove bilirubin in the gut. The drug phenobarbitol is sometimes used to treat type II Crigler-Najjar syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CITROBACTOR FREUNDII.. CITROBACTOR FREUNDII. Does ciprofaxin work well? Is there a better drug if so what.", "response": "Pericarditis - after heart attack (Treatment): The goal of treatment is to make the heart work better and reduce pain and other symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin may be used to treat inflammation of the pericardium. A drug called colchicine is often used with these medicines. Steroids are commonly used for Dressler syndrome. They are not often used for early pericarditis unless the condition does not respond to other treatment. In some cases, excess fluid surrounding the heart (pericardial effusion) may need to be removed. This is done with a procedure called pericardiocentesis. If complications develop, part of the pericardium may need to be removed with surgery (pericardiectomy). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Hi I have a toddler 22 months and he was long exposure to car seat when he was infant and developed a flat head by then that was resolved, but since then he seems like his back is not well, he only sleep on his tummy, he hates to lay down on his back , he has a bad sitting position when on his car seat and other thing, I was wondering if he may need an evaluation to avoid further damage to his back, please let me know what kinf of doctor should I see, cause his pedi. doctor Does not has any concerns about it. Thanks.", "response": "Etiology: Etiology describes the cause or causes of a disease. Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Hi I have a toddler 22 months and he was long exposure to car seat when he was infant and developed a flat head by then that was resolved, but since then he seems like his back is not well, he only sleep on his tummy, he hates to lay down on his back , he has a bad sitting position when on his car seat and other thing, I was wondering if he may need an evaluation to avoid further damage to his back, please let me know what kinf of doctor should I see, cause his pedi. doctor Does not has any concerns about it. Thanks.", "response": "Nerve Damage (Diabetic Neuropathies) (What is proximal neuropathy?): Proximal neuropathy, sometimes called lumbosacral plexus neuropathy, femoral neuropathy, or diabetic amyotrophy, starts with pain in the thighs, hips, buttocks, or legs, usually on one side of the body. This type of neuropathy is more common in those with type 2 diabetes and in older adults with diabetes. Proximal neuropathy causes weakness in the legs and the inability to go from a sitting to a standing position without help. Treatment for weakness or pain is usually needed. The length of the recovery period varies, depending on the type of nerve damage. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Ache. My son was treated for otitis media on . Pains started the previous night. He is taking amoxicillin and antipyrine-benzocaine 5.5%-1.5% ear drops. This morning he woke up with a bit of blood drainage. Is that normal?", "response": "Otitis media with effusion (When to Contact a Medical Professional): Call your provider if: - You think you or your child might have OME. (You should continue to watch the condition until the fluid has disappeared.) - New symptoms develop during or after treatment for this disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Ache. My son was treated for otitis media on . Pains started the previous night. He is taking amoxicillin and antipyrine-benzocaine 5.5%-1.5% ear drops. This morning he woke up with a bit of blood drainage. Is that normal?", "response": "Otitis media with effusion (Outlook (Prognosis)): OME most often goes away on its own over a few weeks or months. Treatment may speed up this process. Glue ear may not clear up as quickly as OME with a thinner fluid. OME is most often not life threatening. Most children do not have long-term damage to their hearing or speaking ability, even when the fluid remains for many months. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ear Ache. My son was treated for otitis media on . Pains started the previous night. He is taking amoxicillin and antipyrine-benzocaine 5.5%-1.5% ear drops. This morning he woke up with a bit of blood drainage. Is that normal?", "response": "What are the treatments for Otitis media with effusion?: Most health care providers will not treat OME at first, unless there are also signs of an infection. Instead, they will recheck the problem in 2 to 3 months. Some children who have had repeat ear infections may receive a small, daily dose of antibiotics to prevent new infections. You can make the following changes to help clear up the fluid behind the eardrum: - Avoid cigarette smoke - Encourage infants to breastfeed - Treat allergies by staying away from triggers (such as dust). Adults and older children may be given allergy medications. Most often the fluid will clear on its own. You doctor may suggest watching the condition for a while to see if it is getting worse before recommending treatment. If the fluid is still present after 6 weeks, the doctor may recommend: - Continuing to watch the problem - A hearing test - A single trial of antibiotics (if they were not given earlier) If the fluid is still present at 8 to 12 weeks, antibiotics may be tried. These medicines are not always helpful. At some point, the child's hearing should be tested. If there is significant hearing loss (more than 20 decibels), antibiotics or ear tubes might be needed. If the fluid is still present after 4 to 6 months, tubes are probably needed, even if there is no major hearing loss. Sometimes the adenoids must be taken out for the Eustachian tube to work properly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "reaction to these 2 drugs. I would like to know if there are any drug reaction between Carvedilol 25 mg to Hydrslazine50 mg", "response": "Drug allergies (Outlook (Prognosis)): Most drug allergies respond to treatment. But sometimes, they can lead to severe asthma, anaphylaxis, or death. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "reaction to these 2 drugs. I would like to know if there are any drug reaction between Carvedilol 25 mg to Hydrslazine50 mg", "response": "Drug allergies (When to Contact a Medical Professional): Call your provider if you are taking a medicine and seem to be having a reaction to it. Go to the emergency room or call the local emergency number (such as 911) if you have difficulty breathing or develop other symptoms of severe asthma or anaphylaxis. These are emergency conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "reaction to these 2 drugs. I would like to know if there are any drug reaction between Carvedilol 25 mg to Hydrslazine50 mg", "response": "Transfusion reaction - hemolytic (Treatment): If symptoms occur during the transfusion, the transfusion must be stopped right away. Blood samples from the recipient (person getting the transfusion) and from the donor may be tested to tell whether symptoms are being caused by a transfusion reaction. Mild symptoms may be treated with: - Acetaminophen, a pain reliever to reduce fever and discomfort - Fluids given through a vein (intravenous) and other medicines to treat or prevent kidney failure and shock. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "mixing medications. Hello, I would like to know if taking Dicyclomine 20mg, phentermine can have a adverse effect?", "response": "What other information should I know about Dicyclomine?: Keep all appointments with your doctor. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "mixing medications. Hello, I would like to know if taking Dicyclomine 20mg, phentermine can have a adverse effect?", "response": "Phentermine and Topiramate (What other information should I know?): Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to phentermine and topiramate. Do not let anyone else take your medication. Giving or selling phentermine and topiramate to others may harm them and is against the law. Phentermine and topiramate is a controlled substance. Prescriptions may be refilled only a limited number of times; ask your pharmacist if you have any questions. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "mixing medications. Hello, I would like to know if taking Dicyclomine 20mg, phentermine can have a adverse effect?", "response": "Phentermine (What side effects can this medication cause?): Phentermine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - dry mouth - unpleasant taste - diarrhea - constipation - vomiting Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately: - increased blood pressure - heart palpitations - restlessness - dizziness - tremor - insomnia - shortness of breath - chest pain - swelling of the legs and ankles - difficulty doing exercise that you have been able to do Phentermine may cause other side effects. Call your doctor if you have any unusual problems during your treatment with phentermine. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Dementia. Is dementia genetically passed down or could anyone get it", "response": "Dementia (Overview): Dementia isn't a specific disease. Instead, dementia describes a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with daily functioning. Though dementia generally involves memory loss, memory loss has different causes. So memory loss alone doesn't mean you have dementia. Alzheimer's disease is the most common cause of a progressive dementia in older adults, but there are a number of causes of dementia. Depending on the cause, some dementia symptoms can be reversed. Dementia care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Dementia. Is dementia genetically passed down or could anyone get it", "response": "What are the genetic changes related to inclusion body myopathy with early-onset Paget disease and frontotemporal dementia?: Mutations in the VCP gene cause IBMPFD. The VCP gene provides instructions for making an enzyme called valosin-containing protein, which has a wide variety of functions within cells. One of its most critical jobs is to help break down (degrade) proteins that are abnormal or no longer needed. Mutations in the VCP gene alter the structure of valosin-containing protein, disrupting its ability to break down other proteins. As a result, excess and abnormal proteins may build up in muscle, bone, and brain cells. The proteins form clumps that interfere with the normal functions of these cells. It remains unclear how damage to muscle, bone, and brain cells leads to the specific features of IBMPFD. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Dementia. Is dementia genetically passed down or could anyone get it", "response": "Dementia (Definition): Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have significantly impaired intellectual functioning that interferes with normal activities and relationships. They also lose their ability to solve problems and maintain emotional control, and they may experience personality changes and behavioral problems, such as agitation, delusions, and hallucinations. While memory loss is a common symptom of dementia, memory loss by itself does not mean that a person has dementia. Doctors diagnose dementia only if two or more brain functions - such as memory and language skills -- are significantly impaired without loss of consciousness. Some of the diseases that can cause symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease. Doctors have identified other conditions that can cause dementia or dementia-like symptoms including reactions to medications, metabolic problems and endocrine abnormalities, nutritional deficiencies, infections, poisoning, brain tumors, anoxia or hypoxia (conditions in which the brain’s oxygen supply is either reduced or cut off entirely), and heart and lung problems. Although it is common in very elderly individuals, dementia is not a normal part of the aging process. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "sleep apnea. Is there a \"sleep apnea surgery\". I've heard that there is , but have never found a doctor that does this. My husband has been on C-pap for two years but has not been able to keep it on for more then 2 hours. He is not overweight, has had a stroke at 40 years old and double by-pass at 50 years old. Otherwise he follows doctors orders and has no other problems. Thank you for your time,", "response": "Sleep Apnea (Treatment): There are a variety of treatments for sleep apnea, depending on an individual’s medical history and the severity of the disorder. Most treatment regimens begin with lifestyle changes, such as avoiding alcohol and medications that relax the central nervous system (for example, sedatives and muscle relaxants), losing weight, and quitting smoking. Some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. If these conservative methods are inadequate, doctors often recommend continuous positive airway pressure (CPAP), in which a face mask is attached to a tube and a machine that blows pressurized air into the mask and through the airway to keep it open. Also available are machines that offer variable positive airway pressure (VPAP) and automatic positive airway pressure (APAP). There are also surgical procedures that can be used to remove tissue and widen the airway. Some individuals may need a combination of therapies to successfully treat their sleep apnea. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "sleep apnea. Is there a \"sleep apnea surgery\". I've heard that there is , but have never found a doctor that does this. My husband has been on C-pap for two years but has not been able to keep it on for more then 2 hours. He is not overweight, has had a stroke at 40 years old and double by-pass at 50 years old. Otherwise he follows doctors orders and has no other problems. Thank you for your time,", "response": "Obstructive sleep apnea - adults (Treatment): Treatment helps keep your airway open while you sleep so your breathing does not stop. Lifestyle changes may help relieve symptoms in people with mild sleep apnea, such as: - Avoid alcohol or medicines that make you sleepy before bedtime. They can make symptoms worse. - Avoid sleeping on your back. - Lose excess weight. Continuous positive airway pressure (CPAP) devices work best to treat obstructive sleep apnea in most people. - You wear a mask over your nose while you sleep. - The mask is connected by a hose to a small machine that sits at the side of your bed. - The machine pumps air under pressure through the hose and mask and into your airway while you sleep. This helps keep your airway open. It can take some time to get used to sleeping with CPAP therapy. Good follow-up and support from a sleep center can help you overcome any problems using CPAP. Dental devices may help some people. You wear them in your mouth while you sleep to keep your jaw forward and the airway open. Other treatments may be available, but there is less evidence that they work. It is best to talk with a doctor who specializes in sleep problems before trying them. Surgery may be an option for some people. It is often a last resort if other treatments did not work and you have severe symptoms. Surgery may be used to: - Remove extra tissue at the back of the throat. - Correct problems with the structures in the face. - Create an opening in the windpipe to bypass the blocked airway if there are physical problems. - Remove the tonsils and adenoids. Surgery may not completely cure obstructive sleep apnea and may have long-term side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diahrrea. I take Loperamide for chronic diahrrea. Then I stop it for about 2 days so I can have a bowel movement. But then the stool is really soft and there were a few times I almost didn't make to the bathroom. Is there a way for a happy medium", "response": "Diarrhea (Summary): Summary What is diarrhea? Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own. Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go. Who gets diarrhea? People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year. People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water. What causes diarrhea? The most common causes of diarrhea include - Bacteria from contaminated food or water - Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children. - Parasites, which are tiny organisms found in contaminated food or water - Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium - Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance. - Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease - Problems with how the colon functions, such as irritable bowel syndrome Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly. Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary. What other symptoms might I have with diarrhea? Other possible symptoms of diarrhea include - Cramps or pain in the abdomen - An urgent need to use the bathroom - Loss of bowel control If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools. Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems. When should I see a doctor for diarrhea? Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have - Signs of dehydration - Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours. - Severe pain in your abdomen or rectum (for adults) - A fever of 102 degrees or higher - Stools containing blood or pus - Stools that are black and tarry If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants. How is the cause of diarrhea diagnosed? To find the cause of diarrhea, your health care provider may - Do a physical exam - Ask about any medicines you are taking - Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection - Ask you to stop eating certain foods to see whether your diarrhea goes away If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease. What are the treatments for diarrhea? Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection. Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food. Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes. Can diarrhea be prevented? Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses. You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries: - Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth - If you do use tap water, boil it or use iodine tablets - Make sure that the cooked food you eat is fully cooked and served hot - Avoid unwashed or unpeeled raw fruits and vegetables NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diahrrea. I take Loperamide for chronic diahrrea. Then I stop it for about 2 days so I can have a bowel movement. But then the stool is really soft and there were a few times I almost didn't make to the bathroom. Is there a way for a happy medium", "response": "Diarrhea (Symptoms): Signs and symptoms associated with diarrhea may include: - Loose, watery stools - Abdominal cramps - Abdominal pain - Fever - Blood in the stool - Bloating - Nausea - Urgent need to have a bowel movement If you're an adult, see your doctor if: - Your diarrhea persists beyond two days - You become dehydrated - You have severe abdominal or rectal pain - You have bloody or black stools - You have a fever above 102 F (39 C) In children, particularly young children, diarrhea can quickly lead to dehydration. Call your doctor if your child's diarrhea doesn't improve within 24 hours or if your baby: - Becomes dehydrated - Has a fever above 102 F (39 C) - Has bloody or black stools. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diahrrea. I take Loperamide for chronic diahrrea. Then I stop it for about 2 days so I can have a bowel movement. But then the stool is really soft and there were a few times I almost didn't make to the bathroom. Is there a way for a happy medium", "response": "Antibiotic-associated diarrhea (Symptoms): For most people, antibiotic-associated diarrhea causes mild signs and symptoms, such as: - Loose stools - More-frequent bowel movements Antibiotic-associated diarrhea is likely to begin about a week after you start taking an antibiotic. Sometimes, however, diarrhea and other symptoms don't appear until days or even weeks after you've finished antibiotic treatment. C. difficile is a toxin-producing bacteria that causes antibiotic-associated colitis, which can occur after the antibiotic therapy upsets the balance of good and bad bacteria in your intestinal tract. Besides loose stools, C. difficile infection can cause: - Lower abdominal pain and cramping - Low-grade fever - Nausea - Loss of appetite Call your doctor right away if you have serious signs and symptoms of antibiotic-associated diarrhea. These signs and symptoms are common to a number of conditions, so your doctor might recommend tests to determine the cause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about uveitis. IS THE UVEITIS, AN AUTOIMMUNE DISEASE?", "response": "Facts About Uveitis (What Causes Uveitis?): Uveitis is caused by inflammatory responses inside the eye. Inflammation is the body’s natural response to tissue damage, germs, or toxins. It produces swelling, redness, heat, and destroys tissues as certain white blood cells rush to the affected part of the body to contain or eliminate the insult. Uveitis may be caused by: - An attack from the body’s own immune system (autoimmunity). - Infections or tumors occurring within the eye or in other parts of the body. - Bruises to the eye. - Toxins that may penetrate the eye. The disease will cause symptoms, such as decreased vision, pain, light sensitivity, and increased floaters. In many cases the cause is unknown. Uveitis is usually classified by where it occurs in the eye. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about uveitis. IS THE UVEITIS, AN AUTOIMMUNE DISEASE?", "response": "Facts About Uveitis (How is uveitis detected?): Diagnosis of uveitis includes a thorough examination and the recording of the patient’s complete medical history. Laboratory tests may be done to rule out an infection or an autoimmune disorder. A central nervous system evaluation will often be performed on patients with a subgroup of intermediate uveitis, called pars planitis, to determine whether they have multiple sclerosis which is often associated with pars planitis. The eye exams used, include: An Eye Chart or Visual Acuity Test: This test measures whether a patient’s vision has decreased. A Funduscopic Exam: The pupil is widened (dilated) with eye drops and then a light is shown through with an instrument called an ophthalmoscope to noninvasively inspect the back, inside part of the eye. Ocular Pressure: An instrument, such a tonometer or a tonopen, measures the pressure inside the eye. Drops that numb the eye may be used for this test. A Slit Lamp Exam: A slit lamp noninvasively inspects much of the eye. It can inspect the front and back parts of the eye and some lamps may be equipped with a tonometer to measure eye pressure. A dye called fluorescein, which makes blood vessels easier to see, may be added to the eye during the examination. The dye only temporarily stains the eye. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about uveitis. IS THE UVEITIS, AN AUTOIMMUNE DISEASE?", "response": "Uveitis: Uveitis is swelling and irritation of the uvea. The uvea is the middle layer of the eye. The uvea provides most of the blood supply to the retina. Uveitis can be caused by autoimmune disorders. These diseases occur when the body's immune system attacks and destroys healthy body tissue by mistake. Examples are: - Ankylosing spondylitis - Psoriasis - Reactive arthritis - Rheumatoid arthritis - Sarcoidosis - Ulcerative colitis Uveitis can also be caused by infections such as: - AIDS - Cytomegalovirus (CMV) retinitis - Herpes zoster infection - Histoplasmosis - Kawasaki disease - Syphilis - Toxoplasmosis - Tuberculosis Exposure to toxins or injury can also cause uveitis. In many cases, the cause is unknown. The most common form of uveitis involves inflammation the front part of the eye. It is often called iritis because it most often only affects the iris. The iris is the colored part of the eye. In most cases, it occurs in healthy people. The disorder may affect only one eye. It is most common in young and middle-aged people. Posterior uveitis affects the back part of the eye. It involves primarily the choroid. This is the layer of blood vessels and connective tissue in the middle layer of the eye. This type of uveitis is called choroiditis. If the retina is also involved, it is called chorioretinitis. Another form of uveitis is pars planitis. Changes involve the narrowed area (pars plana) between the colored part of the eye (iris) and the choroid. Pars planitis most often occurs in young men. It is generally not associated with any other disease. However, it may be linked to Crohn disease and possibly multiple sclerosis. Uveitis can affect one or both eyes. Symptoms may develop rapidly and can include: - Blurred vision - Dark, floating spots in the vision - Eye pain - Redness of the eye - Sensitivity to light The health care provider will take a complete medical history and do an eye exam. Lab tests may be done to rule out infection or a weak immune system. If you are over age 25 and have pars planitis, your provider will suggest a brain and spine MRI. This will rule out multiple sclerosis. Iritis (anterior uveitis) is most often mild. Treatment may involve: - Dark glasses - Eye drops that dilate the pupil to relieve pain - Steroid eye drops Pars planitis is often treated with steroid eye drops. Other medicines, including steroids taken by mouth, may be used to help suppress the immune system. Posterior uveitis treatment depends on the underlying cause. It almost always includes steroids taken by mouth. If the uveitis is caused by a body-wide (systemic) infection, you may be given antibiotics. You may also be given powerful anti-inflammatory medicines called corticosteroids. With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, the problem often returns. Posterior uveitis may last from months to years. It may cause permanent vision damage, even with treatment. Complications may include: - Cataracts - Fluid within the retina - Glaucoma - Irregular pupil - Retinal detachment - Vision loss Symptoms that need urgent medical care are: - Eye pain - Reduced vision If you have a body-wide (systemic) infection or disease, treating the condition will prevent uveitis. Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Customer Service Request. How much urine does an average human bladder hold - in ounces?", "response": "What is bladder cancer?: Bladder cancer is a disease in which certain cells in the bladder become abnormal and multiply without control or order. The bladder is a hollow, muscular organ in the lower abdomen that stores urine until it is ready to be excreted from the body. The most common type of bladder cancer begins in cells lining the inside of the bladder and is called transitional cell carcinoma (TCC). Bladder cancer may cause blood in the urine, pain during urination, frequent urination, or the feeling that one needs to urinate without results. These signs and symptoms are not specific to bladder cancer, however. They also can be caused by noncancerous conditions such as infections. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Customer Service Request. How much urine does an average human bladder hold - in ounces?", "response": "Urine odor: Urine odor refers to the smell from your urine. Urine odor varies. Most of the time, urine does not have a strong smell if you are healthy and drink plenty of fluids. Most changes in urine odor are not a sign of disease and go away in time. Some foods and medicines, including vitamins, may affect your urine's odor. For example, eating asparagus causes a distinct urine odor. Foul-smelling urine may be due to bacteria. Sweet-smelling urine may be a sign of uncontrolled diabetes or a rare disease of metabolism. Liver disease and certain metabolic disorders may cause musty-smelling urine. Some conditions that can cause changes in urine odor include: - Bladder fistula - Bladder infection - Body is low on fluids (concentrated urine can smell like ammonia) - Poorly controlled diabetes (sweet smelling urine) - Liver failure - Ketonuria Call your health care provider if you have signs of a urinary tract infection with abnormal urine odor. These include: - Fever - Chills - Burning pain with urination - Back pain You may have the following tests: - Urinalysis - Urine culture Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Customer Service Request. How much urine does an average human bladder hold - in ounces?", "response": "HCG in urine: This type of human chorionic gonadotropin (HCG) test measures the specific level of HCG in the urine. HCG is a hormone produced in the body during pregnancy. Other HCG tests include: - HCG in blood serum - qualitative - HCG in blood serum - quantitative - Pregnancy test To collect a urine sample, you urinate into a special (sterile) cup. Home pregnancy tests require the test strip to be dipped into the urine sample or passed through the urine stream while urinating. Carefully follow package directions. In most cases, a urine sample taken the first time you urinate in the morning is best. This is when urine is the most concentrated and has enough HCG to be detected. No special preparation is needed. The test involves urinating into a cup or onto a test strip. Urine HCG tests are a common method of determining if a woman is pregnant. The best time to test for pregnancy at home is after you miss your period. The test result will be reported as negative or positive. - The test is negative if you are not pregnant. - The test is positive if you are pregnant. A pregnancy test, including a properly performed home pregnancy test, is considered to be very accurate. Positive results are more likely to be accurate than negative results. When the test is negative but pregnancy is still suspected, the test should be repeated in 1 week. There are no risks, except for false positive or false negative results. Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Amlodipine. I am taking Amlodipine and it has caused my pause rate to be very high. Is there a weaning process when you stop taking Amlodipine and start atenolol? I am taking 5 mg of amlodipine and will be taking 50 mg of atenolol?", "response": "Amlodipine (Brand names of combination products): - Amturnide® (containing Aliskiren, Amlodipine, Hydrochlorothiazide) - Azor® (containing Amlodipine, Olmesartan) - Caduet® (containing Amlodipine, Atorvastatin) - Exforge® (containing Amlodipine, Valsartan) - Exforge® HCT (containing Amlodipine, Hydrochlorothiazide, Valsartan) - Prestalia® (containing Amlodipine, Perindopril) - Tekamlo® (containing Aliskiren, Amlodipine) - Tribenzor® (containing Amlodipine, Hydrochlorothiazide, Olmesartan) - Twynsta® (containing Amlodipine, Telmisartan). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Shingles vacine. At what age should you get the Shingles shot. My children are in theur late 30's, early 40's, all three had bad cases of chicken pox as children.", "response": "Shingles (Should You Get the Shingles Vaccine?): The shingles vaccine is a safe and easy, one-time shot that may keep you from getting shingles. Most people age 60 and older should get vaccinated. You should get the shot even if you have already had shingles or don't remember having chickenpox. However, if you have a weak immune system or allergies to certain medicines, make sure to check with your doctor first.You can get the shingles vaccine at your doctor's office and at some pharmacies. All Medicare Part D plans and most private health insurance plans will cover the cost. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Shingles vacine. At what age should you get the Shingles shot. My children are in theur late 30's, early 40's, all three had bad cases of chicken pox as children.", "response": "Shingles (Causes): After you get chickenpox, the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves after many years. Many people had such a mild case of chickenpox that they do not realize they have had the infection. The reason the virus suddenly becomes active again is not clear. Often only one attack occurs. Shingles can develop in any age group. You are more likely to develop the condition if: - You are older than age 60 - You had chickenpox before age 1 - Your immune system is weakened by medicines or disease If an adult or child has direct contact with the shingles rash and did not have chickenpox as a child or get the chickenpox vaccine, they can develop chickenpox, not shingles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "very worry and need advise .. dear sir i had car accident 2 months a go . other person blood splash one me and i saw a lot of blood on my hand and some on face . not sure about eye . i didn't wash it immediatly and until 15 minute later then i washed it . am i risk hiv ? thank you .", "response": "Child safety seats (Review Date 2/16/2017): Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "very worry and need advise .. dear sir i had car accident 2 months a go . other person blood splash one me and i saw a lot of blood on my hand and some on face . not sure about eye . i didn't wash it immediatly and until 15 minute later then i washed it . am i risk hiv ? thank you .", "response": "Who is at risk for Lyme disease blood test??: Veins and arteries vary in size, so it may be harder to take a blood sample from one person than another. Other slight risks from having blood drawn may include: - Excessive bleeding - Fainting or feeling lightheaded - Hematoma (blood accumulating under the skin) - Infection (a slight risk any time the skin is broken). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "very worry and need advise .. dear sir i had car accident 2 months a go . other person blood splash one me and i saw a lot of blood on my hand and some on face . not sure about eye . i didn't wash it immediatly and until 15 minute later then i washed it . am i risk hiv ? thank you .", "response": "IMH » HIV/AIDS and Mental Health (HIV-Associated Neurocognitive Disorders (HAND)): HAND represents the range of neurocognitive complications associated with HIV infection. Although there is currently no cure for HAND, combination antiretroviral therapy has been shown to be the only option in preventing or delaying the progression of HAND. There are three major types of HAND: - Asymptomatic Neurocognitive Impairment (ANI) is diagnosed if testing shows HIV-associated impairment in cognitive function, but everyday functioning is not affected. - Mild Neurocognitive Disorder (MND) is diagnosed if testing shows HIV-associated impairment in cognitive function, and mild interference in everyday functioning. - HIV-associated Dementia (HAD) is diagnosed if testing shows marked impairment in cognitive function, especially in learning of new information, information processing, and attention or concentration. This impairment significantly limits your ability to function day-to-day at work, home, and during social activities. Although a significant proportion of people living with HIV are affected by a mild form of HAND, there has been significant progress in the treatment of HAND. Since the start of the epidemic, severe cases of HAND have been on the decline and the most severe form, HAD, is rare. The majority of people experience more subtle abnormalities in memory and cognition. Experienced clinicians can diagnose HAND after carefully ruling out other possible causes of the symptoms. They may conduct a thorough neurological exam and history, neuropsychological testing, brain MRI scan, and sometimes lumbar puncture to evaluate the cerebrospinal fluid to obtain information about the nature and severity of HAND. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Swan NDC 0869-0871-43. I found 4 cases of expired (04/2010) Hydrogen Peroxide. How do I safely dispose of this product?", "response": "Hydrogen peroxide poisoning (Where Found): Hydrogen peroxide is used in these products: - Hydrogen peroxide - Hair bleach - Some contact lens cleaners Note: Household hydrogen peroxide has a 3% concentration. That means it contains 97% water and 3% hydrogen peroxide. Hair bleaches are stronger. They usually have a concentration of more than 6%. Some industrial-strength solutions contain more than 10% hydrogen peroxide. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Swan NDC 0869-0871-43. I found 4 cases of expired (04/2010) Hydrogen Peroxide. How do I safely dispose of this product?", "response": "How and when to get rid of unused medicines (How to Dispose of Expired Medicines Safely): Disposing medicines safely prevents others from using them accidentally or intentionally. It also prevents harmful residues from getting into the environment. Look for disposal instructions on the label or information booklet. DO NOT FLUSH UNUSED MEDICINES You should not flush most medicines or pour them down the drain. Medicines contain chemicals that may not break down in the environment. When flushed down the toilet or sink, these residues can pollute our water resources. This may affect fish and other marine life. These residues can also end up in our drinking water. However, some medicines must be disposed of as soon as possible to reduce their potential harm. You can flush them to prevent someone from using them. These include opioids or narcotics usually prescribed for pain. You should ONLY flush medicines when it specifically says to do so on the label. DRUG TAKE-BACK PROGRAMS The best way to dispose of your medicines is to bring them to drug take-back programs. These programs safely dispose of medicines by burning them up. Drug take-back programs are organized from time to time in most communities. Or, your town may have special days when you can bring hazardous household items such as unused medicines to a specific location for disposal. Contact your local trash and recycling service to find out when the next event is scheduled in your community. Medicines NOT accepted by most drug take-back programs include: - Liquid medicines - Needles - Sprays - Inhalers - Creams HOUSEHOLD DISPOSAL If you don't have a take-back program available, you can throw your medicines out with your household trash. To do so safely: - Take the medicine out of its container and mix it with other unpleasant garbage such as kitty litter or used coffee grounds. DO NOT crush pills or capsules. - Place the mixture into a sealable plastic bag or sealed contain that won't leak. - Be sure to remove your Rx number and all personal information from the medicine bottle. Scratch it off or cover it with a permanent marker or duct tape. - Throw the container and pill bottles out with the rest of your trash. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Swan NDC 0869-0871-43. I found 4 cases of expired (04/2010) Hydrogen Peroxide. How do I safely dispose of this product?", "response": "How and when to get rid of unused medicines: Many people have unused or expired prescription or over-the-counter (OTC) medicines at home. Learn when you should get rid of unused medicines and how to dispose of them safely. You should get rid of a medicine when: - Your health care provider changes your prescription but you still have some medicine left - You feel better and your provider says you should stop taking the medicine - You have OTC medicines that you no longer need - You have medicines that are past their expiration dates DO NOT take expired medicines. They may not be as effective or the ingredients of the medicine may have changed. This can make them unsafe for use. Read the labels regularly to check the expiration date of a medicine. Discard any that have expired and those you no longer need. Storing expired or unwanted medicines can increase the risk of: - Taking the wrong medicine due to mix-ups - Accidental poisoning in children or pets - Overdose - Misuse or illegal abuse Disposing medicines safely prevents others from using them accidentally or intentionally. It also prevents harmful residues from getting into the environment. Look for disposal instructions on the label or information booklet. DO NOT FLUSH UNUSED MEDICINES You should not flush most medicines or pour them down the drain. Medicines contain chemicals that may not break down in the environment. When flushed down the toilet or sink, these residues can pollute our water resources. This may affect fish and other marine life. These residues can also end up in our drinking water. However, some medicines must be disposed of as soon as possible to reduce their potential harm. You can flush them to prevent someone from using them. These include opioids or narcotics usually prescribed for pain. You should ONLY flush medicines when it specifically says to do so on the label. DRUG TAKE-BACK PROGRAMS The best way to dispose of your medicines is to bring them to drug take-back programs. These programs safely dispose of medicines by burning them up. Drug take-back programs are organized from time to time in most communities. Or, your town may have special days when you can bring hazardous household items such as unused medicines to a specific location for disposal. Contact your local trash and recycling service to find out when the next event is scheduled in your community. Medicines NOT accepted by most drug take-back programs include: - Liquid medicines - Needles - Sprays - Inhalers - Creams HOUSEHOLD DISPOSAL If you don't have a take-back program available, you can throw your medicines out with your household trash. To do so safely: - Take the medicine out of its container and mix it with other unpleasant garbage such as kitty litter or used coffee grounds. DO NOT crush pills or capsules. - Place the mixture into a sealable plastic bag or sealed contain that won't leak. - Be sure to remove your Rx number and all personal information from the medicine bottle. Scratch it off or cover it with a permanent marker or duct tape. - Throw the container and pill bottles out with the rest of your trash. Call your provider if: - Someone consumes expired medicines accidentally or on purpose - You have an allergic reaction to a medicine Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia.. congenital diaphragmatic hernia. what are the causes of congenital diaphragmatic hernia? Can cousin marriage cause this? What kind of lung disease the baby might experience life long?", "response": "Congenital diaphragmatic hernia (Prognosis): The long-term outlook ( prognosis ) for those with congenital diaphragmatic hernia (CDH) depends on a number of factors and is hard to predict. A large defect is more likely to result in pulmonary hypoplasia (underdevelopment of the lungs) and death than a small defect. [6] Other factors associated with decreased survival include: premature birth having a chromosome abnormality or single gene disorder the presence of other severe birth defects such as a heart defect having a right-sided defect or bilateral CDH (on both sides) liver herniation a lower fetal lung volume[5][6][4] persistent pulmonary hypertension of the newbornhemorrhagechylothoraxtertiary. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia.. congenital diaphragmatic hernia. what are the causes of congenital diaphragmatic hernia? Can cousin marriage cause this? What kind of lung disease the baby might experience life long?", "response": "congenital diaphragmatic hernia: Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth. In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare. Congenital diaphragmatic hernia affects approximately 1 in 2,500 newborns. Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition. Bielinska M, Jay PY, Erlich JM, Mannisto S, Urban Z, Heikinheimo M, Wilson DB. Molecular genetics of congenital diaphragmatic defects. Ann Med. 2007;39(4):261-74. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia.. congenital diaphragmatic hernia. what are the causes of congenital diaphragmatic hernia? Can cousin marriage cause this? What kind of lung disease the baby might experience life long?", "response": "Congenital diaphragmatic hernia (Cause): Congenital diaphragmatic hernia (CDH) can occur as an isolated finding, as part of a genetic syndrome or chromosome abnormality , or with additional birth defects of unknown cause. [5] Some cases have been linked to in utero exposures. [6] In the majority of cases, the cause is not known. [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "shingles. need to know about the work place and someone having shingles, especially while handling food.", "response": "Shingles (Zoster) Vaccine (What is shingles?): Shingles is a painful skin rash, often with blisters. It is also called Herpes Zoster or just Zoster. A shingles rash usually appears on one side of the face or body and lasts from 2 to 4 weeks. Its main symptom is pain, which can be quite severe. Other symptoms of shingles can include fever, headache, chills, and upset stomach. Very rarely, a shingles infection can lead to pneumonia, hearing problems, blindness, brain inflammation (encephalitis), or death. For about one person in five, severe pain can continue even after the rash clears up. This is called post-herpetic neuralgia. Shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox. Only someone who has had chickenpox, or rarely, has gotten chickenpox vaccine, can get shingles. The virus stays in your body, and can cause shingles many years later. You can't catch shingles from another person with shingles. However, a person who has never had chickenpox (or chickenpox vaccine) could get chickenpox from someone with shingles. This is not very common. Shingles is far more common in people 50 and older than in younger people. It is also more common in people whose immune systems are weakened because of a disease such as cancer, or drugs such as steroids or chemotherapy. At least 1 million people a year in the United States get shingles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "shingles. need to know about the work place and someone having shingles, especially while handling food.", "response": "Shingles (What Are the Symptoms of Shingles?): Usually, shingles develops only on one side of the body or face and in a small area rather than all over. The most common place for shingles is a band that goes around one side of your waistline.Most people have some of the following shingles symptoms:- Burning, tingling, or numbness of the skin - Feeling sick-chills, fever, upset stomach, or headache - Fluid-filled blisters - Skin that is sensitive to touch - Mild itching to strong painDepending on where shingles develops, it could also cause symptoms like hiccups or even loss of vision.For some people, the symptoms of shingles are mild. They might just have some itching. For others, shingles can cause intense pain that can be felt from the gentlest touch or breeze. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "shingles. need to know about the work place and someone having shingles, especially while handling food.", "response": "Shingles (How Do You Get Shingles?): Everyone who has had chickenpox has VZV in their body and is at risk for getting shingles. Right now, there is no way of knowing who will get the disease. But, some things make it more likely:- Advanced age. The risk of getting shingles increases as you age. People may have a harder time fighting off infections as they get older. About half of all shingles cases are in adults age 60 or older. The chance of getting shingles becomes much greater by age 70. - Trouble fighting infections. Your immune system is the part of your body that responds to infections. Age can affect your immune system. So can an HIV infection, cancer, cancer treatments, too much sun, or organ transplant drugs. Even stress or a cold can weaken your immune system for a short time. These all can put you at risk for shingles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. My question to you is: what is the reason that there is very little attentions is to Antiphosoholipid Syndrome? To find the causes and possibly some type of cure for us who struggle with this auto-immune blood disorder? I guess that since it is female directed (9-1 female to male) that no one important enough has died from APS? Oh, by the way, I'm a 58 year old man!", "response": "Lupus anticoagulants and antiphospholipid antibodies (Treatment): LUPUS ANTICOAGULANT OR APL Often, you will not need treatment if you do not have symptoms or if you have never had a blood clot in the past. Take the following steps to help prevent blood clots from forming: - Avoid most birth control pills or hormone treatments for menopause (women). - DO NOT smoke or use other tobacco products. - Get up and move around during long plane flights or other times when you have to sit or lie down for extended periods. - Move your ankles up and down when you cannot move around. You will be prescribed blood-thinning medicines (such as heparin and warfarin) to help prevent blood clots: - After surgery - After a bone fracture - With active cancer - When you need to set or lie down for long periods of time, such as during a hospital stay or recovering at home You may also need to take blood thinners for 3 to 4 weeks after surgery to lower your risk of blood clots. ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS) In general, you will need long-term treatment with a blood thinner for a long time if you have the APS. Initial treatment may be heparin, either unfractionated or low-molecular heparin. These medicines are given by injection. In most cases, warfarin (Coumadin), which is given by mouth, is then started. It is necessary to monitor the level of anticoagulation frequently. This is most often done using the INR test. If you have APS and become pregnant, you will need to be followed closely by a provider expert in this condition. You will not take warfarin during pregnancy, but will be given low-molecular weight heparin instead. If you have SLE and APS your provider will also recommend that you take hydroxychloroquine. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. My question to you is: what is the reason that there is very little attentions is to Antiphosoholipid Syndrome? To find the causes and possibly some type of cure for us who struggle with this auto-immune blood disorder? I guess that since it is female directed (9-1 female to male) that no one important enough has died from APS? Oh, by the way, I'm a 58 year old man!", "response": "Schizoaffective disorder (Treatment): Treatment can vary. In general, your provider will prescribe medicines to improve your mood and treat psychosis: - Antipsychotic medicines are used to treat psychotic symptoms. - Antidepressant medicines, or mood stabilizers, may be prescribed to improve mood. Talk therapy can help with creating plans, solving problems, and maintaining relationships. Group therapy can help with social isolation. Support and work training may be helpful for work skills, relationships, money management, and living situations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. My question to you is: what is the reason that there is very little attentions is to Antiphosoholipid Syndrome? To find the causes and possibly some type of cure for us who struggle with this auto-immune blood disorder? I guess that since it is female directed (9-1 female to male) that no one important enough has died from APS? Oh, by the way, I'm a 58 year old man!", "response": "Schizoid personality disorder (Treatment): People with this disorder will often not seek treatment. For this reason, little is known about which treatments work. Talk therapy may not be effective. This is because people with this disorder may have a hard time forming a good working relationship with a therapist. One approach that seems to help is to put fewer demands for emotional closeness or intimacy on the person. People with schizoid personality disorder often do well in relationships that don't focus on emotional closeness. They tend to be better at handling relationships that focus on: - Work - Intellectual activities - Expectations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "side efectes to methadone. i jest started taking methadone and have confusion my face itches", "response": "What are the side effects or risks of Methadone?: Methadone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - weakness - headache - nausea - vomiting - loss of appetite - weight gain - stomach pain - dry mouth - sore tongue - sweating - flushing - difficulty urinating - mood changes - vision problems - difficulty falling asleep or staying asleep - decreased sexual desire or ability - missed menstrual periods Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical help: - seizures - itching - hives - rash - swelling of the eyes, face, mouth, tongue, or throat - hoarseness - difficulty breathing or swallowing - extreme drowsiness - hallucinating (seeing things or hearing voices that do not exist) Methadone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "methylprednisolole. unable to fine info on the above med", "response": "Methylprednisolone (What special dietary instructions should I follow?): Your doctor may instruct you to follow a low-sodium, low-salt, potassium-rich, or high-protein diet. Follow these directions. Methylprednisolone may cause an upset stomach. Take methylprednisolone with food or milk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Simvastatin. Why is it recommended that this medicine be taken in the evening? Any harm in taking it in the morning?", "response": "Simvastatin (How should this medicine be used?): Simvastatin comes as a tablet to take by mouth. It usually is taken once a day in the evening. Take simvastatin at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take simvastatin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of simvastatin and gradually increase your dose, not more than once every 4 weeks. Continue to take simvastatin even if you feel well. Do not stop taking simvastatin without talking to your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Simvastatin. Why is it recommended that this medicine be taken in the evening? Any harm in taking it in the morning?", "response": "Simvastatin (Other uses for this medicine): This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Prednisone. My husband has been on Prednisone for almost a year for a Cancer treatment he had. He started at 30mg and stayed on 10mg until a couple weeks ago. The prednisone was causing other side effects. He reduced down to 5mg for a couple days and now has been off the prednisone for a week. How long should we expect this drug to stay in his system. He is really experiencing chills/fever/abdominal pain..are these common when coming off this drug? Is there anything else we should expect?", "response": "Prednisone (How should this medicine be used?): Prednisone comes as a tablet, a solution (liquid), and a concentrated solution to take by mouth. Prednisone is usually taken with food one to four times a day or once every other day. Your doctor will probably tell you to take your dose(s) of prednisone at certain time(s) of day every day. Your personal dosing schedule will depend on your condition and on how you respond to treatment. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take prednisone exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor. If you are taking the concentrated solution, use the specially marked dropper that comes with the medication to measure your dose. You may mix the concentrated solution with juice, other flavored liquids, or soft foods such as applesauce. Your doctor may change your dose of prednisone often during your treatment to be sure that you are always taking the lowest dose that works for you. Your doctor may also need to change your dose if you experience unusual stress on your body such as surgery, illness, infection, or a severe asthma attack. Tell your doctor if your symptoms improve or get worse or if you get sick or have any changes in your health during your treatment. If you are taking prednisone to treat a long-lasting disease, the medication may help control your condition but will not cure it. Continue to take prednisone even if you feel well. Do not stop taking prednisone without talking to your doctor. If you suddenly stop taking prednisone, your body may not have enough natural steroids to function normally. This may cause symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight loss, changes in skin color, sores in the mouth, and craving for salt. Call your doctor if you experience these or other unusual symptoms while you are taking decreasing doses of prednisone or after you stop taking the medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Prednisone. My husband has been on Prednisone for almost a year for a Cancer treatment he had. He started at 30mg and stayed on 10mg until a couple weeks ago. The prednisone was causing other side effects. He reduced down to 5mg for a couple days and now has been off the prednisone for a week. How long should we expect this drug to stay in his system. He is really experiencing chills/fever/abdominal pain..are these common when coming off this drug? Is there anything else we should expect?", "response": "Prednisone (What should I do if I forget a dose?): When you start to take prednisone, ask your doctor what to do if you forget to take a dose. Write down these instructions so that you can refer to them later. Call your doctor or pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make up for a missed dose. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Does electrical high voltage shock cause swallowing problems in the near future ??", "response": "Swallowing problems (Summary): Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia. This may be caused by a brain or nerve disorder, stress or anxiety, or problems that involve the tube leading from your throat to your stomach-the esophagus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Does electrical high voltage shock cause swallowing problems in the near future ??", "response": "Swallowing problems: Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia. This may be caused by a brain or nerve disorder, stress or anxiety, or problems that involve the tube leading from your throat to your stomach-the esophagus. Symptoms of swallowing problems include: - Coughing or choking, either during or after eating - Gurgling sounds from the throat, during or after eating - Throat clearing after drinking or swallowing - Slow chewing or eating - Coughing food back up after eating - Hiccups after swallowing - Chest discomfort during or after swallowing - Unexplained weight loss Symptoms may be mild or severe. Most people with dysphagia should be checked by a health care provider. But these general tips may help. - Keep mealtime relaxed. - Sit up as straight as possible when you eat. - Take small bites, less than 1 teaspoon (5 ml) of food per bite. - Chew well and swallow your food before taking another bite. - If one side of your face or mouth is weaker, chew food on the stronger side of your mouth. - DO NOT mix solid foods with liquids in the same bite. - DO NOT try to wash down solids with sips of liquids, unless your speech or swallowing therapist says this is OK. - DO NOT talk and swallow at the same time. - Sit upright for 30 to 45 minutes after eating. - DO NOT drink thin liquids without checking with your doctor or therapist first. You may need someone to remind you to finish swallowing. It may also help to ask caregivers and family members not to talk to you when you are eating or drinking. Call your provider if: - You cough or have fever or shortness of breath - You are losing weight - Your swallowing problems are getting worse Updated by: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Does electrical high voltage shock cause swallowing problems in the near future ??", "response": "Swallowing problems (When to Call the Doctor): Call your provider if: - You cough or have fever or shortness of breath - You are losing weight - Your swallowing problems are getting worse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "calcitonin salmon nasal spray.. calcitonin salmon nasal spray. I picked up a bottle of above but noted it had NOT been refrigerated for at least the 3 days since Rx was filled. Box and literature state \"refrigerate until opened.\" Pharmacist insisted it was ok \"for 30 days\" although I said that meant after opening. Cost is $54.08 plus need to know if it will be as effective as should be. Thank you.", "response": "Calcitonin Salmon Injection (How should this medicine be used?): Calcitonin salmon comes as a solution to be injected under the skin (subcutaneously) or into the muscle (intramuscularly). It is usually used once a day or once every other day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use calcitonin salmon injection exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. Your doctor, nurse, or pharmacist will show you how to administer the medication. Follow all directions carefully. Dispose of all empty syringes and vials as directed by your healthcare provider. Before preparing a dose, look at the vial. If the solution is discolored or contains particles, do not use it, and call your pharmacist. Calcitonin salmon helps treat osteoporosis and Paget's disease of bone but does not cure them. Continue to use calcitonin salmon even if you feel well. Do not stop using calcitonin salmon without talking to your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "calcitonin salmon nasal spray.. calcitonin salmon nasal spray. I picked up a bottle of above but noted it had NOT been refrigerated for at least the 3 days since Rx was filled. Box and literature state \"refrigerate until opened.\" Pharmacist insisted it was ok \"for 30 days\" although I said that meant after opening. Cost is $54.08 plus need to know if it will be as effective as should be. Thank you.", "response": "Calcitonin Salmon Nasal Spray (What other information should I know?): Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to calcitonin salmon. You will also need occasional examinations of the nose to make sure calcitonin salmon nasal spray is not causing injury to the nose. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Schmorl's Nodes. I am trying to obtain information on subject matter.", "response": "Cancer and lymph nodes (Removing Lymph Nodes): Surgical removal of lymph nodes is called lymphadenectomy. Surgery can help to get rid of the cancer before spreading further. After nodes are removed, fluid has fewer places to go. Sometimes back up of lymph fluid, or lymphedema, can occur. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Schmorl's Nodes. I am trying to obtain information on subject matter.", "response": "Cancer and lymph nodes (How Cancer Gets in the Lymph Nodes): Cancer can start in the lymph nodes. This is called lymphoma. There are several types of lymphomas, such as non-Hodgkin lymphoma. Cancer cells can also spread to the lymph nodes from a cancer in any part of the body. This is called metastatic cancer. Cancer cells break off from a tumor in the body and travel to an area of lymph nodes. The cancer cells often travel to nodes near the tumor first. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Schmorl's Nodes. I am trying to obtain information on subject matter.", "response": "Cancer and lymph nodes (How Cancer in Lymph Nodes is Found): Nodes swell as they work hard to fight cancer cells. You or your health care provider may feel or see swollen lymph nodes if they are close to the surface of the skin, such as in the neck, groin, or underarms. Keep in mind that many other things also can cause lymph nodes to swell. So having swollen lymph nodes does not mean you definitely have cancer. When a provider suspects that cancer cells may be present in lymph nodes, certain tests may be performed to detect cancer, such as: - Lymph node biopsy - B-cell leukemia/lymphoma panel - Other imaging tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Topic not covered. What exactly is sleep paralysis?", "response": "Isolated sleep paralysis: Isolated sleep paralysis is a type of paralysis that occurs when a person just goes to sleep or upon waking from sleep. It is not associated with another sleep disorder. Episodes of isolated sleep paralysis last from a few seconds to 1 or 2 minutes. During these episodes the person is unable to move or speak. Breathing is not affected. These spells end on their own or when the person is touched or moved. In rare cases, the person may have dream-like sensations or hallucinations, which may be scary to them. Sleep paralysis can be a symptom of narcolepsy. But if you do not have other symptoms of narcolepsy, there is usually no need to have sleep studies done. In most cases, isolated sleep paralysis occurs so rarely that treatment is not needed. If the cause is known, for example due to lack of sleep, correcting the cause, such as getting enough sleep, often resolves the condition. In persons with mental health conditions, medicine and behavioral therapy (talk therapy) to help treat the mental condition may resolve sleep paralysis. Updated by: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutger's New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Topic not covered. What exactly is sleep paralysis?", "response": "Isolated sleep paralysis (Symptoms): Episodes of isolated sleep paralysis last from a few seconds to 1 or 2 minutes. During these episodes the person is unable to move or speak. Breathing is not affected. These spells end on their own or when the person is touched or moved. In rare cases, the person may have dream-like sensations or hallucinations, which may be scary to them. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Topic not covered. What exactly is sleep paralysis?", "response": "Isolated sleep paralysis (Exams and Tests): Sleep paralysis can be a symptom of narcolepsy. But if you do not have other symptoms of narcolepsy, there is usually no need to have sleep studies done. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Article on Exercise for Impaired - Overweight - Asthmatics. I just found the site through the article on breathing difficulty. My frustration is, WHAT exercises to do with asthma? Today I walked out of the door of the house to take a walk, a beautiful, cool, blustery, sunny day. Suddenly I couldn't catch my breath, my upper chest felt 'heavy', and I had to go back inside and sit down for a while. I'm no exercise weenie, before a couple of bad accidents (car crashes waiting at stop lights!) I used to play softball, volleyball, basketball, even a bit of rugby, I was a dancer and a weight-exerciser, a bicyclist, rollerblader, tree climber. Even today, BP is typically 110-120 over 70-80, heart rate is fine too. Is this just asthma? WHAT exercises can I do, safely? Sure, we ALL get it, exercise is good for us. Just which ones? LOTS of us with asthma would love help here. Thanks.", "response": "Exercising and asthma at school: Sometimes exercise triggers asthma symptoms. This is called exercise-induced asthma (EIA). The symptoms of EIA are coughing, wheezing, a feeling of tightness in your chest, or shortness of breath. Most times, these symptoms start soon after you stop exercising. Some people may have symptoms after they start exercising. Having asthma symptoms when exercising does not mean a student cannot or should not exercise. Taking part in recess, physical education (PE), and after-school sports is important for all children. And children with asthma should not have to sit on the side lines. School staff and coaches should know your child's asthma triggers, such as: - Cold or dry air. Breathing through the nose or wearing a scarf or mask over the mouth may help. - Polluted air. - Freshly mowed fields or lawns. A student with asthma should warm up before exercising and cool down afterward. Read the student's asthma action plan. Make sure staff members know where it is kept. Discuss the action plan with the parent or guardian. Find out what type of activities the student can do and for how long. Teachers, coaches, and other school staff should know the symptoms of asthma and what to do if a student has an asthma attack. Help the student take the medicines listed in his or her asthma action plan. Encourage the student to participate in PE. To help prevent an asthma attack, modify PE activities. For example, a running program might be set up this way: - Walk the whole distance - Run part of the distance - Alternate running and walking Some exercises may be less likely to trigger asthma symptoms. - Swimming is often a good choice. The warm, moist air may keep symptoms away. - Football, baseball, and other sports that have periods of inactivity are less likely to trigger asthma symptoms. Activities that are more intense and sustained, such as long periods of running, basketball, and soccer, are more likely to trigger asthma symptoms. If an asthma action plan instructs the student to take medicines before exercising, remind the student to do so. These may include short-acting and long-acting medicines. Short-acting, or quick-relief, medicines: - Are taken 10 to 15 minutes before exercise - Can help for up to 4 hours Long-acting inhaled medicines: - Are used at least 30 minutes before exercise - Last up to 12 hours Children can take long-acting medicines before school and they will help for the whole day. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Article on Exercise for Impaired - Overweight - Asthmatics. I just found the site through the article on breathing difficulty. My frustration is, WHAT exercises to do with asthma? Today I walked out of the door of the house to take a walk, a beautiful, cool, blustery, sunny day. Suddenly I couldn't catch my breath, my upper chest felt 'heavy', and I had to go back inside and sit down for a while. I'm no exercise weenie, before a couple of bad accidents (car crashes waiting at stop lights!) I used to play softball, volleyball, basketball, even a bit of rugby, I was a dancer and a weight-exerciser, a bicyclist, rollerblader, tree climber. Even today, BP is typically 110-120 over 70-80, heart rate is fine too. Is this just asthma? WHAT exercises can I do, safely? Sure, we ALL get it, exercise is good for us. Just which ones? LOTS of us with asthma would love help here. Thanks.", "response": "Asthma (Symptoms): Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked. Symptoms of asthma include: - Cough with or without sputum (phlegm) production - Pulling in of the skin between the ribs when breathing (intercostal retractions) - Shortness of breath that gets worse with exercise or activity - Wheezing Emergency symptoms that need prompt medical help include: - Bluish color to the lips and face - Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack - Extreme difficulty breathing - Rapid pulse - Severe anxiety due to shortness of breath - Sweating Other symptoms that may occur: - Abnormal breathing pattern -- breathing out takes more than twice as long as breathing in - Breathing temporarily stops - Chest pain - Tightness in the chest. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Article on Exercise for Impaired - Overweight - Asthmatics. I just found the site through the article on breathing difficulty. My frustration is, WHAT exercises to do with asthma? Today I walked out of the door of the house to take a walk, a beautiful, cool, blustery, sunny day. Suddenly I couldn't catch my breath, my upper chest felt 'heavy', and I had to go back inside and sit down for a while. I'm no exercise weenie, before a couple of bad accidents (car crashes waiting at stop lights!) I used to play softball, volleyball, basketball, even a bit of rugby, I was a dancer and a weight-exerciser, a bicyclist, rollerblader, tree climber. Even today, BP is typically 110-120 over 70-80, heart rate is fine too. Is this just asthma? WHAT exercises can I do, safely? Sure, we ALL get it, exercise is good for us. Just which ones? LOTS of us with asthma would love help here. Thanks.", "response": "Asthma attack (Treatment): If you and your doctor have worked out an asthma plan, follow its directions at the first sign of an asthma attack. This generally means taking two to six puffs of a quick-acting (rescue) inhaler to get airway-expanding medication, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others), deep into your lungs. Small children and those who have trouble with inhalers can use a nebulizer. After 20 minutes, you can repeat the treatment one time if necessary. For an asthma attack with severe symptoms, such as difficulty speaking because you're so short of breath, start with the same initial step of using quick-acting medication - but instead of waiting for the drug to work, get to a doctor's office or urgent care immediately. Same-day medical care is also warranted if you continue to wheeze and feel at all breathless after initial treatment. Your doctor may recommend that you continue to use quick-acting medication every three to four hours for a day or two after the attack. You might also need to take oral corticosteroid medication for a short time. Emergency treatment If you go to the emergency room for an asthma attack in progress, you'll need medications to get your asthma under immediate control. These can include: - Short-acting beta agonists, such as albuterol (ProAir HFA, Proventil HFA, Ventolin HFA, others). These are the same medications as those in your quick-acting (rescue) inhaler. You may need to use a machine called a nebulizer, which turns the medication into a mist that can be inhaled deep into your lungs. - Oral corticosteroids. Taken in pill form, these medications help reduce lung inflammation and get your asthma symptoms under control. Corticosteroids can also be given intravenously, typically to patients who are vomiting or under respiratory failure. - Ipratropium (Atrovent). Ipratropium is sometimes used as a bronchodilator to treat a severe asthma attack, especially if albuterol is not fully effective. - Intubation, mechanical ventilation and oxygen. If your asthma attack is life-threatening, your doctor may put a breathing tube down your throat into your upper airway. Using a machine that pumps oxygen into your lungs will help you breathe while your doctor gives you medications to bring your asthma under control. After your asthma symptoms improve, your doctor may want you to stay in the emergency room for a few hours or longer to make sure you don't have another asthma attack. When your doctor feels your asthma is sufficiently under control, you'll be able to go home. Your doctor will give you instructions on what to do if you have another asthma attack. If your asthma symptoms don't improve after emergency treatment, your doctor may admit you to the hospital and give you medications every hour or every few hours. If you're having severe asthma symptoms, you may need to breathe oxygen through a mask. In some cases, a severe, persistent asthma attack requires a stay in the intensive care unit (ICU). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi. I can't find this I take Ambien every night for sleep. I want to no how long before I go to bed am I supposed to take it.", "response": "Can't sleep? Try these tips: Everyone has trouble sleeping some of the time. But if it happens often, lack of sleep can affect your health and make it hard to get through the day. Learn lifestyle tips that can help you get the rest you need. Some people have trouble falling asleep. Others wake up in the middle of the night and cannot get back to sleep. You can change your habits and your home to make sleep less fleeting. Stick to a sleep schedule: - Go to bed and get up at the same time. Going to sleep at the same time every night trains your body and brain to wind down and get ready for slumber. - Get up if you cannot sleep. If you lay awake for 15 minutes, get out of bed and go to another part of the house. This way your bed is less likely to become a place of stress. - Do something quiet and relaxing like read a book. This can also help take your mind of the fact that you are not sleeping. When you feel drowsy, return to bed. Make your bedroom comfortable: - Get a comfortable mattress. If your mattress is lumpy, too soft, or too hard, it will be hard to get comfortable enough for sleep. - Keep it cool. Your body temperature goes down when you sleep. Make sure your bedroom is cool enough but not so cool that you wake up cold. Experiment with the thermostat and blankets to find what temperature works for you. - Control the light. Light from the street, a TV, or the next room can make it hard to stay asleep. Use curtains and doors to make your room dark so you can sleep. You can also try using a sleep mask. - Control sounds. Make your room as quiet as you can. You might use a fan, soft music, or sound machine to create white noise you can sleep to. - Hide the clock. Watching the hours tick by can stress you out. Turn the clock so you cannot see it from your pillow. - Put away electronics. Silence any device that reminds you of emails you need to send or things you need to do. You will be better off doing those things after a good night's sleep. Practice Relaxation Try different ways to relax. Find what works for you. Such as: - Drink something warm and non-caffeinated like warm milk or herbal tea. - Take a warm shower or bath. - Read a book or magazine. - Listen to soft music or an audiobook. - Count backward from 300 by 3. - Meditate. - Starting at your feet and working your way up to your head, tense each group of muscles for a second or two and then relax them. - Do belly breathing. Put your hand on your belly. Take a breath in, letting it push your hand out as your belly rises. Your chest should not move. Hold it for a count of 5, release for a count of 5. Repeat. Live for Good Sleep Things you do during the day can affect how well you sleep at night. You should: - Limit evening activities. When you are on the run, your day may not end until late evening. Try to limit evening plans to a few nights a week. Give yourself time for a soothing bedtime ritual to help prepare you for sleep, such as a warm bath or reading in bed. - Exercise. Regular exercise will help you sleep better. Just be sure you plan your workout right. Overtraining or exercising less than 3 hours before bedtime can make you toss and turn. - Limit naps. If you are having trouble sleeping, cut out the catnaps. You will sleep better at night. - Limit caffeine. It might be a helpful pick-up in the morning, but you may go to bed wired if you drink coffee, tea, or caffeinated sodas in the afternoon or evening. - Limit alcohol. It may help you get to sleep at first, but alcohol keeps you from deep, restoring sleep later at night. - Kick the habit. Need another reason to quit smoking? The nicotine in cigarettes can disrupt sleep. - Eat smart. Avoid heavy meals before bedtime. Try to eat 2 or 3 hours before bedtime. If you feel hungry right before you go to bed, have a small, healthy snack like a small bowl of yogurt or low sugar cereal. Call your health care provider if lack of sleep is interfering with your daily activities. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi. I can't find this I take Ambien every night for sleep. I want to no how long before I go to bed am I supposed to take it.", "response": "Day to day with COPD (Sleep): A good night's sleep can make you feel better and keep you healthier. But when you have COPD, certain things make it harder to get enough rest: - You might wake up short of breath or coughing. - Some COPD medicines make it hard to sleep. - You might have to take a dose of medicine in the middle of the night. Here are some safe ways to sleep better: - Let your provider know you are having trouble sleeping. A change in your treatment might help you sleep. - Go to bed at the same time every night. - Do something to relax before you go to bed. You might take a bath or read a book. - Use window shades to block outside light. - Ask your family to help keep the house quiet when it is time for you to sleep. - DO NOT use over-the-counter sleep aids. They can make it harder to breathe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi. I can't find this I take Ambien every night for sleep. I want to no how long before I go to bed am I supposed to take it.", "response": "Timing of breastfeeding (Nursing at Night): You may find that keeping your baby in the same room with you, or in a room close by, helps you rest better. You can use a baby monitor so you can hear your baby cry. - Some mothers like their babies to sleep next to them in a bassinet. They can nurse in bed and return the baby to the bassinet. - Other mothers prefer their baby to sleep in a separate bedroom. They nurse in a chair and return the baby to the crib. The American Academy of Pediatrics recommends that you not sleep with your baby. - Return the baby to the crib or bassinet when breastfeeding is done. - DO NOT bring your baby into bed if you are very tired or taking medicine that makes you really sleepy. Expect your baby to nurse a lot at night when you go back to work. Breastfeeding at night is ok for your baby's teeth. - If your baby is drinking sugary drinks and breastfeeding, your baby may have problems with tooth decay. DO NOT give your baby sugary drinks, especially close to sleep time. - Formula feeding at night can cause tooth decay. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "bundle blockage. could you please tell me what a bundle blockage is. what are the symptoms. what is usually done for this? Thank you", "response": "Bundle branch block (Symptoms): In most people, bundle branch block doesn't cause any symptoms. Sometimes, people with the condition don't even know they have a bundle branch block. For those people who do have signs and symptoms, they may include: - Fainting (syncope) - Feeling as if you're going to faint (presyncope) When to see a doctor If you've fainted, see your doctor to rule out any serious, underlying causes. If you have heart disease, or if your doctor has already diagnosed you as having bundle branch block, ask your doctor how often you should have follow-up visits. You might want to carry a medical alert card that identifies you as having bundle branch block in case you're seen in an emergency by a doctor who isn't familiar with your medical history. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "bundle blockage. could you please tell me what a bundle blockage is. what are the symptoms. what is usually done for this? Thank you", "response": "Bundle branch block: Bundle branch block is a condition in which there's a delay or obstruction along the pathway that electrical impulses travel to make your heart beat. The delay or blockage may occur on the pathway that sends electrical impulses to the left or the right side of the bottom chambers (ventricles) of your heart. Bundle branch block sometimes makes it harder for your heart to pump blood efficiently through your circulatory system. There's no specific treatment for bundle branch block itself. However, any underlying health condition that caused bundle branch block, such as heart disease, will need to be treated. In most people, bundle branch block doesn't cause any symptoms. Sometimes, people with the condition don't even know they have a bundle branch block. For those people who do have signs and symptoms, they may include: - Fainting (syncope) - Feeling as if you're going to faint (presyncope) When to see a doctor If you've fainted, see your doctor to rule out any serious, underlying causes. If you have heart disease, or if your doctor has already diagnosed you as having bundle branch block, ask your doctor how often you should have follow-up visits. You might want to carry a medical alert card that identifies you as having bundle branch block in case you're seen in an emergency by a doctor who isn't familiar with your medical history. Normally, electrical impulses within your heart's muscle signal it to beat (contract). These impulses travel along a pathway, including the right and the left bundles. If one or both of these branch bundles become damaged - due to a heart attack, for example - this change can block the electrical impulses and cause your heart to beat abnormally. The underlying cause for bundle branch blocks may differ depending on whether the left or right bundle branch is affected. It's also possible that this condition can occur without any known underlying cause. Specific causes may include: Left bundle branch block - Heart disease - Thickened, stiffened or weakened heart muscle (cardiomyopathy) - A viral or bacterial infection of the heart muscle (myocarditis) - High blood pressure (hypertension) Right bundle branch block - A heart abnormality that's present at birth (congenital) - such as atrial septal defect, a hole in the wall separating the upper chambers of the heart - A heart attack (myocardial infarction) - A viral or bacterial infection of the heart muscle (myocarditis) - High blood pressure (hypertension) - A blood clot in the lungs (pulmonary embolism) Risk factors for bundle branch block include: - Increasing age. Bundle branch block is more common in older adults than in people who are middle-aged. - Underlying health problems. People who have high blood pressure or heart disease are more likely to have bundle branch block than people without those conditions. Tests that may be used to diagnose a bundle branch block or the underlying problem causing it include: - Electrocardiogram. An electrocardiogram records the electrical impulses in your heart through wires attached to the skin on your chest and other locations on your body. Abnormalities may indicate the presence of bundle branch block, as well as which side is being affected. - Echocardiogram. An echocardiogram can be used to pinpoint an underlying condition that caused the bundle branch block. This test uses sound waves to produce images of the heart, allowing your doctor to see your heart in motion. An echocardiogram provides detailed images of the heart's structure and shows the thickness of your heart muscle and whether your heart valves are moving normally. Most people with bundle branch block are symptom-free and don't need treatment. However, if you have an underlying heart condition causing bundle branch block, treatment of the underlying condition is recommended. Treatment of underlying conditions may involve using medications to reduce high blood pressure or lessen the effects of heart failure, or the use of a coronary angioplasty to open up the artery leading to your heart. Additionally, depending on your symptoms and whether you have other heart problems, your doctor might also recommend: - A pacemaker. For some people with bundle branch block and a history of fainting, doctors may recommend implanting a pacemaker. A pacemaker is a compact device implanted under the skin of your upper chest (internal pacemaker) with two wires that connect to the right side of your heart. The pacemaker provides electrical impulses when needed to keep your heart beating regularly. - Cardiac resynchronization. Also known as biventricular pacing, this procedure is similar to having a pacemaker implanted. However, in cardiac resynchronization, there's a third wire that's connected to the left side of the heart so the device can keep both sides in proper rhythm. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "bundle blockage. could you please tell me what a bundle blockage is. what are the symptoms. what is usually done for this? Thank you", "response": "Bundle branch block (Risk factors): Risk factors for bundle branch block include: - Increasing age. Bundle branch block is more common in older adults than in people who are middle-aged. - Underlying health problems. People who have high blood pressure or heart disease are more likely to have bundle branch block than people without those conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Arrhthmia. can arrhythmia occurs after ablation? What is the success rate of Ablation? During my Holter test it was found that my Heart rate fluctuates from 254 to 21. How do you rate the situation?", "response": "Heart arrhythmia (Treatment): If you have an arrhythmia, treatment may or may not be necessary. Usually, it's required only if the arrhythmia is causing significant symptoms or if it's putting you at risk of a more serious arrhythmia or arrhythmia complication. Treating slow heartbeats If slow heartbeats (bradycardias) don't have a cause that can be corrected, doctors often treat them with a pacemaker because there aren't any medications that can reliably speed up your heart. A pacemaker is a small device that's usually implanted near your collarbone. One or more electrode-tipped wires run from the pacemaker through your blood vessels to your inner heart. If your heart rate is too slow or if it stops, the pacemaker sends out electrical impulses that stimulate your heart to beat at a steady rate. Treating fast heartbeats For fast heartbeats (tachycardias), treatments may include one or more of the following: - Vagal maneuvers. You may be able to stop an arrhythmia that begins above the lower half of your heart (supraventricular tachycardia) by using particular maneuvers that include holding your breath and straining, dunking your face in ice water, or coughing. These maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. However, vagal maneuvers don't work for all types of arrhythmias. - Medications. For many types of tachycardia, you may be prescribed medication to control your heart rate or restore a normal heart rhythm. It's very important to take any anti-arrhythmic medication exactly as directed by your doctor in order to minimize complications. If you have atrial fibrillation, your doctor may prescribe blood-thinning medications to help keep dangerous blood clots from forming. - Cardioversion. If you have a certain type of arrhythmia, such as atrial fibrillation, your doctor may use cardioversion, which can be conducted as a procedure or by using medications. In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm. - Catheter ablation. In this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia. Implantable devices Treatment for heart arrhythmias also may involve use of an implantable device: - Pacemaker. A pacemaker is an implantable device that helps control abnormal heart rhythms. A small device is placed under the skin near the collarbone in a minor surgical procedure. An insulated wire extends from the device to the heart, where it's permanently anchored. If a pacemaker detects a heart rate that's abnormal, it emits electrical impulses that stimulate your heart to beat at a normal rate. - Implantable cardioverter-defibrillator (ICD). Your doctor may recommend this device if you're at high risk of developing a dangerously fast or irregular heartbeat in the lower half of your heart (ventricular tachycardia or ventricular fibrillation). If you have had sudden cardiac arrest or have certain heart conditions that increase your risk of sudden cardiac arrest, your doctor may also recommend an ICD. An ICD is a battery-powered unit that's implanted under the skin near the collarbone - similar to a pacemaker. One or more electrode-tipped wires from the ICD run through veins to the heart. The ICD continuously monitors your heart rhythm. If it detects an abnormal heart rhythm, it sends out low- or high-energy shocks to reset the heart to a normal rhythm. An ICD doesn't prevent an abnormal heart rhythm from occurring, but it treats it if it occurs. Surgical treatments In some cases, surgery may be the recommended treatment for heart arrhythmias: - Maze procedure. In the maze procedure, a surgeon makes a series of surgical incisions in the heart tissue in the upper half of your heart (atria) to create a pattern or maze of scar tissue. Because scar tissue doesn't conduct electricity, it interferes with stray electrical impulses that cause some types of arrhythmia. The procedure is effective, but because it requires surgery, it's usually reserved for people who don't respond to other treatments or for those who are having heart surgery for other reasons. - Coronary bypass surgery. If you have severe coronary artery disease in addition to arrhythmias, your doctor may perform coronary bypass surgery. This procedure may improve the blood flow to your heart. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Arrhthmia. can arrhythmia occurs after ablation? What is the success rate of Ablation? During my Holter test it was found that my Heart rate fluctuates from 254 to 21. How do you rate the situation?", "response": "Heart arrhythmia (Complications): Certain arrhythmias may increase your risk of developing conditions such as: - Stroke. When your heart quivers, it's unable to pump blood effectively, which can cause blood to pool. This can cause blood clots to form. If a clot breaks loose, it can travel from your heart to your brain. There it might block blood flow, causing a stroke. Certain medications, such as blood thinners, can greatly lower your risk of stroke or damage to other organs caused by blood clots. Your doctor will determine if a blood-thinning medication is appropriate for you, depending on your type of arrhythmia and your risk of blood clots. - Heart failure. Heart failure can result if your heart is pumping ineffectively for a prolonged period due to a bradycardia or tachycardia, such as atrial fibrillation. Sometimes controlling the rate of an arrhythmia that's causing heart failure can improve your heart's function. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Arrhthmia. can arrhythmia occurs after ablation? What is the success rate of Ablation? During my Holter test it was found that my Heart rate fluctuates from 254 to 21. How do you rate the situation?", "response": "Arrhythmia (Who Is at Risk): Arrhythmias are very common in older adults. Atrial fibrillation (a common type of arrhythmia that can cause problems) affects millions of people, and the number is rising. Most serious arrhythmias affect people older than 60. This is because older adults are more likely to have heart disease and other health problems that can lead to arrhythmias. Older adults also tend to be more sensitive to the side effects of medicines, some of which can cause arrhythmias. Some medicines used to treat arrhythmias can even cause arrhythmias as a side effect. Some types of arrhythmia happen more often in children and young adults. Paroxysmal supraventricular tachycardia (PSVT), including Wolff-Parkinson-White syndrome, is more common in young people. PSVT is a fast heart rate that begins and ends suddenly. Major Risk Factors Arrhythmias are more common in people who have diseases or conditions that weaken the heart, such as: Heart attack Heart failure or cardiomyopathy, which weakens the heart and changes the way electrical signals move through the heart Heart tissue that's too thick or stiff or that hasn't formed normally Leaking or narrowed heart valves, which make the heart work too hard and can lead to heart failure Congenital heart defects (defects present at birth) that affect the heart's structure or function Other conditions also can raise the risk for arrhythmias, such as: High blood pressure Infections that damage the heart muscle or the sac around the heart Diabetes, which increases the risk of high blood pressure and coronary heart disease Sleep apnea, which can stress the heart because the heart doesn't get enough oxygen An overactive or underactive thyroid gland (too much or too little thyroid hormone in the body) Several other risk factors also can raise your risk for arrhythmias. Examples include heart surgery, certain drugs (such as cocaine or amphetamines), or an imbalance of chemicals or other substances (such as potassium) in the bloodstream. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "fildena. Hello I was wondering if fildena is truly like Viagra. I'm trying to find an alternative since my insurance no longer will cover Viagra for what ever reason. Would like to know all relavent information regarding fildena. About all I've found is that it is not fda approved so any information would be helpful thanks", "response": "Piroxicam (Brand names): - Feldene®. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "fildena. Hello I was wondering if fildena is truly like Viagra. I'm trying to find an alternative since my insurance no longer will cover Viagra for what ever reason. Would like to know all relavent information regarding fildena. About all I've found is that it is not fda approved so any information would be helpful thanks", "response": "Piroxicam overdose (Poisonous Ingredient): Piroxicam. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "fildena. Hello I was wondering if fildena is truly like Viagra. I'm trying to find an alternative since my insurance no longer will cover Viagra for what ever reason. Would like to know all relavent information regarding fildena. About all I've found is that it is not fda approved so any information would be helpful thanks", "response": "Piroxicam overdose (Where Found): Piroxicam is also sold under the brand name Feldene. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Nph.. Nph. I am interested in a movement class. I have nph and can find no help with exercise or support group. Any ideas from Med?", "response": "Normal pressure hydrocephalus: Hydrocephalus is a buildup of spinal fluid inside the fluid chambers of the brain. Hydrocephalus means \"water on the brain.\" Normal pressure hydrocephalus (NPH) is a rise in cerebrospinal fluid (CSF) in the brain that affects brain function. However, the pressure of the fluid is usually normal. There is no known cause for NPH. But the chance of developing NPH is high in someone who has had any of the following: - Bleeding from a blood vessel or aneurysm in the brain (subarachnoid hemorrhage) - Certain head injuries - Meningitis or similar infections - Surgery on the brain (craniotomy) As CSF builds up in the brain, the fluid-filled chambers (ventricles) of the brain swell. This causes pressure on brain tissue. This can damage or destroy parts of the brain. Symptoms of NPH often begin slowly. There are 3 main symptoms of NPH: - Changes in the way a person walks: difficulty when beginning to walk (gait apraxia), feel as if they are stuck to the ground (magnetic gait) - Slowing of mental function: forgetfulness, difficulty paying attention, apathy or no mood - Problems controlling urine (urinary incontinence), and sometimes controlling stools (bowel incontinence) Diagnosis of NPH can be made if any of the above symptoms occur and NPH is suspected and testing is done. The doctor will perform a physical examination and ask about the symptoms. If you have NPH, the doctor will likely find that your walking (gait) is not normal. You may also have memory problems. Tests that may be done include: - Lumbar puncture (spinal tap) with careful testing of walking before and right after the spinal tap - Head CT scan or MRI of the head Treatment for NPH is usually surgery to place a tube called a shunt that routes the excess CSF out of the brain ventricles. This is called a ventricoperitoneal shunt. Without treatment, symptoms often get worse and could lead to death. Surgery improves symptoms in some people. Those with mild symptoms have the best outcome. Walking is the symptom most likely to improve. Problems that may result from NPH or its treatment include: - Complications of surgery (infection, bleeding, shunt that does not work well) - Loss of brain function (dementia) that becomes worse over time - Injury from falls - Shortened life span Call your health care provider if: - You or a loved one is having increasing problems with memory, walking, or urine incontinence. - A person with NPH worsens to the point where you are unable to care for the person yourself. Go to the emergency room or call the local emergency number (such as 911) if a sudden change in mental status occurs. This may mean that another disorder has developed. Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Nph.. Nph. I am interested in a movement class. I have nph and can find no help with exercise or support group. Any ideas from Med?", "response": "Normal pressure hydrocephalus (Treatment): Treatment for NPH is usually surgery to place a tube called a shunt that routes the excess CSF out of the brain ventricles. This is called a ventricoperitoneal shunt. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Nph.. Nph. I am interested in a movement class. I have nph and can find no help with exercise or support group. Any ideas from Med?", "response": "Normal pressure hydrocephalus (Possible Complications): Problems that may result from NPH or its treatment include: - Complications of surgery (infection, bleeding, shunt that does not work well) - Loss of brain function (dementia) that becomes worse over time - Injury from falls - Shortened life span. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - specific study. Can Low dose naltrexone be used for treatment of severe depression?", "response": "What are the treatments for Depression?: Medications called antidepressants work to normalize brain chemicals called neurotransmitters, notably serotonin, norepinephrine, and dopamine. Scientists studying depression have found that these chemicals, and possibly others, are involved in regulating mood, but they are unsure of exactly how they work. Newer Antidepressants. The newest and most popular types of antidepressant medications are called selective serotonin reuptake inhibitors (SSRIs). They include fluoxetine (Prozac), citalopram (Celexa) and several others. Similar to SSRIs are serotonin and norepinephrine reuptake inhibitors (SNRIs) and include venlafaxine (Effexor) and duloxetine (Cymbalta). Another newer antidepressant bupropion (Wellbutrin) is neither an SSRI nor an SNRI but is popular as well. Older Antidepressants. Older antidepressants, called tricyclics and monoamine oxidase inhibitors (MAOIs), are still used sometimes, too. However, these older antidepressants are not as popular as the newer ones because they tend to have more side effects. However, medications affect everyone differently so talk with your doctor to decide which type is best for you. Practical Considerations. People taking MAOIs must follow strict food and medicine restrictions to avoid potentially serious interactions. If you take an MAOI, your doctor should give you a complete list of foods, medicines, and substances to avoid. MAOIs can also react with SSRIs to produce a serious condition called \"serotonin syndrome,\" which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life threatening conditions. MAOIs should not be taken with SSRIs. Caution is required when combining any serotonergic medication (not just MAOIs) with SSRIs. For example, in 2006 the FDA issued specific warnings against using triptans that are commonly-prescribed to treat migraine headaches together with SSRIs or SNRIs. Using these medications together can cause serotonin syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - specific study. Can Low dose naltrexone be used for treatment of severe depression?", "response": "Depression (Overview): Depression affects both men and women, but more women than men are likely to be diagnosed with depression in any given year. That being said, depression is not a \"normal part of being a woman\" nor is it a \"female weakness.\" Many women with depression never seek treatment. But most women, even those with the most severe depression, can get better with treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. How do you catch hepatitis?", "response": "Autoimmune hepatitis: Autoimmune hepatitis is inflammation of the liver. It occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them. This form of hepatitis is an autoimmune disease. The body's immune system cannot tell the difference between healthy body tissue and harmful, outside substances. The result is an immune response that destroys normal body tissues. Liver inflammation, or hepatitis, may occur along with other autoimmune diseases. These include: - Graves disease - Inflammatory bowel disease - Rheumatoid arthritis - Scleroderma - Sjögren syndrome - Systemic lupus erythematosus - Thyroiditis - Type 1 diabetes - Ulcerative colitis Autoimmune hepatitis may occur in family members of people with autoimmune diseases. There may be a genetic cause. This disease is most common in young girls and women. Symptoms may include: - Fatigue - General discomfort, uneasiness, or ill feeling (malaise) - Itching - Loss of appetite - Nausea or vomiting - Joint pain - Pale or clay-colored stools - Dark urine - Abdominal distention Absence of menstruation (amenorrhea) may also be a symptom. Tests for autoimmune hepatitis include the following blood tests: - Liver function tests - Anti-liver kidney microsome type 1 antibody (anti LKM-1) - Anti-nuclear antibody (ANA) - Anti-smooth muscle antibody (SMA) - Serum IgG - Liver biopsy to look for long-term hepatitis You may need prednisone or other corticosteroid medicines to help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help people with autoimmune hepatitis, as well. Some people may need a liver transplant. The outcome varies. Corticosteroid medicines may slow the progress of the disease. However, autoimmune hepatitis may advance to cirrhosis. This would require a liver transplant. Complications may include: - Cirrhosis - Side effects from steroids and other medicines - Hepatocellular carcinoma - Liver failure Call your health care provider if you notice symptoms of autoimmune hepatitis. Autoimmune hepatitis cannot be prevented in most cases. Knowing the risk factors may help you detect and treat the disease early. Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jock Itch. I have Jock itch, and I have read through your symptoms. I wanted know if small lumps under the skin around the scrotum area is a symptoms as well? Should I be concerned?", "response": "Jock itch (Symptoms): Jock itch usually stays around the creases of the upper thigh and does not involve the scrotum or penis. Jock itch may spread to near the anus, causing anal itching and discomfort. Symptoms include: - Red, raised, scaly patches that may blister and ooze. The patches often have sharply-defined edges with scale at the edges. - Abnormally dark or light skin. Sometimes, these changes are permanent. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jock Itch. I have Jock itch, and I have read through your symptoms. I wanted know if small lumps under the skin around the scrotum area is a symptoms as well? Should I be concerned?", "response": "Jock itch (Symptoms): Jock itch usually begins with a reddened area of skin that spreads out from the crease in the groin in a half-moon shape onto the upper thigh. The border of the rash may consist of a line of small, raised blisters. The rash often itches or burns, and the skin may be flaky or scaly. See your doctor if you have a rash on your skin that doesn't improve within two weeks or if you treat it with over-the-counter medications and it returns within a few weeks. You may need prescription medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jock Itch. I have Jock itch, and I have read through your symptoms. I wanted know if small lumps under the skin around the scrotum area is a symptoms as well? Should I be concerned?", "response": "Jock itch: Jock itch (tinea cruris) is a fungal infection that affects the skin of your genitals, inner thighs and buttocks. Jock itch causes an itchy, red, often ring-shaped rash in these warm, moist areas of your body. Jock itch gets its name because it is common in people who sweat a lot, as do athletes. It also is more likely to occur in people who are overweight. Although often uncomfortable and bothersome, jock itch usually isn't serious. Keeping your groin area clean and dry and applying topical antifungal medications usually are sufficient to treat jock itch. Jock itch usually begins with a reddened area of skin that spreads out from the crease in the groin in a half-moon shape onto the upper thigh. The border of the rash may consist of a line of small, raised blisters. The rash often itches or burns, and the skin may be flaky or scaly. See your doctor if you have a rash on your skin that doesn't improve within two weeks or if you treat it with over-the-counter medications and it returns within a few weeks. You may need prescription medication. Jock itch is caused by a type of fungus that can be spread from person to person or from shared use of contaminated towels or clothing. Jock itch is often caused by the same fungus that results in athlete's foot. It's common for the infection to spread from the feet to the groin, as the fungus can travel on your hands or on a towel. The organisms that cause jock itch thrive in damp, close environments. You're at greater risk of jock itch if you: - Are a man - Are a teen or young adult - Wear tight underwear - Are overweight - Sweat heavily - Have a weakened immune system - Have diabetes In many cases, your doctor can diagnose jock itch simply by looking at the rash. If the diagnosis isn't clear cut, your doctor may take skin scrapings or samples from the infected area and view them under a microscope. To rule out other conditions, your doctor might send a sample of the rash to a lab. This test is known as a culture. For a mild case of jock itch, your doctor may suggest first using an over-the-counter antifungal ointment, lotion, powder or spray. The rash may clear up quickly with these treatments, but continue applying the medication as directed for one to two weeks. If you also have athlete's foot, treat it at the same time you are treating your jock itch. This will reduce the risk of recurrence. If jock itch is severe or doesn't respond to over-the-counter medicine, you may need prescription-strength creams or ointments - or even antifungal pills. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the causes of rib cage pain? And and the remedy", "response": "What causes Ribcage pain?: Ribcage pain may be caused by any of the following: - Bruised, cracked, or fractured rib - Inflammation of cartilage near the breastbone (costochondritis) - Osteoporosis - Pleurisy (the pain is worse when breathing deeply). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the causes of rib cage pain? And and the remedy", "response": "General paresis (Summary): General paresis is a problem with mental function due to damage to the brain from untreated syphilis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the causes of rib cage pain? And and the remedy", "response": "General anesthesia (Outlook (Prognosis)): General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. The hantavirus can lead to death?", "response": "What is Hantavirus?: Hantavirus is a life-threatening viral infection spread to humans by rodents. It has symptoms similar to influenza. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. The hantavirus can lead to death?", "response": "General paresis (Summary): General paresis is a problem with mental function due to damage to the brain from untreated syphilis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. The hantavirus can lead to death?", "response": "General anesthesia (Outlook (Prognosis)): General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Is there always elevated temperature associated with appendicitis?", "response": "General paresis (Prevention): Treating primary syphilis and secondary syphilis infections will prevent general paresis. Practicing safer sex, such as limiting partners and using protection, may reduce the risk of getting infected with syphilis. Avoid direct skin contact with people who have secondary syphilis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Is there always elevated temperature associated with appendicitis?", "response": "What is Appendicitis?: The appendix is a small, tube-like organ attached to the first part of the large intestine. It is located in the lower right part of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis. The main symptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include - Swelling in the abdomen - Loss of appetite - Nausea and vomiting - Constipation or diarrhea - Inability to pass gas - Low fever Not everyone with appendicitis has all these symptoms. Appendicitis is a medical emergency. Treatment almost always involves removing the appendix. Anyone can get appendicitis, but it is more common among people 10 to 30 years old. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. Is there always elevated temperature associated with appendicitis?", "response": "What is Appendicitis?: Appendicitis is swelling (inflammation) of the appendix. The appendix is a small pouch attached to the large intestine. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a question for your website an it seems to have difficulty answering .. I want to know if you take Gabamentine an hydrocodene together what would happen? ; if I take them separately it don't work.", "response": "Hydrocodone (What special precautions should I follow?): Before taking hydrocodone, - tell your doctor and pharmacist if you are allergic to hydrocodone, any other medications, or any of the ingredients in hydrocodone extended-release capsules or extended-release tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients. - tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following medications: antihistamines (found in cough and cold medications); amiodarone (Cordarone, Nexterone, Pacerone); azithromycin (Zithromax, Zmax); butorphanol; chlorpromazine; citalopram (Celexa); cyclobenzaprine (Amrix); dextromethorphan (found in many cough medications; in Nuedexta); dronedarone (Multaq); haloperidol (Haldol); laxatives such as lactulose (Cholac, Constulose, Enulose, others); levofloxacin (Levaquin); lithium (Lithobid); medications for irritable bowel disease, Parkinson's disease, ulcers, and urinary problems; medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex, in Treximet), and zolmitriptan (Zomig); mirtazapine (Remeron); nalbuphine; pentazocine (Talwin); 5HT3 serotonin blockers such as alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), ondansetron (Zofran, Zuplenz), or palonosetron (Aloxi); selective serotonin-reuptake inhibitors such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Prozac, Pexeva), and sertraline (Zoloft); serotonin and norepinephrine reuptake inhibitors such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), milnacipran (Savella), and venlafaxine (Effexor); trazodone (Oleptro); or tricyclic antidepressants ('mood elevators') such as amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Also tell your doctor or pharmacist if you are taking or receiving the following medications or have stopped taking them within the past two weeks: isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate). Many other medications may also interact with hydrocodone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. - tell your doctor what herbal products you are taking, especially St. John's wort and tryptophan. - tell your doctor if you have any of the conditions mentioned in the IMPORTANT WARNING section, a blockage or narrowing of your stomach or intestines, or paralytic ileus (condition in which digested food does not move through the intestines). Your doctor may tell you not to take hydrocodone. - tell your doctor if you have or have ever had low blood pressure, difficulty urinating, seizures, or thyroid, gall bladder, pancreas, liver, or kidney disease. If you are taking the extended-release tablets, also tell your doctor if you have or have ever had difficulty swallowing, colon cancer (cancer that begins in the large intestine), esophageal cancer (cancer that begins in the tube that connects the mouth and stomach), heart failure (HF; condition in which the heart cannot pump enough blood to other parts of the body), or heart rhythm problems such long QT syndrome (condition that increases the risk of developing an irregular heartbeat that may cause fainting or sudden death). - tell your doctor if you are breastfeeding. - you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking hydrocodone. - if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking hydrocodone. - you should know that hydrocodone may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. - you should know that hydrocodone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking hydrocodone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. - you should know that hydrocodone may cause constipation. Talk to your doctor about changing your diet and using other medications to treat or prevent constipation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Drug interactions. is it safe to take diclofenac when taking lisinopril or aleve or extra-strength Tylenol?", "response": "Lisinopril (What special precautions should I follow?): Before taking lisinopril, - tell your doctor and pharmacist if you are allergic to lisinopril; other ACE inhibitors such as enalapril (Vasotec, in Vaseretic), benazepril (Lotensin, in Lotrel), captopril (Capoten), fosinopril (Monopril), moexipril (Univasc, in Uniretic), perindopril (Aceon), quinapril (Accupril, in Accuretic, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); any other medications; or any ingredients in lisinopril tablets. Ask your pharmacist for a list of the ingredients. - tell your doctor or pharmacist if you are taking valsartan and sacubitril (Entresto) or if you have stopped taking it within the last 36 hours. Your doctor will probably tell you not to take lisinopril, if you are also taking valsartan and sacubitril. Also, tell your doctor if you have diabetes and you are taking aliskiren (Tekturna, in Amturnide, Tekamlo, Tekturna HCT). Your doctor will probably tell you not to take lisinopril if you have diabetes and you are also taking aliskiren. - tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as indomethacin (Indocin, Tivorbex); diuretics ('water pills'); lithium (Lithobid); and potassium supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. - tell your doctor if you have or have ever had heart or kidney disease; diabetes; lupus; scleroderma (a condition in which extra tissue grows on the skin and some organs); or angioedema (a condition that causes difficulty swallowing or breathing and painful swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs). - tell your doctor if you are breastfeeding. - if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lisinopril. - you should know that diarrhea, vomiting, not drinking enough fluids, and sweating a lot can cause a drop in blood pressure, which may cause lightheadedness and fainting. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Drug interactions. is it safe to take diclofenac when taking lisinopril or aleve or extra-strength Tylenol?", "response": "What other information should I know about Diclofenac?: Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "patau sydrome/ trisomy 13. i was wondering the condition of trisomy progresses over time (gets worse as they become older) also, how to diognose the disorder thank you!", "response": "Trisomy 13 (Outlook (Prognosis)): More than 90% of children with trisomy 13 die in the first year. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "patau sydrome/ trisomy 13. i was wondering the condition of trisomy progresses over time (gets worse as they become older) also, how to diognose the disorder thank you!", "response": "Trisomy 13 (Prevention): Trisomy 13 can be diagnosed before birth by amniocentesis with chromosome studies of the amniotic cells. Parents of infants with trisomy 13 that is caused by a translocation should have genetic testing and counseling. This may help them avoid having another child with the condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "patau sydrome/ trisomy 13. i was wondering the condition of trisomy progresses over time (gets worse as they become older) also, how to diognose the disorder thank you!", "response": "Trisomy 13 (Exams and Tests): The infant may have a single umbilical artery at birth. There are often signs of congenital heart disease, such as: - Abnormal placement of the heart toward the right side of the chest instead of the left - Atrial septal defect - Patent ductus arteriosus - Ventricular septal defect Gastrointestinal x-rays or ultrasound may show rotation of the internal organs. MRI or CT scans of the head may reveal a problem with the structure of the brain. The problem is called holoprosencephaly. It is the joining together of the 2 sides of the brain. Chromosome studies show trisomy 13, trisomy 13 mosaicism, or partial trisomy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "quinine in seltzer water.. quinine in seltzer water. Is it ok to drink quinine in seltzer water to ease leg cramps? If so, what would be the correct \"dosage\"? It has a nasty taste but it does ease leg cramps. Thank you.", "response": "Leg pain (Home Care): If you have leg pain from cramps or overuse, take these steps first: - Rest as much as possible. - Elevate your leg. - Apply ice for up to 15 minutes. Do this 4 times per day, more often for the first few days. - Gently stretch and massage cramping muscles. - Take over-the-counter pain medicines like acetaminophen or ibuprofen. Other homecare will depend on the cause of your leg pain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "quinine in seltzer water.. quinine in seltzer water. Is it ok to drink quinine in seltzer water to ease leg cramps? If so, what would be the correct \"dosage\"? It has a nasty taste but it does ease leg cramps. Thank you.", "response": "Muscle cramps (Home Care): If you have a muscle cramp, stop your activity and try stretching and massaging the muscle. Heat will relax the muscle when the spasm begins, but ice may be helpful when the pain has improved. If the muscle is still sore, nonsteroidal anti-inflammatory medicines can help with pain. If the muscle cramps are severe, your health care provider can prescribe other medicines. The most common cause of muscle cramps during sports activity is not getting enough fluids. Often, drinking water will ease the cramping. However, water alone does not always help. Salt tablets or sports drinks, which also replenish lost minerals, can be helpful. Other tips for relieving muscle cramps: - Change your workouts so that you are exercising within your ability. - Drink plenty of fluids while exercising and increase your potassium intake (orange juice and bananas are great sources of potassium). - Stretch to improve flexibility. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "quinine in seltzer water.. quinine in seltzer water. Is it ok to drink quinine in seltzer water to ease leg cramps? If so, what would be the correct \"dosage\"? It has a nasty taste but it does ease leg cramps. Thank you.", "response": "Muscle cramps: Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of one or more muscles. The most commonly involved muscle groups are: - Back of the lower leg/calf - Back of the thigh (hamstrings) - Front of the thigh (quadriceps) Cramps in the feet, hands, arms, abdomen, and along the rib cage are also very common. Muscle cramps are common and may be stopped by stretching the muscle. The cramping muscle may feel hard or bulging. Muscle cramps are different than muscle twitches, which are covered in a separate article. Muscle cramps are common and often occur when a muscle is overused or injured. Working out when you have not had enough fluids (dehydration) or when you have low levels of minerals such as potassium or calcium can also make you more likely to have a muscle spasm. Muscle cramps can occur while you play tennis or golf, bowl, swim, or do any other exercise. They can also be triggered by: - Alcoholism - Hypothyroidism (underactive thyroid) - Kidney failure - Medicines - Menstruation - Pregnancy If you have a muscle cramp, stop your activity and try stretching and massaging the muscle. Heat will relax the muscle when the spasm begins, but ice may be helpful when the pain has improved. If the muscle is still sore, nonsteroidal anti-inflammatory medicines can help with pain. If the muscle cramps are severe, your health care provider can prescribe other medicines. The most common cause of muscle cramps during sports activity is not getting enough fluids. Often, drinking water will ease the cramping. However, water alone does not always help. Salt tablets or sports drinks, which also replenish lost minerals, can be helpful. Other tips for relieving muscle cramps: - Change your workouts so that you are exercising within your ability. - Drink plenty of fluids while exercising and increase your potassium intake (orange juice and bananas are great sources of potassium). - Stretch to improve flexibility. Call your provider if your muscle cramps: - Are severe - Do not go away with simple stretching - Keep coming back - Last a long time Your provider will examine you and ask questions about your symptoms and medical history, such as: - When did the spasms first begin? - How long do they last? - How often do you experience muscle spasms? - What muscles are affected? - Is the cramp always in the same location? - Are you pregnant? - Have you been vomiting, had diarrhea, excessive sweating, excessive urine volume, or any other possible cause of dehydration? - What medicines do you take? - Have you been exercising heavily? - Have you been drinking alcohol heavily? Blood tests may be done to check for the following: - Calcium, potassium, or magnesium metabolism - Kidney function - Thyroid function Pain medicines may be prescribed. Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Mite Infestation. Please inform me of the recommended treatment and prevention protocol for mite infestation in humans, particularly one that is non-toxic or has minimal side effects.", "response": "Dust mite allergy (Lifestyle and home remedies): Avoiding exposure to dust mites is the best strategy for controlling dust mite allergy. While you can't completely eliminate dust mites from your home, you can significantly reduce their number. Here's how: - Use allergen-proof bed covers. Keep your mattress and pillows in dustproof or allergen-blocking covers. These covers, made of tightly woven fabric, prevent dust mites from colonizing or escaping from the mattress or pillows. Encase box springs in allergen-proof covers. - Wash bedding weekly. Wash all sheets, blankets, pillowcases and bedcovers in hot water that is at least 130 F (54.4 C) to kill dust mites and remove allergens. If bedding can't be washed hot, put the items in the dryer for at least 15 minutes at a temperature above 130 F (54.4 C) to kill the mites. Then wash and dry the bedding to remove allergens. Freezing nonwashable items for 24 hours also can kill dust mites, but this won't remove the allergens. - Keep humidity low. Maintain a relative humidity below 50 percent in your home. A dehumidifier or air conditioner can help keep humidity low, and a hygrometer (available at hardware stores) can measure humidity levels. - Choose bedding wisely. Avoid bedcovers that trap dust easily and are difficult to clean frequently. - Buy washable stuffed toys. Wash them often in hot water and dry thoroughly. Also, keep stuffed toys off beds. - Remove dust. Use a damp or oiled mop or rag rather than dry materials to clean up dust. This prevents dust from becoming airborne and resettling. - Vacuum regularly. Vacuuming carpeting and upholstered furniture removes surface dust - but vacuuming isn't effective at removing most dust mites and dust mite allergens. Use a vacuum cleaner with a double-layered microfilter bag or a high-efficiency particulate air (HEPA) filter to help decrease house-dust emissions from the cleaner. If your allergies are severe, stay out of the area being vacuumed while someone else does the work. Wait about two hours before going back in the vacuumed room. - Cut clutter. If it collects dust, it also collects dust mites. Remove knickknacks, tabletop ornaments, books, magazines and newspapers from your bedroom. - Remove carpeting and other dust mite habitats. Carpeting provides a comfortable habitat for dust mites. This is especially true if carpeting is over concrete, which holds moisture easily and provides a humid environment for mites. If possible, replace wall-to-wall bedroom carpeting with tile, wood, linoleum or vinyl flooring. Consider replacing other dust-collecting furnishings in bedrooms, such as upholstered furniture, nonwashable curtains and horizontal blinds. - Install a high-efficiency media filter in your furnace and air conditioning unit. Look for a filter with a Minimum Efficiency Reporting Value (MERV) of 11 or 12 and leave the fan on to create a whole house air filter. Be sure to change the filter every three months. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Mite Infestation. Please inform me of the recommended treatment and prevention protocol for mite infestation in humans, particularly one that is non-toxic or has minimal side effects.", "response": "Dust mite allergy (Treatment): The first treatment for controlling dust mite allergy is avoiding dust mites as much as possible. When you minimize your exposure to dust mites, you can expect fewer or less severe allergic reactions. However, it's impossible to completely eliminate dust mites from your environment. You may also need medications to control symptoms. Allergy medications Your doctor may direct you to take one of the following medications to improve nasal allergy symptoms: - Antihistamines reduce the production of an immune system chemical that is active in an allergic reaction. These drugs relieve itching, sneezing and runny nose. Over-the-counter antihistamine tablets, such as fexofenadine (Allegra Allergy), loratadine (Alavert, Claritin,), cetirizine (Zyrtec) and others, as well as antihistamine syrups for children, are available. Prescription antihistamines taken as a nasal spray include azelastine (Astelin, Astepro) and olopatadine (Patanase). - Corticosteroids delivered as a nasal spray can reduce inflammation and control symptoms of hay fever. These drugs include fluticasone propionate (Flonase), mometasone furoate (Nasonex), triamcinolone (Nasacort Allergy 24HR), ciclesonide (Omnaris) and others. Nasal corticosteroids provide a low dose of the drug and have a much lower risk of side effects compared with oral corticosteroids. - Decongestants can help shrink swollen tissues in your nasal passages and make it easier to breathe through your nose. Some over-the-counter allergy tablets combine an antihistamine with a decongestant. Oral decongestants can increase blood pressure and shouldn't be taken if you have severe high blood pressure, glaucoma or cardiovascular disease. In men with an enlarged prostate, the drug can worsen the condition. Talk to your doctor about whether you can safely take a decongestant. Over-the-counter decongestants taken as a nasal spray may briefly reduce allergy symptoms. If you use a decongestant spray for more than three days in a row, however, it can actually make nasal congestion worse. - Leukotriene modifiers block the action of certain immune system chemicals. Your doctor may prescribe the leukotriene modifier montelukast (Singulair), which comes in tablet form. Possible side effects of montelukast include upper respiratory infection, headache and fever. Less common side effects include behavior or mood changes, such as anxiousness or depression. Other therapies - Immunotherapy. You can \"train\" your immune system not to be sensitive to an allergen. This is done through a series of allergy shots called immunotherapy. One to two weekly shots expose you to very small doses of the allergen, in this case, the dust mite proteins that cause the allergic reaction. The dose is gradually increased, usually during a three- to six-month period. Maintenance shots are needed every four weeks for three to five years. Immunotherapy is usually used when other simple treatments are not satisfactory. - Nasal irrigation. You can use a neti pot or a specially designed squeeze bottle to flush thickened mucus and irritants from your sinuses with a prepared saltwater (saline) rinse. If you're preparing the saline solution yourself, use water that's contaminant-free - distilled, sterile, previously boiled and cooled, or filtered with a filter that has an absolute pore size of 1 micron or smaller. Be sure to rinse the irrigation device after each use with contaminant-free water, and leave open to air-dry. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "meds taken with wine at dinnertime. Is it safe to take my meds with wine at dinnertime?", "response": "Alcohol use and safe drinking: Alcohol use involves drinking beer, wine, or hard liquor. Alcohol is one of the most widely used drug substances in the world. TEEN DRINKING Alcohol use is not only an adult problem. Most American high school seniors have had an alcoholic drink within the past month. This is in spite of the fact that the legal drinking age is 21 years old in the United States. About 1 in 5 teens are considered \"problem drinkers.\" This means that they: - Get drunk - Have accidents related to alcohol use - Get into trouble with the law, family members, friends, school, or dates because of alcohol THE EFFECTS OF ALCOHOL Alcoholic drinks have different amounts of alcohol in them. - Beer is about 5% alcohol, although some beers can have more. - Wine is usually 12% to 15% alcohol. - Hard liquor is about 45% alcohol. Alcohol gets into your bloodstream quickly. The amount and type of food in your stomach can change how quickly this occurs. For example, high-carbohydrate and high-fat foods can make your body absorb alcohol more slowly. Certain types of alcoholic drinks get into your bloodstream faster. Stronger drinks tend to be absorbed faster. Alcohol slows your breathing rate, heart rate, and how well your brain functions. These effects may appear within 10 minutes and peak at around 40 to 60 minutes. Alcohol stays in your bloodstream until it is broken down by the liver. The amount of alcohol in your blood is called your blood alcohol level. If you drink alcohol faster than the liver can break it down, this level rises. Your blood alcohol level is used to legally define whether or not you are drunk. The legal limit for blood alcohol usually falls between 0.08 and 0.10 in most states. Below is a list of blood alcohol levels and the likely symptoms: - 0.05 -- reduced inhibitions - 0.10 -- slurred speech - 0.20 -- euphoria and motor impairment - 0.30 -- confusion - 0.40 -- stupor - 0.50 -- coma - 0.60 -- breathing stops and death You can have symptoms of being drunk at blood alcohol levels below the legal definition of being drunk. Also, people who drink alcohol frequently may not have symptoms until a higher blood alcohol level is reached. HEALTH RISKS OF ALCOHOL Alcohol increases the risk of: - Alcoholism - Falls, drownings, and other accidents - Head, neck, stomach, colon, breast, and other cancers - Motor vehicle accidents - Risky sex behaviors, unplanned or unwanted pregnancy, and sexually transmitted infections (STIs) - Suicide and homicide Drinking during pregnancy can harm the developing baby. Severe birth defects or fetal alcohol syndrome are possible. RESPONSIBLE DRINKING If you drink alcohol, it is best to do so in moderation. Moderation means the drinking is not getting you intoxicated (or drunk) and you are drinking no more than 1 drink per day if you are a woman and no more than 2 if you are a man. A drink is defined as 12 ounces (350 milliliters) of beer, 5 ounces (150 milliliters) of wine, or 1.5 ounces (45 milliliters) of liquor. Here are some ways to drink responsibly, provided you do not have a drinking problem, are of legal age to drink alcohol, and are not pregnant: - Never drink alcohol and drive a car. - If you are going to drink, have a designated driver, or plan an alternative way home, such as a taxi or bus. - DO NOT drink on an empty stomach. Snack before and while drinking alcohol. If you are taking medicines, including over-the-counter drugs, check with your health care provider before drinking alcohol. Alcohol can make the effects of many medicines stronger. It can also interact with other medicines, making them ineffective or dangerous or make you sick. If alcohol use runs in your family, you may be at increased risk of developing this disease yourself. So, you may want to avoid drinking alcohol altogether. CALL YOUR HEALTH CARE PROVIDER IF: - You are concerned about your personal alcohol use or that of a family member - You are interested in more information regarding alcohol use or support groups - You are unable to reduce or stop your alcohol consumption, in spite of attempts to stop drinking Other resources include: - Local Alcoholics Anonymous or Al-anon/Alateen groups - Local hospitals - Public or private mental health agencies - School or work counselors - Student or employee health centers Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "meds taken with wine at dinnertime. Is it safe to take my meds with wine at dinnertime?", "response": "Wine and heart health: Studies have shown that adults who drink light to moderate amounts of alcohol may be less likely to develop heart disease than those who do not drink at all or are heavy drinkers. However, people who do not drink alcohol should not start just because they want to avoid developing heart disease. There is a fine line between healthy drinking and risky drinking. DO NOT begin drinking or drink more often just to lower your risk of heart disease. Heavier drinking can harm the heart and liver. Heart disease is the leading cause of death in people who abuse alcohol. Health care providers recommend that if you drink alcohol, drink only light to moderate amounts: - For men, limit alcohol to 1 to 2 drinks a day. - For women, limit alcohol to 1 drink a day. One drink is defined as: - 4 ounces (118 milliliters, mL) of wine - 12 ounces (355 mL) of beer - 1 1/2 ounces (44 mL) of 80-proof spirits - 1 ounce (30 mL) of 100-proof spirits Though research has found that alcohol may help prevent heart disease, much more effective ways to prevent heart disease include: - Controlling blood pressure and cholesterol - Exercising and following a low-fat, healthy diet - Not smoking - Maintaining an ideal weight Anyone who has heart disease or heart failure should talk to their provider before drinking alcohol. Alcohol can make heart failure and other heart problems worse. Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Internal review and update on 07/24/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "meds taken with wine at dinnertime. Is it safe to take my meds with wine at dinnertime?", "response": "Outdoor fitness routine (Staying Safe): Whenever you exercise outside, you should take a few precautions to make sure you stay safe. - Watch the weather. While you can exercise in most types of weather, extreme heat or cold can be dangerous. In cold weather, dress in layers, and wear a hat and gloves. In hot weather, wear plenty of sunscreen, choose lightweight clothing, and drink lots of water. - Use caution on streets. Walk or jog facing oncoming traffic and wear bright clothing so drivers can see you. If you are out when it is dark, wear reflective clothing or carry a flashlight. - Be prepared. Carry an ID and a cell phone, just in case. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "neo oxy. pkease send me the indication and usage info for this powder. NEO-OXY 100/100 MR - neomycin sulfate and oxytetracycline hydrochloride powder", "response": "Glucosamine Hydrochloride (Are there interactions with herbs and supplements?): Chondroitin sulfate Taking chondroitin sulfate together with glucosamine hydrochloride might reduce blood levels of glucosamine. In theory, taking glucosamine hydrochloride with chondroitin sulfate might reduce the absorption of glucosamine hydrochloride. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "neo oxy. pkease send me the indication and usage info for this powder. NEO-OXY 100/100 MR - neomycin sulfate and oxytetracycline hydrochloride powder", "response": "Protecting yourself from cancer scams (Investigational Drugs): There is a difference between an unproven treatment and investigational drugs. These are drugs that are being studied to see if they work well to treat cancer. Cancer patients may take investigational drugs as part of a clinical trial. This is a study to test how well the drug works, and to check its side effects and safety. Clinical trials are the last step before a drug can get approval from the FDA. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "neo oxy. pkease send me the indication and usage info for this powder. NEO-OXY 100/100 MR - neomycin sulfate and oxytetracycline hydrochloride powder", "response": "Gastric bypass surgery - discharge (Drugs): You may need to take some medicines when you go home. - You may need to give yourself shots underneath the skin of a blood-thinning drug for 2 or more weeks. Your provider will show you how. - You may need to take medicine to prevent gallstones. - You will need to take certain vitamins that your body may not absorb well from your food. Two of these are vitamin B-12 and vitamin D. - You may need to take calcium and iron supplements as well. Aspirin, ibuprofen (Advil, Motrin), and some other drugs may harm the lining of your stomach or even cause ulcers. Talk with your provider before you take these drugs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the reasons for Hypoglycemia in newborns.. and what steps should a pregnent take to avoid this.", "response": "Low blood sugar - newborns: A low blood sugar level in newborn babies is also called neonatal hypoglycemia. It refers to low blood sugar (glucose) in the first few days after birth. Babies need blood sugar (glucose) for energy. Most of that glucose is used by the brain. The baby gets glucose from the mother through the placenta before birth. After birth, the baby gets glucose from the mother through her milk or from formula, and the baby also produces it in the liver. Glucose level can drop if: - There is too much insulin in the blood. Insulin is a hormone that pulls glucose from the blood. - The baby is not producing enough glucose. - The baby's body is using more glucose than is being produced. - The baby is not able to feed enough to keep the glucose level up. Neonatal hypoglycemia occurs when the newborn's glucose level causes symptoms or is below the level considered safe for the baby's age. It occurs in about 1 to 3 out of every 1,000 births. Low blood sugar level is more likely in infants with one or more of these risk factors: - Born early, has a serious infection, or needed oxygen right after delivery - Mother has diabetes (these infants are often larger than normal) - Have slower than usual growth in the womb during pregnancy - Are smaller in size than normal for their gestational age Infants with low blood sugar may not have symptoms. If your baby has one of the risk factors for low blood sugar, nurses in the hospital will check your baby's blood sugar level, even if there are no symptoms. Also, blood sugar level is very often checked for babies with these symptoms: - Bluish-colored or pale skin - Breathing problems, such as pauses in breathing (apnea), rapid breathing, or a grunting sound - Irritability or listlessness - Loose or floppy muscles - Poor feeding or vomiting - Problems keeping the body warm - Tremors, shakiness, sweating, or seizures Newborns at risk for hypoglycemia should have a blood test to measure blood sugar level every few hours after birth. This will be done using a heel stick. The health care provider should continue taking blood tests until the baby's glucose level stays normal for about 12 to 24 hours. Other possible tests: - Newborn screening for metabolic disorders, including blood and urine tests Infants with a low blood sugar level will need to receive extra feedings with mother's milk or formula. Babies who are breast-fed may need to receive extra formula if the mother is not able to produce enough milk. (Hand expression and massage can help mothers express more milk.) The infant may need a sugar solution given through a vein (intravenously) if unable to eat by mouth, or if the blood sugar level is very low. Treatment will be continued until the baby can maintain blood sugar level. This may take hours or days. Infants who were born early, have an infection, or were born at a low weight may need to be treated for a longer period of time. If the low blood sugar continues, in rare cases, the baby may also receive medicine to increase blood sugar level. In very rare cases, newborns with very severe hypoglycemia who do not improve with treatment may need surgery to remove part of the pancreas (to reduce insulin production). The outlook is good for newborns who do not have symptoms, or who respond well to treatment. However, low blood sugar level can return in a small number of babies after treatment. The condition is more likely to return when babies are taken off feedings given through a vein before they are fully ready to eat by mouth. Babies with more severe symptoms are more likely to develop learning problems. This is more often true for babies who are at a lower-than-average weight or whose mother has diabetes. Severe or persistent low blood sugar level may affect the baby's mental function. In rare cases, heart failure or seizures may occur. However, these problems may also be due to the underlying cause of the low blood sugar, rather than a result of the low blood sugar itself. If you have diabetes during pregnancy, work with your health care provider to control your blood sugar level. Be sure that your newborn's blood sugar level is monitored after birth. Updated by: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the reasons for Hypoglycemia in newborns.. and what steps should a pregnent take to avoid this.", "response": "Low Blood Glucose (Hypoglycemia) (What is hypoglycemia?): Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. For many people with diabetes, that means a level of 70 milligrams per deciliter (mg/dL) or less. Your numbers might be different, so check with your health care provider to find out what level is too low for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "general health. What are the reasons for Hypoglycemia in newborns.. and what steps should a pregnent take to avoid this.", "response": "Low Blood Glucose (Hypoglycemia) (What causes hypoglycemia in diabetes?): Hypoglycemia can be a side effect of insulin or other types of diabetes medicines that help your body make more insulin. Two types of diabetes pills can cause hypoglycemia: sulfonylureas and meglitinides. Ask your health care team if your diabetes medicine can cause hypoglycemia.Although other diabetes medicines don’t cause hypoglycemia by themselves, they can increase the chances of hypoglycemia if you also take insulin, a sulfonylurea, or a meglitinide.If you take insulin or some other diabetes medicines, your blood glucose level can drop too low. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diverticulitis. can diverticulosis or diverticulitis be detected by a cat scan if there is no infection at that time?", "response": "Diverticulitis: Diverticula are small, bulging sacs or pouches that form on the inner wall of the intestine. Diverticulitis occurs when these pouches become inflamed or infected. Most often, these pouches are in the large intestine (colon). The formation of pouches or sacs on the intestinal lining is called diverticulosis. It is found in more than half of Americans over age 60. However, no one knows exactly what causes the pouches to form. Eating a low-fiber diet mostly made up of processed foods may be a cause. Constipation and hard stools are more likely when you do not eat enough fiber. Straining to pass stools increases the pressure in the colon or intestines, which may lead to the formation of these pouches. Diverticulitis is caused by small pieces of stool (feces) that become trapped in these pouches, causing infection or inflammation. People with diverticulosis often have no symptoms, but they may have bloating and cramping in the lower part of the belly. Rarely, they may notice blood in their stool or on toilet paper. Symptoms of diverticulitis are more severe and often start suddenly, but they may become worse over a few days. They include: - Tenderness, usually in the left lower side of the abdomen - Bloating or gas - Fever and chills - Nausea and vomiting - Not feeling hungry and not eating Your health care provider will examine you. You may need blood tests to see if you have an infection. Other tests that help diagnose diverticulitis may include: - CT scan - Ultrasound of the abdomen - X-rays of the abdomen The treatment of diverticulitis depends on how serious the symptoms are. Some people may need to be in the hospital, but most of the time, the problem can be treated at home. To help with the pain, your provider may suggest that you: - Rest in bed and use a heating pad on your belly. - Take pain medicines (ask your provider which ones you should use). - Drink only fluids for a day or two, and then slowly begin drinking thicker liquids and then eating foods. The provider may treat you with antibiotics. After you are better, your provider will suggest that you add more fiber to your diet. Eating more fiber can help prevent future attacks. If you have bloating or gas, reduce the amount of fiber you eat for a few days. Once these pouches have formed, you will have them for life. Diverticulitis can return, but some providers think a high-fiber diet may lessen your chances of a recurrence. Most often, this is a mild condition that responds well to treatment. Some people will have more than 1 attack of diverticulitis. Surgery may be needed in some cases. Many times, providers will recommend that you have a colonoscopy after diverticulitis has healed. More serious problems that may develop are: - Abnormal connections that form between parts of the colon or between the colon and another part of the body (fistula) - Hole or tear in the colon (perforation) - Narrowed area in the colon (stricture) - Pocket filled with pus or infection (abscess) - Bleeding from the diverticula Call your provider if symptoms of diverticulitis occur. Also call if you have diverticulitis and you have: - Blood in your stools - Fever above 100.4°F (38°C) that does not go away - Nausea, vomiting, or chills - Sudden belly or back pain that gets worse or is very severe Updated by: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diverticulitis. can diverticulosis or diverticulitis be detected by a cat scan if there is no infection at that time?", "response": "Diverticulitis (Exams and Tests): Your health care provider will examine you. You may need blood tests to see if you have an infection. Other tests that help diagnose diverticulitis may include: - CT scan - Ultrasound of the abdomen - X-rays of the abdomen. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diverticulitis. can diverticulosis or diverticulitis be detected by a cat scan if there is no infection at that time?", "response": "What is Diverticulosis and Diverticulitis?: Diverticula are small pouches that bulge outward through the colon, or large intestine. If you have these pouches, you have a condition called diverticulosis. It becomes more common as people age. About half of all people over age 60 have it. Doctors believe the main cause is a low-fiber diet. Most people with diverticulosis don't have symptoms. Sometimes it causes mild cramps, bloating or constipation. Diverticulosis is often found through tests ordered for something else. For example, it is often found during a colonoscopy to screen for cancer. A high-fiber diet and mild pain reliever will often relieve symptoms. If the pouches become inflamed or infected, you have a condition called diverticulitis. The most common symptom is abdominal pain, usually on the left side. You may also have fever, nausea, vomiting, chills, cramping, and constipation. In serious cases, diverticulitis can lead to bleeding, tears, or blockages. Your doctor will do a physical exam and imaging tests to diagnose it. Treatment may include antibiotics, pain relievers, and a liquid diet. A serious case may require a hospital stay or surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAUSE OF A COLD. i UNDERSTAND CONTAGION AND TRANSFERRENCE OF COLD \"GERMS\" WHY ARE SOME PEOPLE AFFECTED AND OTHERS NOT?", "response": "Germs and Hygiene (Summary): Summary When you cough or sneeze, you send tiny germ-filled droplets into the air. Colds and flu usually spread that way. You can help stop the spread of germs by - Covering your mouth and nose when you sneeze or cough. Sneeze or cough into your elbow, not your hands. - Cleaning your hands often - always before you eat or prepare food, and after you use the bathroom or change a diaper - Avoiding touching your eyes, nose or mouth Hand washing is one of the most effective and most overlooked ways to stop disease. Soap and water work well to kill germs. Wash for at least 20 seconds and rub your hands briskly. Disposable hand wipes or gel sanitizers also work well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAUSE OF A COLD. i UNDERSTAND CONTAGION AND TRANSFERRENCE OF COLD \"GERMS\" WHY ARE SOME PEOPLE AFFECTED AND OTHERS NOT?", "response": "Common Cold (Summary): Summary Sneezing, sore throat, a stuffy nose, coughing - everyone knows the symptoms of the common cold. It is probably the most common illness. In the course of a year, people in the United States suffer 1 billion colds. You can get a cold by touching your eyes or nose after you touch surfaces with cold germs on them. You can also inhale the germs. Symptoms usually begin 2 or 3 days after infection and last 2 to 14 days. Washing your hands and staying away from people with colds will help you avoid colds. There is no cure for the common cold. For relief, try - Getting plenty of rest - Drinking fluids - Gargling with warm salt water - Using cough drops or throat sprays - Taking over-the-counter pain or cold medicines However, do not give aspirin to children. And do not give cough medicine to children under four. NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAUSE OF A COLD. i UNDERSTAND CONTAGION AND TRANSFERRENCE OF COLD \"GERMS\" WHY ARE SOME PEOPLE AFFECTED AND OTHERS NOT?", "response": "Cleaning to prevent the spread of germs (Summary): Germs from a person may be found on any object the person touched or on equipment that was used during the person's care. Some germs can live up to 5 months on a dry surface. Germs on any surface can pass to you or another person. Cleaning helps prevent the spread of germs. Your workplace has policies about how to clean: - Patient rooms - Spills or contamination - Supplies and equipment that are reusable. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "SSPE. My son is 33years of age and did not have the measles vaccination.Could SSPE occur at this age or in the future?", "response": "Subacute sclerosing panencephalitis (Cause): Subacute sclerosing panencephalitis (SSPE) is caused by a measles infection that is acquired earlier in life (often 7-10 years prior to the onset of SSPE symptoms). It is unclear why some people develop SSPE after they have seemingly recovered from the measles while others do not. Researchers suspect that SSPE may be due to an abnormal immune response or a mutant form of the measles virus that causes a persistent infection within the central nervous system (brain and spinal cord). [1] [2] [3] Although the underlying cause of SSPE is poorly understood, several risk factors appear to be associated with the condition. SSPE affects males more often than females and is generally diagnosed in children and adolescents. The risk of developing SSPE may be higher for a person who gets measles before they are two years of age. [1] [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "SSPE. My son is 33years of age and did not have the measles vaccination.Could SSPE occur at this age or in the future?", "response": "Subacute sclerosing panencephalitis: Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to measles (rubeola) infection. The disease develops many years after the measles infection. Normally, the measles virus does not cause brain damage. But an abnormal immune response to measles or, possibly, certain mutant forms of the virus may cause severe illness and death. This response leads to brain inflammation (swelling and irritation) that may last for years. SSPE has been reported in all parts of the world, but in western countries it is a rare disease. Very few cases are seen in the U.S. since the nationwide measles vaccination program. SSPE tends to occur several years after a person has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females. The disease generally occurs in children and adolescents. Symptoms of SSPE occur in four general stages. With each stage, the symptoms are worse than the stage before: - Stage I: There may be personality changes, mood swings, or depression. Fever and headache may also be present. This stage may last up to 6 months. - Stage II: There may be uncontrolled movement problems including jerking and muscle spasms. Other symptoms that may occur in this stage are loss of vision, dementia, and seizures. - Stage III: Jerking movements are replaced by writhing (twisting) movements and rigidity. Death may occur from complications. - Stage IV: Areas of the brain that control breathing, heart rate, and blood pressure are damaged. This leads to coma and then death. There may be a history of measles in an unvaccinated child. A physical examination may reveal: - Damage to the optic nerve, which is responsible for sight - Damage to the retina, the part of the eye that receives light - Muscle twitching - Poor performance on motor (movement) coordination tests The following tests may be performed: - Electroencephalogram (EEG) - Brain MRI - Serum antibody titer to look for signs of previous measles infection - Spinal tap No cure for SSPE exists. However, certain antiviral drugs and drugs that boost the immune system may slow the progression of the disease. SSPE is always fatal. People with this disease die 1 to 3 years after diagnosis. Some people may survive longer. Call your health care provider if your child has not completed their scheduled vaccines. The measles vaccine is included in the MMR vaccine. Immunization against measles is the only known prevention for SSPE. The measles vaccine has been highly effective in reducing the numbers of affected children. Measles immunization should be done according to the recommended American Academy of Pediatrics and Centers for Disease Control schedule. Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information.. My granddaughter was born with Klippel-Tranaunay Syndrome...There is very little information about this. We are looking for the current research and treatments available. She is 5 months old now and her leg seems to be most affected. We want to get her help as soon as possible to address the symptoms and treat her condition.", "response": "Klippel-Trenaunay Syndrome (KTS): Klippel-Trenaunay syndrome (KTS) is a rare congenital malformation involving blood and lymph vessels and abnormal growth of soft and bone tissue. Typical symptoms include hemangiomas (abnormal benign growths on the skin consisting of masses of blood vessels) and varicose veins. Fused toes or fingers, or extra toes or fingers, may be present. In some cases, internal bleeding may occur as a result of blood vessel malformations involving organs such as the stomach, rectum, vagina, liver, spleen, bladder, kidneys, lungs, or heart. Individuals are also at risk for blood clots. The cause of the disorder is unknown. A similar port-wine stain disorder in which individuals have vascular anomalies on the face as well as in the brain is Sturge-Weber syndrome. These individuals may experience seizures and mental deficiency. In some cases, features of the Klippel-Trenaunay syndrome and Sturge-Weber syndrome coincide. Another overlapping condition is the Parkes-Weber syndrome, which is characterized by abnormal connectivity between the arterial and venous system (arteriovenous fistulas). There is no cure for KTS. Treatment is symptomatic. Laser surgery can diminish or erase some skin lesions. Surgery may correct discrepancies in limb size, but orthopedic devices may be more appropriate. KTS is often a progressive disorder, and complications may be life-threatening. However, many individuals can live well while managing their symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information.. My granddaughter was born with Klippel-Tranaunay Syndrome...There is very little information about this. We are looking for the current research and treatments available. She is 5 months old now and her leg seems to be most affected. We want to get her help as soon as possible to address the symptoms and treat her condition.", "response": "Klippel-Trenaunay syndrome (Treatment): Although there's no cure for Klippel-Trenaunay syndrome, your doctor can help you manage symptoms and prevent complications. Because KTS may affect many systems in the body, your health care team may include specialists in vascular medicine and surgery, skin diseases (dermatology), interventional radiology, orthopedic surgery, physical therapy and rehabilitation, and other areas as needed. You and your doctor can work together to determine which of the following treatments are most appropriate for you. Treatments may include: - Compression therapy. Bandages or elastic garments are wrapped around affected limbs to help prevent swelling, problems with varicose veins and skin ulcers. These bandages or elastic garments often need to be custom-fit. Intermittent pneumatic compression devices - leg or arm sleeves that automatically inflate and deflate at set intervals - may be used. - Physical therapy. Massage, compression and limb movement as appropriate may help relieve lymphedema in arms or legs and swelling of the blood vessels. - Orthopedic devices. These may include orthopedic shoes or shoe inserts to compensate for differences in leg length. - Epiphysiodesis (ep-ih-fiz-e-OD-uh-sis). This is an orthopedic surgical procedure that effectively can stop length overgrowth of the lower limb. - Embolization. This procedure, performed through small catheters placed into the veins or arteries, blocks blood flow to certain blood vessels. - Laser therapy. This procedure may be used to lighten port-wine stains and to treat early blebs on the skin. - Laser or radiofrequency ablation of veins. This minimally invasive procedure is used to close off abnormal veins. - Sclerotherapy. A solution is injected into a vein, which creates scar tissue that helps close the vein. - Surgery. In some cases, surgical removal or reconstruction of affected veins, removal of excess tissue, and correction of the overgrowth of bone may be beneficial. - Medication. Early research indicates that a drug called sirolimus (Rapamune) may help to treat symptomatic complex vascular malformations, but it may have significant side effects and more studies are needed. In addition, treatment may be needed for complications such as bleeding, pain, infection, blood clots or skin ulcers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Iron Overdose. Um...i took 25 iron pills...what do i do...this was last night", "response": "Iron overdose: Iron is a mineral found in many over-the-counter supplements. Iron overdose occurs when someone takes more than the normal or recommended amount of this mineral. This can be by accident or on purpose. Iron overdose is especially dangerous for children. A severe overdose can happen if a child eats adult multivitamins, such as prenatal vitamins. If the child eats too many pediatric multivitamins, the effect is usually minor. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Iron can be harmful in large amounts. Iron is an ingredient in many mineral and vitamin supplements. Iron supplements are also sold by themselves. Types include: - Ferrous sulfate (Feosol, Slow Fe) - Ferrous gluconate (Fergon) - Ferrous fumarate (Femiron, Feostat) Other products may also contain iron. Below are symptoms of an iron overdose in different parts of the body. AIRWAYS AND LUNGS - Buildup of fluids in the lungs STOMACH AND INTESTINES - Black, and possibly bloody stools - Diarrhea - Liver damage - Metallic taste in mouth - Nausea - Vomiting blood HEART AND BLOOD - Dehydration - Low blood pressure - Fast and weak pulse - Shock NERVOUS SYSTEM - Chills - Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose) - Convulsions - Dizziness - Drowsiness - Fever - Headache - Lack of desire to do anything SKIN - Bluish-colored lips and fingernails - Flushing - Loss of color from the skin (pallor) Note: Symptoms may go away in a few hours, then return again after 1 day or later. Have this information ready: - Person's age, weight, and condition - Name of the product (ingredients and strength, if known) - Time it was swallowed - Amount swallowed - If the medicine was prescribed for the person Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. Take the container to the hospital with you, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive: - Blood and urine tests, including tests to check iron levels - Breathing support, including tube through the mouth into the lungs, and breathing machine (ventilator) - Camera and tube down the throat to see the esophagus and the stomach and remove pills or stop internal bleeding - EKG (electrocardiogram, or heart tracing) - Fluids through a vein (by IV) - Medicine to help remove iron from the body and treat symptoms - Whole bowel irrigation with a special solution to quickly flush the iron through the stomach and intestines (taken by mouth or through a tube through the nose into the stomach) - X-ray to detect and track iron tablets through the stomach and intestines There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival. Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy. Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Iron Overdose. Um...i took 25 iron pills...what do i do...this was last night", "response": "Iron overdose (Outlook (Prognosis)): There is a good chance of recovery if the person's symptoms are gone 48 hours after the iron overdose. But, severe liver damage can occur 2 to 5 days after the overdose. Some people have died up to a week after an iron overdose. The more quickly the person receives treatment, the better the chance for survival. Iron overdose can be very severe in children. Children may sometimes eat large amounts of iron pills because they look like candy. Many manufacturers have changed their pills so they no longer look like candy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Iron Overdose. Um...i took 25 iron pills...what do i do...this was last night", "response": "Iron overdose (Symptoms): Below are symptoms of an iron overdose in different parts of the body. AIRWAYS AND LUNGS - Buildup of fluids in the lungs STOMACH AND INTESTINES - Black, and possibly bloody stools - Diarrhea - Liver damage - Metallic taste in mouth - Nausea - Vomiting blood HEART AND BLOOD - Dehydration - Low blood pressure - Fast and weak pulse - Shock NERVOUS SYSTEM - Chills - Coma (decreased level of consciousness and lack of responsiveness, may occur within 1/2 hour to 1 hour after overdose) - Convulsions - Dizziness - Drowsiness - Fever - Headache - Lack of desire to do anything SKIN - Bluish-colored lips and fingernails - Flushing - Loss of color from the skin (pallor) Note: Symptoms may go away in a few hours, then return again after 1 day or later. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Inherited Ricketts. Mother has inherited ricketts. Passing A child but not B child. How likely would B child pass it on their child?", "response": "Rocky Mountain Spotted Fever (How Is NIAID Addressing This Critical Topic?): Because of the work started by doctor Ricketts in the early 1900s, NIAID Rocky Mountain Laboratories (RML) remains a thriving center for infectious disease research on tickborne diseases, such as Lyme disease and relapsing fever. RML also continues to do research on rickettsial diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Inherited Ricketts. Mother has inherited ricketts. Passing A child but not B child. How likely would B child pass it on their child?", "response": "Is monilethrix inherited?: Monilethrix can have multiple patterns of inheritance. When the condition is caused by a mutation in one of the keratin genes, it is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In rare cases, the condition results from a new mutation in the gene and is not inherited. When the condition is caused by mutations in the DSG4 gene, it is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Inherited Ricketts. Mother has inherited ricketts. Passing A child but not B child. How likely would B child pass it on their child?", "response": "Alagille Syndrome (Genetic Disorders): Each cell contains thousands of genes that provide the instructions for making proteins for growth and repair of the body. If a gene has a mutation, the protein made by that gene may not function properly, which sometimes creates a genetic disorder. Not all gene mutations cause a disorder.People have two copies of most genes; one copy is inherited from each parent. A genetic disorder occurs when one or both parents pass a mutated gene to a child at conception. A genetic disorder can also occur through a spontaneous gene mutation, meaning neither parent carries a copy of the mutated gene. Once a spontaneous gene mutation has occurred in a person, it can be passed to the person's children.Read more about genes and genetic conditions at the U.S. National Library of Medicine's (NLM's) Genetics Home Reference at www.ghr.nlm.nih.gov.www.ghr.nlm.nih.gov. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Medicare Part B coverage. I suffer with acute fibromyalgia (sp?) and the various drugs my doctor has prescribed for me have little if any effect in helping to control the pain. My doctor has since given me a prescription to have massage therapy which she thought medicare would cover. However, when checking with medicare, it turns out that it does not! Can you suggest any other type of treatment?", "response": "Fibromyalgia (Treatment): The goals of treatment are to help relieve pain and other symptoms, and to help a person cope with the symptoms. The first type of treatment may involve: - Physical therapy - Exercise and fitness program - Stress-relief methods, including light massage and relaxation techniques If these treatments do not work, your health care provider may also prescribe an antidepressant or muscle relaxant. - The goal of these medicines is to improve your sleep and help you better tolerate pain. - Medicine should be used along with exercise and behavior therapy. - Duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella) are drugs that are approved specifically for treating fibromyalgia. Other drugs are also used to treat the condition, such as: - Anti-seizure drugs, such as gabapentin. - Other antidepressants, such as amytriptyline. - Muscle relaxants, such as cyclobenzeprine. - Pain relievers, but avoid narcotics, since they usually do not help. - Sleeping aids: If you have sleep apnea, an apparatus called CPAP may be prescribed. Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to: - Deal with negative thoughts. - Keep a diary of pain and symptoms. - Recognize what makes your symptoms worse. - Seek out enjoyable activities. - Set limits. Support groups may also be helpful. Things you can do to help take care of yourself include: - Eat a well-balanced diet. - Avoid caffeine. - Practice a good sleep routine to improve quality of sleep. - Exercise regularly, starting with low-level exercise. - Try acupressure and acupuncture treatments. Your doctor may refer you to a pain clinic if your condition is severe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Medicare Part B coverage. I suffer with acute fibromyalgia (sp?) and the various drugs my doctor has prescribed for me have little if any effect in helping to control the pain. My doctor has since given me a prescription to have massage therapy which she thought medicare would cover. However, when checking with medicare, it turns out that it does not! Can you suggest any other type of treatment?", "response": "Fibromyalgia (Treatment): In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: - Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. - Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. - Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia. Therapy A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: - Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. - Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. - Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Homozygout MTHFR A1298C Health Issues and long term prognosis?. What is your position on Homozygout MTHFR A1298C Health Issues and long term prognosis?", "response": "MTHFR gene variant (Inheritance): Because each person has two copies of the MTHFR gene , people can inherit one copy of a MTHFR gene variant or two copies of it (one from each parent). People who inherit two copies of C677T have a higher risk for having a child with a neural tube defect. Having two C677T variants and elevated homocysteine levels may cause a slightly higher risk for blood clots. [7] Risks associated with having one C677T and one A1298C is the same, or possibly slightly lower than, that of having two C677T gene changes. [7] [4] Rare MTHFR gene variants can lead to homocystinuria, which is inherited in an autosomal recessive manner. [12] Visit our \" Homocystinuria due to MTHFR deficiency\" webpage. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Homozygout MTHFR A1298C Health Issues and long term prognosis?. What is your position on Homozygout MTHFR A1298C Health Issues and long term prognosis?", "response": "MTHFR gene variant (Diagnosis): Genetic testing is available for MTHFR gene variants, however testing is rarely recommended. The American Congress of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics recommends against testing for common MTHFR gene variants. Common MTHFR gene variants have not been proven to be a concerning risk factor for blood clots, pregnancy loss, or other negative pregnancy outcomes. [6] The American Heart Association recommends against testing for the common MTHFR gene variants or homocysteine as a screen for increased risk of cardiovascular conditions. [13] [7] [6] The Association does not consider MTHFR a major risk factor for heart disease. The College of American Pathologists , the American College of Medical Genetics, and the American Heart Association recommend against testing for C677T and A1298C in people with blood clots. This is because results have little impact on a persons medical management. [13] [7] [4] Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Homozygout MTHFR A1298C Health Issues and long term prognosis?. What is your position on Homozygout MTHFR A1298C Health Issues and long term prognosis?", "response": "MTHFR gene variant (Summary): MTHFR is a gene . We all carry two copies of MTHFR. MTHFR tells our body how to create an enzyme involved in breaking down the amino acid homocysteine. [1] [2] [3] As is true for any gene, the DNA code of the MTHFR gene can vary. When we identify a part of the sequence that varies, we call it a \"variant.\" Genetic research aims to identify specific variants that cause harm or benefit to health. There are two MTHFR gene variants, called C677T and A1298C, that have been an active area of study. These variants are common. In America, about 25% of people who are Hispanic, and 10-15% of people who are Caucasian have two copies of C677T. [4] Studies have found that women with two C677T gene variants have an increased risk for having a child with a neural tube defect. [4] Studies have also found that men and women with two C677T gene variants and elevated homocysteine levels may be at a mild increased risk for blood clots (venous thromboembolism). [4] Many studies on MTHFR and other health risks have been completed, but with conflicting results. [5] [6] For information about rare disease causing MTHFR gene variants, visit our page: Homocystinuria due to MTHFR Deficiency. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Vitamin D intake. Can high doses of Vitamin D (50,000 IUs per week) cause flatulence, among other possible effects? And is such a high dose safe to raise very low levels of Vitamin D in the body?", "response": "Vitamin D (Side Effects): Too much vitamin D can make the intestines absorb too much calcium. This may cause high levels of calcium in the blood. High blood calcium can lead to: - Calcium deposits in soft tissues such as the heart and lungs - Confusion and disorientation - Damage to the kidneys - Kidney stones - Nausea, vomiting, constipation, poor appetite, weakness, and weight loss. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Vitamin D intake. Can high doses of Vitamin D (50,000 IUs per week) cause flatulence, among other possible effects? And is such a high dose safe to raise very low levels of Vitamin D in the body?", "response": "Vitamin C and colds (Summary): Popular belief is that vitamin C can cure the common cold. However, research about this claim is conflicting. Although not fully proven, large doses of vitamin C may help reduce how long a cold lasts. They do not protect against getting a cold. Vitamin C may also be helpful for those exposed to brief periods of severe or extreme physical activity. The likelihood of success may vary from person to person. Some people improve, while others do not. Taking 1000 to 2000 mg per day can be safely tried by most people. Taking too much can cause stomach upset. People with kidney disease should NOT take vitamin C supplements. Large doses of vitamin C supplementation are not recommended during pregnancy. A balanced diet almost always provides the required vitamin and minerals for the day. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Shingles. I am looking for information on how to prevent a shingles outbreak.", "response": "Shingles (Prevention): Do not touch the rash and blisters on people with shingles or chickenpox if you have never had chickenpox or the chickenpox vaccine. A shingles vaccine is available. It is different than the chickenpox vaccine. Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Shingles. I am looking for information on how to prevent a shingles outbreak.", "response": "How to prevent Shingles?: A Vaccine for Adults 60 and Older In May 2006, the U.S. Food and Drug Administration approved a vaccine (Zostavax) to prevent shingles in people age 60 and older. The vaccine is designed to boost the immune system and protect older adults from getting shingles later on. Even if you have had shingles, you can still get the shingles vaccine to help prevent future occurrences of the disease. There is no maximum age for getting the vaccine, and only a single dose is recommended. In a clinical trial involving thousands of adults 60 years old or older, the vaccine reduced the risk of shingles by about half. A One-time Dose To reduce the risk of shingles, adults 60 years old or older should talk to their healthcare professional about getting a one-time dose of the shingles vaccine. Even if the shingles vaccine doesnt prevent you from getting shingles, it can still reduce the chance of having long-term pain. If you have had shingles before, you can still get the shingles vaccine to help prevent future occurrences of the disease. There is no maximum age for getting the vaccine. Side Effects Vaccine side effects are usually mild and temporary. In most cases, shingles vaccine causes no serious side effects. Some people experience mild reactions that last up to a few days, such as headache or redness, soreness, swelling, or itching where the shot was given. When To Get the Vaccine The decision on when to get vaccinated should be made with your health care provider. The shingles vaccine is not recommended if you have active shingles or pain that continues after the rash is gone. Although there is no specific time that you must wait after having shingles before receiving the shingles vaccine, you should generally make sure that the shingles rash has disappeared before getting vaccinated. Where To Get the Vaccine The shingles vaccine is available in doctors offices, pharmacies, workplaces, community health clinics, and health departments. Most private health insurance plans cover recommended vaccines. Check with your insurance provider for details and for a list of vaccine providers. Medicare Part D plans cover shingles vaccine, but there may be costs to you depending on your specific plan. If you do not have health insurance, visit www.healthcare.gov to learn more about health insurance options. Who Should Not Get the Vaccine? You should NOT get the shingles vaccine if you - have an active case of shingles or have pain that continues after the rash is gone - have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine. Tell your doctor if you have any severe allergies. - have a weakened immune system because of: -- HIV/AIDS or another disease that affects the immune system -- treatment with drugs that affect the immune system, such as steroids -- cancer treatment such as radiation or chemotherapy -- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. have an active case of shingles or have pain that continues after the rash is gone have ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of the shingles vaccine. Tell your doctor if you have any severe allergies. have a weakened immune system because of: -- HIV/AIDS or another disease that affects the immune system -- treatment with drugs that affect the immune system, such as steroids -- cancer treatment such as radiation or chemotherapy -- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma. - are pregnant or might be pregnant. are pregnant or might be pregnant. To learn more about the vaccine, see Zostavax: Questions and Answers. Could Vaccines Make Shingles a Rare Disease? The shingles vaccine is basically a stronger version of the chickenpox vaccine, which became available in 1995. The chickenpox shot prevents chickenpox in 70 to 90 percent of those vaccinated, and 95 percent of the rest have only mild symptoms. Millions of children and adults have already received the chickenpox shot. Interestingly, the chickenpox vaccine may reduce the shingles problem. Widespread use of the chickenpox vaccine means that fewer people will get chickenpox in the future. And if people do not get chickenpox, they cannot get shingles. Use of the shingles and chickenpox vaccines may one day make shingles a rare disease. To find out more, visit Shingles Vaccination: What You Need to Know or Shingles Vaccine). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Shingles. I am looking for information on how to prevent a shingles outbreak.", "response": "Shingles: Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain (which can be severe), or sometimes numbness or itch,generally on one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that some of the virus particles from the original exposure to the varicella-zoster virus,leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles. The severity and duration of an attack of shingles can be significantly reduced by immediate treatment with antiviral drugs, which include acyclovir, valcyclovir, or famcyclovir. Antiviral drugs may also help stave off the painful after-effects of shingles known as postherpetic neuralgia. Other treatments for postherpetic neuralgia include steroids, antidepressants, anticonvulsants (including pregabalin and gabapentin enacarbil), and topical agents. The varicella zoster virus vaccine (Zostavax) has been approved by the food and Drug Administration for adults age 50 and older. Researchers found that giving older adults the vaccine reduced the expected number of later cases of shingles by half. And in people who still got the disease despite immunization, the severity and complications of shingles were dramatically reduced. The shingles vaccine is a preventive therapy and not a treatment for those who already have shingles or long-lasting nerve pain (postherpetic neuralgia). For most healthy people who receive treatment soon after the outbreak of blisters, the lesions heal, the pain subsides within 3 to 5 weeks, and the blisters often leave no scars. However, shingles is a serious threat in immunosuppressed individuals — for example, those with HIV infection or who are receiving cancer treatments that can weaken their immune systems. People who receive organ transplants are also vulnerable to shingles because they are given drugs that suppress the immune system. A person with a shingles rash can pass the virus to someone, usually a child, who has never had chickenpox, but the child will develop chickenpox, not shingles. A person with chickenpox cannot give shingles to someone else. Shingles comes from the virus hiding inside the person's body, not from an outside source. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. my father age 65 his always leg pain which use medicine", "response": "Leg pain: Leg pain is a common problem. It can be due to a cramp, injury, or other cause. Leg pain can be due to a muscle cramp (also called a charley horse). Common causes of cramps include: - Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood - Medicines (such as diuretics and statins) - Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time An injury can also cause leg pain from: - A torn or overstretched muscle (strain) - Hairline crack in the bone (stress fracture) - Inflamed tendon (tendinitis) - Shin splints (pain in the front of the leg from overuse) Other common causes of leg pain include: - Atherosclerosis that blocks blood flow in the arteries (this type of pain, called claudication, is generally felt when exercising or walking and is relieved by rest) - Blood clot (deep vein thrombosis) from long-term bed rest - Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis) - Inflammation of the leg joints caused by arthritis or gout - Nerve damage common to people with diabetes, smokers, and alcoholics - Varicose veins Less common causes include: - Cancerous bone tumors (osteosarcoma, Ewing sarcoma) - Legg-Calve-Perthes disease: Poor blood flow to the hip that may stop or slow the normal growth of the leg - Noncancerous (benign) tumors or cysts of the femur or tibia (osteoid osteoma) - Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back - Slipped capital femoral epiphysis: Most often seen in boys and overweight children between ages 11 and 15 If you have leg pain from cramps or overuse, take these steps first: - Rest as much as possible. - Elevate your leg. - Apply ice for up to 15 minutes. Do this 4 times per day, more often for the first few days. - Gently stretch and massage cramping muscles. - Take over-the-counter pain medicines like acetaminophen or ibuprofen. Other homecare will depend on the cause of your leg pain. Call your health care provider if: - The painful leg is swollen or red. - You have a fever. - Your pain gets worse when you walk or exercise and improves with rest. - The leg is black and blue. - The leg is cold and pale. - You are taking medicines that may be causing leg pain. DO NOT stop taking or change any of your medicines without talking to your provider. - Self-care steps do not help. Your provider will perform a physical exam and look at your legs, feet, thighs, hips, back, knees, and ankles. Your provider may ask questions such as: - Where on the leg is the pain? Is the pain in one or both legs? - Is the pain dull and aching or sharp and stabbing? Is the pain severe? Is the pain worse at any time of day? - What makes the pain feel worse? Does anything make your pain feel better? - Do you have any other symptoms such as numbness, tingling, back pain, or fever? Your provider may recommend physical therapy for some causes of leg pain. Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. my father age 65 his always leg pain which use medicine", "response": "Leg pain (What to Expect at Your Office Visit): Your provider will perform a physical exam and look at your legs, feet, thighs, hips, back, knees, and ankles. Your provider may ask questions such as: - Where on the leg is the pain? Is the pain in one or both legs? - Is the pain dull and aching or sharp and stabbing? Is the pain severe? Is the pain worse at any time of day? - What makes the pain feel worse? Does anything make your pain feel better? - Do you have any other symptoms such as numbness, tingling, back pain, or fever? Your provider may recommend physical therapy for some causes of leg pain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. my father age 65 his always leg pain which use medicine", "response": "Leg pain (Summary): Leg pain is a common problem. It can be due to a cramp, injury, or other cause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CVID. I have recently been diagnosed with CVID. As a person with thyroid a thyroid tumor greater than 1 cm. and several thyroid cysys I am concerned about cancer. What are the current stats. The tumor is being monitored by my endocrinologist.", "response": "Thyroid nodule (Summary): A thyroid nodule is a growth (lump) in the thyroid gland. The thyroid gland is located at the front of the neck, just above where your collarbones meet in the middle. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CVID. I have recently been diagnosed with CVID. As a person with thyroid a thyroid tumor greater than 1 cm. and several thyroid cysys I am concerned about cancer. What are the current stats. The tumor is being monitored by my endocrinologist.", "response": "Thyroid nodule (Exams and Tests): If a provider finds a nodule or you have symptoms of a nodule, the following tests may be done: - TSH level and other thyroid blood tests - Thyroid ultrasound - Thyroid scan (nuclear medicine) - Fine needle aspiration biopsy of the nodule or of multiple nodules. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CVID. I have recently been diagnosed with CVID. As a person with thyroid a thyroid tumor greater than 1 cm. and several thyroid cysys I am concerned about cancer. What are the current stats. The tumor is being monitored by my endocrinologist.", "response": "Thyroid nodule (Outlook (Prognosis)): Noncancerous thyroid nodules are not life-threatening. Many do not require treatment. Follow-up exams are enough. The outlook for thyroid cancer depends on the type of cancer. For most common kinds of thyroid cancer, the outlook is very good after treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diabete. whats diabete", "response": "Diabetes (What is diabetes?): Diabetes is a disease caused by high levels of blood sugar (glucose) in your body. This can happen when your body does not make insulin or does not use insulin correctly. Insulin is a hormone made in the pancreas, an organ near your stomach. Insulin helps the glucose from food get into your body's cells for energy. If your body does not make enough insulin, or your body does not use the insulin correctly, the glucose stays and builds up in your blood. Over time, this extra glucose can lead to prediabetes or diabetes. Diabetes puts you at risk for other serious and life-threatening health problems, such as heart disease, stroke, blindness, and kidney damage. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diabete. whats diabete", "response": "What is Diabetes?: The most common types of diabetes are type 1, type 2, and gestational diabetes.Type 1 diabetesIf you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.Type 2 diabetesIf you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. Type 2 is the most common type of diabetes.Gestational diabetesGestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.Other types of diabetesLess common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes. As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didn’t know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1 You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes. Over time, high blood glucose leads to problems such asheart disease stroke kidney disease eye problems dental disease nerve damage foot problemsYou can take steps to lower your chances of developing these diabetes-related health problems. [1] Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Centers for Disease Control and Prevention website. www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf (PDF, 1.3 MB) . Updated July, 18 2017. Accessed August 1, 2017. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diabete. whats diabete", "response": "What is Diagnosis of Diabetes and Prediabetes?: Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia. Diabetes is a disorder of metabolismthe way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy. Insulin is made in the pancreas, an organ located behind the stomach. As the blood glucose level rises after a meal, the pancreas is triggered to release insulin. Within the pancreas, clusters of cells called islets contain beta cells, which make the insulin and release it into the blood. Diabetes develops when the body doesnt make enough insulin or is not able to use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body. The bodys cells are then starved of energy despite high blood glucose levels. Over time, high blood glucose damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney disease, blindness, dental disease, and amputations. Other complications of diabetes may include increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy problems. Main Types of Diabetes The three main types of diabetes are type 1, type 2, and gestational diabetes: - Type 1 diabetes, formerly called juvenile diabetes, is usually first diagnosed in children, teenagers, and young adults. In this type of diabetes, the beta cells of the pancreas no longer make insulin because the bodys immune system has attacked and destroyed them. - Type 2 diabetes, formerly called adult-onset diabetes, is the most common type of diabetes. About 90 to 95 percent of people with diabetes have type 2.1 People can develop type 2 diabetes at any age, even during childhood, but this type of diabetes is most often associated with older age. Type 2 diabetes is also associated with excess weight, physical inactivity, family history of diabetes, previous history of gestational diabetes, and certain ethnicities. Type 2 diabetes usually begins with insulin resistance, a condition linked to excess weight in which muscle, liver, and fat cells do not use insulin properly. As a result, the body needs more insulin to help glucose enter cells to be used for energy. At first, the pancreas keeps up with the added demand by producing more insulin. But in time, the pancreas loses its ability to produce enough insulin in response to meals, and blood glucose levels rise. - Gestational diabetes is a type of diabetes that develops only during pregnancy. The hormones produced during pregnancy increase the amount of insulin needed to control blood glucose levels. If the body cant meet this increased need for insulin, women can develop gestational diabetes during the late stages of pregnancy. Gestational diabetes usually goes away after the baby is born. Shortly after pregnancy, 5 to 10 percent of women with gestational diabetes continue to have high blood glucose levels and are diagnosed as having diabetes, usually type 2.1 Research has shown that lifestyle changes and the diabetes medication, metformin, can reduce or delay the risk of type 2 diabetes in these women. Babies born to mothers who had gestational diabetes are also more likely to develop obesity and type 2 diabetes as they grow up. More information about gestational diabetes is provided in the NIDDK health topic, What I need to know about Gestational Diabetes,or by calling 18008608747. Other Types of Diabetes Many other types of diabetes exist, and a person can exhibit characteristics of more than one type. For example, in latent autoimmune diabetes in adults, people show signs of both type 1 and type 2 diabetes. Other types of diabetes include those caused by genetic defects, diseases of the pancreas, excess amounts of certain hormones resulting from some medical conditions, medications that reduce insulin action, chemicals that destroy beta cells, infections, rare autoimmune disorders, and genetic syndromes associated with diabetes. More information about other types of diabetes is provided in the NIDDK health topic, Causes of Diabetes, or by calling 18008608747. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "wellbutrin xl 150. how to taper off", "response": "Bupropion (How should this medicine be used?): Bupropion comes as a tablet and a sustained-release or extended-release (long-acting) tablet to take by mouth. The regular tablet (Wellbutrin) is usually taken three times a day, with doses at least 6 hours apart, or four times a day, with doses at least 4 hours apart. The sustained-release tablet (Wellbutrin SR, Zyban) is usually taken twice a day, with doses at least 8 hours apart. The extended-release tablet (Aplenzin, Wellbutrin XL) is usually taken once daily in the morning; doses of the extended-release tablet should be taken at least 24 hours apart. When bupropion is used to treat seasonal affective disorder, it is usually taken once a day in the morning beginning in the early fall, continuing through the winter, and stopping in the early spring. Sometimes a lower dose of bupropion is taken for 2 weeks before the medication is stopped. Take bupropion with food if the medication upsets your stomach. If you have trouble falling asleep or staying asleep, do not take bupropion too close to bedtime. Take bupropion at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bupropion exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Swallow the sustained-release and extended-release tablets whole; do not split, chew, or crush them. Your doctor will probably start you on a low dose of bupropion and gradually increase your dose. It may take 4 weeks or longer before you feel the full benefit of bupropion. Continue to take bupropion even if you feel well. Do not stop taking bupropion without talking to your doctor. Your doctor may decrease your dose gradually. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "wellbutrin xl 150. how to taper off", "response": "Bupropion (Brand names): - Aplenzin® - Budeprion® SR¶ - Budeprion® XL¶ - Buproban®¶ - Forfivo® XL - Wellbutrin® - Wellbutrin® SR - Wellbutrin® XL - Zyban®. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Periodic liver tests for patients on Lipitor. I was told at one point that anyone on Lipitor should have blood screening for liver damage every 6 months. Is this currently still the recommendation? NOTE: Although I am in recovery, I also have a history of alcoholism.", "response": "Serum phenylalanine screening (What Abnormal Results Mean): If the screening test results are abnormal, PKU is a possibility. Further testing will be done if the phenylalanine levels in your baby's blood are too high. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Periodic liver tests for patients on Lipitor. I was told at one point that anyone on Lipitor should have blood screening for liver damage every 6 months. Is this currently still the recommendation? NOTE: Although I am in recovery, I also have a history of alcoholism.", "response": "Creating a family health history (When to Create Your Family History): Everyone can benefit from a family history. Create your family history as soon as you can. It is especially useful when: - You are planning to have a baby - You already know that a certain condition runs in the family - You or your child develops signs of a disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Periodic liver tests for patients on Lipitor. I was told at one point that anyone on Lipitor should have blood screening for liver damage every 6 months. Is this currently still the recommendation? NOTE: Although I am in recovery, I also have a history of alcoholism.", "response": "Serum phenylalanine screening (How the Test is Performed): The test is usually done as part of routine screening tests before a newborn leaves the hospital. If the child is not born in a hospital, the test should be done in the first 48 to 72 hours of life. An area of the infant's skin, usually the heel, is cleaned with a germ killer and punctured with a sharp needle or a lancet. Three drops of blood are placed in 3 separate test circles on a piece of paper. Cotton or a bandage may be applied to the puncture site if it is still bleeding after the blood drops are taken. The test paper is taken to the laboratory, where it is mixed with a type of bacteria that needs phenylalanine to grow. Another substance that blocks phenylalanine from reacting with anything else is added. See also: Newborn screening tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. Hi I have heard in order to get benefit of calcium, it should take with Magnesium, is that right ? I bought Calcium Castco ( Kirkland ) brand with D please let me know if is good for me because I am osteoporosis . Please help me . thanks", "response": "What are the brand names of Calcium Carbonate?: - Alka-Mints - Calel-D - Calcid - Caltrate 600 - Chooz - Miralac - Os-Cal 500 - Rolaids - Titralac - Tums. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. Hi I have heard in order to get benefit of calcium, it should take with Magnesium, is that right ? I bought Calcium Castco ( Kirkland ) brand with D please let me know if is good for me because I am osteoporosis . Please help me . thanks", "response": "Osteoporosis (How is it treated?): Treatment for osteoporosis includes: - A balanced diet rich in calcium and vitamin D. - An exercise plan. - A healthy lifestyle. - Medicines to help prevent and treat the disease. Treatment for osteoporosis includes: - A balanced diet rich in calcium and vitamin D. - An exercise plan. - A healthy lifestyle. - Medicines to help prevent and treat the disease. Treatment for osteoporosis includes: - A balanced diet rich in calcium and vitamin D. - An exercise plan. - A healthy lifestyle. - Medicines to help prevent and treat the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. Hi I have heard in order to get benefit of calcium, it should take with Magnesium, is that right ? I bought Calcium Castco ( Kirkland ) brand with D please let me know if is good for me because I am osteoporosis . Please help me . thanks", "response": "Juvenile osteoporosis (Summary): Juvenile osteoporosis is a condition of bone demineralization characterized by pain in the back and extremities, multiple fractures, difficulty walking, and evidence of osteoporosis. [1] [2] Symptoms typically develop just before puberty. Osteoporosis is rare in children and adolescents. When it does occur, it is usually caused by an underlying medical disorder or by medications used to treat the disorder. This is called secondary osteoporosis. Sometimes, however, there is no identifiable cause of osteoporosis in a child. This is known as idiopathic osteoporosis. There is no established medical or surgical therapy for juvenile osteoporosis. In some cases, treatment is not necessary, as the condition resolves spontaneously. Early diagnosis may allow for preventive steps, including physical therapy , avoidance of weight-bearing activities, use of crutches and other supportive care. A well-balanced diet rich in calcium and vitamin D is also important. In severe, long-lasting cases, medications such as bisphosphonates may be used. In most cases, complete recovery of bone occurs. [2]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Testing for EDS. I would like to know if you can point me in the direction of a laboratory in Southern California, Specifically San Bernardino County or LA County or even Riverside County that does genetic testing for EDS or Osteogenesis Imperfecta and do you know if the two diseases are similiar in symptoms? Thank you for you help and time.", "response": "What are the genetic changes related to osteogenesis imperfecta?: Mutations in the COL1A1, COL1A2, CRTAP, and P3H1 genes cause osteogenesis imperfecta. Mutations in the COL1A1 and COL1A2 genes are responsible for more than 90 percent of all cases of osteogenesis imperfecta. These genes provide instructions for making proteins that are used to assemble type I collagen. This type of collagen is the most abundant protein in bone, skin, and other connective tissues that provide structure and strength to the body. Most of the mutations that cause osteogenesis imperfecta type I occur in the COL1A1 gene. These genetic changes reduce the amount of type I collagen produced in the body, which causes bones to be brittle and to fracture easily. The mutations responsible for most cases of osteogenesis imperfecta types II, III, and IV occur in either the COL1A1 or COL1A2 gene. These mutations typically alter the structure of type I collagen molecules. A defect in the structure of type I collagen weakens connective tissues, particularly bone, resulting in the characteristic features of osteogenesis imperfecta. Mutations in the CRTAP and P3H1 genes are responsible for rare, often severe cases of osteogenesis imperfecta. Cases caused by CRTAP mutations are usually classified as type VII; when P3H1 mutations underlie the condition, it is classified as type VIII. The proteins produced from these genes work together to process collagen into its mature form. Mutations in either gene disrupt the normal folding, assembly, and secretion of collagen molecules. These defects weaken connective tissues, leading to severe bone abnormalities and problems with growth. In cases of osteogenesis imperfecta without identified mutations in one of the genes described above, the cause of the disorder is unknown. These cases include osteogenesis imperfecta types V and VI. Researchers are working to identify additional genes that may be responsible for these conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Testing for EDS. I would like to know if you can point me in the direction of a laboratory in Southern California, Specifically San Bernardino County or LA County or even Riverside County that does genetic testing for EDS or Osteogenesis Imperfecta and do you know if the two diseases are similiar in symptoms? Thank you for you help and time.", "response": "VDRL test (How the Test will Feel): When the needle is inserted to draw blood, some people may feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Testing for EDS. I would like to know if you can point me in the direction of a laboratory in Southern California, Specifically San Bernardino County or LA County or even Riverside County that does genetic testing for EDS or Osteogenesis Imperfecta and do you know if the two diseases are similiar in symptoms? Thank you for you help and time.", "response": "VDRL test (Review Date 9/10/2015): Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Consultation. Hello! I have acute chronic cervicitis caused by tampon use. It took a year and a half of treatment (medicines, cauterization), but the symptoms do not stop inflammation and analyzes not determined that bacteria produce inflammation me. I wonder if, despite not being a sexual cervicitis infection, it can cause infertility. And that's what makes a tampon that causes inflammation. Thank you very much!", "response": "Cervicitis (Possible Complications): Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse (dyspareunia). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Consultation. Hello! I have acute chronic cervicitis caused by tampon use. It took a year and a half of treatment (medicines, cauterization), but the symptoms do not stop inflammation and analyzes not determined that bacteria produce inflammation me. I wonder if, despite not being a sexual cervicitis infection, it can cause infertility. And that's what makes a tampon that causes inflammation. Thank you very much!", "response": "Cervicitis: Cervicitis is swelling or inflamed tissue of the end of the uterus (cervix). Cervicitis is most often caused by an infection that is caught during sexual activity. Sexually transmitted infections (STIs) that can cause cervicitis include: - Chlamydia - Gonorrhea - Herpes virus (genital herpes) - Human papilloma virus (genital warts) - Trichomoniasis Other things that can cause cervicitis include: - A device inserted into the pelvic area such as a cervical cap, diaphragm, or pessary - Allergy to spermicides used for birth control - Allergy to latex in condoms - Exposure to a chemical Cervicitis is very common. It affects more than one half of all women at some point during their adult life. Risks include: - High-risk sexual behavior - History of STIs - Many sexual partners - Sex (intercourse) at an early age - Sexual partners who have engaged in high-risk sexual behavior or have had an STI Bacteria (such as staphylococcus and streptococcus) and too much growth of normal bacteria in the vagina (bacterial vaginosis) can also cause cervicitis. Symptoms include: - Abnormal vaginal bleeding that occurs after intercourse, after menopause, or between periods - Unusual vaginal discharge that does not go away: discharge may be gray, white or yellow in color - Painful sexual intercourse - Pain in the vagina - Pressure or heaviness in the pelvis Note: There may be no symptoms. Women who may be at risk for chlamydia should be tested for this infection, even if they do not have symptoms. A pelvic exam is done to look for: - Discharge from the cervix - Redness of the cervix - Swelling (inflammation) of the walls of the vagina Tests that may be done include: - Inspection of the discharge under a microscope (may show candidiasis, trichomoniasis, or bacterial vaginosis) - Pap test - Tests for gonorrhea or chlamydia Rarely, colposcopy and biopsy of the cervix is necessary. Antibiotics are used to treat chlamydia or gonorrhea. Drugs called antivirals may be used to treat herpes infections. Hormonal therapy (with estrogen or progesterone) may be used in women who have reached menopause. When these treatments have not worked or when cervicitis has been present for a long time, treatment may include: - Cryosurgery (freezing) - A small probe with an electric current running through it is used to burn or destroy the tissue - Laser therapy Most of the time, simple cervicitis usually heals with treatment if the cause is found and there is a treatment for that cause. Cervicitis may last for months to years. Cervicitis may lead to pain with intercourse (dyspareunia). Call your health care provider if you have symptoms of cervicitis. Things you can do to reduce your risk of developing cervicitis include: - Avoid irritants such as douches and deodorant tampons. - Make sure that any foreign objects you insert into your vagina (such as tampons) are properly placed. Be sure to follow instructions on how long to leave it inside, how often to change it, or how often to clean it. - Make sure your partner is free of any STI. You and your partner should not have sex with any other people. - Use a condom every time you have sex to lower your risk of getting an STI. Condoms are available for both men and women, but are most commonly worn by the man. A condom must be used properly every time. Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Consultation. Hello! I have acute chronic cervicitis caused by tampon use. It took a year and a half of treatment (medicines, cauterization), but the symptoms do not stop inflammation and analyzes not determined that bacteria produce inflammation me. I wonder if, despite not being a sexual cervicitis infection, it can cause infertility. And that's what makes a tampon that causes inflammation. Thank you very much!", "response": "Cervicitis (When to Contact a Medical Professional): Call your health care provider if you have symptoms of cervicitis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "trisomy 7. trisomy 7. i am a 32 y/o who has had 4 miscarriages in the past 19 months. Upon my last DNC two weeks ago revealed a genetics study diagnosis of the baby having trisomy 7. could you offer me any information on this? could this have been maternal or paternal? is this something i would be a carrier of? What are the causes? i have tried but haven't found much information", "response": "Etiology: Etiology describes the cause or causes of a disease. Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "trisomy 7. trisomy 7. i am a 32 y/o who has had 4 miscarriages in the past 19 months. Upon my last DNC two weeks ago revealed a genetics study diagnosis of the baby having trisomy 7. could you offer me any information on this? could this have been maternal or paternal? is this something i would be a carrier of? What are the causes? i have tried but haven't found much information", "response": "Trisomy 17 mosaicism (Symptoms): While trisomy 17 mosaicism is rare, there are a few cases that have been reported in the medical literature as well as a few reviews. Most cases of trisomy 17 mosaicism reported in the medical literature that were detected during pregnancy via chorionic villus sampling (CVS) or amniocentesis have not been confirmed in the baby after birth. In those cases, the babies appeared to be in good health at birth and it is suspected that in those cases, trisomy 17 was confined to extra-embryonic ( placental) cells and tissues . [3] [4] Some cases of trisomy 17 mosaicism detected during pregnancy have been confirmed in the baby after birth. The symptoms reported include: developmental delays, body asymmetry, slow growth, and cerebellar hypoplasia. Again, signs and symptoms may vary in these individuals depending on which cells and how many cells contain an extra chromosome 17. [3] [4]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "trisomy 7. trisomy 7. i am a 32 y/o who has had 4 miscarriages in the past 19 months. Upon my last DNC two weeks ago revealed a genetics study diagnosis of the baby having trisomy 7. could you offer me any information on this? could this have been maternal or paternal? is this something i would be a carrier of? What are the causes? i have tried but haven't found much information", "response": "Chromosome 20 trisomy (Summary): Chromosome 20 trisomy , (also called trisomy 20) is a condition in which a fetus or individual has an extra full or partial copy of chromosome 20 in some or all of of his/her cells . An extra full copy of chromosome 20 in all of a person's cells is rare, and almost all fetuses with this do not survive past the first trimester of pregnancy. [1] The presence of an extra copy of only part of chromosome 20 is called partial trisomy 20; and an extra copy of chromosome 20 in only some of a person's cells is called mosaic trisomy 20. Mosaic trisomy 20 is the most common type of chromosome 20 trisomy and is one of the more common chromosomal abnormalities found during prenatal diagnostic testing. Studies have shown that the child is normal in the vast majority of prenatally diagnosed individuals. However, features that have been reported include spinal abnormalities (including spinal stenosis, vertebral fusion, and kyphosis), hypotonia (decreased muscle tone), lifelong constipation, sloped shoulders, and significant learning disabilities despite normal intelligence. [2] Trisomy 20 usually results from an error that occurs when an egg or sperm cell develops (before fertilization); mosaic trisomy 20 usually results from errors in cell division soon after fertilization. [3]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "metformin. Does metformin cause high blood pressure?", "response": "High blood pressure (Some High Blood Pressure Risks You Can’t Change): Anyone can get high blood pressure. But, some people have a greater chance of having it because of things they can't change. These are:- Age. The chance of having high blood pressure increases as you get older. - Gender. Before age 55, men have a greater chance of having high blood pressure. Women are more likely to have high blood pressure after menopause. - Family history. High blood pressure tends to run in some families. - Race. African Americans are at increased risk for high blood pressure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "metformin. Does metformin cause high blood pressure?", "response": "What is High Blood Pressure?: Blood pressure rises as body weight increases. Losing even 10 pounds can lower blood pressure -- and it has the greatest effect for those who are overweight and already have hypertension. If you are overweight or obese, work with your health care provider to develop a plan to help you lower your weight and maintain a healthy weight. Aim to reduce your weight by 7 to 10 percent over six months, which can lower your risk for health problems. For example, if you are overweight at 200 pounds, try to lose 14 to 20 pounds over six months. After that, you may have to continue to lose weight to get to a healthy weight. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "metformin. Does metformin cause high blood pressure?", "response": "What is High Blood Pressure?: \"DASH\" stands for \"Dietary Approaches to Stop Hypertension.\" This is the name of a clinical study that tested the effects of nutrients in food on blood pressure. Study results indicated that you can reduce high blood pressure by following an eating plan that emphasizes fruits, vegetables, and fat-free or low-fat milk and milk products, and that is low in saturated fat, cholesterol, total fat, and added sugars. The DASH eating plan also includes whole grains, poultry, fish, and nuts, and has reduced amounts of red meats, sweets, added sugars, and beverages containing sugars. A second study, called \"DASH-Sodium,\" showed that eating less salt also lowered blood pressure in people following either the DASH eating plan or the typical American diet. But those following DASH, especially those with high blood pressure, benefited the most. For more information on using the DASH eating plan, see Your Guide to Lowering Your Blood Pressure with DASH. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "aclidinium. is this a steroid? is there a problem using this if there is a possibility of the need for cataract surgery within the next 12 months?", "response": "What is Congenital cataract?: A congenital cataract is a clouding of the lens of the eye that is present at birth. The lens of the eye is normally clear. It focuses light that comes into the eye onto the retina. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "aclidinium. is this a steroid? is there a problem using this if there is a possibility of the need for cataract surgery within the next 12 months?", "response": "Cataract removal (Outlook (Prognosis)): Most people do well and recover quickly after cataract surgery. If a person has other eye problems, such as glaucoma or macular degeneration, the surgery may be more difficult or the outcome may not be as good. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "aclidinium. is this a steroid? is there a problem using this if there is a possibility of the need for cataract surgery within the next 12 months?", "response": "Cataract removal (Why the Procedure is Performed): The normal lens of the eye is clear (transparent). As a cataract develops, the lens becomes cloudy. This blocks light from entering your eye. Without enough light, you cannot see as clearly. Cataracts are painless. They are most often seen in older adults. Sometimes, children are born with them. Cataract surgery is usually done if you cannot see well enough because of cataracts. Cataracts usually do not damage your eye, so you and your eye doctor can decide when surgery is right for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "intestines digestion and sbsorption. kindly explain the general effects of smoking or rather the effects of nicotine to digestion and arbsoption", "response": "What are the side effects or risks of Nicotine Oral Inhalation?: Nicotine oral inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - irritation in the mouth and throat - cough - runny nose - taste changes - pain of the jaw, neck, or back - tooth problems - sinus pressure and pain - headache - pain, burning, or tingling in the hands or feet - gas Some side effects can be serious. If you experience the following symptom, call your doctor immediately: - rapid heart rate Nicotine inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "intestines digestion and sbsorption. kindly explain the general effects of smoking or rather the effects of nicotine to digestion and arbsoption", "response": "Gastrointestinal perforation (Summary): Perforation is a hole that develops through the wall of a body organ. This problem may occur in the esophagus, stomach, small intestine, large intestine, rectum, or gallbladder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "intestines digestion and sbsorption. kindly explain the general effects of smoking or rather the effects of nicotine to digestion and arbsoption", "response": "Gastrointestinal perforation (Exams and Tests): X-rays of the chest or abdomen may show air in the abdominal cavity. This is called free air. It is a sign of a tear. A CT scan of the abdomen often shows where the hole is located. The white blood cell count is often higher than normal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "sswollen feet ankles legs I have fibromyalgia. When suffering from fibromyalgia will that cause swollen in your body . The swollen started yesterday", "response": "Fibromyalgia (What are the symptoms of fibromyalgia?): Chronic (long-term), widespread pain is the most common symptom of fibromyalgia. You may feel the pain all over your body. Or, you may feel it more in the muscles you use most often, like in your back or legs. The pain may feel like a deep muscle ache, or it may throb or burn. Your pain may also be worse in the morning. Other symptoms of fibromyalgia include:3,4,5 Women with fibromyalgia often have more morning fatigue, pain all over the body, and IBS symptoms than men with fibromyalgia have.8. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "sswollen feet ankles legs I have fibromyalgia. When suffering from fibromyalgia will that cause swollen in your body . The swollen started yesterday", "response": "Fibromyalgia (Symptoms): Symptoms of fibromyalgia include: - Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist. - Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea. - Cognitive difficulties. A symptom commonly referred to as \"fibro fog\" impairs the ability to focus, pay attention and concentrate on mental tasks. Fibromyalgia often co-exists with other painful conditions, such as: - Irritable bowel syndrome - Migraine and other types of headaches - Interstitial cystitis or painful bladder syndrome - Temporomandibular joint disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can cancer spread through blood contact. Sir, after giving an insulin injection to my uncle who is a cancer patient the needle accidentally pined my finger. Is there a problem for me? Plz reply.", "response": "How to tell your child that you have cancer (Common Fears): There are some common fears that many children have when they learn about cancer. Since your child may not tell you about these fears, it is a good idea to bring them up yourself. - Your child is to blame. It is common for children to think that something they did caused a parent's cancer. Let your child know that no one in your family did anything to cause the cancer. - Cancer is contagious. Many children worry that cancer can spread like the flu, and other people in your family will catch it. Make sure to let your child know that you cannot \"catch\" cancer from someone else, and they will not get cancer by touching or kissing you. - Everyone dies from cancer. You can explain that cancer is a serious illness, but modern treatments have helped millions of people survive cancer. If your child knows someone who has died of cancer, let them know that there are many kinds of cancer and everyone's cancer is different. Just because Uncle Mike died of his cancer, it does not mean that you will too. You may need to repeat these points to your child many times during your treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can cancer spread through blood contact. Sir, after giving an insulin injection to my uncle who is a cancer patient the needle accidentally pined my finger. Is there a problem for me? Plz reply.", "response": "Vulva cancer (Outlook (Prognosis)): Most women with vulvar cancer who are diagnosed and treated at an early stage do well. But a woman's outcome depends on: - The size of the tumor - The type of vulvar cancer - Whether the cancer has spread The cancer commonly comes back at or near the site of the original tumor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can cancer spread through blood contact. Sir, after giving an insulin injection to my uncle who is a cancer patient the needle accidentally pined my finger. Is there a problem for me? Plz reply.", "response": "Intestinal Cancer (Summary): Summary Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn's disease, celiac disease, or a history of colonic polyps can increase your risk. Possible signs of small intestine cancer include - Abdominal pain - Weight loss for no reason - Blood in the stool - A lump in the abdomen Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread. Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy, or a combination. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Plantar Fasiciitis. Is it true that more likely than not that Plantar fasiciitis could be aggravated by a consistancy of weight bearing activities? Are there other forms of aggravation? if so will you please inform me.", "response": "Plantar fasciitis (Risk factors): Though plantar fasciitis can arise without an obvious cause, factors that can increase your risk of developing plantar fasciitis include: - Age. Plantar fasciitis is most common between the ages of 40 and 60. - Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue - such as long-distance running, ballistic jumping activities, ballet dancing and aerobic dance - can contribute to an earlier onset of plantar fasciitis. - Foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can affect the way weight is distributed when you're standing and put added stress on the plantar fascia. - Obesity. Excess pounds put extra stress on your plantar fascia. - Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Plantar Fasiciitis. Is it true that more likely than not that Plantar fasiciitis could be aggravated by a consistancy of weight bearing activities? Are there other forms of aggravation? if so will you please inform me.", "response": "Plantar fasciitis: The plantar fascia is the thick tissue on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot. When this tissue becomes swollen or inflamed, it is called plantar fasciitis. Swelling occurs when the thick band of tissue on the bottom of the foot (fascia) is overstretched or overused. This can be painful and make walking more difficult. You are more likely to get plantar fasciitis if you: - Have foot arch problems (both flat feet and high arches) - Run long distances, downhill or on uneven surfaces - Are obese or gain weight suddenly - Have a tight Achilles tendon (the tendon connecting the calf muscles to the heel) - Wear shoes with poor arch support or soft soles - Change your activities Plantar fasciitis is seen in both men and women. It is one of the most common orthopedic foot complaints. Plantar fasciitis was commonly thought to be caused by a heel spur. However, research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis. The most common symptom is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain is often worse: - In the morning when you take your first steps - After standing or sitting for awhile - When climbing stairs - After intense activity - Walking, running, and jumping sports The pain may develop slowly over time, or come on suddenly after intense activity. The health care provider will perform a physical exam. This may show: - Pain on the bottom of your foot. - Pain along the sole of the foot. - Flat feet or high arches. - Mild foot swelling or redness. - Stiffness or tightness of the arch in the bottom of your foot. X-rays may be taken to rule out other problems. Your provider will often recommend these steps first: - Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation. Heel and foot stretching exercises - Night splints to wear while sleeping to stretch the foot - Resting as much as possible for at least a week - Wearing shoes with good support and cushions You can also apply ice to the painful area. Do this at least twice a day for 10 to 15 minutes, more often in the first couple of days. If these treatments do not work, your provider may recommend: - Wearing a boot cast, which looks like a ski boot, for 3 to 6 weeks. It can be removed for bathing. - Custom-made shoe inserts (orthotics) - Steroid shots or injections into the heel Sometimes, foot surgery is needed. Nonsurgical treatments almost always improve the pain. Treatment can last from several months to 2 years before symptoms get better. Most people feel better with 6 to 18 months. Some people need surgery to relieve the pain. Contact your provider if you have symptoms of plantar fasciitis. Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis. Stretch your plantar fascia in the morning before you get out of bed. Doing activities in moderation can also help. Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI. CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI", "response": "Upper GI and small bowel series (What Abnormal Results Mean): Abnormal results in the esophagus may indicate the following problems: - Achalasia - Diverticula - Esophageal cancer - Esophageal narrowing (stricture) - benign - Hiatal hernia - Ulcers Abnormal results in the stomach may indicate the following problems: - Gastric cancer - Gastric ulcer - benign - Gastritis - Polyps (a tumor that is usually noncancerous and grows on the mucus membrane) - Pyloric stenosis (narrowing) Abnormal results in the small intestine may indicate the following problems: - Malabsorption syndrome - Swelling and irritation of the small intestines - Tumors - Ulcers The test may also be done for the following conditons: - Annular pancreas - Duodenal ulcer - Gastroesophageal reflux disease - Gastroparesis - Intestinal obstruction - Lower esophageal ring - Primary or idiopathic intestinal pseudo-obstruction. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI. CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI", "response": "Liver cancer (Diagnosis): Diagnosing liver cancer Tests and procedures used to diagnose liver cancer include: - Blood tests. Blood tests may reveal liver function abnormalities. - Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI). - Removing a sample of liver tissue for testing. Your doctor may recommend removing a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer. During a liver biopsy, your doctor inserts a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection. Determining the extent of the liver cancer Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of the cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans. There are different methods of staging liver cancer. One method uses Roman numerals I through IV, and another uses letters A through D. Your doctor uses your cancer's stage to determine your treatment options and your prognosis. Stage IV and stage D indicate the most advanced liver cancer with the worst prognosis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI. CAN LIPNODES AND OR LIVER CANCER BE DETECTED IN A UPPER GI", "response": "Upper GI and small bowel series (Considerations): The upper GI series should be done after other x-ray procedures. This is because the barium that remains in the body may block details in other imaging tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abscess teeth. Can an abscess teeth cause a heart attack", "response": "Heart attack (Causes): A heart attack occurs when one or more of your coronary arteries become blocked. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol (atherosclerosis). This condition, known as coronary artery disease, causes most heart attacks. During a heart attack, one of these plaques can rupture and spill cholesterol and other substances into the bloodstream. A blood clot forms at the site of the rupture. If large enough, the clot can completely block the flow of blood through the coronary artery. Another cause of a heart attack is a spasm of a coronary artery that shuts down blood flow to part of the heart muscle. Use of tobacco and of illicit drugs, such as cocaine, can cause a life-threatening spasm. A heart attack can also occur due to a tear in the heart artery (spontaneous coronary artery dissection). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abscess teeth. Can an abscess teeth cause a heart attack", "response": "Heart attack (Risk factors): Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack. Heart attack risk factors include: - Age. Men age 45 or older and women age 55 or older are more likely to have a heart attack than are younger men and women. - Tobacco. Smoking and long-term exposure to secondhand smoke increase the risk of a heart attack. - High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. High blood pressure that occurs with obesity, smoking, high cholesterol or diabetes increases your risk even more. - High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the \"bad\" cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the \"good\" cholesterol) lowers your risk of heart attack. - Diabetes. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, a form of sugar. Having diabetes - not producing enough insulin or not responding to insulin properly - causes your body's blood sugar levels to rise. Diabetes, especially uncontrolled, increases your risk of a heart attack. - Family history of heart attack. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you may be at increased risk. - Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure. - Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however. - Stress. You may respond to stress in ways that can increase your risk of a heart attack. - Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack. - A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease. - A history of an autoimmune condition, such as rheumatoid arthritis or lupus. Conditions such as rheumatoid arthritis, lupus and other autoimmune conditions can increase your risk of having a heart attack. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abscess teeth. Can an abscess teeth cause a heart attack", "response": "Heart attack - what to ask your doctor (Summary): A heart attack occurs when blood flow to a part of your heart is blocked for a period of time and a part of the heart muscle is damaged. It is also called a myocardial infarction (MI). Watch this video about: Coronary artery disease Angina is pain or pressure in the chest. It occurs when your heart muscle is not getting enough blood or oxygen. You may feel angina in your neck or jaw. Sometimes you may notice that you are short of breath. Below are some questions you may want to ask your health care provider to help you take care of yourself after a heart attack. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ischemic syncope stroke diagonses. define?", "response": "What is Ischemic Stroke?: A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually caused by a blood clot that blocks or plugs a blood vessel in the brain. This keeps blood from flowing to the brain. Within minutes, brain cells begin to die. Another cause is stenosis, or narrowing of the artery. This can happen because of atherosclerosis, a disease in which plaque builds up inside your arteries. Transient ischemic attacks (TIAs) occur when the blood supply to the brain is interrupted briefly. Having a TIA can mean you are at risk for having a more serious stroke. Symptoms of stroke are - Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) - Sudden confusion, trouble speaking or understanding speech - Sudden trouble seeing in one or both eyes - Sudden trouble walking, dizziness, loss of balance or coordination - Sudden severe headache with no known cause It is important to treat strokes as quickly as possible. Blood thinners may be used to stop a stroke while it is happening by quickly dissolving the blood clot. Post-stroke rehabilitation can help people overcome disabilities caused by stroke damage. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ischemic syncope stroke diagonses. define?", "response": "Stroke (What Is a Stroke?): A stroke happens when something changes how blood flows through the brain. Blood brings oxygen and nutrients to brain cells. If blood can't flow to a part of the brain, cells that do not receive enough oxygen suffer and eventually die. If brain cells are without oxygen for only a short time, they can sometimes get better. But brain cells that have died can't be brought back to life. So, someone who has had a stroke may have trouble speaking, thinking, or walking.There are two major types of stroke. The most common kind, ischemic, is caused by a blood clot or the narrowing of a blood vessel (an artery) leading to the brain. This keeps blood from flowing into other parts of the brain and keeps needed oxygen and nutrients from reaching brain cells. Blockages that cause ischemic strokes stem from three conditions:- Formation of a clot within a blood vessel of the brain or neck, called thrombosis - Movement of a clot from another part of the body, such as from the heart to the neck or brain, called an embolism - Severe narrowing of an artery (stenosis) in or leading to the brain, due to fatty deposits lining the blood vessel wallsIn the second major kind of stroke, hemorrhagic, a broken blood vessel causes bleeding in the brain. This break in the vessel also stops oxygen and nutrients from reaching brain cells.Sometimes the symptoms of a stroke last only a few minutes and then go away. That could be a transient ischemic attack (TIA), also called a mini-stroke. A TIA is a medical emergency. You should get medical help right away. If a TIA is not treated quickly, it could be followed within hours or days by a major disabling stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ischemic syncope stroke diagonses. define?", "response": "Syncope: Syncope is a medical term used to describe a temporary loss of consciousness due to the sudden decline of blood flow to the brain. Syncope is commonly called fainting or “passing out.” If an individual is about to faint, he or she will feel dizzy, lightheaded, or nauseous and their field of vision may “white out” or “black out.” The skin may be cold and clammy. The person drops to the floor as he or she loses consciousness. After fainting, an individual may be unconscious for a minute or two, but will revive and slowly return to normal. Syncope can occur in otherwise healthy people and affects all age groups, but occurs more often in the elderly. There are several types of syncope. Vasovagal syncope usually has an easily identified triggering event such as emotional stress, trauma, pain, the sight of blood, or prolonged standing. Carotid sinus syncope happens because of constriction of the carotid artery in the neck and can occur after turning the head, while shaving, or when wearing a tight collar. Situational syncope happens during urination, defecation, coughing, or as a result of gastrointestinal stimulation. Syncope can also be a symptom of heart disease or abnormalities that create an uneven heart rate or rhythm that temporarily affect blood volume and its distribution in the body. Syncope isn’t normally a primary sign of a neurological disorder, but it may indicate an increased risk for neurologic disorders such as Parkinson’s disease, postural orthostatic tachycardia syndrome (POTS), diabetic neuropathy, and other types of neuropathy. Certain classes of drugs are associated with an increased risk of syncope, including diuretics, calcium antagonists, ACE inhibitors, nitrates, antipsychotics, antihistamines, levodopa, narcotics, and alcohol. The immediate treatment for an individual who has fainted involves checking first to see if their airway is open and they are breathing. The person should remain lying down for at least 10-15 minutes, preferably in a cool and quiet space. If this isn’t possible, have the individual sit forward and lower their head below their shoulders and between their knees. Ice or cold water in a cup is refreshing. For individuals who have problems with chronic fainting spells, therapy should focus on recognizing the triggers and learning techniques to keep from fainting. At the appearance of warning signs such as lightheadedness, nausea, or cold and clammy skin, counter-pressure maneuvers that involve gripping fingers into a fist, tensing the arms, and crossing the legs or squeezing the thighs together can be used to ward off a fainting spell. If fainting spells occur often without a triggering event, syncope may be a sign of an underlying heart disease. Syncope is a dramatic event and can be life-threatening if not treated properly. Generally, however, people recover completely within minutes to hours. If syncope is symptomatic of an underlying condition, then the prognosis will reflect the course of the disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "SPECIFY COMPONENTS. COENZYME Q10(100-mg). WHAT ARE THE COMPONENTS OF THIS MEDICINE? IS IT USEABLE FOR MUSLIMS?", "response": "HIBCH deficiency (Treatment): Treatment of HIBCH deficiency involves frequent carbohydrate-rich meals, along with coenzyme Q10, vitamin C, and vitamin E supplementation. [5] People with HIBCH deficiency may also benefit from a low-valine diet with carnitine and N-acetyl-cysteine supplementation. [5] Prompt, supportive, treatment during periods of physical stress and viral illness is vital. This may involve frequent infusions of bicarbonate, plus additional supports as required. [5] We strongly recommend that these and other treatment options be carefully reviewed with a healthcare provider. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "SPECIFY COMPONENTS. COENZYME Q10(100-mg). WHAT ARE THE COMPONENTS OF THIS MEDICINE? IS IT USEABLE FOR MUSLIMS?", "response": "Essential thrombocythemia (Treatment): If you have life-threatening complications, you may have a treatment called platelet pheresis. It quickly reduces platelets in the blood. Long-term, medicines are used to decrease the platelet count to avoid complications. The most common medicines used include hydroxyurea, interferon-alpha, or anagrelide. In some people with a JAK2 mutation, specific inhibitors of the JAK2 protein may be used. In people who are at a high risk of clotting, aspirin at a low dose (81 to 100 mg per day) may decrease clotting episodes. Many people do not need any treatment, but they must be followed closely by their provider. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "SPECIFY COMPONENTS. COENZYME Q10(100-mg). WHAT ARE THE COMPONENTS OF THIS MEDICINE? IS IT USEABLE FOR MUSLIMS?", "response": "Myoclonic epilepsy with ragged red fibers (Treatment): While there is no cure for MERRF, there are various medications and therapies that can be helpful in managing symptoms. This includes: Antiseizure medications, levetiracetam for myoclonus, physical therapy , and aerobic exercise. Standard medication is used to treat cardiac symptoms. Daily use of Coenzyme Q10 and L-carnitine have been of some benefit to individuals. Other supplements that might be utilized include creatinine and lipoic acid. [1] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Autoimmune illness. What doctor specializes in testing for and treatment of autoimmune illness?", "response": "Autoimmune diseases (What types of doctors treat autoimmune diseases?): Juggling your health care needs among many doctors and specialists can be hard. But specialists, along with your main doctor, may be helpful in managing some symptoms of your autoimmune disease. If you see a specialist, make sure you have a supportive main doctor to help you. Often, your family doctor may help you coordinate care if you need to see one or more specialists. Here are some specialists who treat autoimmune diseases:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Autoimmune illness. What doctor specializes in testing for and treatment of autoimmune illness?", "response": "What are the treatments for Autoimmune disorders?: The goals of treatment are to: - Reduce symptoms - Control the autoimmune process - Maintain the body's ability to fight disease Treatments will depend on your disease and symptoms. Types of treatments include: - Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease - Blood transfusions if blood is affected - Physical therapy to help with movement if the bones, joints, or muscles are affected Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs called tumor necrosis factor (TFN) blockers can be used for some diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Autoimmune illness. What doctor specializes in testing for and treatment of autoimmune illness?", "response": "Autoimmune hepatitis (Treatment): You may need prednisone or other corticosteroid medicines to help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help people with autoimmune hepatitis, as well. Some people may need a liver transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. how does effextor cause ED and what is the mimimum amount that causes ED. I take effexor. Is there a mimimum amount that will not cause ED", "response": "Venlafaxine (Brand names): - Effexor®¶ - Effexor® XR¶. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. how does effextor cause ED and what is the mimimum amount that causes ED. I take effexor. Is there a mimimum amount that will not cause ED", "response": "Erectile Dysfunction (Summary): Summary Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But it's not a natural part of aging. Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated. Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. how does effextor cause ED and what is the mimimum amount that causes ED. I take effexor. Is there a mimimum amount that will not cause ED", "response": "Erection problems - aftercare (Lifestyle): For many men, lifestyle changes can help with ED. For example, alcohol and illegal drugs may make you feel more relaxed. But they can cause ED or make it worse. Avoid illegal drugs, and consider limiting the amount of alcohol you drink. Smoking and smokeless tobacco can cause narrowing of blood vessels all over the body, including those that supply blood to the penis. Talk to your provider about quitting. Other lifestyle tips include: - Get plenty of rest and take time to relax. - Exercise and eat healthy foods to maintain good circulation. - Use safe sex practices. Reducing your worry about STDs may help prevent negative emotions that can affect your erection. - Talk with your provider and review your daily prescription medicine list. Many prescription medicines can cause or worsen ED. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "NSAIDS as a potential cause of ED. How long has this non prescription drug been implicated in erectile dysfunction?", "response": "How to prevent What I need to know about Erectile Dysfunction?: You can prevent many of the causes of ED by making healthy lifestyle choices. Following a healthy diet may help prevent ED. Quitting smoking and getting physical activity are also important ways to prevent ED. Physical activity increases blood flow throughout your body, including your penis. Talk with your doctor before starting new activities. If you have not been active, start slow, with easier activities such as walking at a normal pace or gardening. Then you can work up to harder activities such as walking briskly or swimming. Try to aim for at least 30 minutes of activity most days of the week. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "NSAIDS as a potential cause of ED. How long has this non prescription drug been implicated in erectile dysfunction?", "response": "Prescription drug abuse (Diagnosis): Doctors generally base a diagnosis of prescription drug abuse on medical history and answers to other questions. In some cases, certain signs and symptoms also provide clues. Blood or urine tests can detect many types of drugs. These tests can also help track the progress of a person who's getting treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "NSAIDS as a potential cause of ED. How long has this non prescription drug been implicated in erectile dysfunction?", "response": "Medicare Prescription Drug Coverage (Summary): Summary Part D is the name of Medicare's prescription drug coverage. It's insurance that helps people pay for prescription drugs. It is available to everyone who has Medicare. It provides protection if you pay high drug costs or have unexpected prescription drug bills. It doesn't cover all costs. You have to pay part of the cost of prescription drugs. Most people also have to pay an additional monthly cost. Private companies provide Medicare prescription drug coverage. You choose the drug plan you like best. Whether or not you should sign up depends on how good your current coverage is. You need to sign up as soon as you are eligible for Medicare. Otherwise, there may be additional charges. Centers for Medicare and Medicaid Services. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. i want to know more about aeortic stenosis", "response": "Aortic valve stenosis: Aortic valve stenosis (AVS) is a condition characterized by narrowing of the heart's aortic valve opening. This narrowing prevents the valve from opening fully, which obstructs blood flow from the heart into the aorta, and onward to the rest of the body. [1] AVS can range from mild to severe. Signs and symptoms typically develop when the narrowing of the opening is severe and may include chest pain (angina) or tightness; shortness of breath or fatigue (especially during exertion); feeling faint or fainting; heart palpitations; and heart murmur. [1] [2] Individuals with less severe congenital AVS (present at birth) may not develop symptoms until adulthood. Individuals with severe cases may faint without warning. [2] The condition can eventually lead to heart failure. AVS can have several causes including abnormal development before birth (such as having 1 or 2 valve leaflets instead of 3); calcium build-up on the valve in adulthood; and rheumatic fever. Treatment may include medications to ease the symptoms, but surgery to repair or replace the valve is the only way to eliminate the condition. [1] Aortic valve stenosis can be congenital (present at birth) or can develop later in life. When the condition is congenital, it is typically due to abnormal development of the aortic valve - either it forms abnormally narrow, or it is made up of one flap or leaflet (called a unicuspid valve, which is very rare) or two leaflets (bicuspid valve) instead of the usual three. Having a bicuspid valve can run in families. A bicuspid valve may not cause any problems until adulthood, when the valve begins to narrow or leak. In most cases, the exact underlying cause of congenital aortic valve stenosis is unknown. [1] Aortic valve stenosis can also be caused by the buildup of calcium deposits on the heart valve with increasing age. This cause is most common in people older than 65. Rheumatic fever can also cause the condition because it may result in scar tissue forming on the valve, causing the leaflets to stiffen and fuse. Rheumatic fever can also cause a rough surface on the valve, which can lead to accumulation of calcium deposits later in life. [1]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "General health. i want to know more about aeortic stenosis", "response": "What is Aortic stenosis?: The aorta is the main artery that carries blood out of the heart to the rest of the body. Blood flows out of the heart and into the aorta through the aortic valve. In aortic stenosis, the aortic valve does not open fully. This decreases blood flow from the heart. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": ". What can cause white cells ti uprate", "response": "white sponge nevus (Frequency): The exact prevalence of white sponge nevus is unknown, but it is estimated to affect less than 1 in 200,000 individuals worldwide. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": ". What can cause white cells ti uprate", "response": "Etiology: Etiology describes the cause or causes of a disease. Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Glimepiride Storage & Alloweable Excursion Data. Can you please provide Glimepiride storage & allowable temperature excursion data, specifically for pharmacy and warehouse storage", "response": "What should I know about storage and disposal of Glimepiride?: Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Glimepiride Storage & Alloweable Excursion Data. Can you please provide Glimepiride storage & allowable temperature excursion data, specifically for pharmacy and warehouse storage", "response": "Lipid Storage Diseases: Lipid storage diseases are a group of inherited metabolic disorders in which harmful amounts of fatty materials (lipids) accumulate in various tissues and cells in the body. Lipids are important parts of the membranes found within and between each cell and in the myelin sheath that coats and protects the nerves. Over time, this excessive storage of fats can cause permanent cellular and tissue damage, particularly in the brain, peripheral nervous system, liver, spleen, and bone marrow. Lipid storage diseases are inherited from one or both parents who carry a defective gene. Symptoms may appear early in life or develop in the teen or even adult years. Neurological complications of the lipid storage diseases may include lack of muscle coordination, brain degeneration, seizures, loss of muscle tone, learning problems, spasticity, feeding and swallowing difficulties, slurred speech, hypersensitivity to touch, pain in the arms and legs, and clouding of the cornea. Currently there is no specific treatment available for most of the lipid storage dThe prognosis for a lipid storage disorder is determined by the type of disease, the age of onset, and the severity of symptoms. Children treated for some forms of Gaucher disease may live well into adulthood, while children with Niemann-Pick disease often die at a young age from infection or progressive neurological loss. Children with Fabry disease often die prematurely of complications from heart disease, renal failure, or stroke. Most children with Farber’s disease die by age 2, usually from lung disease. Children with Tay-Sachs and Sandhoff diseases often die at an early age from recurring or respiratory infection. The prognosis for a lipid storage disorder is determined by the type of disease, the age of onset, and the severity of symptoms. Children treated for some forms of Gaucher disease may live well into adulthood, while children with Niemann-Pick disease often die at a young age from infection or progressive neurological loss. Children with Fabry disease often die prematurely of complications from heart disease, renal failure, or stroke. Most children with Farber’s disease die by age 2, usually from lung disease. Children with Tay-Sachs and Sandhoff diseases often die at an early age from recurring or respiratory infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about uveitis. IS THE UVEITIS, AN AUTOIMMUNE DISEASE?", "response": "Facts About Uveitis (What Causes Uveitis?): Uveitis is caused by inflammatory responses inside the eye. Inflammation is the body’s natural response to tissue damage, germs, or toxins. It produces swelling, redness, heat, and destroys tissues as certain white blood cells rush to the affected part of the body to contain or eliminate the insult. Uveitis may be caused by: - An attack from the body’s own immune system (autoimmunity). - Infections or tumors occurring within the eye or in other parts of the body. - Bruises to the eye. - Toxins that may penetrate the eye. The disease will cause symptoms, such as decreased vision, pain, light sensitivity, and increased floaters. In many cases the cause is unknown. Uveitis is usually classified by where it occurs in the eye. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about uveitis. IS THE UVEITIS, AN AUTOIMMUNE DISEASE?", "response": "Uveitis: Uveitis is swelling and irritation of the uvea. The uvea is the middle layer of the eye. The uvea provides most of the blood supply to the retina. Uveitis can be caused by autoimmune disorders. These diseases occur when the body's immune system attacks and destroys healthy body tissue by mistake. Examples are: - Ankylosing spondylitis - Psoriasis - Reactive arthritis - Rheumatoid arthritis - Sarcoidosis - Ulcerative colitis Uveitis can also be caused by infections such as: - AIDS - Cytomegalovirus (CMV) retinitis - Herpes zoster infection - Histoplasmosis - Kawasaki disease - Syphilis - Toxoplasmosis - Tuberculosis Exposure to toxins or injury can also cause uveitis. In many cases, the cause is unknown. The most common form of uveitis involves inflammation the front part of the eye. It is often called iritis because it most often only affects the iris. The iris is the colored part of the eye. In most cases, it occurs in healthy people. The disorder may affect only one eye. It is most common in young and middle-aged people. Posterior uveitis affects the back part of the eye. It involves primarily the choroid. This is the layer of blood vessels and connective tissue in the middle layer of the eye. This type of uveitis is called choroiditis. If the retina is also involved, it is called chorioretinitis. Another form of uveitis is pars planitis. Changes involve the narrowed area (pars plana) between the colored part of the eye (iris) and the choroid. Pars planitis most often occurs in young men. It is generally not associated with any other disease. However, it may be linked to Crohn disease and possibly multiple sclerosis. Uveitis can affect one or both eyes. Symptoms may develop rapidly and can include: - Blurred vision - Dark, floating spots in the vision - Eye pain - Redness of the eye - Sensitivity to light The health care provider will take a complete medical history and do an eye exam. Lab tests may be done to rule out infection or a weak immune system. If you are over age 25 and have pars planitis, your provider will suggest a brain and spine MRI. This will rule out multiple sclerosis. Iritis (anterior uveitis) is most often mild. Treatment may involve: - Dark glasses - Eye drops that dilate the pupil to relieve pain - Steroid eye drops Pars planitis is often treated with steroid eye drops. Other medicines, including steroids taken by mouth, may be used to help suppress the immune system. Posterior uveitis treatment depends on the underlying cause. It almost always includes steroids taken by mouth. If the uveitis is caused by a body-wide (systemic) infection, you may be given antibiotics. You may also be given powerful anti-inflammatory medicines called corticosteroids. With proper treatment, most attacks of anterior uveitis go away in a few days to weeks. However, the problem often returns. Posterior uveitis may last from months to years. It may cause permanent vision damage, even with treatment. Complications may include: - Cataracts - Fluid within the retina - Glaucoma - Irregular pupil - Retinal detachment - Vision loss Symptoms that need urgent medical care are: - Eye pain - Reduced vision If you have a body-wide (systemic) infection or disease, treating the condition will prevent uveitis. Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "achalasia. after surgery for achalasia, will spasms continue in the upper chest area and if so what can assist in ending spasms", "response": "Idiopathic achalasia (Treatment): The aim of treatment is to reduce the pressure at the lower esophageal sphincter. Therapy may involve: [4] [6] [5] Injection with botulinum toxin (Botox) to help relax the sphincter muscles (used as a temporary fix) Medications, such as long-acting nitrates (i.e. isosorbide dinitrate) or calcium channel blockers (i.e. nifedipine), to relax the lower esophagus sphincter Surgery (Heller myotomy) to decrease the pressure in the lower sphincter Pneumatic balloon dilation of the esophagus at the location of the narrowing (done during esophagogastroduodenoscopy) You can learn more about these treatment options by clicking on the following links: eMedicine Esophageal Motility Disorders Merck Manuals Motility Disorders A doctor should help to determine the best treatment for each individual situation. [4]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "achalasia. after surgery for achalasia, will spasms continue in the upper chest area and if so what can assist in ending spasms", "response": "Achalasia (Treatment): Achalasia treatment focuses on relaxing or forcing open the lower esophageal sphincter so that food and liquid can move more easily through your digestive tract. Specific treatment depends on your age and the severity of the condition. Nonsurgical treatment Nonsurgical options include: - Pneumatic dilation. A balloon is inserted into 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 six years. - Botox (botulinum toxin type A). This muscle relaxant can be injected directly into the esophageal sphincter with an endoscope. 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. - 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. Surgery Surgery may be recommended for younger people because nonsurgical treatment tends to be less effective in this group. Surgical options 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). People who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD). - Fundoplication. The surgeon wraps the top of your stomach around the lower esophageal sphincter, to tighten the muscle and prevent acid reflux. Fundoplication might be performed at the same time as Heller myotomy, to avoid future problems with acid reflux. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure. - Peroral endoscopic myotomy (POEM). 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. POEM doesn't include an anti-reflux procedure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "achalasia. after surgery for achalasia, will spasms continue in the upper chest area and if so what can assist in ending spasms", "response": "Idiopathic achalasia: Achalasia is a disorder of the esophagus, the tube that carries food from the mouth to the stomach. It is characterized by enlargement of the esophagus, impaired ability of the esophagus to push food down toward the stomach (peristalsis), and failure of the ring-shaped muscle at the bottom of the esophagus (the lower esophageal sphincter) to relax. [1] Achalasia is typically diagnosed in individuals between 25 and 60 years of age. The exact etiology is unknown, however, symptoms are caused by damage to the nerves of the esophagus. [2] Familial studies have shown evidence of a potential genetic influence. When a genetic influence is suspected, achalasia is called familial esophageal achalasia. Treatment is aimed at reducing the pressure at the lower esophageal sphincter and may include Botox, medications, or surgery. [3] Most people with achalasia experience difficulty swallowing, also known as dysphagia and heartburn. Other symptoms might include: regurgitation or vomiting, noncardiac chest pain, odynophagia (painful swallowing), and pain in the upper central region of the abdomen. Non esophageal symptoms might include: coughing or asthma, chronic aspiration (breathing a foreign object such as food into the airway), hoarseness or sore throat, and unintentional weight loss. [3] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Achalasia Very frequent The lower esophageal sphincter, the ring-shaped muscle at the bottom of the esophagus, normally relaxes during swallowing. In people with achalasia, this muscle ring does not relax as well. [4] The reason for this problem is damage to the nerves of the esophagus. [4] [5] In some people, this problem appears to be inherited . [4] There is additionally a suspected autoimmune component involved in the development of achalasia as individuals with achalasia are more likely to have a concomitant autoimmune disease than the general population. [3] Achalasia is suspected in individuals with dysphagia (difficulty swallowing) and in instances where regurgitation symptoms are not responsive to protein pump inhibitor medication. The diagnosis of achalasia is confirmed by manometry (test that measures how well the esophagus is working); however, other tests such as upper endoscopy and upper GI X-ray can additionally be useful. [4] [2] The aim of treatment is to reduce the pressure at the lower esophageal sphincter. Therapy may involve: [4] [6] [5] Injection with botulinum toxin (Botox) to help relax the sphincter muscles (used as a temporary fix) Medications, such as long-acting nitrates (i.e. isosorbide dinitrate) or calcium channel blockers (i.e. nifedipine), to relax the lower esophagus sphincter Surgery (Heller myotomy) to decrease the pressure in the lower sphincter Pneumatic balloon dilation of the esophagus at the location of the narrowing (done during esophagogastroduodenoscopy) You can learn more about these treatment options by clicking on the following links: eMedicine Esophageal Motility Disorders Merck Manuals Motility Disorders A doctor should help to determine the best treatment for each individual situation. [4] Although there is no cure for achalasia, treatment options are estimated to be effective in 90% of cases. Without treatment, individuals with achalasia develop progressive dilation of the esophagus. This then leads to late or end-stage achalasia, characterized by esophageal tortuosity (twisting and turning), angulation, and severe dilation. Approximately 10-15% of individuals who have undergone treatment will progress to late or end-stage achalasia. Treatment for late or end-stage achalasia is typically esophagectomy (surgery to remove all or part of the esophagus). [2] [7]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ankle injury. I got hurt in my left leg ankle almost 5 months ago. I went to doctor, got x-ray, where no damage was found. He suggested me some pain killers and advised me to wear anklet. I have been following the instruction since then; I went to another doctor who advised me to go for physiotherapy (Short Wave Diathermy) and advised me some exercises. I have been following them too. But yet now, I have not been fully recovered from the pain. Especially when I try to walk quickly or try to put pressure with my left leg, I feel pain. I am very tensed about this. Can you please suggest me how to overcome the pain. Thanks.", "response": "Ankle pain: Ankle pain involves any discomfort in one or both ankles. Ankle pain is often due to an ankle sprain. - An ankle sprain is an injury to the ligaments, which connect bones to one another. - In most cases, the ankle is twisted inward, causing small tears in the ligaments. The tearing leads to swelling and bruising, making it difficult to bear weight on the joint. In addition to ankle sprains, ankle pain can be caused by: - Damage or swelling of tendons (which join muscles to bone) or cartilage (which cushions joints) - Infection in the ankle joint - Osteoarthritis, gout, rheumatoid arthritis, Reiter syndrome, and other types of arthritis Problems in areas near the ankle that can cause you to feel pain in the ankle include: - Blockage of blood vessels in the leg - Heel pain or injuries - Nerve injuries (such as tarsal tunnel syndrome or sciatica) Home care for ankle pain depends on the cause and what other treatment or surgery has taken place. You may be asked to: - Rest your ankle for several days. Try to NOT put much weight on your ankle. - Put on an ACE bandage. You also can buy a brace that supports your ankle. - Use crutches or a cane to help take the weight off a sore or unsteady ankle. - Keep your foot raised above the level of your heart. When you are sitting or sleeping, place two pillows under your ankle. - Ice the area right away. Apply ice for 10 to 15 minutes every hour for the first day. Then, apply ice every 3 to 4 hours for 2 more days. - Try acetaminophen, ibuprofen, or other pain relievers made by the store. As the swelling and pain improve, you may still need to keep extra weight stress off your ankle for a period of time. The injury may take a few weeks to many months to fully heal. Once the pain and swelling are mostly gone, the injured ankle will still be a little weaker and less stable than the uninjured ankle. - You will need to start exercises to strengthen your ankle and avoid injury in the future. - DO NOT begin these exercises until a health care professional tells you it is safe to start. - You will also need to work on your balance and agility. Other advice your health care provider may give you include: - Lose weight if you are overweight. Extra weight puts strain on your ankles. - Warm up before exercising. Stretch the muscles and tendons that support the ankle. - Avoid sports and activities for which you are not properly conditioned. - Make sure that shoes fit you properly. Avoid high-heeled shoes. - If you are prone to ankle pain or twisting your ankle during certain activities, use ankle support braces. These include air casts, ACE bandages, or lace-up ankle supports. - Work on your balance and do agility exercises. Go to the hospital if: - You have severe pain even when you are NOT bearing weight. - You suspect a broken bone (the joint looks deformed and you cannot put any weight on the leg). - You can hear a popping sound and have immediate pain of the joint. - You can't move your ankle back and forth. Call your provider if: - Swelling does not go down within 2 to 3 days. - You have symptoms of infection. The area becomes red, more painful, or warm, or you have a fever over 100°F (37.7°C). - The pain does not go away after several weeks. - Other joints are also involved. - You have a history of arthritis and are having new symptoms. Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ankle injury. I got hurt in my left leg ankle almost 5 months ago. I went to doctor, got x-ray, where no damage was found. He suggested me some pain killers and advised me to wear anklet. I have been following the instruction since then; I went to another doctor who advised me to go for physiotherapy (Short Wave Diathermy) and advised me some exercises. I have been following them too. But yet now, I have not been fully recovered from the pain. Especially when I try to walk quickly or try to put pressure with my left leg, I feel pain. I am very tensed about this. Can you please suggest me how to overcome the pain. Thanks.", "response": "Ankle pain (When to Contact a Medical Professional): Go to the hospital if: - You have severe pain even when you are NOT bearing weight. - You suspect a broken bone (the joint looks deformed and you cannot put any weight on the leg). - You can hear a popping sound and have immediate pain of the joint. - You can't move your ankle back and forth. Call your provider if: - Swelling does not go down within 2 to 3 days. - You have symptoms of infection. The area becomes red, more painful, or warm, or you have a fever over 100°F (37.7°C). - The pain does not go away after several weeks. - Other joints are also involved. - You have a history of arthritis and are having new symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Ankle injury. I got hurt in my left leg ankle almost 5 months ago. I went to doctor, got x-ray, where no damage was found. He suggested me some pain killers and advised me to wear anklet. I have been following the instruction since then; I went to another doctor who advised me to go for physiotherapy (Short Wave Diathermy) and advised me some exercises. I have been following them too. But yet now, I have not been fully recovered from the pain. Especially when I try to walk quickly or try to put pressure with my left leg, I feel pain. I am very tensed about this. Can you please suggest me how to overcome the pain. Thanks.", "response": "Heel pain (What to Expect at Your Office Visit): Your provider will perform a physical exam and ask questions about your medical history and symptoms, such as: - Have you had this type of heel pain before? - When did your pain begin? - Do you have pain upon your first steps in the morning or after your first steps after rest? - Is the pain dull and aching or sharp and stabbing? - Is it worse after exercise? - Is it worse when standing? - Did you fall or twist your ankle recently? - Are you a runner? If so, how far and how often do you run? - Do you walk or stand for long periods of time? - What kind of shoes do you wear? - Do you have any other symptoms? Your provider may order a foot x-ray. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. Your provider may recommend a night splint to help stretch your foot. At times, further imaging, like CT scan or MRI may be needed. Surgery may be recommended in some cases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Body Lice. How do I get rid of these little devils? Me and My mom have tried so many things to get rid of these bugs and they just don't go away were the family that takes 2 showers and now about 3 showers a day we never understood how they could have infected us but I was just wondering is washing our clothes the best bet to get rid of these things, because apparently it hasn't worked for us. So is there any suggestions?", "response": "Body lice (Treatment): Body lice are primarily treated by thoroughly washing yourself and any contaminated items with soap and hot water. Dry cleaning and ironing clothing that cannot be washed is also effective. If these measures don't work, you can try using an over-the-counter lotion or shampoo - such as Nix or Rid. If that still doesn't work, your doctor can provide a prescription lotion. Lice-killing products can be toxic to humans, so follow the directions carefully. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Body Lice. How do I get rid of these little devils? Me and My mom have tried so many things to get rid of these bugs and they just don't go away were the family that takes 2 showers and now about 3 showers a day we never understood how they could have infected us but I was just wondering is washing our clothes the best bet to get rid of these things, because apparently it hasn't worked for us. So is there any suggestions?", "response": "Body lice: Body lice are tiny insects, about the size of a sesame seed. Body lice live in your clothing and bedding and travel to your skin several times a day to feed on blood. The most common sites for bites are around the neck, shoulders, armpits, waist and groin - places where clothing seams are most likely to touch skin. Body lice are most common in crowded and unhygienic living conditions, such as refugee camps and shelters for the homeless. Body lice bites can spread certain types of diseases and can even cause epidemics. Clothing and bedding that have been infested with body lice should be laundered in hot, soapy water and machine dried using the hot cycle. Body lice bites can cause intense itching, and you may notice small areas of blood and crust on your skin at the site of the bite marks. See your doctor if improved hygiene doesn't eliminate the infestation, or if you develop a skin infection from scratching the bites. Body lice are similar to head lice, but have different habits. While head lice live in your hair and feed on your scalp, body lice typically live in your clothes and bedding. They travel to your skin several times a day to feed on blood. The seams of your clothing are the most common places for body lice to lay their eggs (nits). You can become infested with body lice if you come into close contact with a person who has body lice, or with clothing or bedding that is infested with body lice. People who are at higher risk of body lice tend to live in crowded, unclean conditions. They include: - War refugees - Homeless people - Victims of natural disasters Dogs, cats and other pets do not spread body lice. Body lice infestations usually cause minimal problems. However, a body lice infestation sometimes leads to complications such as: - Secondary infections. When body lice scratch and dig to feed on your blood, they may irritate your skin. If you scratch to alleviate itching, this also can irritate your skin. If your skin becomes raw from these irritations, other infections may develop. - Skin changes. If you're infested with body lice for a long time, you may experience skin changes such as thickening and discoloration - particularly around your waist, groin or upper thighs. - Spread of disease. Body lice can carry and spread some bacterial diseases, such as typhus, relapsing fever or trench fever. You or your doctor can usually confirm a body lice infestation through a visual examination of your body and clothing items. The presence of eggs and moving lice confirms infestation. Body lice are primarily treated by thoroughly washing yourself and any contaminated items with soap and hot water. Dry cleaning and ironing clothing that cannot be washed is also effective. If these measures don't work, you can try using an over-the-counter lotion or shampoo - such as Nix or Rid. If that still doesn't work, your doctor can provide a prescription lotion. Lice-killing products can be toxic to humans, so follow the directions carefully. You can usually get rid of body lice by cleaning yourself and any personal belongings that may be contaminated. Wash infested bedding, clothing and towels with hot, soapy water - at least 130 F (54 C) - and machine dry them on high heat for at least 20 minutes. Clothing that can't be washed may be dry cleaned and ironed. Items that can't be washed should be sealed in a plastic bag and stored in a warm area for two weeks. Mattresses, couches and other upholstered furniture items should be hot ironed or sprayed with lice-killing products to eliminate eggs from seams. Exposure to infested items should be avoided for two weeks. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Body Lice. How do I get rid of these little devils? Me and My mom have tried so many things to get rid of these bugs and they just don't go away were the family that takes 2 showers and now about 3 showers a day we never understood how they could have infected us but I was just wondering is washing our clothes the best bet to get rid of these things, because apparently it hasn't worked for us. So is there any suggestions?", "response": "Body lice (Lifestyle and home remedies): You can usually get rid of body lice by cleaning yourself and any personal belongings that may be contaminated. Wash infested bedding, clothing and towels with hot, soapy water - at least 130 F (54 C) - and machine dry them on high heat for at least 20 minutes. Clothing that can't be washed may be dry cleaned and ironed. Items that can't be washed should be sealed in a plastic bag and stored in a warm area for two weeks. Mattresses, couches and other upholstered furniture items should be hot ironed or sprayed with lice-killing products to eliminate eggs from seams. Exposure to infested items should be avoided for two weeks. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "burn to my wrist. Hello I burnt my wrist 2 days ago and after last night ive woken up with a swollen had its really noticeable to other people but I ca feel the skin has gone tight when I put it against the other hand you can see its bigger what should I do about this?", "response": "Burns (When to Contact a Medical Professional): Call 911 or your local emergency number if: - The burn is very large, about the size of your palm or larger. - The burn is severe (third degree). - You aren't sure how serious it is. - The burn is caused by chemicals or electricity. - The person shows signs of shock. - The person breathed in smoke. - Physical abuse is the known or suspected cause of the burn. - There are other symptoms associated with the burn. For minor burns, call your health care provider if you still have pain after 48 hours. Call a provider right away if signs of infection develop. These signs include: - Drainage or pus from the burned skin - Fever - Increased pain - Red streaks spreading from the burn - Swollen lymph nodes Also call a provider right away if symptoms of dehydration occur with a burn: - Decreased urination - Dizziness - Dry skin - Headache - Lightheadedness - Nausea (with or without vomiting) - Thirst Children, older people, and anyone with a weakened immune system (for example, from HIV) should be seen right away. The provider will perform a history and physical examination. Tests and procedures will be done as needed. These may include: - Airway and breathing support, including a face mask, tube through the mouth into the trachea, or breathing machine (ventilator) for serious burns or those involving the face or airway - Blood and urine tests if shock or other complications are present - Chest x-ray for face or airway burns - EKG (electrocardiogram, or heart tracing), if shock or other complications are present - Intravenous fluids (fluids through a vein), if shock or other complications are present - Medicines for pain relief and to prevent infection - Ointments or creams applied to the burned areas - Tetanus immunization, if not up to date The outcome will depend on the type (degree), extent, and location of the burn. It also depends upon whether internal organs have been affected, and if other trauma has occurred. Burns can leave permanent scars. They can also be more sensitive to temperature and light than normal skin. Sensitive areas, such as the eyes, nose, or ears, may be badly injured and have lost normal function. With airway burns, the person may have less breathing capacity and permanent lung damage. Severe burns that affect the joints may result in contractures, leaving the joint with decreased movement and a reduction in function. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "burn to my wrist. Hello I burnt my wrist 2 days ago and after last night ive woken up with a swollen had its really noticeable to other people but I ca feel the skin has gone tight when I put it against the other hand you can see its bigger what should I do about this?", "response": "Burns (First Aid): Before giving first aid, it is important to determine what type of burn the person has. If you are not sure, treat it as a major burn. Serious burns need medical care right away. Call your local emergency number or 911. MINOR BURNS If the skin is unbroken: - Run cool water over the area of the burn or soak it in a cool water bath (not ice water). Keep the area under water for at least 5 minutes. A clean, cold, wet towel will help reduce pain. - Calm and reassure the person. - After flushing or soaking the burn, cover it with a dry, sterile bandage or clean dressing. - Protect the burn from pressure and friction. - Over-the-counter ibuprofen or acetaminophen can help relieve pain and swelling. Do NOT give aspirin to children under 12. - Once the skin has cooled, moisturizing lotion also can help. Minor burns will often heal without further treatment. Make sure the person is up to date on their tetanus immunization. MAJOR BURNS If someone is on fire, tell the person to stop, drop, and roll. Then, follow these steps: - Wrap the person in thick material; such as a wool or cotton coat, rug, or blanket. This helps put out the flames. - Pour water on the person. - Call 911 or your local emergency number. - Make sure that the person is no longer touching any burning or smoking materials. - Do NOT remove burned clothing that is stuck to the skin. - Make sure the person is breathing. If necessary, begin rescue breathing and CPR. - Cover the burn area with a dry sterile bandage (if available) or clean cloth. A sheet will do if the burned area is large. Do NOT apply any ointments. Avoid breaking burn blisters. - If fingers or toes have been burned, separate them with dry, sterile, non-sticky bandage. - Raise the body part that is burned above the level of the heart. - Protect the burn area from pressure and friction. - If an electrical injury may have caused the burn, DO NOT touch the victim directly. Use a non-metallic object to move the person away from exposed wires before starting first aid. You will also need to prevent shock. If the person does not have a head, neck, back, or leg injury, follow these steps: - Lay the person flat - Raise the feet about 12 inches (30 centimeters) - Cover the person with a coat or blanket Continue to monitor the person's pulse, rate of breathing, and blood pressure until medical help arrives. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can a 40 year old get throat cancer.... I have drank a lot of alcohol and lots of drugs. Not very many fruits and vegetables. This year I have gotten strep throat twice and sore throats with ear aches. Antibiotics have taken 4 different kinds this year alone. Raspy voice, very painful when swallowing", "response": "Throat or larynx cancer: Throat cancer is cancer of the vocal cords, larynx (voice box), or other areas of the throat. People who smoke or use tobacco are at risk of developing throat cancer. Drinking too much alcohol over a long time also increases risk. Smoking and drinking alcohol combined lead to an increased risk for throat cancer. Most throat cancers develop in adults older than 50. Men are more likely than women to develop throat cancer. Watch this video about: Cancer of the throat or larynx Symptoms of throat cancer include any of the following: - Abnormal (high-pitched) breathing sounds - Cough - Coughing up blood - Difficulty swallowing - Hoarseness that does not get better in 3 to 4 weeks - Neck or ear pain - Sore throat that does not get better in 2 to 3 weeks, even with antibiotics - Swelling or lumps in the neck - Weight loss not due to dieting The health care provider will perform a physical exam. This may show a lump on the outside of the neck. The provider may look in your throat or nose using a flexible tube with a small camera at the end. Other tests that may be ordered include: - Biopsy of suspected tumor - Chest x-ray - CT scan of chest - CT scan of head and neck - MRI of the head or neck - PET scan The goal of treatment is to completely remove the cancer and prevent it from spreading to other parts of the body. When the tumor is small, either surgery or radiation therapy alone can be used to remove the tumor. When the tumor is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to save the voice box (vocal cords). If this is not possible, the voice box is removed. This surgery is called laryngectomy. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Throat cancers may be cured when detected early. If the cancer has spread (metastasized) to surrounding tissues or lymph nodes in the neck, about half of patients can be cured. If the cancer has spread to parts of the body outside the head and neck, the cancer is not curable. Treatment is aimed at prolonging and improving quality of life. After treatment, therapy is needed to help with speech and swallowing. If the person is not able to swallow, a feeding tube will be needed. Complications of this type of cancer may include: - Airway obstruction - Difficulty swallowing - Disfigurement of the neck or face - Hardening of the skin of the neck - Loss of voice and speaking ability - Spread of the cancer to other body areas (metastasis) Call your provider if: - You have symptoms of throat cancer, especially hoarseness or a change in voice with no obvious cause that lasts longer than 3 weeks - You find a lump in your neck that does not go away in 3 weeks Do not smoke or use other tobacco. Limit or avoid alcohol use. Updated by: Sumana Jothi, MD, specialist in laryngology, Clinical Instructor UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can a 40 year old get throat cancer.... I have drank a lot of alcohol and lots of drugs. Not very many fruits and vegetables. This year I have gotten strep throat twice and sore throats with ear aches. Antibiotics have taken 4 different kinds this year alone. Raspy voice, very painful when swallowing", "response": "Throat cancer (Symptoms): Signs and symptoms of throat cancer may include: - A cough - Changes in your voice, such as hoarseness or not speaking clearly - Difficulty swallowing - Ear pain - A lump or sore that doesn't heal - A sore throat - Weight loss When to see a doctor Make an appointment with your doctor if you notice any new signs and symptoms that are persistent. Most throat cancer symptoms aren't specific to cancer, so your doctor will likely investigate other more common causes first. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Chronic lymphocytic leukemia. How can I get Information on Cronic Lymphocytice Leukemia sent to me thru MedlinkPlus or which way you will send them.", "response": "Chronic lymphocytic leukemia (CLL) (Summary): Chronic lymphocytic leukemia (CLL) is cancer of a type of white blood cells called lymphocytes. These cells are found in the bone marrow and other parts of the body. Bone marrow is the soft tissue in the center of bones that helps form all blood cells. CLL causes a slow increase in a certain type of white blood cells called B lymphocytes, or B cells. Cancer cells spread through the blood and bone marrow. CLL can also affect the lymph nodes or other organs such as the liver and spleen. CLL eventually can cause the bone marrow to lose its function. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Chronic lymphocytic leukemia. How can I get Information on Cronic Lymphocytice Leukemia sent to me thru MedlinkPlus or which way you will send them.", "response": "What is Chronic Lymphocytic Leukemia?: Leukemia is cancer of the white blood cells. White blood cells help your body fight infection. Your blood cells form in your bone marrow. In leukemia, the bone marrow produces abnormal white blood cells. These cells crowd out the healthy blood cells, making it hard for blood to do its work. In chronic lymphocytic leukemia (CLL), there are too many lymphocytes, a type of white blood cell. CLL is the second most common type of leukemia in adults. It often occurs during or after middle age, and is rare in children. Usually CLL does not cause any symptoms. If you have symptoms, they may include - Painless swelling of the lymph nodes in the neck, underarm, stomach, or groin - Fatigue - Pain or a feeling of fullness below the ribs - Fever and infection - Weight loss Tests that examine the blood, bone marrow, and lymph nodes diagnose CLL. Your doctor may choose to just monitor you until symptoms appear or change. Treatments include radiation therapy, chemotherapy, surgery to remove the spleen, and targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Compliment. Hi I have retinitis pigmentosa for 3years. Im suffering from this disease. Please intoduce me any way to treat mg eyes such as stem cell ....I am 25 years old and I have only central vision. Please help me. Thank you", "response": "Retinitis pigmentosa (Treatment): Available treatments aim to slow the progression of the disease and primarily include light avoidance and the use of low-vision aids. Some practitioners also consider vitamin A as a possible treatment option. However, taking too much vitamin A can be toxic and the effects of vitamin A on the disease appear to be relatively weak. [4] Studies have explored potential treatment with DHA, an omega-3 fatty acid naturally found in fish. While DHA is known to play a structural role in retinal cells , more research is needed to determine whether supplements should be recommended. [2] Current research is focused on the development of new treatments including gene therapy , retinal transplantation, and the use of a retinal prosthesis. Stem cell transplantation would involve the injection and integration of stem cells into the retina, in hopes these cells will replace dead cells and provide the missing enzymes and chemicals needed for sight. Gene therapy could potentially be used when the disease-causing mutation is known and would aim to restore production of the missing or abnormal protein . Studies with retinal prosthetics have tested devices that transform light into electrical signals that can be sent directly to the inner retina and brain, avoiding the diseased part of the outer retina. Though challenges remain, preliminary research into these technologies has been promising. [2] [3] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Compliment. Hi I have retinitis pigmentosa for 3years. Im suffering from this disease. Please intoduce me any way to treat mg eyes such as stem cell ....I am 25 years old and I have only central vision. Please help me. Thank you", "response": "Facts About Retinitis Pigmentosa (Are there treatments for RP?): Living with vision loss A number of services and devices are available to help people with vision loss carry out daily activities and maintain their independence. In addition to an eye care professional, itís important to have help from a team of experts, which may include occupational therapists, orientation and mobility specialists, certified low vision therapists, and others. NEI has more information on living with low vision. Children with RP may benefit from low vision aids that maximize existing vision. For example, there are special lenses that magnify central vision to expand visual field and eliminate glare. Computer programs that read text are readily available. Closed circuit televisions with a camera can adjust text to suit oneís vision. Portable lighting devices can adjust a dark or dim environment. Mobility training can teach people to use a cane or a guide dog, and eye scanning techniques can help people to optimize remaining vision. Once a child is diagnosed, he or she will be referred to a low vision specialist for a comprehensive evaluation. Parents may also want to meet with the childís school administrators and teachers to make sure that necessary accommodations are put in place. For parents of children with RP, one challenge is to determine when a child might need to learn to use a cane or a guide dog. Having regular eye examinations to measure the progress of the disorder will help parents make informed decisions regarding low vision services and rehabilitation. Targeted therapies for RP An NEI-sponsored clinical trial found that a daily dose of 15,000 international units of vitamin A palmitate modestly slowed the progression of the disorder in adults. Because there are so many forms of RP, it is difficult to predict how any one patient will respond to this treatment. Talk to an eye care professional to determine if taking vitamin A is right for you or your child. An artificial vision device called the Argus II has also shown promise for restoring some vision to people with late-stage RP. The Argus II, developed by Second Sight with NEI support, is a prosthetic device that functions in place of lost photoreceptor cells. It consists of a light-sensitive electrode that is surgically implanted on the retina. A pair of glasses with a camera wirelessly transmits signals to the electrode that are then relayed to the brain. Although it does not restore normal vision, in clinical studies, the Argus II enabled people with RP to read large letters and navigate environments without the use of a cane or guide dog. In 2012, the U.S. Food and Drug Administration (FDA) granted a humanitarian device exemption for use of the Argus II to treat late-stage RP. This means the device has not proven effective, but the FDA has determined that its probable benefits outweigh its risks to health. The Argus II is eligible for Medicare payment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - General Complaint. Please help me out as to whom to consult for anxiety and depression", "response": "Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. Please i really need your reply and your help :( My wife has Allergy from all milk products and whenever she drinks or eats any thing contains small amount of any milk products she goes to the hospital. I have faith that there is a cure for that but i really donno what to say to her. She thinks that she will never be cured. So please can you tell me is there is any cure for milk products allergy, any cure? or any cure in the very near future? I will be very very very grateful if you replied, Thanks alot. :)", "response": "Food allergy (Treatment): If you suspect that you or your child has a food allergy, see an allergy specialist doctor (allergist). Treatment may involve any of the following: - Avoiding the food (this is the most effective treatment). - Desensitization, during which you eat a small amount of the food each day. This must be done under an allergist's guidance. Other treatments, including allergy shots and probiotics, have not been proven to help with food allergies. If your child has a problem with cow's milk formula, your provider may suggest trying a soy-based formula or something called an elemental formula, if it is available. If you have symptoms on only one area of the body, for example, a hive on the chin after eating the food, you may not need any treatment. The symptoms will likely go away in a brief time. Antihistamines may relieve the discomfort. Soothing skin creams may also provide some relief. If you have been diagnosed with a food allergy, learn how to use injectable epinephrine. You should have it with you at all times. If you develop any type of serious or whole-body reaction (even hives) after eating the food: - Inject the epinephrine. - Then go to the nearest hospital or emergency facility right away, preferably by ambulance. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. Please i really need your reply and your help :( My wife has Allergy from all milk products and whenever she drinks or eats any thing contains small amount of any milk products she goes to the hospital. I have faith that there is a cure for that but i really donno what to say to her. She thinks that she will never be cured. So please can you tell me is there is any cure for milk products allergy, any cure? or any cure in the very near future? I will be very very very grateful if you replied, Thanks alot. :)", "response": "Food allergy (Treatment): The only way to avoid an allergic reaction is to avoid the foods that cause signs and symptoms. However, despite your best efforts, you may come into contact with a food that causes a reaction. For a minor allergic reaction, over-the-counter or prescribed antihistamines may help reduce symptoms. These drugs can be taken after exposure to an allergy-causing food to help relieve itching or hives. However, antihistamines can't treat a severe allergic reaction. For a severe allergic reaction, you may need an emergency injection of epinephrine and a trip to the emergency room. Many people with allergies carry an epinephrine autoinjector (Adrenaclick, EpiPen). This device is a combined syringe and concealed needle that injects a single dose of medication when pressed against your thigh. If your doctor has prescribed an epinephrine autoinjector: - Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to administer the drug - if they're with you in an anaphylactic emergency, they could save your life. - Carry it with you at all times. It may be a good idea to keep an extra autoinjector in your car or in your desk at work. - Always be sure to replace epinephrine before its expiration date or it may not work properly. Experimental treatments While there's ongoing research to find better treatments to reduce food allergy symptoms and prevent allergy attacks, there isn't any proven treatment that can prevent or completely relieve symptoms. Treatments being studied are: - Anti-IgE therapy. The medication omalizumab (Xolair) interferes with the body's ability to use IgE. The drug is currently being studied for treatment of allergic asthma and food allergies. This treatment is still considered experimental, and more research needs to be done on the drug's long-term safety. It has been associated with a potential increased risk of anaphylaxis. - Oral immunotherapy. Researchers have been studying the use of oral immunotherapy as a treatment for food allergy. Small doses of the food you're allergic to are swallowed or placed under your tongue (sublingual). The dose of the allergy-provoking food is gradually increased. Initial results look promising, even in people with peanut, egg and milk allergies. But more research needs to be done to ensure that this treatment is safe. - Early exposure. In the past, it's been generally recommended that children avoid allergenic foods to reduce the likelihood of developing allergies. But in a recent study, high-risk infants - such as those with atopic dermatitis or egg allergy or both - were selected to either ingest or avoid peanut products from 4 to 11 months of age until 5 years of age. Researchers found that high-risk children who regularly consumed peanut protein, such as peanut butter or peanut-flavored snacks, were 70 to 86 percent less likely to develop a peanut allergy. These findings may impact food allergy guidelines in the future. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Question - general information. Please i really need your reply and your help :( My wife has Allergy from all milk products and whenever she drinks or eats any thing contains small amount of any milk products she goes to the hospital. I have faith that there is a cure for that but i really donno what to say to her. She thinks that she will never be cured. So please can you tell me is there is any cure for milk products allergy, any cure? or any cure in the very near future? I will be very very very grateful if you replied, Thanks alot. :)", "response": "Penicillin allergy (Treatment): Interventions for a penicillin allergy can be divided into two general strategies: - Treatment for the current allergy symptoms - Desensitization to penicillin Treating current symptoms The following interventions may be used to treat the symptoms of an allergic reaction to penicillin: - Withdrawal of the drug. If your doctor determines that you have a penicillin allergy - or likely allergy - discontinuing the drug is the first step in treatment. - Antihistamines. Your doctor may prescribe an antihistamine or recommend an over-the-counter antihistamine such as diphenhydramine (Benadryl) that can block immune system chemicals activated during an allergic reaction. - Corticosteroids. Either oral or injected corticosteroids may be used to treat inflammation associated with more-serious reactions. - Treatment of anaphylaxis. Anaphylaxis requires an immediate epinephrine injection as well as hospital care to maintain blood pressure and support breathing. Drug desensitization If there are no other antibiotic treatment options available, your doctor may recommend a treatment called drug desensitization that would enable you to take a course of penicillin to treat an infection. With this treatment, you receive a very small dose and then progressively larger doses every 15 to 30 minutes over the course of several hours or a few days. If you can reach the desired dosage with no reaction, then you can continue the treatment. It's important to take the drug as directed to maintain your tolerance to it during the entire course of treatment. If you need penicillin in the future, you will need to repeat the desensitization treatment. You're carefully monitored during the intervention, and supportive care is available to treat reactions. Desensitization is rarely used if penicillin has caused a severe, life-threatening reaction in the past. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Suggestion. Please help me with my brother with locked-in syndrome in Martinique for 3 years.Somebody please help. God bless . NAME", "response": "Locked-In Syndrome (Treatment): There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Suggestion. Please help me with my brother with locked-in syndrome in Martinique for 3 years.Somebody please help. God bless . NAME", "response": "Locked-In Syndrome (Prognosis): While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "ClinicalTrials.gov - Suggestion. Please help me with my brother with locked-in syndrome in Martinique for 3 years.Somebody please help. God bless . NAME", "response": "Locked-In Syndrome (Definition): Locked-in syndrome is a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "EPI 743. hi My name is NAME My son, His age 4 month discovered it leigh disease infected from the mother side. and we have full family history with the leigh disease. my Daughter she lived for 7 years with the same disease, we have her Hospital reports, it is confirmed leigh Disease. Kindly, if there is any hope for my son with EPI743 treatment, and we are appreciate to accept him in the treatment study. i have a full reports for my son and the MRI. and all of it under your request. Hope get your help ASAP because he is in the first stage. and we have a we are all hope he will be better. Best Regards", "response": "Leigh syndrome (Treatment): Treatment of Leigh syndrome is directed toward the specific symptoms present in each person. [6] Supportive care for Leigh syndrome includes treatment of acidosis, seizures , dystonia , and cardiomyopathy , and attention to nutritional status. [4] [3] Because anesthesia can potentially aggravate respiratory symptoms and bring on respiratory failure, careful consideration should be given to its use and close monitoring prior to, during, and after its use. [4] [3] Progression and new symptoms should be monitored regularly (typically every 6-12 months). Evaluations with a neurologist , ophthalmologist , audiologist , and cardiologist are recommended. [4] [3] Specific treatment is possible for the three nuclear gene -encoded Leigh-like syndromes (milder conditions with similar features). These include biotin-thiamine-responsive basal ganglia disease (BTBGD), biotinidase deficiency, and coenzyme Q10 deficiency caused by mutation of PDSS2. [4] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Mitochondrial DNA-Associated Leigh Syndrome Nuclear Gene-Encoded Leigh Syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "EPI 743. hi My name is NAME My son, His age 4 month discovered it leigh disease infected from the mother side. and we have full family history with the leigh disease. my Daughter she lived for 7 years with the same disease, we have her Hospital reports, it is confirmed leigh Disease. Kindly, if there is any hope for my son with EPI743 treatment, and we are appreciate to accept him in the treatment study. i have a full reports for my son and the MRI. and all of it under your request. Hope get your help ASAP because he is in the first stage. and we have a we are all hope he will be better. Best Regards", "response": "Mitochondrial DNA-associated Leigh syndrome (Treatment): The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "father suffering from IBS. My father is suffering from IBS and is losing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (Treatment): Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.Your doctor may recommend medicine to relieve your symptoms.Fiber supplements to relieve constipation when increasing fiber in your diet doesn’t help. Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative that’s right for you. Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is an antidiarrheal that reduces diarrhea in people with IBS, though it doesn’t reduce pain, bloating, or other symptoms. Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce pain in your abdomen. Antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for people with IBS with constipation, or IBS-C, although studies haven’t confirmed this theory. Tricyclic antidepressants work in people with IBS by reducing their sensitivity to pain in the gastrointestinal (GI) tract as well as normalizing their GI motility and secretion. Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation symptoms. Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel movements. The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still debating and researching the use of antibiotics to treat IBS. Coated peppermint oil capsules to reduce IBS symptoms.Follow your doctor’s instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any medicine. MedlinePlus maintains the latest information about side effects and drug warnings.Your doctor may also recommend probiotics. Probiotics are live microorganisms—tiny organisms that can be seen only with a microscope. These microorganisms, most often bacteria, are like the microorganisms that are normally present in your GI tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.Discuss your use of complementary and alternative medical practices, including probiotics and dietary supplements, with your doctor.Psychological therapies may improve your IBS symptoms.Managing StressLearning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.Some options for managing stress includetaking part in stress reduction and relaxation therapies such as meditation getting counseling and support taking part in regular exercise such as walking or yoga reducing stressful life situations as much as possible getting enough sleepTalk TherapyTalk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS symptoms. This type of therapy often involves relaxation and stress management techniques.Gut-Directed HypnotherapyIn gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.Mindfulness TrainingMindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid catastrophizing, or worrying about the meaning of those sensations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "father suffering from IBS. My father is suffering from IBS and is losing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (How can my diet treat the symptoms of IBS?): Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large meals can cause cramping and diarrhea if you have IBS.Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help.Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 (PDF, 2.963 MB) that adults should get 22 to 34 grams of fiber a day.3While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Genetic testing. My mother in law is in the last stage if lung cancer and only has days to live. My question is...testing her and comparing her tests with my husbands and his sisters test help to determine if it is genetic? My mother in law and her mother and her mothers sister both had lung cancer and none if them were smokers. I'm real worried about my husband getting lung cancer now and I want find out what we can do to protect him.Thank you", "response": "Solitary pulmonary nodule (Exams and Tests): A solitary pulmonary nodule is most often found on a chest x-ray or chest CT scan. These imaging tests are often done for other symptoms or reasons. Your health care provider must decide whether the nodule in your lung is most likely benign or of concern. A nodule more likely benign if: The nodule is small, has a smooth border, and has a solid and even appearance on an x-ray or CT scan. You are young and do not smoke. Your provider may then choose to monitor the nodule over time by repeating a series of x-rays or CT scans. Repeat chest x-rays or chest CT scans are the most common way to monitor the nodule. Sometimes, lung PET scans may be done. If repeated x-rays show that the nodule size has not changed in 2 years, it is most likely benign and a biopsy is not needed. Your provider may choose to biopsy the nodule to rule out cancer if: You are a smoker. You have other symptoms of lung cancer. The nodule has grown in size or has changed when compared to earlier images. A lung needle biopsy may be done by placing a needle directly through the wall of your chest, or during procedures called bronchoscopy or mediastinoscopy. Tests to rule out TB and other infections may also be done. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello i would like more info about Familial Mediterean Fever please as my husband suffers from this. THANKS", "response": "What is familial Mediterranean fever?: Familial Mediterranean fever is an inherited condition characterized by recurrent episodes of painful inflammation in the abdomen, chest, or joints. These episodes are often accompanied by fever and sometimes a rash or headache. Occasionally inflammation may occur in other parts of the body, such as the heart; the membrane surrounding the brain and spinal cord; and in males, the testicles. In about half of affected individuals, attacks are preceded by mild signs and symptoms known as a prodrome. Prodromal symptoms include mildly uncomfortable sensations in the area that will later become inflamed, or more general feelings of discomfort. The first episode of illness in familial Mediterranean fever usually occurs in childhood or the teenage years, but in some cases, the initial attack occurs much later in life. Typically, episodes last 12 to 72 hours and can vary in severity. The length of time between attacks is also variable and can range from days to years. During these periods, affected individuals usually have no signs or symptoms related to the condition. However, without treatment to help prevent attacks and complications, a buildup of protein deposits (amyloidosis) in the body's organs and tissues may occur, especially in the kidneys, which can lead to kidney failure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello i would like more info about Familial Mediterean Fever please as my husband suffers from this. THANKS", "response": "Familial Mediterranean fever: Familial Mediterranean fever is an inflammatory disorder that causes recurrent fevers and painful inflammation of your abdomen, lungs and joints. Familial Mediterranean fever is an inherited disorder that usually occurs in people of Mediterranean origin - including Sephardic Jews, Arabs, Greeks, Italians, Armenians and Turks. But it may affect any ethnic group. Familial Mediterranean fever is typically diagnosed during childhood. While there's no cure for this disorder, you may be able to relieve signs and symptoms of familial Mediterranean fever - or even prevent them altogether - by sticking to your treatment plan. Signs and symptoms of familial Mediterranean fever usually begin during childhood. They occur in bouts called attacks that last one to three days. Arthritic attacks may last for weeks or months. Signs and symptoms of familial Mediterranean fever include: - Fever - Abdominal pain - Chest pain - Achy, swollen joints - Constipation followed by diarrhea - A red rash on your legs, especially below your knees - Muscle aches - A swollen, tender scrotum Between attacks, you'll likely feel normal. Symptom-free periods may be as short as a few days or as long as several years. When to see a doctor If you or your child experiences sudden worrisome signs or symptoms, such as shortness of breath or passing out, call 911 or emergency medical help. See your doctor if you or your child has a sudden fever accompanied by pain in the abdomen, chest and joints. Familial Mediterranean fever is caused by a gene mutation that's passed from parents to children. The gene mutation causes problems in regulating inflammation in the body. In people with familial Mediterranean fever, the gene mutation occurs in a gene called MEFV. Many different mutations in MEFV are linked to familial Mediterranean fever. Some mutations may cause very severe cases, while others may be milder. Factors that may increase the risk of familial Mediterranean fever include: - Having a family history of the disease. If you have a family history of familial Mediterranean fever, your risk of the disease is increased. - Being of Mediterranean ancestry. If your family can trace its history to the Mediterranean region, your risk of the disease may be increased. Familial Mediterranean fever can affect any ethnic group, but it may be more likely in Sephardic Jews, Arabs, Italians, Armenians and Turks. Tests and procedures used to diagnose familial Mediterranean fever include: - Physical exam. Your doctor may ask you about your signs and symptoms and conduct a physical exam to gather more information. - Review of your family medical history. A family history of familial Mediterranean fever increases your likelihood of developing the condition because this genetic mutation is passed from parents to their children. - Blood tests. During an attack, blood tests may show elevated levels of certain markers that indicate an inflammatory condition in your body. An elevated level of white blood cells, which fight infections, is one such marker. - Genetic testing. Genetic testing may determine if your MEFV gene contains a mutation that is associated with familial Mediterranean fever. Genetic tests aren't advanced enough to test for every gene mutation that's linked to familial Mediterranean fever, so there is a possibility of false-negative results. For this reason, doctors typically don't use genetic tests as the sole method of diagnosing familial Mediterranean fever. There's no cure for familial Mediterranean fever. However, treatment can help prevent signs and symptoms. Medications used to control signs and symptoms of familial Mediterranean fever include: - Colchicine. This drug, taken in pill form, reduces inflammation in your body and helps prevent attacks. Work with your doctor to determine the best dosing strategy for you. Some people take one dose a day, while others need smaller, more-frequent doses. Common side effects include bloating, abdominal cramps and diarrhea. - Other drugs to prevent inflammation. For people whose signs and symptoms aren't controlled with colchicine, other medications that control inflammation may be options, though these treatments are considered experimental. Other medications include rilonacept (Arcalyst) and anakinra (Kineret). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello i would like more info about Familial Mediterean Fever please as my husband suffers from this. THANKS", "response": "Familial Mediterranean fever (Summary): Familial Mediterranean fever (FMF) is a rare disorder passed down through families (inherited). It involves repeated fevers and inflammation that often affects the lining of the abdomen, chest, or joints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "High Blood Pressure. I know you may not answer this but my blood pressure comes up at night when I am asleep. I take four medicines. I have asked doctors why this happens and no one knows. This morning at four A.M. It was 164 and I took a clonidine to help get it done. It worries me so.", "response": "High blood pressure - infants (Treatment): The treatment depends on the cause of high blood pressure in the infant. Treatment can include: - Dialysis to treat kidney failure - Medicines to lower blood pressure or help the heart pump better - Surgery (including transplantation surgery or repair of the coarctation). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "High Blood Pressure. I know you may not answer this but my blood pressure comes up at night when I am asleep. I take four medicines. I have asked doctors why this happens and no one knows. This morning at four A.M. It was 164 and I took a clonidine to help get it done. It worries me so.", "response": "Preeclampsia (Treatment): Preeclampsia often resolves after the baby is born and the placenta is delivered. However, it may persist or even begin after delivery. Most often, at 37 weeks, your baby is developed enough to be healthy outside of the womb. As a result, your provider will likely want your baby to be delivered so the preeclampsia does not get worse. You may get medicines to help trigger labor, or you may need a C-section. If your baby is not fully developed and you have mild preeclampsia, the disease can often be managed at home until your baby has matured. The provider will recommend: Frequent doctor visits to make sure you and your baby are doing well. Medicines to lower your blood pressure (sometimes). The severity of preeclampsia may change quickly, so you'll need very careful follow-up. Complete bed rest is no longer recommended. Sometimes, a pregnant woman with preeclampsia is admitted to the hospital. This allows the health care team to watch the baby and mother more closely. Treatment in the hospital may include: Close monitoring of the mother and baby Medicines to control blood pressure and prevent seizures and other complications Steroid injections for pregnancies under 34 weeks gestation to help speed up the development of the baby's lungs You and your provider will continue to discuss the safest time to deliver your baby, considering: How close you are to your due date. The severity of the preeclampsia. Preeclampsia has many severe complications that can harm the mother. How well the baby is doing in the womb. The baby must be delivered if there are signs of severe preeclampsia. These include: Tests that show your baby is not growing well or is not getting enough blood and oxygen. The bottom number of your blood pressure is over 110 mm Hg or is greater than 100 mm Hg consistently over a 24-hour period. Abnormal liver function test results. Severe headaches. Pain in the belly area (abdomen). Seizures or changes in mental function (eclampsia). Fluid buildup in the mother's lungs. HELLP syndrome (rare). Low platelet count or bleeding. Low urine output, a lot of protein in the urine, and other signs that your kidneys are not working properly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to remove my mouth ulcer/canker. Hello dear Dr, i am NAME, the mouth ulcer problem is the worst problem in my lifetime, even three or four times the ulcer grow up in the mouth during of a month. even i can not eat or drink, even though i take care of my mouth every day, so i wish you to consult me about of removing of these ulcer forever. thank you so much", "response": "Mouth ulcers: Mouth ulcers are sores or open lesions in the mouth. Mouth ulcers are caused by many disorders. These include: - Canker sores - Gingivostomatitis - Herpes simplex (fever blister) - Leukoplakia - Oral cancer - Oral lichen planus - Oral thrush A skin sore caused by histoplasmosis may also appear as a mouth ulcer. Symptoms will vary, based on the cause of the mouth ulcer. Symptoms may include: - Open sores in the mouth - Pain or discomfort in the mouth Most of the time, a health care provider or dentist will look the ulcer and where it is in the mouth to make the diagnosis. You may need blood tests or a biopsy of the ulcer may be needed to confirm the cause. The goal of treatment is to relieve symptoms. - The underlying cause of the ulcer should be treated if it is known. - Gently cleaning your mouth and teeth may help relieve your symptoms. - Medicines that you rub directly on the ulcer. These include antihistamines, antacids, and corticosteroids that may help soothe discomfort. - Avoid hot or spicy foods until the ulcer is healed. The outcome varies depending on the cause of the ulcer. Many mouth ulcers are harmless and heal without treatment. Some types of cancer may first appear as a mouth ulcer that does not heal. Complications may include: - Cellulitis of the mouth, from secondary bacterial infection of ulcers - Dental infections (tooth abscesses) - Oral cancer - Spread of contagious disorders to other people Call your provider if: - A mouth ulcer does not go away after 3 weeks. - You have mouth ulcers return often, or if new symptoms develop. To help prevent mouth ulcers and complications from them: - Brush your teeth at least twice a day and floss once a day. - Get regular dental cleanings and checkups. Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to remove my mouth ulcer/canker. Hello dear Dr, i am NAME, the mouth ulcer problem is the worst problem in my lifetime, even three or four times the ulcer grow up in the mouth during of a month. even i can not eat or drink, even though i take care of my mouth every day, so i wish you to consult me about of removing of these ulcer forever. thank you so much", "response": "Canker sore: A canker sore is a painful, open sore in the mouth. Canker sores are white or yellow and surrounded by a bright red area. They are not cancerous. A canker sore is not the same as a fever blister (cold sore). Canker sores are a common form of mouth ulcer. They may occur with viral infections. In some cases, the cause is unknown. Canker sores may also be linked to problems with the body's immune system. The sores may also be brought on by: - Mouth injury from dental work - Cleaning the teeth too roughly - Biting the tongue or cheek Other things that can trigger canker sores include: - Emotional stress - Lack of certain vitamins and minerals in the diet (especially iron, folic acid, or vitamin B-12) - Hormonal changes - Food allergies Anyone can develop a canker sore. Women are more likely to get them than men. Canker sores may run in families. Canker sores most often appear on the inner surface of the cheeks and lips, tongue, upper surface of the mouth, and the base of the gums. Symptoms include: - One or more painful, red spots or bumps that develops into an open ulcer - White or yellow center - Small size (most often under one third inch or 1 centimeter across) - Gray color as healing starts Less common symptoms include: - Fever - General discomfort or uneasiness (malaise) - Swollen lymph nodes Pain often goes away in 7 to 10 days. It can take 1 to 3 weeks for a canker sore to completely heal. Large ulcers can take longer to heal. Your health care provider can often make the diagnosis by looking at the sore. If canker sores persist or continue to return, tests should be done to look for other causes, such as erythema multiforme, drug allergies, herpes infection, and bullous lichen planus. You may need further testing or a biopsy to look for other causes of mouth ulcers. Canker sores are not cancer and do not cause cancer. There are types of cancer, however, that may first appear as a mouth ulcer that does not heal. In most cases, the canker sores go away without treatment. Try not to eat hot or spicy foods, which can cause pain. Use over-the-counter medicines that ease pain in the area. - Rinse your mouth with salt water or mild, over-the-counter mouthwashes. (DO NOT use mouthwashes that contain alcohol which can irritate the area more.) - Apply a mixture of half hydrogen peroxide and half water directly to the sore using a cotton swab. Follow by dabbing a small amount of Milk of Magnesia on the canker sore afterward. Repeat these steps 3 to 4 times a day. - Rinse your mouth with a mixture of half Milk of Magnesia and half Benadryl liquid allergy medicine. Swish mixture in the mouth for about 1 minute and then spit out. Medicines prescribed by your provider may be needed for severe cases. These may include: - Chlorhexidine mouthwash - Stronger medicines called corticosteroids that are placed on the sore or are taken in pill form Brush your teeth twice a day and floss your teeth every day. Also, get routine dental check-ups. Canker sores almost always heal on their own. The pain should decrease in a few days. Other symptoms disappear in 10 to 14 days. Call your provider if: - A canker sore or mouth ulcer does not go away after 2 weeks of home care or gets worse. - You get canker sores more than 2 or 3 times a year. - You have symptoms with the canker sore such as fever, diarrhea, headache, or skin rash. Updated by: Sumana Jothi MD, Otolaryngology-Head and Neck Surgery, Airway, Voice, and Swallowing Disorders, Clinical Instructor UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to remove my mouth ulcer/canker. Hello dear Dr, i am NAME, the mouth ulcer problem is the worst problem in my lifetime, even three or four times the ulcer grow up in the mouth during of a month. even i can not eat or drink, even though i take care of my mouth every day, so i wish you to consult me about of removing of these ulcer forever. thank you so much", "response": "Mouth ulcers (Treatment): The goal of treatment is to relieve symptoms. - The underlying cause of the ulcer should be treated if it is known. - Gently cleaning your mouth and teeth may help relieve your symptoms. - Medicines that you rub directly on the ulcer. These include antihistamines, antacids, and corticosteroids that may help soothe discomfort. - Avoid hot or spicy foods until the ulcer is healed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to Stop Snoring. How to Stop Snoring", "response": "Snoring - adults: Snoring is a loud, hoarse, harsh breathing sound that occurs during sleep. Snoring is common in adults. Loud, frequent snoring can make it hard for both you and your bed partner to get enough sleep. Sometimes snoring can be a sign of a sleep disorder called sleep apnea. When you sleep, the muscles in your throat relax and your tongue slips back in your mouth. Snoring occurs when something blocks air from flowing freely through your mouth and nose. When you breathe, the walls of your throat vibrate, causing the sound of snoring. There are several factors that can lead to snoring, including - Being overweight. The extra tissue in your neck puts pressure on your airways. - Tissue swelling during the last month of pregnancy. - Crooked or bent nasal septum, which is the wall of bone and cartilage between your nostrils. - Growths in your nasal passages (nasal polyps). - Stuffy nose from a cold or allergies. - Swelling in the roof of your mouth (soft palate) or the uvula, the piece of tissue that hangs down in the back of your mouth. These areas may also be longer than normal. - Swollen adenoids and tonsils that block the airways. This is a common cause of snoring in children. - A tongue that is wider at the base, or a larger tongue in a smaller mouth. - Poor muscle tone. This may be caused by aging or by using sleeping pills, antihistamines, or alcohol at bedtime. Sometimes snoring can be a sign of a sleep disorder called sleep apnea. - This occurs when you completely or partly stop breathing for more than 10 seconds while you sleep. - This is followed by a sudden snort or gasp when you start breathing again. During that time you wake up without realizing it. - Then you start to snore again. - This cycle usually happens many times a night, which makes it hard to sleep deeply. Sleep apnea can make it especially hard for your bed partner to get a good night's sleep. To help reduce snoring: - Avoid alcohol and medicines that make you sleepy at bedtime. - DO NOT sleep flat on your back. Try to sleep on your side instead. You can sew a golf or tennis ball into the back of your night clothes. If you roll over, the pressure of the ball will help remind you to stay on your side. Over time, side sleeping will become a habit. - Lose weight, if you are overweight. - Try over-the-counter, drug-free nasal strips that help widen the nostrils. (These are not treatments for sleep apnea.) If your health care provider has given you a breathing device, use it on a regular basis. Follow your provider's advice for treating allergy symptoms. Talk to your health care provider if you: - Have problems with attention, concentration, or memory - Wake up in the morning not feeling rested - Feel very drowsy during the day - Have morning headaches - Gain weight - Tried self-care for snoring, and it has not helped You should also talk with your provider if you have episodes of no breathing (apnea) during the night. Your partner can tell you if you are snoring loudly or making choking and gasping sounds. Depending on your symptoms and the cause of your snoring, your provider may refer you to a sleep specialist. Updated by: Sumana Jothi MD, Specialist in Laryngology, Clinical Instructor UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How to Stop Snoring. How to Stop Snoring", "response": "Snoring (Lifestyle and home remedies): To prevent or quiet snoring, try these tips: - If you're overweight, lose weight. People who are overweight may have extra tissues in the throat that contribute to snoring. Losing weight can help reduce snoring. - Sleep on your side. Lying on your back allows your tongue to fall backward into your throat, narrowing your airway and partially obstructing airflow. Try sleeping on your side. If you find that you always end up on your back in the middle of the night, try sewing a tennis ball in the back of your pajama top. - Raise the head of your bed. Raising the head of your bed by about 4 inches may help. - Nasal strips or an external nasal dilator. Adhesive strips applied to the bridge of the nose help many people increase the area of their nasal passage, enhancing their breathing. A nasal dilator is a stiffened adhesive strip applied externally across the nostrils that may help decrease airflow resistance so you breathe easier. Nasal strips and external nasal dilators aren't effective for people with OSA, however. - Treat nasal congestion or obstruction. Having allergies or a deviated septum can limit airflow through your nose. This forces you to breathe through your mouth, increasing the likelihood of snoring. Ask your doctor about a prescription steroid spray if you have chronic congestion. To correct a structural defect in your airway, such as a deviated septum, you may need surgery. - Limit or avoid alcohol and sedatives. Avoid drinking alcoholic beverages at least two hours before bedtime, and let your doctor know about your snoring before taking sedatives. Sedatives and alcohol depress your central nervous system, causing excessive relaxation of muscles, including the tissues in your throat. - Quit smoking. Smoking cessation may reduce snoring, in addition to having numerous other health benefits. - Get enough sleep. Adults should aim for at least seven hours of sleep per night. The recommended hours of sleep for children vary by age. Preschool-aged children should get 10 to 13 hours a day. School-age children need nine to 12 hours a day, and teens should have eight to 10 hours a day. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have exercise induced asthma. Would any of these non drug devises be suitable please?", "response": "Exercise-induced asthma (Be Careful Where and When you Exercise): Having asthma symptoms when you exercise does not mean you cannot or should not exercise. But be aware of your EIA triggers. Cold or dry air may trigger your asthma symptoms. If you do exercise in cold or dry air: - Breathe through your nose. - Wear a scarf or mask over your mouth. DO NOT exercise when the air is polluted. DO NOT exercise near fields or lawns that have just been mowed. Warm up before you exercise, and cool down afterward: - To warm up, walk or do your exercise activity slowly before you speed up. - The longer you warm up, the better. - To cool down, walk or do your exercise activity slowly for several minutes. Some kinds of exercise may be less likely to trigger asthma symptoms than others. - Swimming is a good sport for people with EIA. The warm, moist air helps keep asthma symptoms away. - Football, baseball, and other sports with periods when you do not move fast are less likely to trigger your asthma symptoms. Activities that keep you moving fast all the time are more likely to trigger asthma symptoms, such as running, basketball, or soccer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have exercise induced asthma. Would any of these non drug devises be suitable please?", "response": "Exercise-induced asthma (Use Your Asthma Medicine Before you Exercise): Take your short-acting, or quick-relief, inhaled medicines before you exercise. - Take them 10 to 15 minutes before exercise. - They can help for up to 4 hours. Long-acting, inhaled medicines may also help. - Use them at least 30 minutes before exercise. - They can help for up to 12 hours. Children can take this medicine before school, and it will help for the whole day. - Be aware that using this kind of medicine every day before exercise will make it less effective over time. Follow your doctor's advice on which medicines to use and when. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I just read an article submitted by you that stated your research shows that you've identified the mechanism that causes burning mouth syndrome. Also because of these findings you can find a treatment. I've had this for 15 yrs and am just holding on. When will a good treatment be available?? I belong to a group of over 500 bmsers. We're suffering terribly and were from all over the world. What would the treatment be?", "response": "Burning mouth syndrome (Treatment): For secondary burning mouth syndrome, treatment depends on any underlying conditions that may be causing your mouth discomfort. For example, replacing poorly fitting dentures or taking supplements for a vitamin deficiency may relieve your discomfort. That's why it's important to try to pinpoint the cause. Once any underlying causes are treated, your burning mouth syndrome symptoms should get better. There's no known cure for primary burning mouth syndrome and no one sure way to treat it. Solid research on the most effective methods is lacking. Treatment depends on your particular symptoms and is aimed at controlling them. You may need to try several treatment methods before finding one or a combination that helps reduce your mouth discomfort. Treatment options may include: - Saliva replacement products - Specific oral rinses or lidocaine - Capsaicin, a pain reliever that comes from chili peppers - An anticonvulsant medication called clonazepam (Klonopin) - Certain antidepressants - Medications that block nerve pain - Cognitive behavioral therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I just read an article submitted by you that stated your research shows that you've identified the mechanism that causes burning mouth syndrome. Also because of these findings you can find a treatment. I've had this for 15 yrs and am just holding on. When will a good treatment be available?? I belong to a group of over 500 bmsers. We're suffering terribly and were from all over the world. What would the treatment be?", "response": "Burning mouth syndrome (Diagnosis): There's no one test that can determine if you have burning mouth syndrome. Instead, your doctor or dentist will try to rule out other problems before diagnosing burning mouth syndrome. Your doctor or dentist will review your medical history and medications, examine your mouth, and ask you to describe your symptoms, oral habits and oral care routine. In addition, your doctor will likely perform a general medical exam, looking for signs of other conditions. You may have some of the following tests: - Blood tests. Blood tests can check your complete blood count, glucose level, thyroid function, nutritional factors and immune functioning, all of which may provide clues about the source of your mouth discomfort. - Oral cultures or biopsies. Taking and analyzing samples from your mouth can determine whether you have a fungal, bacterial or viral infection. - Allergy tests. Your doctor may suggest allergy testing to see if you may be allergic to certain foods, additives or even substances in dentures. - Salivary measurements. With burning mouth syndrome, you may feel that you have a dry mouth. Salivary tests can confirm whether you have a reduced salivary flow. - Gastric reflux tests. These tests can determine if you have GERD. - Imaging. Your doctor may recommend an MRI, CT scan or other imaging tests to check for other health problems. - Temporarily stopping medication. If you take medications that may contribute to mouth discomfort, your doctor may suggest temporarily stopping them, if possible, to see if your discomfort goes away. Don't try this on your own, because it can be dangerous to stop some medications. - Psychological questionnaires. You may be asked to fill out questionnaires that can help determine if you have symptoms of depression, anxiety or other mental health conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I just read an article submitted by you that stated your research shows that you've identified the mechanism that causes burning mouth syndrome. Also because of these findings you can find a treatment. I've had this for 15 yrs and am just holding on. When will a good treatment be available?? I belong to a group of over 500 bmsers. We're suffering terribly and were from all over the world. What would the treatment be?", "response": "Burning mouth syndrome (Complications): Complications that burning mouth syndrome may cause or be associated with are mainly related to discomfort. They include, for example: - Difficulty falling asleep - Difficulty eating - Depression - Anxiety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I want more information on Hypertension and fibromyalgia, I seem to be getting only topics on diabetes and I do not have this. I enjoy reading the current info.", "response": "Fibromyalgia (Causes): Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include: - Genetics. Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder. - Infections. Some illnesses appear to trigger or aggravate fibromyalgia. - Physical or emotional trauma. Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident. Psychological stress may also trigger the condition. Why does it hurt? Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jaundice. Can older infants get jaundice? What is the age range?", "response": "Jaundice and breastfeeding (Causes): Bilirubin is a yellow pigment that is produced as the body recycles old red blood cells. The liver helps break down bilirubin so that it can be removed from the body in the stool. It can be normal for newborn babies to be a little yellow between days 1 and 5 of life. The color most often peaks around day 3 or 4. Breast milk jaundice is seen after the first week of life. It is likely caused by: - Factors in a mother's milk that help a baby absorb bilirubin from the intestine - Factors that keep certain proteins in the baby's liver from breaking down bilirubin Sometimes, jaundice occurs when your baby does not get enough breast milk, instead of from the breast milk itself. This kind of jaundice is different because it starts in the first few days of life. It is called \"breastfeeding failure jaundice,\" \"breast-non-feeding jaundice,\" or even \"starvation jaundice.\" - Babies who are born early (before 37 or 38 weeks) are not always able to feed well. - Breastfeeding failure or breast-non-feeding jaundice may also occur when feedings are scheduled by the clock (such as, every 3 hours for 10 minutes) or when babies who show signs of hunger are given pacifiers. Breast milk jaundice may run in families. It occurs just as often in males and females and affects about a third of all newborns who get only their mother's milk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jaundice. Can older infants get jaundice? What is the age range?", "response": "Newborn jaundice - what to ask your doctor (Questions): - What causes jaundice in a newborn child? - How common is newborn jaundice? - Will the jaundice harm my child? - What are the treatments for jaundice? - How long does it take for the jaundice to go away? - How can I tell if the jaundice is getting worse? - How often should I feed my child? - What should I do if I am having trouble breastfeeding? - Does my child need blood transfusions for the jaundice? - Does my child need light therapy for the jaundice? Can this be done at home? - How do I arrange to have light therapy at home? Who do I call if I am having problems with the light therapy? - Do I need to use light therapy all day and night? How about when I am holding or feeding my child? - Can the light therapy harm my child? - When do we need to have a follow-up visit with my child's provider?. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Jaundice. Can older infants get jaundice? What is the age range?", "response": "Newborn jaundice - what to ask your doctor: Newborn jaundice is a common condition. It is caused by high levels of bilirubin (a yellow coloring) in your child's blood. This can make your child's skin and sclera (the whites of their eyes) look yellow. Your child may go home with some jaundice or may develop jaundice after going home. Below are some questions you may want to ask your health care provider about your child's jaundice. - What causes jaundice in a newborn child? - How common is newborn jaundice? - Will the jaundice harm my child? - What are the treatments for jaundice? - How long does it take for the jaundice to go away? - How can I tell if the jaundice is getting worse? - How often should I feed my child? - What should I do if I am having trouble breastfeeding? - Does my child need blood transfusions for the jaundice? - Does my child need light therapy for the jaundice? Can this be done at home? - How do I arrange to have light therapy at home? Who do I call if I am having problems with the light therapy? - Do I need to use light therapy all day and night? How about when I am holding or feeding my child? - Can the light therapy harm my child? - When do we need to have a follow-up visit with my child's provider? Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "latest information. WANT TO KNOW LATEST DEVELOPMENT IN LUNG CANCER treatment, MY FRIENDS WIFE AGE 45, NAME *NAME* SUFFERING WITH THIS DISEASE,WILL BE TAKING FIRST DOSE OF ALMITA PEMETREXED ON THRUSDAY THAT IS AFTER FOUR DAYS. PL. ADD MY E-MAIL ID", "response": "Lung cancer (Treatment): Treatment for lung cancer depends on the type of cancer, how advanced it is, and how healthy you are: - Surgery to remove the tumor may be done when it has not spread beyond nearby lymph nodes. - Chemotherapy uses drugs to kill cancer cells and stop new cells from growing. - Radiation therapy uses powerful x-rays or other forms of radiation to kill cancer cells. The above treatments may be done alone or in combination. Your doctor can tell you more about the specific treatment you will receive depending on the specific type of lung cancer and what stage it is. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "latest information. WANT TO KNOW LATEST DEVELOPMENT IN LUNG CANCER treatment, MY FRIENDS WIFE AGE 45, NAME *NAME* SUFFERING WITH THIS DISEASE,WILL BE TAKING FIRST DOSE OF ALMITA PEMETREXED ON THRUSDAY THAT IS AFTER FOUR DAYS. PL. ADD MY E-MAIL ID", "response": "Lung cancer (Exams and Tests): Lung cancer is often found when an x-ray or CT scan is done for another reason. If lung cancer is suspected, the doctor will perform a physical exam and ask about your medical history. You will be asked if you smoke. If so, you'll be asked how much you smoke and for how long you have smoked. You will also be asked about other things that may have put you at risk of lung cancer, such as exposure to certain chemicals. When listening to the chest with a stethoscope, the doctor may hear fluid around the lungs. This may suggest cancer. Tests that may be done to diagnose lung cancer or see if it has spread include: - Bone scan - Chest x-ray - Complete blood count (CBC) - CT scan of the chest - MRI of the chest - Positron emission tomography (PET) scan - Sputum test to look for cancer cells - Thoracentesis (sampling of fluid buildup around the lung) In most cases, a piece of tissue is removed from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this: - Bronchoscopy combined with biopsy - CT-scan-directed needle biopsy - Endoscopic esophageal ultrasound (EUS) with biopsy - Mediastinoscopy with biopsy - Open lung biopsy - Pleural biopsy If the biopsy shows cancer, more imaging tests are done to find out the stage of the cancer. Stage means how big the tumor is and how far it has spread. Staging helps guide treatment and follow-up and gives you an idea of what to expect. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "lupus. Hi, I want to know about Lupus and its treatment. Best, NAME", "response": "Lupus: Lupus is an autoimmune disease that can affect almost every organ in the body. Symptoms of lupus can range from very mild to life-threatening. There are three main types of lupus; systemic lupus erythematosus, discoid lupus, and drug-induced lupus. [1] Symptoms may include pain or swelling in joints, muscle pain, fever, red rashes, most often on the face (also called the \"butterfly rash\"), hair loss, chest pain, sensitivity to the sun, swelling in legs or around the eyes, and feeling tired. [2] Genetics is thought to play a role in the development of lupus along with other lifestyle and environmental factors . Studies suggest that a number of different genes may be involved in determining a person’s likelihood of developing the disease, which tissues and organs are affected, and the severity of disease. Lupus is more common in young women. The treatment of lupus depends on the severity of the condition and what parts of the body are affected. Treatment may include acetaminophen, ibuprofen, antimalarial drugs, anti-inflammatory steroids, immunosuppressive drugs, and other such as BLyS-specific inhibitors ( Belimumab). [1] You can read about the signs and symptoms of lupus from MedlinePlus and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Antinuclear antibody positivity - Antiphospholipid antibody positivity - Arthritis - Autosomal dominant inheritance - Cutaneous photosensitivity - Hemolytic anemia - Leukopenia - Nephritis - Pericarditis - Pleuritis - Psychosis - Seizures - Systemic lupus erythematosus - Thrombocytopenia - View complete list of signs and symptoms... The Lupus Foundation of American has a page called Is lupus hereditary? that provides a good overview. They also have a Genetics page for all of their content tagged as related to genetics. Medscape Reference has an in-depth review of the genetics of lupus that was written for healthcare professionals but can be useful to anyone looking for detailed information. You may have to register to view the article, but registration is free. For information on the treatment of lupus, you can read the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) publication called Handout on Health: Systemic Lupus Erythematosus. NIAMS is the primary NIH organization for research and information on lupus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "lupus. Hi, I want to know about Lupus and its treatment. Best, NAME", "response": "What are the treatments for Lupus?: How might lupus be treated? For information on the treatment of lupus, you can read the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) publication called Handout on Health: Systemic Lupus Erythematosus. NIAMS is the primary NIH organization for research and information on lupus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Medical Diagnosis of Asbestosis. My doctors hint that I have asbestosis but do not say I have asbestosis. All the medical information that I have read from the CDC, Medlin and NIH all say that the symptoms presented are related to a high level of asbestos. Why won't the doctor say it?", "response": "Asbestosis (Diagnosis): Asbestosis can be difficult to diagnose because its signs and symptoms are similar to those of many other types of respiratory diseases. A variety of diagnostic tests might be needed to help pinpoint the diagnosis. Imaging tests - Chest X-ray. Advanced asbestosis appears as excessive whiteness in your lung tissue. If the asbestosis is severe, the tissue in both lungs might be affected, giving them a honeycomb appearance. - Computerized tomography (CT). CT scans combine a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. These scans generally provide greater detail and might help detect asbestosis in its early stages, even before it shows up on a chest X-ray. Pulmonary function tests These tests determine how well your lungs are functioning. Pulmonary function tests measure how much air your lungs can hold and the airflow in and out of your lungs. During the test, you might be asked to blow as hard as you can into an air-measurement device called a spirometer. More-complete pulmonary function tests can measure the amount of oxygen being transferred to your bloodstream. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Medical Diagnosis of Asbestosis. My doctors hint that I have asbestosis but do not say I have asbestosis. All the medical information that I have read from the CDC, Medlin and NIH all say that the symptoms presented are related to a high level of asbestos. Why won't the doctor say it?", "response": "Asbestosis: Asbestosis (as-bes-TOE-sis) is a chronic lung disease caused by inhaling asbestos fibers. Prolonged exposure to these fibers can cause lung tissue scarring and shortness of breath. Asbestosis symptoms can range from mild to severe, and usually don't appear until many years after continued exposure. Asbestos is a natural mineral product that's resistant to heat and corrosion. It was used extensively in the past in products such as insulation, cement and some floor tiles. Most people with asbestosis acquired it on the job before the federal government began regulating the use of asbestos and asbestos products in the 1970s. Today, its handling is strictly regulated. Acquiring asbestosis is extremely unlikely if you follow your employer's safety procedures. Treatment focuses on relieving your symptoms. The effects of long-term exposure to asbestos typically don't show up for 10 to 40 years after initial exposure. Asbestosis signs and symptoms can include: - Shortness of breath - A persistent, dry cough - Loss of appetite with weight loss - Fingertips and toes that appear wider and rounder than normal (clubbing) - Chest tightness or pain When to see a doctor If you have a history of exposure to asbestos and you're experiencing increasing shortness of breath, talk to your doctor about the possibility of asbestosis. If you are exposed to high levels of asbestos dust over a long period of time, some of the airborne fibers can become lodged within your alveoli - the tiny sacs inside your lungs where oxygen is exchanged for carbon dioxide in your blood. The asbestos fibers irritate and scar lung tissue, causing the lungs to become stiff. This makes it difficult to breathe. As asbestosis progresses, more and more lung tissue becomes scarred. Eventually, your lung tissue becomes so stiff that it can't contract and expand normally. Smoking cigarettes appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease. People who worked in mining, milling, manufacturing, installation or removal of asbestos products before the late 1970s are at risk of asbestosis. Examples include: - Asbestos miners - Aircraft and auto mechanics - Boiler operators - Building construction workers - Electricians - Railroad workers - Shipyard workers - Workers removing asbestos insulation around steam pipes in older buildings In general, it's safe to be around materials that are made with asbestos as long as the asbestos fibers are contained. This prevents them from getting into the air. If you have asbestosis, you're at increased risk of developing lung cancer - especially if you smoke or have a history of smoking. Asbestosis can be difficult to diagnose because its signs and symptoms are similar to those of many other types of respiratory diseases. A variety of diagnostic tests might be needed to help pinpoint the diagnosis. Imaging tests - Chest X-ray. Advanced asbestosis appears as excessive whiteness in your lung tissue. If the asbestosis is severe, the tissue in both lungs might be affected, giving them a honeycomb appearance. - Computerized tomography (CT). CT scans combine a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. These scans generally provide greater detail and might help detect asbestosis in its early stages, even before it shows up on a chest X-ray. Pulmonary function tests These tests determine how well your lungs are functioning. Pulmonary function tests measure how much air your lungs can hold and the airflow in and out of your lungs. During the test, you might be asked to blow as hard as you can into an air-measurement device called a spirometer. More-complete pulmonary function tests can measure the amount of oxygen being transferred to your bloodstream. There's no treatment to reverse the effects of asbestos on the alveoli. Treatment focuses on slowing the progression of the disease and relieving symptoms. You'll need routine follow-up care, such as chest X-rays and lung function tests, at regular intervals depending on the severity of your condition. Therapy To ease breathing difficulty caused by advanced asbestosis, your doctor might prescribe supplemental oxygen. This is delivered by thin plastic tubing with prongs that fit into your nostrils or a mask. Surgery If your symptoms are severe, you might be a candidate for a lung transplant. - Stop smoking. Asbestosis increases the risk of lung cancer. Quitting smoking can reduce this risk. Try to avoid secondhand smoke. Smoking might also cause emphysema, which further reduces your lung reserves. - Get vaccinated. Talk to your doctor about flu and pneumonia vaccines, which can help lower your risk of lung infections. Promptly treat respiratory infections. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Medical Diagnosis of Asbestosis. My doctors hint that I have asbestosis but do not say I have asbestosis. All the medical information that I have read from the CDC, Medlin and NIH all say that the symptoms presented are related to a high level of asbestos. Why won't the doctor say it?", "response": "Asbestosis (Treatment): There's no treatment to reverse the effects of asbestos on the alveoli. Treatment focuses on slowing the progression of the disease and relieving symptoms. You'll need routine follow-up care, such as chest X-rays and lung function tests, at regular intervals depending on the severity of your condition. Therapy To ease breathing difficulty caused by advanced asbestosis, your doctor might prescribe supplemental oxygen. This is delivered by thin plastic tubing with prongs that fit into your nostrils or a mask. Surgery If your symptoms are severe, you might be a candidate for a lung transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks", "response": "Bassen-Kornzweig syndrome: Bassen-Kornzweig syndrome is a rare disease passed down through families. The person is unable to fully absorb dietary fats through the intestines. Bassen-Kornzweig syndrome is caused by a defect in a gene that tells the body to create lipoproteins (molecules of fat combined with protein). The defect makes it hard for the body to properly digest fat and essential vitamins. It is an autosomal recessive condition that more often affects males. Symptoms include: - Balance and coordination difficulties - Curvature of spine - Decreased vision that gets worse over time - Developmental delay - Failure to thrive (grow) in infancy - Muscle weakness - Poor muscle coordination that usually develops after age 10 - Protruding abdomen - Slurred speech - Stool abnormalities, including fatty stools that appear pale in color, frothy stools, and abnormally foul-smelling stools There may be damage to the retina of the eye (retinitis pigmentosa). Tests that may be done to help diagnose this condition include: - Apolipoprotein B blood test - Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) - \"Burr-cell\" malformation of the red cells (acanthocytosis) - Complete blood count (CBC) - Cholesterol studies - Electromyography - Eye exam - Nerve conduction velocity - Stool sample analysis Genetic testing may be available for mutations in the MTP gene. Treatment involves large doses of vitamin supplements containing fat-soluble vitamins (vitamin A, vitamin D, vitamin E, and vitamin K). Linoleic acid supplements are also recommended. People with this condition should talk to a nutritionist. Diet changes are needed to prevent stomach problems. This involves: - Limiting fat intake to 5 to 20 grams per day. - Do not eat more than 5 ounces daily (140 grams) of lean meat, fish, or poultry. - Use skim milk instead of whole milk. Supplements of medium-chain triglycerides are taken under the supervision of a health care provider. They should be used with caution, because they may cause liver damage. How well a person does depends on the amount of brain and nervous system problems. Complications may include: - Blindness - Mental deterioration - Loss of function of peripheral nerves, uncoordinated movement (ataxia) Call your provider if your infant or child has symptoms of this disease. Genetic counseling can help families understand the condition and the risks of inheriting it, and learn how to care for the person. High doses of fat-soluble vitamins may slow the progression of some problems, such as retina damage and decreased vision. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks", "response": "Bassen-Kornzweig syndrome (Exams and Tests): There may be damage to the retina of the eye (retinitis pigmentosa). Tests that may be done to help diagnose this condition include: - Apolipoprotein B blood test - Blood tests to look for vitamin deficiencies (fat-soluble vitamins A, D, E, and K) - \"Burr-cell\" malformation of the red cells (acanthocytosis) - Complete blood count (CBC) - Cholesterol studies - Electromyography - Eye exam - Nerve conduction velocity - Stool sample analysis Genetic testing may be available for mutations in the MTP gene. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Thalassemia (Treatment): Treatment for thalassemia depends on which type you have and how severe it is. Treatments for mild thalassemia Signs and symptoms are usually mild with thalassemia minor and little, if any, treatment is needed. Occasionally, you may need a blood transfusion, particularly after surgery, after having a baby or to help manage thalassemia complications. People with severe beta-thalassemia will need blood transfusions. And because this treatment can cause iron overload, they will also need treatment to remove excess iron. An oral medication called deferasirox (Exjade, Jadenu) can help remove the excess iron. Treatments for moderate to severe thalassemia Treatments for moderate to severe thalassemia may include: - Frequent blood transfusions. More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Sickle beta thalassemia (Treatment): Treatment for sickle beta thalassemia is supportive and usually depends on the signs and symptoms present in each person. It is generally recommended that all affected people drink plenty of water; avoid climate extremes, activities that lead to inflammation and extreme fatigue; and stay up-to-date on all immunizations. Because sickle beta thalassemia is associated with a variety of health problems, affected people are usually followed closely by their healthcare provider with regular physical examinations that may include specialized laboratory tests and imaging studies (i.e. chest X-ray, transcranial doppler ultrasound, ECG). Blood transfusions may be prescribed on a regular basis for affected people with a history of or risk factors for stroke and other specific health problems, such as pulmonary hypertension. Hydroxyurea, a drug approved by the U.S. Food and Drug Administration for the treatment of sickle cell disease, can decrease the frequency and severity of pain episodes; reduce the need of blood transfusions; and increase life span. [1] [3] For more information regarding the treatment of sickle beta thalassemia and other sickle cell diseases, please click here. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Anemia (Treatment): Anemia treatment depends on the cause. - Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and making changes to your diet. If the underlying cause of iron deficiency is loss of blood - other than from menstruation - the source of the bleeding must be located and stopped. This may involve surgery. - Vitamin deficiency anemias. Treatment for folic acid and B-12 deficiency involves dietary supplements and increasing these nutrients in your diet. If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you may need vitamin B-12 shots. At first, you may receive the shots every other day. Eventually, you'll need shots just once a month, which may continue for life, depending on your situation. - Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by your kidneys, may help stimulate red blood cell production and ease fatigue. - Aplastic anemia. Treatment for this anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells. - Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation. - Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells. Depending on the severity of your anemia, a blood transfusion or plasmapheresis may be necessary. Plasmapheresis is a type of blood-filtering procedure. In certain cases, removal of the spleen can be helpful. - Sickle cell anemia. Treatment for this anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also may recommend blood transfusions, folic acid supplements and antibiotics. A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia. - Thalassemia. This anemia may be treated with blood transfusions, folic acid supplements, medication, removal of the spleen (splenectomy), or a blood and bone marrow stem cell transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Absence seizures Does any damage occurre from these spells. Mental or physical", "response": "Absence seizure: An absence seizure is the term for a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain. Absence seizures occur most often in people under age 20, usually in children ages 6 to 12. In some cases, the seizures are triggered by flashing lights or when the person breathes faster and more deeply than usual (hyperventilates). They may occur with other types of seizures, such as generalized tonic-clonic seizures (grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures). Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: - Occur many times a day - Occur for weeks to months before being noticed - Interfere with school and learning - Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures. During the seizure, the person may: - Stop walking and start again a few seconds later - Stop talking in mid-sentence and start again a few seconds later The person usually does not fall during the seizure. Right after the seizure, the person is usually: - Wide awake - Thinking clearly - Unaware of the seizure Specific symptoms of typical absence seizures may include: - Changes in muscle activity, such as no movement, hand fumbling, fluttering eyelids, lip smacking, chewing - Changes in alertness (consciousness), such as staring episodes, lack of awareness of surroundings, sudden halt in movement, talking, and other awake activities Some absence seizures begin slower and last longer. These are called atypical absence seizures. Symptoms are similar to regular absence seizures, but muscle activity changes may be more noticeable. The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. Blood tests may also be ordered to check for other health problems that may be causing the seizures. Head CT or MRI scan may be done to find the cause and location of the problem in the brain. Treatment for absence seizures includes medicines, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options. Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Absence seizures Does any damage occurre from these spells. Mental or physical", "response": "Epilepsy juvenile absence: The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 1941 Disease definition Juvenile absence epilepsy (JAE) is a genetic epilepsy with onset occurring around puberty. JAE is characterized by sporadic occurrence of absence seizures , frequently associated with a long-life prevalence of generalized tonic-clonic seizures (GTCS) and sporadic myoclonic jerks. Epidemiology The incidence of JAE is still unknown but it accounts for approximately 2-3% of patients with adult epilepsy in general, and about 8-10% of patients with genetic generalized epilepsy (GGE). No sex predominance has been observed. Clinical description JAE is characterized by sporadic occurrence of absence seizures (only one or a few absences daily; 100% of cases), frequently associated with a long-life prevalence of generalized tonic-clonic seizures (GTCS; 80%) and sporadic myoclonic jerks (20%). The seizures onset is typically between 9 and 13 years of age and it manifests as a ''staring spell'' that can be accompanied by atonic postures such as drooping of the head and/or automatisms such as lip smacking. GTCS and myoclonic seizures often occur 1-10 years after the absence seizure onset. Patients with JAE usually develop normally, although uncontrolled absence seizures may have an impact on their ability to learn at school. Etiology The exact etiology of JAE is still elusive. However, genetic mutations for voltage-gated sodium channels ( CACNB4 gene (2q22-q23)), potassium channels ( CLCN2 gene (3q27.1)), and EFHC1 (6p12.3) may be involved in a subset of patients. Moreover, different mutations have been found in genes for GABA receptors (ligand ion channels), specifically in the GABRA1 gene (5q34). Diagnostic methods Diagnosis relies on the clinical features and on electroencephalogram (EEG) recorded awake and during sleep, that displays a generalized 3-4 Hz spike-and-slow-wave complexes. Differential diagnosis Differential diagnosis includes childhood absence epilepsy, juvenile myoclonic epilepsy, Jeavons syndrome (see these terms). Genetic counseling The transmission is still unknown although an increased risk for first degree related parents to develop JME may exist. Management and treatment The antiepileptic drugs of choice are valproic acid (VPA) and lamotrigine (LTG). In cases where VPA deals with only partial seizure control, add-on of LTG (GTCS) or ethosuximide (absence seizures) can be beneficial. Prognosis Prognosis of JAE is usually favorable with good therapy responsiveness. Generally, seizure freedom can be achieved with antiepileptic medication in 62-84% of all patients with JAE. However, the occurrence of GTCS predicts a worse prognosis. Visit the Orphanet disease page for more resources. The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) EEG with polyspike wave complexes Very frequent Generalized tonic-clonic seizures Very frequent Abnormality of the mouth Frequent Absence seizures Occasional Febrile seizures Occasional Myoclonus Very rare Autosomal dominant inheritance - EEG with spike-wave complexes (>3.5 Hz) - Generalized myoclonic seizures - Generalized tonic-clonic seizures on awakening - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "Adrenoleukodystrophy: Adrenoleukodystrophy describes several closely related disorders that disrupt the breakdown of certain fats. These disorders are passed down (inherited) in families. Adrenoleukodystrophy is usually passed down from parent to child as an X-linked genetic trait. It affects mostly males, although some women who are carriers can have milder forms of the disease. It affects about 1 in 20,000 people from all races. The condition results in the buildup of very-long-chain fatty acids in the nervous system, adrenal gland, and testes. This disrupts normal activity in these parts of the body. There are 3 major categories of disease: - Childhood cerebral form -- appears in mid-childhood (at ages 4 to 8) - Adrenomyelopathy -- occurs in men in their 20s or later in life - Impaired adrenal gland function (called Addison disease or Addison-like phenotype) -- adrenal gland does not produce enough steroid hormones Childhood cerebral type symptoms include: - Changes in muscle tone, especially muscle spasms and uncontrolled movements - Crossed eyes - Handwriting that gets worse - Difficulty at school - Difficulty understanding what people are saying - Hearing loss - Hyperactivity - Worsening nervous system damage, including coma, decreased fine motor control, and paralysis - Seizures - Swallowing difficulties - Visual impairment or blindness Adrenomyelopathy symptoms include: - Difficulty controlling urination - Possible worsening muscle weakness or leg stiffness - Problems with thinking speed and visual memory Adrenal gland failure (Addison type) symptoms include: - Coma - Decreased appetite - Increased skin color - Loss of weight and muscle mass (wasting) - Muscle weakness - Vomiting Tests for this condition include: - Blood levels of very long chain fatty acids and hormones that are produced by the adrenal gland - Chromosome study to look for changes (mutations) in the ABCD1 gene - MRI of the head Adrenal dysfunction may be treated with steroids (such as cortisol) if the adrenal gland is not producing enough hormones. A specific treatment for X-linked adrenoleukodystrophy is not available. A bone marrow transplant can cure a people of the condition. The childhood form of X-linked adrenoleukodystrophy is a progressive disease. It leads to a long-term coma (vegetative state) about 2 years after nervous system symptoms develop. The child can live in this condition for as long as 10 years until death occurs. The other forms of this disease are milder. These complications can occur: - Adrenal crisis - Vegetative state Call your health care provider if: - Your child develops symptoms of X-linked adrenoleukodystrophy - Your child has X-linked adrenoleukodystrophy and is getting worse Genetic counseling is recommended for couples with a family history of X-linked adrenoleukodystrophy. Mothers of affected sons have an 85% chance of being a carrier for this condition. Prenatal diagnosis of X-linked adrenoleukodystrophy is also available. It is done by testing cells from chorionic villus sampling or amniocentesis. These tests look for either a known genetic change in the family or for very long chain fatty acid levels. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "X-linked adrenoleukodystrophy (Summary): X-linked adrenoleukodystrophy (X-ALD) is an inherited condition that occurs mostly in males. The condition mainly affects the nervous system and the adrenal glands (small glands located on top of each kidney). People with this disorder often have progressive destruction of the fatty covering ( myelin ) that insulates nerves in the brain and spinal cord. They may also have a shortage of certain hormones caused by damage to the outer layer of the adrenal glands (adrenal cortex), called adrenocortical insufficiency. X-ALD is caused by mutations in the gene . These gene mutations cause a shortage (deficiency) of a protein called adrenoleukodystrophy protein (ALDP). A deficiency of this protein leads to an abnormally high level of fat molecules called very long-chain fatty acids (VLCFA) to build up in the body. High levels of VLCFA may be toxic to the adrenal cortex and myelin. There are several forms of X-ALD including: a childhood cerebral form, an adrenomyeloneuropathy (AMN) type, and an adrenal insufficiency-only type. Another form of ALD is occasionally seen in women who are carriers of the condition [1] A specific treatment for X-ALD is not currently available, but eating a diet low in VLCFA and taking special oils can lower the blood levels of VLCFA. Bone marrow transplantation (BMT) may be an option for boys and adolescents in early stages who have evidence of brain involvement on MRI . [2] Adrenocortical insufficiency is treated with cortisone replacement. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "What is Adrenoleukodystrophy?: X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.", "response": "Anal fissure (Treatment): Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.", "response": "Anal fissure (Lifestyle and home remedies): Several lifestyle changes may help relieve discomfort and promote healing of an anal fissure, as well as prevent recurrences: - Add fiber to your diet. Eating about 25 to 30 grams of fiber a day can help keep stools soft and improve fissure healing. Fiber-rich foods include fruits, vegetables, nuts and whole grains. You also can take a fiber supplement. Adding fiber may cause gas and bloating, so increase your intake gradually. - Drink adequate fluids. Fluids help prevent constipation. - Exercise regularly. Engage in 30 minutes or more of moderate physical activity, such as walking, most days of the week. Exercise promotes regular bowel movements and increases blood flow to all parts of your body, which may promote healing of an anal fissure. - Avoid straining during bowel movements. Straining creates pressure, which can open a healing tear or cause a new tear. If your infant has an anal fissure, be sure to change diapers frequently, wash the area gently and discuss the problem with your child's doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?", "response": "Is Angelman syndrome inherited?: Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?", "response": "Angelman syndrome: Angelman syndrome is a complex genetic disorder that primarily affects the nervous system. Characteristic features of this condition include delayed development, intellectual disability, severe speech impairment, and problems with movement and balance (ataxia). Most affected children also have recurrent seizures (epilepsy) and a small head size (microcephaly). Delayed development becomes noticeable by the age of 6 to 12 months, and other common signs and symptoms usually appear in early childhood. Children with Angelman syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements. Hyperactivity, a short attention span, and a fascination with water are common. Most affected children also have difficulty sleeping and need less sleep than usual. With age, people with Angelman syndrome become less excitable, and the sleeping problems tend to improve. However, affected individuals continue to have intellectual disability, severe speech impairment, and seizures throughout their lives. Adults with Angelman syndrome have distinctive facial features that may be described as \"coarse.\" Other common features include unusually fair skin with light-colored hair and an abnormal side-to-side curvature of the spine (scoliosis). The life expectancy of people with this condition appears to be nearly normal. Angelman syndrome affects an estimated 1 in 12,000 to 20,000 people. Many of the characteristic features of Angelman syndrome result from the loss of function of a gene called UBE3A. People normally inherit one copy of the UBE3A gene from each parent. Both copies of this gene are turned on (active) in many of the body's tissues. In certain areas of the brain, however, only the copy inherited from a person's mother (the maternal copy) is active. This parent-specific gene activation is caused by a phenomenon called genomic imprinting. If the maternal copy of the UBE3A gene is lost because of a chromosomal change or a gene mutation, a person will have no active copies of the gene in some parts of the brain. Several different genetic mechanisms can inactivate or delete the maternal copy of the UBE3A gene. Most cases of Angelman syndrome (about 70 percent) occur when a segment of the maternal chromosome 15 containing this gene is deleted. In other cases (about 11 percent), Angelman syndrome is caused by a mutation in the maternal copy of the UBE3A gene. In a small percentage of cases, Angelman syndrome results when a person inherits two copies of chromosome 15 from his or her father (paternal copies) instead of one copy from each parent. This phenomenon is called paternal uniparental disomy. Rarely, Angelman syndrome can also be caused by a chromosomal rearrangement called a translocation, or by a mutation or other defect in the region of DNA that controls activation of the UBE3A gene. These genetic changes can abnormally turn off (inactivate) UBE3A or other genes on the maternal copy of chromosome 15. The causes of Angelman syndrome are unknown in 10 to 15 percent of affected individuals. Changes involving other genes or chromosomes may be responsible for the disorder in these cases. In some people who have Angelman syndrome, the loss of a gene called OCA2 is associated with light-colored hair and fair skin. The OCA2 gene is located on the segment of chromosome 15 that is often deleted in people with this disorder. However, loss of the OCA2 gene does not cause the other signs and symptoms of Angelman syndrome. The protein produced from this gene helps determine the coloring (pigmentation) of the skin, hair, and eyes. Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next. Buiting K. Prader-Willi syndrome and Angelman syndrome. Am J Med Genet C Semin Med Genet. 2010 Aug 15;154C(3):365-76. doi: 10.1002/ajmg.c.30273. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?", "response": "Angelman syndrome (Risk factors): Angelman syndrome is rare. Researchers usually don't know what causes the genetic changes that result in Angelman syndrome. Most people with Angelman syndrome don't have a family history of the disease. Occasionally, Angelman syndrome may be inherited from a parent. A family history of the disease may increase a baby's risk of developing Angelman syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Treatment): Treatment isn't always necessary for people with hairy cell leukemia. Because this cancer progresses very slowly and sometimes doesn't progress at all, some people prefer to wait to treat their cancer only if it causes signs and symptoms. The majority of people with hairy cell leukemia eventually need treatment. If your hairy cell leukemia causes signs and symptoms, you may decide to undergo treatment. There is no cure for hairy cell leukemia. But treatments are effective at putting hairy cell leukemia in remission for years. Chemotherapy Doctors consider chemotherapy drugs the first line of treatment for hairy cell leukemia. The great majority of people will experience complete or partial remission through the use of chemotherapy. Two chemotherapy drugs are used in hairy cell leukemia: - Cladribine. Treatment for hairy cell leukemia typically begins with cladribine. You receive a continuous infusion of the drug into a vein over several days. Most people who receive cladribine experience a complete remission that can last for several years. If your hairy cell leukemia returns, you can be treated with cladribine again. Side effects of cladribine may include infection and fever. - Pentostatin (Nipent). Pentostatin causes remission rates similar to cladribine, but it's given on a different schedule. People who take pentostatin receive infusions every other week for three to six months. Side effects of pentostatin may include fever, nausea and infection. Biological treatments Biological therapy attempts to make cancer cells more recognizable to your immune system. Once your immune system identifies cancer cells as intruders, it can set about destroying your cancer. Two types of biological treatments are used in hairy cell leukemia: - Interferon. Currently, the role of interferon in hairy cell leukemia treatment is limited. You might receive interferon if chemotherapy hasn't been effective or if you can't take chemotherapy. Most people experience partial remission with interferon, which is taken for a year. Side effects include flu-like symptoms, such as fever and fatigue. - Rituximab (Rituxan). Rituximab is a monoclonal antibody approved to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia, though it's sometimes used in hairy cell leukemia. If chemotherapy drugs haven't worked for you or you can't take chemotherapy, your doctor might consider rituximab. Side effects of rituximab include fever and infection. Surgery Surgery to remove your spleen (splenectomy) might be an option if your spleen ruptures or if it's enlarged and causing pain. Though removing your spleen can't cure hairy cell leukemia, it can usually restore normal blood counts. Splenectomy isn't commonly used to treat hairy cell leukemia, but it may be helpful in certain situations. Any surgery carries a risk of bleeding and infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Symptoms): Some people have no signs or symptoms of hairy cell leukemia, but a blood test for another disease or condition may inadvertently reveal hairy cell leukemia. Other times people with hairy cell leukemia experience signs and symptoms common to a number of diseases and conditions, such as: - A feeling of fullness in your abdomen that may make it uncomfortable to eat more than a little at a time - Fatigue - Easy bruising - Recurring infections - Weakness - Weight loss When to see a doctor Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Diagnosis): To diagnose hairy cell leukemia, your doctor may recommend tests and procedures that include: - Physical exam. By feeling your spleen - an oval-shaped organ on the left side of your upper abdomen - your doctor can determine if it's enlarged. An enlarged spleen may cause a sensation of fullness in your abdomen that makes it uncomfortable to eat. Your doctor may also check for enlarged lymph nodes that may contain leukemia cells. - Blood tests. Your doctor uses blood tests, such as the complete blood count, to monitor the levels of blood cells in your blood. People with hairy cell leukemia have low levels of all three types of blood cells - red blood cells, white blood cells and platelets. Another blood test called a peripheral blood smear looks for hairy cell leukemia cells in a sample of your blood. - Bone marrow biopsy. During a bone marrow biopsy, a small amount of bone marrow is removed from your hip area. This sample is used to look for hairy cell leukemia cells and to monitor your healthy blood cells. - Computerized tomography (CT) scan. A CT scan shows detailed images of the inside of your body. Your doctor may order a CT scan to detect enlargement of your spleen and your lymph nodes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Asthma (Overview): Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Asthma (How is asthma treated?): Asthma is a chronic disease. This means that it can be treated but not cured. However, some people are able to manage asthma so that symptoms do not happen again or happen rarely. You can take steps to control asthma and prevent problems by:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Asthma (Outlook (Prognosis)): There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead a normal life. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "What is Bad Breath?: There are many reasons why you might have bad breath. You can get it if you don't brush and floss regularly. Bacteria that build up in your mouth and between your teeth produce the bad odor. Other problems in your mouth, such as gum disease, dry mouth or cavities, may also cause it. Sinusitis or problems with your nose may be to blame. You can also have bad breath if you eat some foods, like raw onions, garlic or cabbage. And of course smoking causes its own bad aroma. Some diseases and medicines are associated with a specific breath odor. Having good dental habits, like brushing and flossing regularly, help fight bad breath. Mouthwashes, mints or chewing gum may make your breath fresher. If you have an underlying disorder, treating it may help eliminate the breath odor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "Breath odor (Home Care): Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking. Otherwise, follow your health care provider's instructions to treat any underlying cause of bad breath. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "Bad breath (Treatment): To reduce bad breath, help avoid cavities and lower your risk of gum disease, consistently practice good oral hygiene. Further treatment for bad breath can vary, depending on the cause. If your bad breath is thought to be caused by an underlying health condition, your dentist will likely refer you to your primary care provider. For causes related to oral health, your dentist will work with you to help you better control that condition. Dental measures may include: - Mouth rinses and toothpastes. If your bad breath is due to a buildup of bacteria (plaque) on your teeth, your dentist may recommend a mouth rinse that kills the bacteria. Your dentist may also recommend a toothpaste that contains an antibacterial agent to kill the bacteria that cause plaque buildup. - Treatment of dental disease. If you have gum disease, you may be referred to a gum specialist (periodontist). Gum disease can cause gums to pull away from your teeth, leaving deep pockets that fill with odor-causing bacteria. Sometimes only professional cleaning removes these bacteria. Your dentist might also recommend replacing faulty tooth restorations, a breeding ground for bacteria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "Generalized anxiety disorder (Treatment): Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "What are the treatments for Generalized anxiety disorder - self-care?: Taking medicine and going to talk therapy can get you started on the road to feeling better. It can also help you take care of your body and relationships. To help improve your condition: - Get enough sleep. - Eat healthy foods. - Keep a regular daily schedule. - Get out of the house every day. - Exercise every day. Even a little bit of exercise, such as a 15-minute walk, can help. - Stay away from alcohol and street drugs. - Talk with family or friends when you feel nervous or frightened. - Find out about different types of group activities you can join. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "Generalized anxiety disorder: Generalized anxiety disorder (GAD) is a mental disorder in which a person is often worried or anxious about many things and finds it hard to control this anxiety. The cause of GAD is unknown. Genes may play a role. Stress may also contribute to the development of GAD. GAD is a common condition. Anyone can develop this disorder, even children. GAD occurs more often in women than in men. The main symptom is frequent worry or tension for at least 6 months, even when there is little or no clear cause. Worries seem to float from one problem to another. Problems may involve family, other relationships, work, school, money, and health. Even when aware that worries or fears are stronger than appropriate for the situation, a person with GAD still has difficulty controlling them. Other symptoms of GAD include: - Problems concentrating - Fatigue - Irritability - Problems falling or staying asleep, or sleep that is restless and unsatisfying - Restlessness when awake The person may also have other physical symptoms. These can include muscle tension, upset stomach, sweating, or difficulty breathing. There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. The goal of treatment is to help you feel better and function well in daily life. Talk therapy or medicine alone can be helpful. Sometimes, a combination of these may work best. TALK THERAPY Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, behaviors, and symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Other types of talk therapy may also be helpful in managing symptoms of an anxiety disorder. MEDICINES Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives or hypnotics may also be prescribed. - These medicines should only be taken under a doctor's direction. - Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. - They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. - If you are prescribed a sedative, do not drink alcohol while on this medicine. SELF-CARE Other than taking medicine and going to therapy, you can help yourself get better by: - Reducing caffeine - Not using street drugs or large amounts of alcohol - Exercising, getting enough rest, and eating healthy foods You can ease the stress of having GAD by joining a support group. Sharing with others who have common experiences and problems can help you not feel alone. Support groups are usually not a good substitute for talk therapy or taking medicine, but can be a helpful addition. Resources for more information include: Anxiety and Depression Association of America: www.adaa.org National Institute of Mental Health: www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml How well a person does depends on how severe the condition is. In some cases, GAD is long-term and is difficult to treat. Most people, though, get better with medicine and/or talk therapy. Depression and substance abuse may occur with an anxiety disorder. Call your provider if you frequently worry or feel anxious, especially if it interferes with your daily activities. Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.", "response": "Breast cancer (Treatment): Treatment is based on many factors, including: - Type of breast cancer - Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: - Hormone therapy. - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.", "response": "Recurrent breast cancer (Treatment): Your treatment options will depend on several factors, including the extent of the disease, its hormone receptor status, the type of treatment you received for your first breast cancer and your overall health. Your doctor also considers your goals and your preferences for treatment. Treating a local recurrence Treatment for a local recurrence typically starts with an operation and may include radiation if you haven't had it before. Chemotherapy and hormone therapy may also be recommended. - Surgery. For recurrent breast cancer that's confined to the breast, treatment usually involves removing any remaining breast tissue. If your first cancer was treated with lumpectomy, your doctor may recommend a mastectomy to remove all of your breast tissue - lobules, ducts, fatty tissue, skin and nipple. If your first breast cancer was treated with mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the new cancer along with a margin of normal tissue. A local recurrence may be accompanied by hidden cancer in nearby lymph nodes. For this reason, the surgeon may remove some or all of the nearby lymph nodes if they weren't removed during your initial treatment. - Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. If you didn't have radiation therapy for your first breast cancer, your doctor may recommend it now. But if you had radiation after a lumpectomy, radiation to treat the recurrence isn't usually recommended because of the risk of side effects. - Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Your doctor may recommend chemotherapy after surgery to reduce your risk of another cancer recurrence. - Hormone therapy. Medications that block the growth-promoting effects of the hormones estrogen and progesterone may be recommended if your cancer is hormone receptor positive. Treating a regional recurrence Treatments for a regional breast cancer recurrence include: - Surgery. If it's possible, surgery to remove the cancer is the recommended treatment for a regional recurrence. Your surgeon may also remove the lymph nodes under your arm if they're still present. - Radiation therapy. Sometimes radiation therapy may be used after surgery. If surgery isn't possible, radiation therapy may be used as the main treatment for a regional breast cancer recurrence. - Drug treatments. Chemotherapy, targeted therapy or hormone therapy also may be recommended as the main treatment or may follow surgery or radiation. Treating a metastatic recurrence Many treatments exist for metastatic breast cancer. Your options will depend on where your cancer has spread. If one treatment doesn't work or stops working, you may be able to try other treatments. In general, the goal of treatment for a metastatic breast cancer isn't to cure the disease. Treatment may allow you to live longer and can help relieve symptoms the cancer is causing. Your doctor works to achieve a balance between controlling your symptoms while minimizing toxic effects from treatment. The aim is to help you live as well as possible for as long as possible. Treatments may include: - Hormone therapy. If your cancer is hormone receptor positive, you may benefit from hormone therapy. In general, hormone therapy has fewer side effects than chemotherapy, so in many cases it's the first treatment used for metastatic breast cancer. - Chemotherapy. Your doctor may recommend chemotherapy if your cancer is hormone receptor negative or if hormone therapy is no longer working. - Targeted therapy. If your cancer cells have certain characteristics that make them vulnerable to targeted therapy, your doctor may recommend these medications. - Bone-building drugs. If cancer has spread to your bones, your doctor may recommend a bone-building drug to reduce your risk of broken bones or reduce bone pain you may experience. - Other treatments. Radiation therapy and surgery may be used in certain situations to control signs and symptoms of advanced breast cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "Peripheral Neuropathy (Definition): Peripheral neuropathy describes damage to the peripheral nervous system, which transmits information from the brain and spinal cord to every other part of the body. More than 100 types of peripheral neuropathy have been identified, each with its own characteristic set of symptoms, pattern of development, and prognosis. Impaired function and symptoms depend on the type of nerves -- motor, sensory, or autonomic -- that are damaged. Some people may experience temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness. Others may suffer more extreme symptoms, including burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Peripheral neuropathy may be either inherited or acquired. Causes of acquired peripheral neuropathy include physical injury (trauma) to a nerve, tumors, toxins, autoimmune responses, nutritional deficiencies, alcoholism, medical procedures, and vascular and metabolic disorders. Acquired peripheral neuropathies are caused by systemic disease, trauma from external agents, or infections or autoimmune disorders affecting nerve tissue. Inherited forms of peripheral neuropathy are caused by inborn mistakes in the genetic code or by new genetic mutations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "Peripheral neuropathy (Causes): Not a single disease, peripheral neuropathy is nerve damage caused by a number of conditions. Causes of neuropathies include: - Alcoholism. Poor dietary choices made by people with alcoholism can lead to vitamin deficiencies. - Autoimmune diseases. These include Sjogren's syndrome, lupus, rheumatoid arthritis, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and necrotizing vasculitis. - Diabetes. More than half the people with diabetes develop some type of neuropathy. - Exposure to poisons. Toxic substances include heavy metals or chemicals. - Medications. Certain medications, especially those used to treat cancer (chemotherapy), can cause peripheral neuropathy. - Infections. These include certain viral or bacterial infections, including Lyme disease, shingles, Epstein-Barr virus, hepatitis C, leprosy, diphtheria and HIV. - Inherited disorders. Disorders such as Charcot-Marie-Tooth disease are hereditary types of neuropathy. - Trauma or pressure on the nerve. Traumas, such as from motor vehicle accidents, falls or sports injuries, can sever or damage peripheral nerves. Nerve pressure can result from having a cast or using crutches or repeating a motion such as typing many times. - Tumors. Growths, cancerous (malignant) and noncancerous (benign), can develop on the nerves or press nerves. Also, polyneuropathy can arise as a result of some cancers related to the body's immune response. These are a form of paraneoplastic syndrome. - Vitamin deficiencies. B vitamins - including B-1, B-6 and B-12 - vitamin E and niacin are crucial to nerve health. - Bone marrow disorders. These include abnormal protein in the blood (monoclonal gammopathies), a form of bone cancer (osteosclerotic myeloma), lymphoma and amyloidosis. - Other diseases. These include kidney disease, liver disease, connective tissue disorders and an underactive thyroid (hypothyroidism). In a number of cases, no cause can be identified (idiopathic). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "Peripheral neuropathy (Overview): Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy. Peripheral neuropathy care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Pneumonia (Treatment): Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more. Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: - Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic. - Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. - Fever reducers/pain relievers. You may take these as needed for fever and discomfort. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others). Hospitalization You may need to be hospitalized if: - You are older than age 65 - You are confused about time, people or places - Your kidney function has declined - Your systolic blood pressure is below 90 millimeters of mercury (mm Hg) or your diastolic blood pressure is 60 mm Hg or below - Your breathing is rapid (30 breaths or more a minute) - You need breathing assistance - Your temperature is below normal - Your heart rate is below 50 or above 100 You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe. Children may be hospitalized if: - They are younger than age 2 months - They are lethargic or excessively sleepy - They have trouble breathing - They have low blood oxygen levels - They appear dehydrated. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Viral pneumonia (Treatment): Antibiotics do not treat this type of lung infection. Medicines that treat viruses may work against some pneumonias caused by influenza and the herpes family of viruses. These medicines may be tried if the infection is caught early. Treatment may also involve: - Corticosteroid medicines - Increased fluids - Oxygen - Use of humidified air A hospital stay may be needed if you are unable to drink enough and to help with breathing if oxygen levels are too low. People are more likely to be admitted to the hospital if they: - Are older than 65 years or are children - Are unable to care for themselves at home, eat, or drink - Have another serious medical problem, such as a heart or kidney problem - Have been taking antibiotics at home and are not getting better - Have severe symptoms However, many people can be treated at home. You can take these steps at home: - Control your fever with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do chores. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Atypical pneumonia (Treatment): To feel better, you can take these self-care measures at home: - Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do household chores. Antibiotics are used to treat atypical pneumonia. - You may be able to take antibiotics by mouth at home. - If your condition is severe, you will likely be admitted to a hospital. There, you will be given antibiotics through a vein (intravenously), as well as oxygen. - Antibiotics might be used for 2 weeks or more. - Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, and so on", "response": "Fibromyalgia (Treatment): In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: - Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. - Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. - Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia. Therapy A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: - Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. - Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. - Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, and so on", "response": "Fibromyalgia (Who treats it?): Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?", "response": "Cervical cancer (Prevention): Cervical cancer can be prevented by doing the following: - Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you. - Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs). - Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors. - Get Pap smears as often as your provider recommends. Pap smears can help detect early changes, which can be treated before they turn into cervical cancer. - Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older. - If you smoke, quit. Smoking increases your chance of getting cervical cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?", "response": "Cervical cancer (Treatment): Treatment of cervical cancer depends on: - The stage of the cancer - The size and shape of the tumor - The woman's age and general health - Her desire to have children in the future Early cervical cancer can be cured by removing or destroying the precancerous or cancerous tissue. This is why routine Pap smears are so important to prevent cervical cancer. There are surgical ways to do this without removing the uterus or damaging the cervix, so that a woman can still have children in the future. Types of surgery for early cervical cancer include: - Loop electrosurgical excision procedure (LEEP): Uses electricity to remove abnormal tissue - Cryotherapy: Freezes abnormal cells - Laser therapy: Uses light to burn abnormal tissue A hysterectomy (surgery to remove the uterus but not the ovaries) is not often done for cervical cancer that has not spread. It may be done in women who have had repeated LEEP procedures. Treatment for more advanced cervical cancer may include: - Radical hysterectomy, which removes the uterus and much of the surrounding tissues, including lymph nodes and the upper part of the vagina. - Pelvic exenteration, an extreme type of surgery in which all of the organs of the pelvis, including the bladder and rectum, are removed. Radiation may be used to treat cancer that has spread beyond the cervix or cancer that has returned. Chemotherapy uses drugs to kill cancer. It may be given alone or with surgery or radiation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.", "response": "Type 2 diabetes - what to ask your doctor (Questions): Ask your provider to check the nerves, skin, and pulses in your feet. Also ask these questions: - How often should I check my feet? What should I do when I check them? What problems should I call my provider about? - Who should trim my toenails? Is it OK if I trim them? - How should I take care of my feet every day? What type of shoes and socks should I wear? - Should I see a foot doctor (podiatrist)? Ask your provider about getting exercise: - Before I start, do I need to have my heart checked? My eyes? My feet? - What type of exercise program should I do? What type of activities should I avoid? - When should I check my blood sugar when I exercise? What should I bring with me when I exercise? Should I eat before or during exercise? Do I need to adjust my medicines when I exercise? When should I next have an eye doctor check my eyes? What eye problems should I call my doctor about? Ask your provider about meeting with a dietitian. Questions for the dietitian may include: - What foods increase my blood sugar the most? - What foods can help me with my weight loss goals? Ask your provider about your diabetes medicines: - When should I take them? - What should I do if I miss a dose? - Are there any side effects? How often should I check my blood sugar level at home? Should I do it at different times of the day? What is too low? What is too high? What should I do if my blood sugar is too low or too high? Should I get a medical alert bracelet or necklace? Should I have glucagon at home? Ask your provider about symptoms that you are having if they have not been discussed. Tell your provider about blurred vision, skin changes, depression, reactions at injection sites, sexual dysfunction, tooth pain, muscle pain, or nausea. Ask your provider about other tests you may need, such as cholesterol, A1C, and a urine test to check for kidney problems. Ask your provider about vaccinations you should have like the flu shot, hepatitis B, or pneumonia vaccines. How should I take care of my diabetes when I travel? Ask your provider how you should take care of your diabetes when you are sick: - What should I eat or drink? - How should I take my diabetes medicines? - How often should I check my blood sugar? - When should I call the provider?. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.", "response": "Diabetes type 2 - meal planning (Summary): When you have type 2 diabetes, taking time to plan your meals goes a long way toward controlling your blood sugar and weight. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Leber congenital amaurosis (Treatment): The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Leber congenital amaurosis: Leber congenital amaurosis is an eye disorder that primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning in infancy. The visual impairment tends to be stable, although it may worsen very slowly over time. Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all. Additionally, the clear front covering of the eye (the cornea) may be cone-shaped and abnormally thin, a condition known as keratoconus. A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of poking, pressing, and rubbing the eyes with a knuckle or finger. Researchers suspect that this behavior may contribute to deep-set eyes and keratoconus in affected children. In rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. However, researchers are uncertain whether these individuals actually have Leber congenital amaurosis or another syndrome with similar signs and symptoms. At least 13 types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities. Leber congenital amaurosis occurs in 2 to 3 per 100,000 newborns. It is one of the most common causes of blindness in children. Leber congenital amaurosis can result from mutations in at least 14 genes, all of which are necessary for normal vision. These genes play a variety of roles in the development and function of the retina. For example, some of the genes associated with this disorder are necessary for the normal development of light-detecting cells called photoreceptors. Other genes are involved in phototransduction, the process by which light entering the eye is converted into electrical signals that are transmitted to the brain. Still other genes play a role in the function of cilia, which are microscopic finger-like projections that stick out from the surface of many types of cells. Cilia are necessary for the perception of several types of sensory input, including vision. Mutations in any of the genes associated with Leber congenital amaurosis disrupt the development and function of the retina, resulting in early vision loss. Mutations in the CEP290, CRB1, GUCY2D, and RPE65 genes are the most common causes of the disorder, while mutations in the other genes generally account for a smaller percentage of cases. In about 30 percent of all people with Leber congenital amaurosis, the cause of the disorder is unknown. Leber congenital amaurosis usually has an autosomal recessive pattern of inheritance. Autosomal recessive inheritance means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. When Leber congenital amaurosis is caused by mutations in the CRX or IMPDH1 genes, the disorder has an autosomal dominant pattern of inheritance. Autosomal dominant inheritance means one copy of the altered gene in each cell is sufficient to cause the disorder. In most of these cases, an affected person inherits a gene mutation from one affected parent. Other cases result from new mutations and occur in people with no history of the disorder in their family. Bainbridge JW, Smith AJ, Barker SS, Robbie S, Henderson R, Balaggan K, Viswanathan A, Holder GE, Stockman A, Tyler N, Petersen-Jones S, Bhattacharya SS, Thrasher AJ, Fitzke FW, Carter BJ, Rubin GS, Moore AT, Ali RR. Effect of gene therapy on visual function in Leber's congenital amaurosis. N Engl J Med. 2008 May 22;358(21):2231-9. doi: 10.1056/NEJMoa0802268. Epub 2008 Apr 27. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Leber hereditary optic neuropathy (Treatment): Currently, there is no cure for this disease but there are several ongoing studies aiming to find an effective treatment. Management of affected individuals is usually supportive, with provision of visual aids. [2] High-dose oral idebenone may be considered as a treatment option, especially for individuals with LHON with relatively recent disease onset. Some studies have reported a benefit from using idebenone with quinone analogues, such as ubiquinone (Coenzyme Q10) and with vitamin C and vitamin B12. [2] In an open-label study of five individuals with acute LHON treated within 90 days of disease onset, the antioxidant α-tocotrienol-quinone (EPI-743), a vitamin E derivative, showed good results. [2] Those with established LHON mitochondrial DNA mutations are advised not to smoke and to limit their alcohol intake. People with Leber hereditary optic neuropathy may also find it helpful to speak with other affected individuals and to seek extra psychosocial or counseling support. [2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "Stiff-Person Syndrome: Stiff-person syndrome (SPS) is a rare neurological disorder with features of an autoimmune disease. SPS is characterized by fluctuating muscle rigidity in the trunk and limbs and a heightened sensitivity to stimuli such as noise, touch, and emotional distress, which can set off muscle spasms. Abnormal postures, often hunched over and stiffened, are characteristic of the disorder. People with SPS can be too disabled to walk or move, or they are afraid to leave the house because street noises, such as the sound of a horn, can trigger spasms and falls. SPS affects twice as many women as men. It is frequently associated with other autoimmune diseases such as diabetes, thyroiditis, vitiligo, and pernicious anemia. Scientists don’t yet understand what causes SPS, but research indicates that it is the result of an autoimmune response gone awry in the brain and spinal cord. The disorder is often misdiagnosed as Parkinson’s disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia. A definitive diagnosis can be made with a blood test that measures the level of glutamic acid decarboxylase (GAD) antibodies in the blood. People with SPS have elevated levels of GAD, an antibody that works against an enzyme involved in the synthesis of an important neurotransmitter in the brain. People with SPS respond to high doses of diazepam and several anti-convulsants, gabapentin and tiagabine. A recent study funded by the NINDS demonstrated the effectiveness of intravenous immunoglobulin (IVIg) treatment in reducing stiffness and lowering sensitivity to noise, touch, and stress in people with SPS. Treatment with IVIg, anti-anxiety drugs, muscle relaxants, anti-convulsants, and pain relievers will improve the symptoms of SPS, but will not cure the disorder. Most individuals with SPS have frequent falls and because they lack the normal defensive reflexes; injuries can be severe. With appropriate treatment, the symptoms are usually well controlled. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "Stiff person syndrome (Treatment): Treatment of stiff person syndrome (SPS) focuses on the specific symptoms present in each person. Benzodiazepines, diazepam, or baclofen may be used to treat muscle stiffness and spasms. Anti-seizure medications and pain medications may also be effective for some people. [2] Recently, studies have shown that intravenous immunoglobulin (IVIG) or plasmapheresis may be effective in improving some of the symptoms of SPS. [2] For some people, autologous stem cell transplants have been shown to successfully treat SPS. [7] Clinical trials are being completed to confirm if this may be an effective treatment. Physical and occupational therapy may help to slow the progression of stiff person syndrome, but should be completed by someone who is familiar with the condition so as not to make symptoms worse. [2] [4] Additional information about the treatment of stiff person syndrome can be viewed on Medscape Reference's Web site. Management Guidelines Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "Stiff-Person Syndrome (Treatment): People with SPS respond to high doses of diazepam and several anti-convulsants, gabapentin and tiagabine. A recent study funded by the NINDS demonstrated the effectiveness of intravenous immunoglobulin (IVIg) treatment in reducing stiffness and lowering sensitivity to noise, touch, and stress in people with SPS. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "Locked-In Syndrome (Treatment): There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "Locked-In Syndrome (Prognosis): While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "What is Locked-In Syndrome?: Locked-in syndrome is a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "congenital diaphragmatic hernia: Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth. In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare. Congenital diaphragmatic hernia affects approximately 1 in 2,500 newborns. Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition. Bielinska M, Jay PY, Erlich JM, Mannisto S, Urban Z, Heikinheimo M, Wilson DB. Molecular genetics of congenital diaphragmatic defects. Ann Med. 2007;39(4):261-74. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "congenital diaphragmatic hernia (Genetic Changes): Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "Do you have information about Diaphragmatic hernia repair - congenital: Summary : Diaphragmatic hernia repair is surgery to correct an opening or space in a baby's diaphragm. This opening is called a hernia. It is a rare type of birth defect. (Congenital means the problem is present at birth.) Description : Before this surgery, nearly all infants need a breathing device to improve their oxygen levels. The surgery is done while your child is under general anesthesia (asleep and not able to feel pain). The surgeon makes a cut (incision) in the belly under the upper ribs. This allows the organs in the area to be reached. The surgeon gently pulls these organs down into place through the opening in the diaphragm and into the abdominal cavity. The surgeon repairs the hole in the diaphragm. If the hole is small, it may be repaired with stitches. In most cases, a piece of plastic patch is used to cover the hole. Why the Procedure is Performed : The diaphragm is a muscle. It is important for breathing. It separates the chest cavity (where the heart and lungs are) from the belly area. In a child born with a diaphragmatic hernia, the diaphragm muscle is not completely formed. So, organs from the belly (stomach, spleen, liver, and intestines) may go up into the chest cavity where the lungs are. This prevents the lung(s) from growing normally. The lungs stay too small for babies to breathe on their own when they are born. A diaphragmatic hernia can be life-threatening. Surgery to repair it must be done in the first few days or weeks of a child's life. Risks : Risks for this surgery include: - Breathing problems, which may be severe - Bleeding - Collapsed lung - Lung problems that do not go away - Infection - Reactions to medicines Before the Procedure : Infants with a diaphragmatic hernia are admitted to a neonatal intensive care unit (NICU). It may be days or weeks before the baby is stable enough for surgery. - In the NICU, your baby will probably need a breathing machine (mechanical ventilator) before the surgery. This helps the baby breathe. - If your child is very sick, a heart-lung bypass machine (ECMO) may be needed to do the work of the heart and lungs. - Before surgery, your baby will have x-rays and regular blood tests to see how well the lungs are working. A light sensor (called a pulse oximeter) is taped to baby's skin to monitor the oxygen level in the blood. - Your baby may be given medicines to control blood pressure and keep him or her comfortable. Your baby will have tubes placed: - From the mouth or nose to the stomach to keep air out of the stomach - In an artery to monitor blood pressure - In a vein to deliver nutrients and medicines After the Procedure : Your baby will be on a breathing machine after the surgery and will stay in the hospital for several weeks. Once the baby is taken off the breathing machine, they may still need oxygen and some medicine for a while. Feedings will start after your baby's bowels start working. Feedings are usually given through a small, soft feeding tube from the mouth or nose into the stomach or small intestines until your baby can take all the milk they need by mouth. Most infants with diaphragmatic hernias have reflux when they eat. This means the food or acid in their stomach moves up into their esophagus, the tube that leads from the throat to the stomach. This can be uncomfortable for your baby. It also leads to frequent spitting up, vomiting, and pneumonia, which makes feedings more difficult once your baby is taking food by mouth. The nurses and feeding specialists will teach you ways to hold and feed your baby to prevent reflux. Some babies need to be on a feeding tube for a long time to get enough food to grow. Outlook (Prognosis) : The outcome of this surgery depends on how well your baby's lungs have developed. Some babies have other medical problems, including problems with the brain, muscles, and joints, which may slow recovery. Usually, the outlook is good for infants who have well-developed lung tissue. Most babies who are born with a diaphragmatic hernia are very ill and will stay in the hospital for a long time. With advances in medicine, the outlook for these infants is gradually improving. All babies who have had diaphragmatic hernia repairs will need to be watched closely to make sure the hole in their diaphragm does not open up again as they grow. Babies who had a large opening or defect in the diaphragm, or who had more problems with their lungs after birth, may have lung disease after they leave the hospital. They may need oxygen, medicines, and a feeding tube for months or years. Some babies will have problems crawling, walking, talking, and eating. They will need to see physical or occupational therapists to help them develop muscles and strength. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Colon cancer cure seen on tv. My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer. He cannot remember any details about it. I was wondering if you know anything about something like this. Please let me know. Thank you,", "response": "Understanding your colon cancer risk (How to Reduce Your Risk): Some risk factors are in your control, and some are not. Many of the risk factors above, such as age and family history, can't be changed. But just because you have risk factors you can't control doesn't mean you can't take steps to lower your risk. Start by getting colon cancer screenings starting at age 50. You may want to start screening earlier if you have a family history. Screening can help prevent colon cancer, and it is one of the best things you can do to lower your risk. Certain lifestyle habits also may help lower your risk: - Maintain a healthy weight - Eat a low-fat foods with plenty of vegetables and fruits - Limit red meat and processed meat - Get regular exercise - Limit alcohol to no more than 1 drink per day for women and 2 drinks per day for men - DO NOT smoke You can also have genetic testing done to assess your risk for colon cancer. If you have a strong family history of the disease, talk with your health care provider about testing. Low-dose aspirin may be recommended for some people who are at very high risk for colon cancer found with genetic testing. It is NOT recommended for most people because of side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "Diarrhea (Treatment): Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor might recommend medications or other treatments. Antibiotics Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Treatment to replace fluids Your doctor likely will advise you to replace the fluids and salts. For most adults, that means drinking water, juice or broth. If drinking liquids upsets your stomach or causes diarrhea, your doctor might recommend getting fluids through a vein in your arm (intravenously). Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes - minerals such as sodium and potassium - you need to maintain the electric currents that keep your heart beating. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium. Certain fruit juices, such as apple juice, might make diarrhea worse. For children, ask your doctor about using an oral rehydration solution, such as Pedialyte, to prevent dehydration or replace lost fluids. Adjusting medications you're taking If your doctor determines that an antibiotic caused your diarrhea, your doctor might lower your dose or switch to another medication. Treating underlying conditions If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. You might be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "E coli enteritis (Treatment): Most of the time, you will recover from the most common types of E coli infection within a couple of days. The goal of treatment is to make you feel better and avoid dehydration. Getting enough fluids and learning what to eat will help keep you or your child comfortable. You may need to: - Manage the diarrhea - Control nausea and vomiting - Get plenty of rest You can drink oral rehydration mixtures to replace fluids and minerals lost through vomiting and diarrhea. Oral rehydration powder can be purchased from a pharmacy. Be sure to mix the powder in safe water. You can make your own rehydration mixture by dissolving one half teaspoon (3 grams) of salt, one half teaspoon (2.5 grams) of baking soda and 4 tablespoons (50 grams) of sugar in 4 ¼ cups (1 liter) of water. You may need to get fluids through a vein (IV) if you have diarrhea or vomiting and cannot drink or keep enough fluids in your body. You will need to go to your provider's office or the emergency room. If you take diuretics (water pills), talk to your provider. You may need to stop taking the diuretic while you have diarrhea. Never stop or change medicines without first talking to your provider. You can buy medicines at the drugstore that can help stop or slow diarrhea. Do not use these medicines without talking to your provider if you have bloody diarrhea or a fever. Do not give these medicines to children. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "What is Drug-induced diarrhea?: Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.", "response": "Duchenne muscular dystrophy (Causes): Duchenne muscular dystrophy is a form of muscular dystrophy. It worsens quickly. Other muscular dystrophies (including Becker's muscular dystrophy) get worse much more slowly. Duchenne muscular dystrophy is caused by a defective gene for dystrophin (a protein in the muscles). However, it often occurs in people without a known family history of the condition. The condition most often affects boys due to the way the disease is inherited. The sons of women who are carriers of the disease (women with a defective gene, but no symptoms themselves) each have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers. Very rarely, a female can be affected by the disease. Duchenne muscular dystrophy occurs in about 1 out of every 3,600 male infants. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.", "response": "Duchenne muscular dystrophy (Outlook (Prognosis)): Duchenne muscular dystrophy leads to progressively worsening disability. Death often occurs by age 25, typically from lung disorders. However, advances in supportive care have resulted in many men living much longer than this. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Esophageal cancer: Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach. Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope. Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. Symptoms may include any of the following: - Backward movement of food through the esophagus and possibly mouth (regurgitation) - Chest pain not related to eating - Difficulty swallowing solids or liquids - Heartburn - Vomiting blood - Weight loss Tests used to help diagnose esophageal cancer may include: - Barium swallow - Chest MRI or thoracic CT (usually used to help determine the stage of the disease) - Endoscopic ultrasound (also sometimes used to determine the stage of disease) - Esophagogastroduodenoscopy (EGD) and biopsy - PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible) Stool testing may show small amounts of blood in the stool. Upper endoscopy (EGD) will be used to obtain a tissue sample from the esophagus to diagnose cancer. When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using: - Open surgery, during which one or two larger incisions are made. - Minimally invasive surgery, during which a 2 to 4 small incisions are made in the belly. A laparoscope with a tiny camera is inserted into the belly through one of the incisions. Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus. Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform. If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable. Beside a change in diet, other treatments that may be used to help the patient swallow include: - Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open. - A feeding tube into the stomach. - Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone When the cancer has not spread outside the esophagus, surgery may improve the chance of survival. When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms. Complications may include: - Pneumonia - Severe weight loss from not eating enough Call your health care provider if you have difficulty swallowing with no known cause and it does not get better. Also call if you have other symptoms of esophageal cancer. To reduce your risk of cancer of the esophagus: - DO NOT smoke - Limit or DO NOT drink alcoholic beverages - Get checked by your doctor if you have severe GERD - Get regular checkups if you have Barrett esophagus Updated by: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Esophageal cancer: Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow. [1] [2] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Squamous cell carcinoma - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Esophagectomy - minimally invasive (Why the Procedure is Performed): The most common reason for removing part, or all, of your esophagus is to treat cancer. You may also have radiation therapy or chemotherapy before or after surgery. Surgery to remove the lower esophagus may also be done to treat: - A condition in which the ring of muscle in the esophagus does not work well (achalasia) - Severe damage of the lining of the esophagus that can lead to cancer (Barrett esophagus) - Severe trauma. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "Hernia (Treatment): Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for people with serious medical problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed with stitches and sometimes with mesh patches to plug the hole. An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be repaired. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "Hiatal hernia (Treatment): The goals of treatment are to relieve symptoms and prevent complications. Treatments may include: - Medicines to control stomach acid - Surgery to repair the hiatal hernia and prevent reflux Other measures to reduce symptoms include: - Avoiding large or heavy meals - Not lying down or bending over right after a meal - Reducing weight and not smoking - Raising the head of the bed 4 to 6 inches (10 to 15 centimeters) If medicines and lifestyle measures do not help control symptoms, you may need surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "Diaphragmatic hernia (Treatment): A diaphragmatic hernia repair is an emergency that requires surgery. Surgery is done to place the abdominal organs into the proper position and repair the opening in the diaphragm. The infant will need breathing support during the recovery period. Some infants are placed on a heart/lung bypass machine to help deliver enough oxygen to the body. If a diaphragmatic hernia is diagnosed early during pregnancy (before 24 to 28 weeks), fetal surgery may be an option in some situations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (Treatment): Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.Your doctor may recommend medicine to relieve your symptoms.Fiber supplements to relieve constipation when increasing fiber in your diet doesn’t help. Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative that’s right for you. Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is an antidiarrheal that reduces diarrhea in people with IBS, though it doesn’t reduce pain, bloating, or other symptoms. Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce pain in your abdomen. Antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for people with IBS with constipation, or IBS-C, although studies haven’t confirmed this theory. Tricyclic antidepressants work in people with IBS by reducing their sensitivity to pain in the gastrointestinal (GI) tract as well as normalizing their GI motility and secretion. Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation symptoms. Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel movements. The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still debating and researching the use of antibiotics to treat IBS. Coated peppermint oil capsules to reduce IBS symptoms.Follow your doctor’s instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any medicine. MedlinePlus maintains the latest information about side effects and drug warnings.Your doctor may also recommend probiotics. Probiotics are live microorganisms—tiny organisms that can be seen only with a microscope. These microorganisms, most often bacteria, are like the microorganisms that are normally present in your GI tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.Discuss your use of complementary and alternative medical practices, including probiotics and dietary supplements, with your doctor.Psychological therapies may improve your IBS symptoms.Managing StressLearning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.Some options for managing stress includetaking part in stress reduction and relaxation therapies such as meditation getting counseling and support taking part in regular exercise such as walking or yoga reducing stressful life situations as much as possible getting enough sleepTalk TherapyTalk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS symptoms. This type of therapy often involves relaxation and stress management techniques.Gut-Directed HypnotherapyIn gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.Mindfulness TrainingMindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid catastrophizing, or worrying about the meaning of those sensations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (How can my diet treat the symptoms of IBS?): Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large meals can cause cramping and diarrhea if you have IBS.Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help.Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 (PDF, 2.963 MB) that adults should get 22 to 34 grams of fiber a day.3While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable bowel syndrome - aftercare: Irritable bowel syndrome (IBS) is a disorder that leads to abdominal pain and bowel changes. Your health care provider will talk about things you can do at home to manage your condition. Irritable bowel syndrome (IBS) may be a lifelong condition. You may be suffering from cramping and loose stools, diarrhea, constipation, or some combination of these symptoms. For some people, IBS symptoms may interfere with work, travel, and attending social events. But taking medicines and making lifestyle changes can help you manage your symptoms. Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. - Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. - Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. - Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly. No one drug will work for everyone. Medicines your provider may have you try include: - Antispasmodic medicines that you take before eating to control colon muscle spasms and abdominal cramping - Antidiarrheal medicines such as loperamide - Laxatives, such as lubiprostone, bisacodyl , and other ones bought without a prescription - Antidepressants to help relieve pain or discomfort - Rifaximin, an antibiotic that is not absorbed from your intestines It is very important to follow your provider's instructions when using medicines for IBS. Taking different medicines or not taking medicines the way you have been advised can lead to more problems. Stress may cause your intestines to be more sensitive and contract more. Many things can cause stress, including: - Not being able to do activities because of your pain - Changes or problems at work or at home - A busy schedule - Spending too much time alone - Having other medical problems A first step toward reducing your stress is to figure out what makes you feel stressed. - Look at the things in your life that cause you the most worry. - Keep a diary of the experiences and thoughts that seem to be related to your anxiety and see if you can make changes to these situations. - Reach out to other people. - Find someone you trust (such as a friend, family member, neighbor, or clergy member) who will listen to you. Often, just talking to someone helps relieve anxiety and stress. Call your provider if: - You develop a fever - You have gastrointestinal bleeding - You have bad pain that does not go away - You lose over 5 to 10 pounds (2 to 4.5 kilograms) when you are not trying to lose weight Updated by: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?", "response": "Frozen shoulder: Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck - Women 40 to 70 years old are most affected Main symptoms of a frozen shoulder are: - Decreased motion of the shoulder - Pain - Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. Your health care provider will ask about your symptoms and examine your shoulder. A diagnosis is often made when you are not able to rotate your shoulder. You may have x-rays of the shoulder. This is to make sure there is no other problem, such as arthritis or calcium deposits. Sometimes, an MRI exam shows inflammation, but these types of imaging tests are not needed to diagnose frozen shoulder. Pain is treated with NSAIDs and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done under anesthesia. During surgery the scar tissue is released (cut) by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks (shots) so you can do physical therapy. Follow instructions on caring for your shoulder at home. Treatment with physical therapy and NSAIDs often restores motion and function of the shoulder within a year. Even untreated, the shoulder may get better by itself in 2 years. After surgery restores motion, you must continue physical therapy for several weeks or months. This is to prevent the frozen shoulder from returning. If you do not keep up with physical therapy, the frozen shoulder may come back. Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your provider for referral and treatment. Early treatment may help prevent stiffness. Call your provider if you develop shoulder pain that limits your range of motion for an extended period. People who have diabetes or thyroid problems will be less likely to get frozen shoulder if they keep their condition under control. Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?", "response": "Frozen shoulder (Causes): The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks", "response": "Gastroparesis (Points to Remember): Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine. Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether. Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests. Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve. The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food— sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite. Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests. Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed. Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition. For people with gastroparesis and diabetes, a health care provider will likely adjust the person’s insulin regimen.Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine.Gastroparesis can occur when the vagus nerve is damaged by illness or injury and the stomach muscles stop working normally. Food then moves slowly from the stomach to the small intestine or stops moving altogether.Most people diagnosed with gastroparesis have idiopathic gastroparesis, which means a health care provider cannot identify the cause, even with medical tests.Diabetes is the most common known cause of gastroparesis. People with diabetes have high levels of blood glucose, also called blood sugar. Over time, high blood glucose levels can damage the vagus nerve.The most common symptoms of gastroparesis are nausea, a feeling of fullness after eating only a small amount of food, and vomiting undigested food— sometimes several hours after a meal. Other common symptoms include gastroesophageal reflux (GER), pain in the stomach area, abdominal bloating, and lack of appetite.Gastroparesis is diagnosed through a physical exam, medical history, blood tests, tests to rule out blockage or structural problems in the gastrointestinal (GI) tract, and gastric emptying tests.Changing eating habits can sometimes help control the severity of gastroparesis symptoms. A health care provider may suggest eating six small meals a day instead of three large ones. When a person has severe symptoms, a liquid or puréed diet may be prescribed.Treatment of gastroparesis may include medications, botulinum toxin, gastric electrical stimulation, jejunostomy, and parenteral nutrition.For people with gastroparesis and diabetes, a health care provider will likely adjust the person’s insulin regimen. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Gastritis (Treatment): Treatment depends on what is causing the problem. Some of the causes will go away over time. You may need to stop taking aspirin, ibuprofen, naproxen, or other medicines that may be causing gastritis. Always talk to your health care provider before stopping any medicine. You may use other over-the-counter and prescription drugs that decrease the amount of acid in the stomach, such as: - Antacids - H2 antagonists: famotidine (Pepsid), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid) - Proton pump inhibitors (PPIs): omeprazole (Prilosec), esomeprazole (Nexium), iansoprazole (Prevacid), rabeprazole (AcipHex), and pantoprazole (Protonix) Antibiotics may be used to treat chronic gastritis caused by infection with Helicobacter pylori bacteria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Do I need to see a doctor for Diverticulosis?: Call your health care provider if symptoms of diverticulitis occur. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Gastritis (Treatment): Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Medications used to treat gastritis include: - Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days. - Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix). Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk. - Medications to reduce acid production. Acid blockers - also called histamine (H-2) blockers - reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR). - Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.", "response": "Glaucoma (Treatment): The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have. OPEN-ANGLE GLAUCOMA - If you have open-angle glaucoma, you will probably be given eye drops. - You may need more than one type. Most people can be treated with eye drops. - Most of the eye drops used today have fewer side effects than those used in the past. - You also may be given pills to lower pressure in the eye. If drops alone do not work, you may need other treatment: - Laser treatment uses a painless laser to open the channels where fluid flows out. - If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure. - Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery. ACUTE ANGLE GLAUCOMA An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated. - You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure. - Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack. - To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack. CONGENITAL GLAUCOMA - Congenital glaucoma is almost always treated with surgery. - This is done using general anesthesia. This means the child is asleep and feels no pain. SECONDARY GLAUCOMA If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.", "response": "Glaucoma (Outlook (Prognosis)): Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions. Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How you do with secondary glaucoma depends on what is causing the condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Hair loss (Treatment): Effective treatments for some types of hair loss are available. But some hair loss is permanent. With some conditions, such as patchy alopecia, hair may regrow without treatment within a year. Treatments for hair loss include medications, surgery, laser therapy, and wigs or hairpieces. Your doctor may suggest a combination of these approaches in order to get the best results. The goals of treatment are to promote hair growth, slow hair loss or hide hair loss. Medication If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. This may include drugs to reduce inflammation and suppress your immune system, such as prednisone. If a certain medication is causing the hair loss, your doctor may advise you to stop using it for at least three months. Medications are available to treat pattern baldness. Two medications approved by the Food and Drug Administration (FDA) to treat hair loss are: - Minoxidil (Rogaine). Minoxidil is an over-the-counter liquid or foam that you rub into your scalp twice a day to grow hair and to prevent further hair loss. It may be used by men and women. With this treatment, some people experience hair regrowth, a slower rate of hair loss or both. The effect peaks at 16 weeks and you need to keep applying the medication to retain benefits. Possible side effects include scalp irritation, unwanted hair growth on the adjacent skin of the face and hands, and rapid heart rate (tachycardia). - Finasteride (Propecia). This prescription drug is available only to men. It's taken daily in pill form. Many men taking finasteride experience a slowing of hair loss, and some may show some new hair growth. You need to keep taking it to retain benefits. Rare side effects of finasteride include diminished sex drive and sexual function and an increased risk of prostate cancer. Women who are or may be pregnant need to avoid touching crushed or broken tablets. Surgery In the most common type of permanent hair loss, only the top of the head is affected. Hair transplant or restoration surgery can make the most of the hair you have left. During this procedure, your surgeon removes tiny plugs of skin, each containing a few hairs, from the back or sides of your scalp. He or she then implants the plugs into the bald sections of your scalp. You may be asked to take a hair loss medication before and after surgery to improve results. Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring. Wigs and hairpieces You may want to try a wig or a hairpiece as an alternative to medical treatment or if you don't respond to treatment. It can be used to cover either permanent or temporary hair loss. Quality, natural-looking wigs and hairpieces are available. If your hair loss is due to a medical condition, the cost of a wig may be covered by insurance. You'll need a prescription for the wig from your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Female pattern baldness (Treatment): Untreated, hair loss in female pattern baldness is permanent. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance. MEDICINES The only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil: - It is applied to the scalp. - For women, the 2% solution or 5% foam is recommended. - Minoxidil may help hair grow in about 1 in 4 or 5 of women. In most women, it may slow or stop hair loss. - You must continue to use this medicine for a long time. Hair loss starts again when you stop using it. Also, the hair that it helps grow will fall out. If minoxidil does not work, your provider may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. Your provider can tell you more about these if needed. HAIR TRANSPLANT During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed (transplanted) in areas that are balding. Minor scarring may occur where hair is removed. There is a slight risk of skin infection. You will likely need many transplants, which can be expensive. However, the results are often excellent and permanent. OTHER SOLUTIONS Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Do you have information about Spitting up - self-care: Summary : Spitting up is common with babies. Babies may spit up when they burp or with their drool. Spitting up should not cause your baby any distress. Usually babies stop spitting up when they are about 7 to 12 months old. Why Babies Spit up : Your baby is spitting up because: - The muscle at the top of your baby's stomach may not be fully developed. So baby's stomach cannot hold in milk. - The valve at the bottom of the stomach may be too tight. So the stomach gets too full and milk comes out. - Your baby may drink too much milk too fast, and take in a lot of air in the process. These air bubbles fill up the stomach and milk comes out. - Overfeeding causes your baby to get too full. So milk comes up. Spitting up is usually not due to a formula intolerance or an allergy to something in the nursing mother's diet. Spitting up is Usually Normal : If your baby is healthy, happy, and growing well, you don't need to worry. Babies that are growing well usually gain at least 6 ounces a week and have wet diapers at least every 6 hours. How to Reduce Spitting up : - Burp your baby several times during and after feeding. To do so sit the baby upright with your hand supporting the head. Let the baby lean forward slightly, bending at the waist. Gently pat your baby's back. (Burping your baby over your shoulder puts pressure on the stomach. This might cause more spitting up.) - If you are breastfeeding, try nursing with just one breast per feeding. - If you are bottle feeding, feed smaller amounts of formula more frequently. Avoid large amounts at one time. Be sure that the hole in the nipple is not too large. - Hold your baby upright for 15 to 30 minutes after feedings. - Avoid a lot of movement during and immediately after feeding. - Slightly elevate the head of babies' cribs so babies can sleep with their heads slightly up. - Talk to your doctor about trying a different formula or removing certain foods from the mother's diet (usually cow's milk). When to Call the Doctor : If your baby's spit up is forceful, call your baby's doctor. You want to make sure your baby does not have pyloric stenosis, a problem where the valve at the bottom of the stomach is too tight and needs to be fixed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Scoliosis (Treatment): Treatment depends on many things: - The cause of scoliosis - Where the curve is in your spine - How big the curve is - If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: - Surgery is done with a cut through the back, belly area, or beneath the ribs. - The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. - After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: - Emotional support: Some children, especially teens, may be self-conscious when using a back brace. - Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Scoliosis (Treatment): Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include: - Sex. Girls have a much higher risk of progression than do boys. - Severity of curve. Larger curves are more likely to worsen with time. - Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves. - Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine. - Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing. Braces If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve. The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips. Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities. Braces are discontinued after the bones stop growing. This typically occurs: - About two years after girls begin to menstruate - When boys need to shave daily - When there are no further changes in height Surgery Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months. Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Scoliosis: Scoliosis is an abnormal curving of the spine. Your spine is your backbone. It runs straight down your back. Everyone's spine naturally curves a bit. But people with scoliosis have a spine that curves too much. The spine might look like the letter C or S. Most of the time, the cause of scoliosis is unknown. This is called idiopathic scoliosis. It is the most common type. It is grouped by age. - In children age 3 and younger, it is called infantile scoliosis. - In children age 4 through 10, it is called juvenile scoliosis. - In children age 11 through 18, it is called adolescent scoliosis. Scoliosis most often affects girls. Some people are more likely to have curving of the spine. Curving generally gets worse during a growth spurt. Other types of scoliosis are: - Congenital scoliosis: This type of scoliosis is present at birth. It occurs when the baby’s ribs or spine bones do not form properly. - Neuromuscular scoliosis: This type is caused by a nervous system problem that affects the muscles. Problems can include cerebral palsy, muscular dystrophy, spina bifida, and polio. Most often, there are no symptoms. If there are symptoms, they may include: - Backache or low-back pain - Tired feeling in the spine after sitting or standing for a long time - Uneven hips or shoulders (one shoulder may be higher than the other) - Spine curves more to one side The health care provider will perform a physical exam. You will be asked to bend forward. This makes your spine easier to see. It may be hard to see changes in the early stages of scoliosis. The exam may show: - One shoulder is higher than the other - The pelvis is tilted X-rays of the spine are done. X-rays are important because the actual curving of the spine may be worse than what your doctor can see during an exam. Other tests may include: - Spinal curve measurement (scoliometer screening) - MRI of the spine Treatment depends on many things: - The cause of scoliosis - Where the curve is in your spine - How big the curve is - If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: - Surgery is done with a cut through the back, belly area, or beneath the ribs. - The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. - After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: - Emotional support: Some children, especially teens, may be self-conscious when using a back brace. - Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly. Seek support and more information from organizations that specialize in scoliosis. How well a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing. People with mild scoliosis do well with braces. They usually do not have long-term problems. Back pain may be more likely when the person gets older. Outlook for those with neuromuscular or congenital scoliosis varies. They may have another serious disorder, such as cerebral palsy or muscular dystrophy, so their goals are much different. Often, the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair. Congenital scoliosis is difficult to treat and usually requires many surgeries. Complications of scoliosis can include: - Breathing problems (in severe scoliosis) - Low back pain - Lower self-esteem - Persistent pain if there is wear and tear of the spine bones - Spinal infection after surgery - Spine or nerve damage from an uncorrected curve or spinal surgery Call your provider if you suspect your child may have scoliosis. Routine scoliosis screening is now done in middle schools. Such screening has helped detect early scoliosis in many children. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "help with obesity I would like help on my obesity problem and if I can get help", "response": "Obesity (Treatment): CHANGING YOUR LIFESTYLE An active lifestyle and plenty of exercise, along with healthy eating, is the safest way to lose weight. Even modest weight loss can improve your health. You may need a lot of support from family and friends. Your main goal should be to learn new, healthy ways of eating and make them part of your daily routine. Many people find it hard to change their eating habits and behaviors. You may have practiced some habits for so long that you may not even know they are unhealthy, or you do them without thinking. You need to be motivated to make lifestyle changes. Make the behavior change part of your life over the long term. Know that it takes time to make and keep a change in your lifestyle. Work with your provider and dietitian to set realistic, safe daily calorie counts that help you lose weight while staying healthy. Remember that if you drop pounds slowly and steadily, you are more likely to keep them off. Your dietitian can teach you about: - Healthy food choices - Healthy snacks - Reading nutrition labels - New ways to prepare food - Portion sizes - Sweetened drinks Extreme diets (fewer than 1100 calories per day) are not thought to be safe or to work very well. These types of diets often DO NOT contain enough vitamins and minerals. Most people who lose weight this way return to overeating and become obese again. Learn ways to manage stress other than snacking. Examples may be meditation, yoga, or exercise. If you are depressed or stressed a lot, talk to your provider. MEDICINES AND HERBAL REMEDIES You may see ads for supplements and herbal remedies that claim they will help you lose weight. Some of these claims may not be true. And some of these supplements can have serious side effects. Talk to your provider before using them. You can discuss weight loss medicines with your doctor. Many people lose at least 5 pounds (2 kg) by taking these drugs, but they may regain the weight when they stop taking the medicine unless they have made lifestyle changes. SURGERY Bariatric (weight-loss) surgery can reduce the risk of certain diseases in people with severe obesity. These risks include: - Arthritis - Diabetes - Heart disease - High blood pressure - Sleep apnea - Some cancers - Stroke Surgery may help people who have been very obese for 5 years or more and have not lost weight from other treatments, such as diet, exercise, or medicine. Surgery alone is not the answer for weight loss. It can train you to eat less, but you still have to do much of the work. You must be committed to diet and exercise after surgery. Talk to your doctor to learn if surgery is a good option for you. Weight-loss surgeries include: - Laparoscopic gastric banding - Gastric bypass surgery - Sleeve gastrectomy (less common) - Duodenal switch. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi my name is I'm currently working with and I was wondering I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment", "response": "HIV/AIDS (Treatment): One of NIAID’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS, turning what was once a uniformly fatal disease into a manageable chronic condition for many. NIAID is working to find new and more effective therapeutic products, drug classes, and combinations as well as safe and effective treatments for dangerous related co-infections and complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi my name is I'm currently working with and I was wondering I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment", "response": "HIV/AIDS (Finding a Cure): NIAID is exploring therapies that suppress the amount of HIV to such low levels that an HIV-infected person would no longer need treatment because his or her immune system could keep the remaining virus in check, creating in essence a “functional cure.”. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi my name is I'm currently working with and I was wondering I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment", "response": "HIV/AIDS - pregnancy and infants (Treatment): HIV/AIDS is treated with antiretroviral therapy (ART). These medicines stop the virus from multiplying. TREATING PREGNANT WOMEN Treating pregnant women with HIV prevents children from becoming infected. - If a woman tests positive during pregnancy, she will receives ART while pregnant. Most often she will receive a three-drug regimen. - The risk of these ART drugs for the baby in the womb is low. The mother may have another ultrasound at the second trimester. - HIV may be found in a woman when she goes into labor, especially if she has not previously received prenatal care. If so, she will be treated with antiretroviral drugs right away. Sometimes these drugs will be given through a vein (IV). - If the first positive test is during labor, receiving ART right away during labor can reduce the rate of infection in children to about 10%. TREATING BABIES AND INFANTS Infants born to infected mothers start receiving ART within 6 to 12 hours after birth. One or more antiretroviral drugs should be continued for at least 6 weeks after birth. BREASTFEEDING HIV-positive women should not breastfeed. This holds true even for women who are taking HIV medicines. Doing so may pass HIV to the baby through breast milk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "Endometriosis (Possible Complications): Endometriosis can lead to problems getting pregnant. However, most women with mild symptoms can still get pregnant. Laparoscopy to remove growths and scar tissue may help improve your chances of becoming pregnant. If it does not, you may want to consider fertility treatments. Other complications of endometriosis include: - Long-term pelvic pain that interferes with social and work activities - Large cysts in the pelvis that may break open (rupture) In rare cases, endometriosis tissue may block the intestines or urinary tract. Very rarely, cancer may develop in the areas of tissue growth after menopause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "Living with endometriosis (Summary): You have a condition called endometriosis. Symptoms of endometriosis include: - Heavy menstrual bleeding - Bleeding between periods - Problems getting pregnant Having this condition can interfere with your social and work life. No one knows what causes endometriosis. There is also no cure. However, there are different ways to treat the symptoms. These treatments can also help relieve menstrual pain. Learning how to manage your symptoms can make it easier to live with endometriosis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "Endometriosis (Other Endometriosis FAQs): - If I have endometriosis, will I be able to get pregnant? Among women with fertility problems, endometriosis may occur in as many as 50%.1 But exactly how endometriosis causes infertility is not clear. Some evidence suggests that infertility is related to the extent of the endometriosis patches, because the patches can distort the pelvic anatomy. This would make it difficult for sperm to travel to the ovary or a fertilized egg to travel to the uterus.2,3 Other evidence suggests that the inflammation in the abdomen may disrupt ovulation or fertilization, or that the endometrium may not develop properly, hampering the attachment of the embryo to the uterus. There are treatments for endometriosis-related infertility that may help women get pregnant even with endometriosis. - Is endometriosis the same as endometrial cancer? Endometriosis and endometrial cancer are not the same. The word \"endometrium\" describes the tissue that lines the inside of the uterus. Endometrial cancer is a type of cancer that affects the lining of the inside of the uterus. Endometriosis itself is not a form of cancer. - Can endometriosis lead to cancer? There is a slight increase in the risk of ovarian cancer among women with endometriosis, particularly among women who were diagnosed with the condition at an early age. However, it is unclear whether endometriosis causes ovarian cancer or if the two conditions share risk factors or disease mechanisms that make them more likely to occur together.3,4 In some cases, women with endometriosis also have breast cancer or non-Hodgkin's lymphoma. However, these situations are rare.5 - Does endometriosis ever go away? For about one-quarter of women diagnosed with endometriosis, endometriosis patches go away on their own.6 Also, after menopause, symptoms of endometriosis typically lessen because there is a drop in the woman's natural hormones and the growths gradually shrink. However, this is not true for all women. If a woman takes hormones for menopausal symptoms, both her pain symptoms and the growths may return. Women with endometriosis who are experiencing symptoms, especially after menopause, should talk with their health care providers about treatment options. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees: Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as: - Injury of the shinbone (only one leg will be knock-kneed) - Osteomyelitis (bone infection) - Overweight or obesity - Rickets (a disease caused by a lack of vitamin D) A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development. Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. Complications may include: - Difficulty walking (very rare) - Self-esteem changes related to cosmetic appearance of knock knees - If left untreated, knock knees can lead to early arthritis of the knee Call your provider if you think your child has knock knees. There is no known prevention for normal knock knees. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees (Treatment): Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees (Outlook (Prognosis)): Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a fractured nose i need it fixed. its been broke for 3 years now", "response": "Nose fracture: A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose. A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face. Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck. Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse. For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape. Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. Symptoms may include: - Blood coming from the nose - Bruising around the eyes - Difficulty breathing through the nose - Misshapen appearance (may not be obvious until the swelling goes down) - Pain - Swelling The bruised appearance most often disappears after 2 weeks. If a nose injury happens: - Try to stay calm. - Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat. - Squeeze the nostrils closed and hold pressure to stop the bleeding. - Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose. - To help relieve pain, try acetaminophen (Tylenol). - DO NOT try to straighten a broken nose - DO NOT move the person if there is reason to suspect a head or neck injury Get medical help right away if: - Bleeding will not stop - Clear fluid keeps draining from the nose - You suspect a blood clot in the septum - You suspect a neck or head injury - The nose looks deformed or out of its usual shape - The person is having difficulty breathing Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades. Use seat belts and appropriate car seats when driving. Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a fractured nose i need it fixed. its been broke for 3 years now", "response": "Rhinoplasty: Rhinoplasty is surgery to repair or reshape the nose. Rhinoplasty can be performed under local or general anesthesia, depending on the exact procedure and the person's preference. It is performed in a surgeon's office, a hospital, or an outpatient surgery center. Complex procedures may require a short hospital stay. The procedure often takes 1 to 2 hours. It may take longer. With local anesthesia, the nose and the area around it are numbed. You will probably be lightly sedated, but awake during the surgery (relaxed and not feeling pain). General anesthesia allows you to sleep through the operation. The surgery is usually done through a cut (incision) made inside the nostrils. In some cases, the cut is made from outside, around the base of the nose. This type of cut is used to perform work on the tip of the nose or if you need a cartilage graft. If the nose needs to be narrowed, the incision may extend around the nostrils. Small incisions may be made on the side of the nose to break, and reshape the bone. A splint (metal or plastic) may be placed on the outside of the nose. This helps maintain the new shape of the bone when the surgery is finished. Soft plastic splints or nasal packs also may be placed in the nostrils. This helps keep the dividing wall between the air passages (septum) stable. Rhinoplasty is one of the most common plastic surgery procedures. It can be used to: - Reduce or increase the size of the nose - Change the shape of the tip or the nasal bridge - Narrow the opening of the nostrils - Change the angle between the nose and the upper lip - Correct a birth defect or injury - Help relieve some breathing problems Nose surgery is considered elective when it is done for cosmetic reasons. In these cases, the purpose is to change the shape of the nose to one that the person finds more desirable. Many surgeons prefer to perform cosmetic nose surgery after the nasal bone has finished growing. This is around age 14 or 15 for girls and a bit later for boys. Risks for anesthesia and surgery in general are: - Reactions to medicines, problems breathing - Bleeding, infection, or bruising Risks for this procedure include: - Loss of support of the nose - Contour deformities of the nose - Need for further surgery After surgery, tiny blood vessels that have burst may appear as tiny red spots on the skin surface. These are usually minor, but are permanent. There are no visible scars if the rhinoplasty is performed from inside the nose. If the procedure narrows flared nostrils, there may be small scars at the base of the nose that are not often visible. In rare cases, a second procedure is needed to fix a minor deformity. Your surgeon may give you instructions to follow before your surgery. You may need to: - Stop any medicines that thin your blood. Your surgeon will give you a list of these medicines. - See your regular health care provider to have some routine tests and make sure it is safe for you to have surgery. - To aid with healing, stop smoking 2 to 3 weeks before and after surgery. - Arrange to have someone drive you home after surgery. You will usually go home on the same day as your surgery. Right after surgery, your nose and face will be swollen and painful. Headaches are common. The nasal packing is usually removed in 3 to 5 days, after which you will feel more comfortable. The splint may be left in place for 1 to 2 weeks. Full recovery takes several weeks. Healing is a slow and gradual process. The tip of the nose may have some swelling and numbness for months. You may not be able to see the final results for up to a year. Updated by: David A. Lickstein, MD, FACS, specializing in cosmetic and reconstructive plastic surgery, Palm Beach Gardens, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks", "response": "Anal fissure (Treatment): Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks", "response": "Anal fissure (Treatment): Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "Ingrown toenail (Treatment): If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don't try to treat an ingrown nail at home. Otherwise, to treat an ingrown nail at home: - Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. - Gently massage over the inflamed skin. - Place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic. When trimming your toenails: - Briefly soak your foot in warm water to soften the nails. - Use a clean, sharp trimmer. - Trim toenails straight across the top. Do not taper or round the corners or trim too short. - Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist). If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail: - Numbing medicine is first injected into the toe. - The ingrown part of the nail is removed. This procedure is called a partial nail avulsion. - It takes 2 to 4 months for the nail to regrow. If the toe is infected, your doctor may prescribe antibiotics. After the procedure, follow any instructions for helping your nail heal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "Ingrown toenail removal – discharge (Summary): You had surgery to remove part or all of your toenail. This was done to relieve pain and discomfort due to an ingrown toenail. Ingrown toenails can occurs when the edge of your toenail grows into the skin of the toe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "Ingrown toenail removal – discharge (When to Call the Doctor): Call your provider if you notice: - Your toenail is not healing - Fever - Pain, even after taking pain-relief medicine - Bleeding from the toenail - Pus from the toenail - Swelling or redness of the toe or foot - Regrowth of the nail into the skin of the toe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am suffering from Kartagener's syndrome and wanted information from you or from doctor . for this syndrome. (About fertility) and if possible other symptoms. Thank you.", "response": "Kartagener syndrome (Symptoms): Kartagener syndrome is characterized by p and situs inversus totalis. In people affected by situs inversus totalis, the internal organs including the heart, liver, spleen and intestine are on the opposite side of the body. Although the internal organs are abnormally placed, this condition typically does not cause any health problems. [1] [2] The signs and symptoms of primary ciliary dyskinesia vary, but may include: [1] [2] [3] Neonatal respiratory distress Frequent respiratory infections that can lead to severe lung damage Chronic nasal congestion Frequent sinus infections Recurrent middle ear infections, particularly in early childhood Hearing loss Hydrocephalus Infertility. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am suffering from Kartagener's syndrome and wanted information from you or from doctor . for this syndrome. (About fertility) and if possible other symptoms. Thank you.", "response": "Kartagener syndrome (Treatment): There is currently no cure for Kartagener syndrome . Treatment varies based on the signs and symptoms present in each person. Airway clearance therapy, similar to that used in cystic fibrosis, can loosen thick, sticky mucus so it can be cleared away. Antibiotics may be prescribed to treat respiratory, sinus, and middle ear infections and may be given on a long-term basis in people with chronic or frequent infections. Surgery to insert ear tubes may be recommended in children with chronic ear infections that are resistant to antibiotics. In people with severe lung disease, lung transplantation may be an option. [1] [2] [3] For more information on the treatment and management of Kartagener syndrome, please click here. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "SLC4A1-associated distal renal tubular acidosis (Description): SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "SLC4A1-associated distal renal tubular acidosis (Genetic Changes): Both the autosomal dominant and autosomal recessive forms of SLC4A1-associated distal renal tubular acidosis are caused by mutations in the SLC4A1 gene. This gene provides instructions for making the anion exchanger 1 (AE1) protein, which transports negatively charged atoms (anions) across cell membranes. Specifically, AE1 exchanges negatively charged atoms of chlorine (chloride ions) for negatively charged bicarbonate molecules (bicarbonate ions). The AE1 protein is found in the cell membrane of kidney cells and red blood cells. In kidney cells, the exchange of bicarbonate through AE1 allows acid to be released from the cell into the urine. In red blood cells, AE1 attaches to other proteins that make up the structural framework (the cytoskeleton) of the cells, helping to maintain their structure. The SLC4A1 gene mutations involved in either form of SLC4A1-associated distal renal tubular acidosis lead to production of altered AE1 proteins that cannot get to the correct location in the cell membrane. In the autosomal dominant form of the condition, gene mutations affect only one copy of the SLC4A1 gene, and normal AE1 protein is produced from the other copy. However, the altered protein attaches to the normal protein and keeps it from getting to the correct location, leading to a severe reduction or absence of AE1 protein in the cell membrane. In autosomal recessive distal renal tubular acidosis, both copies of the SLC4A1 gene are mutated, so all of the protein produced from this gene is altered and not able to get to the correct location. Improper location or absence of AE1 in kidney cell membranes disrupts bicarbonate exchange, and as a result, acid cannot be released into the urine. Instead, the acid builds up in the blood in most affected individuals, leading to metabolic acidosis and the other features of complete distal renal tubular acidosis. It is not clear why some people develop metabolic acidosis and others do not. Researchers suggest that in individuals with incomplete distal renal tubular acidosis, another mechanism is able to help regulate blood acidity (pH) and keep metabolic acidosis from developing. In red blood cells, interaction with a protein called glycophorin A can often help the altered AE1 protein get to the cell membrane where it can perform its function, which explains why most people with SLC4A1-associated distal renal tubular acidosis do not have blood cell abnormalities. However, some altered AE1 proteins cannot be helped by glycophorin A and are not found in the cell membrane. Without AE1, the red blood cells are unstable; breakdown of these abnormal red blood cells may lead to hemolytic anemia. Some people have nonhereditary forms of distal renal tubular acidosis; these forms can be caused by immune system problems or other conditions that damage the kidneys. These individuals often have additional signs and symptoms related to the original condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "Do I need to see a doctor for Distal renal tubular acidosis?: Call your health care provider if you have symptoms of distal renal tubular acidosis. Get medical help right away if you develop emergency symptoms such as: - Decreased consciousness - Seizures - Severe decrease in alertness or orientation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia: Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms. [1] [2] [3] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Delusions - Dementia - Fluctuations in consciousness - Parkinsonism - Visual hallucinations - The exact underlying cause of Lewy body dementia is poorly understood. The symptoms of the condition are thought to occur when clumps of a protein called alpha-synuclein accumulate in the regions of the brain involved in thinking, memory and movement. The build-up of these clumps (which are called \"Lewy bodies\") appears to be associated with a loss of certain neurons (nerve cells ) in the brain that produce two important neurotransmitters (chemicals that act as messengers between brain cells). The neurotransmitter, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood. [4] Although Lewy body dementia usually occurs sporadically, more than one family member can rarely be affected. Studies of these families suggest that there may be a genetic component to the condition in some cases. For example, copy number variants or changes ( mutations ) in the SNCA gene have been reported in a few affected families. [5] [6] The APOE ε4 allele and mutations in the GBA gene have been associated with an increased risk of Lewy body dementia and the APOE ε2 allele with a decreased risk. [5] [7] [2] Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5] Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. The Lewy Body Dementia Association offers detailed and up-to-date information regarding the treatment and management of Lewy body dementia . Please click on the link to access this resource. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia (Inheritance): Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia (Symptoms): Lewy body dementia signs and symptoms may include: - Visual hallucinations. Hallucinations may be one of the first symptoms, and they often recur. They may include seeing shapes, animals or people that aren't there. Sound (auditory), smell (olfactory) or touch (tactile) hallucinations are possible. - Movement disorders. Signs of Parkinson's disease (parkinsonian symptoms), such as slowed movement, rigid muscles, tremor or a shuffling walk may occur. - Poor regulation of body functions (autonomic nervous system). Blood pressure, pulse, sweating and the digestive process are regulated by a part of the nervous system that is often affected by Lewy body dementia. This can result in dizziness, falls and bowel issues such as constipation. - Cognitive problems. You may experience thinking (cognitive) problems similar to those of Alzheimer's disease, such as confusion, poor attention, visual-spatial problems and memory loss. - Sleep difficulties. You may have rapid eye movement (REM) sleep behavior disorder, which can cause you to physically act out your dreams while you're asleep. - Fluctuating attention. Episodes of drowsiness, long periods of staring into space, long naps during the day or disorganized speech are possible. - Depression. You may experience depression sometime during the course of your illness. - Apathy. You may have loss of motivation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "Tay-Sachs Disease: Tay-Sachs disease is a inherited metabolic disease caused by the harmful buildup of lipids (fatty materials such as oils and acids) in various cells and tissues in the body. It is part of a group of genetic disorders called the GM2 gangliosidoses. Tay-Sachs and its variant form are caused by a deficiency in the enzyme hexosaminidase A. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. A much rarer form of the disorder, called late-onset Tay-Sachs disease, occurs in individuals in their twenties and early thirties and is characterized by an unsteady gait and progressive neurological deterioration. The incidence of Tay-Sachs has been particularly high among people of Eastern European and Askhenazi Jewish descent., as well as in certain French Canadians and Louisiana Cajuns. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test that measures hexosaminidase A activity. Both parents must carry the mutated gene in order to have an affected child. In these instances, there is a 25 percent chance with each pregnancy that the child will be affected with Tay-Sachs disease. Prenatal diagnosis is available if desired. A very severe form of Tay-Sachs disease is know as Sandhoff disease, which is not limited to any ethnic group. Presently there is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatment includes proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "Tay-Sachs disease (Treatment): There is no cure for Tay-Sachs disease, but some treatments can help in managing symptoms. The goal of treatment is support and comfort. Supportive treatments include: - Medication. To reduce your child's symptoms, a number of prescription medications are available, including anti-seizure medications. - Respiratory care. Children who have Tay-Sachs disease are at high risk of lung infections that cause breathing problems and frequently accumulate mucus in their lungs. Your child may need the mucus using chest physiotherapy (CPT) to help remove mucus from the lungs. - Feeding tubes. Your child may have trouble swallowing, or develop respiratory problems by inhaling food or liquid into the lungs while eating. To prevent those problems, your doctor may recommend an assistive feeding device such as a gastrostomy tube, which is inserted through your child's nose and goes to your child's stomach. Or, a doctor trained in stomach surgery may surgically insert an esophagogastrostomy tube. - Physical therapy. As the disease progresses, your child may benefit from physical therapy to help keep joints flexible and maintain as much ability to move (range of motion) as possible. Physical therapy can delay joint stiffness and reduce or delay the loss of function and pain that can result from shortened muscles. Potential future treatments Gene therapy or enzyme replacement therapy research may eventually lead to a cure or treatment to slow the progression of Tay-Sachs disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "How many people are affected by critical congenital heart disease?: Heart defects are the most common type of birth defect, accounting for more than 30 percent of all infant deaths due to birth defects. CCHD represents some of the most serious types of heart defects. About 7,200 newborns, or 18 per 10,000, in the United States are diagnosed with CCHD each year. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "What is Menkes syndrome?: Menkes syndrome is a disorder that affects copper levels in the body. It is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate (failure to thrive); and deterioration of the nervous system. Additional signs and symptoms include weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood. Occipital horn syndrome (sometimes called X-linked cutis laxa) is a less severe form of Menkes syndrome that begins in early to middle childhood. It is characterized by wedge-shaped calcium deposits in a bone at the base of the skull (the occipital bone), coarse hair, and loose skin and joints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "Menkes syndrome: In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. It is one of several conditions called an \"inborn error of metabolism.\" Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute copper in food from the intestines into the bloodstream for use in other areas. As a result, the brain and other parts of the body do not get enough copper. Copper can build up in the small intestine and kidneys, but low copper levels in other areas can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is inherited, which means it runs in families. The gene is on the X-chromosome, so if a mother carries the defective gene, each of her sons has a 50% (1 in 2) chance of developing the disease, and 50% of her daughters will be a carrier of the disease. Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes There is often a history of Menkes syndrome in a male relative. Signs include: - Abnormal appearance of the hair under a microscope - Abnormally low body temperature - Bleeding in the brain - Slow growth in the womb In males, all of the hairs will be abnormal. In females who carry this trait, half of them may have areas of abnormal hair. Tests may include: - Serum ceruloplasmin (substance that transports copper in the blood) - Serum copper level - Skin cell culture - X-ray of the skeleton or x-ray of the skull Genetic testing may show a change (mutation) in the ATP7A gene. Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results. Most people with this condition die within the first few years of life. - Seizures - Death Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy. See a genetic counselor if you want to have children and you have a family history of Menkes syndrome. Maternal relatives (relatives on the mother's side of the family) of a boy with this syndrome should be seen by a geneticist to find out if they are carriers. Updated by: Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "Menkes syndrome (Symptoms): Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "Cardiac amyloidosis (Summary): Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "Cardiac amyloidosis (Causes): Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis (\"stiff heart syndrome\") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "Cardiac amyloidosis (Symptoms): Some people may have no symptoms. When present, symptoms may include: - Excessive urination at night - Fatigue, reduced exercise ability - Palpitations (sensation of feeling heartbeat) - Shortness of breath with activity - Swelling of the abdomen, legs, ankles, or other part of the body - Trouble breathing while lying down. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "Milroy disease (Treatment): There is currently no cure for Milroy disease. Management is typically conservative and usually successful in most people. [3] Management of lymphedema should be guided by a lymphedema therapist. Some improvement is usually possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. These measures may improve the cosmetic appearance of the affected areas, decrease their size, and reduce the risk of complications. [2] Decongestive physiotherapy , which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, has become the standard of care for primary lymphedema. [3] People with recurrent cellulitis may benefit from prophylactic antibiotics . [2] [3] Surgical intervention is considered a last option when other medical management fails. [3] When possible, people with Milroy disease should avoid: wounds to swollen areas (because of their reduced resistance to infection) long periods of immobility prolonged standing elevation of the affected limb certain medications (particularly calcium channel-blocking drugs that can cause increased leg swelling in some people)[2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "Milroy disease (Prognosis): The symptoms and severity of Milroy disease can vary among affected people (even within the same family), so the long-term effects of the condition may be difficult to predict. [2] Swelling varies in degree and distribution, and can be disabling and disfiguring. [3] For some people the outlook depends on how chronic the lymphedema is, as well as whether complications arise. [4] However, Milroy disease is rarely associated with significant complications. [3] The degree of edema sometimes progresses, but in some cases can improve (particularly in early years). [2] Complications of lymphedema may include recurrent bouts of cellulitis and/or lymphangitis, bacterial and fungal infections, deep venous thrombosis, functional impairment, cosmetic embarrassment, and amputation. Complications following surgery are common. [4] It has also been reported that people with chronic lymphedema for many years may have a significantly higher risk to develop lymphangiosarcoma (a type of angiosarcoma). This type of tumor is highly aggressive and has a very poor prognosis . [4]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "Milroy disease: Milroy disease is a condition that affects the normal function of the lymphatic system. The lymphatic system produces and transports fluids and immune cells throughout the body. Impaired transport with accumulation of lymph fluid can cause swelling (lymphedema). Individuals with Milroy disease typically have lymphedema in their lower legs and feet at birth or develop it in infancy. The lymphedema typically occurs on both sides of the body and may worsen over time. Milroy disease is associated with other features in addition to lymphedema. Males with Milroy disease are sometimes born with an accumulation of fluid in the scrotum (hydrocele). Males and females may have upslanting toenails, deep creases in the toes, wart-like growths (papillomas), and prominent leg veins. Some individuals develop non-contagious skin infections called cellulitis that can damage the thin tubes that carry lymph fluid (lymphatic vessels). Episodes of cellulitis can cause further swelling in the lower limbs. Milroy disease is a rare disorder; its incidence is unknown. Mutations in the FLT4 gene cause some cases of Milroy disease. The FLT4 gene provides instructions for producing a protein called vascular endothelial growth factor receptor 3 (VEGFR-3), which regulates the development and maintenance of the lymphatic system. Mutations in the FLT4 gene interfere with the growth, movement, and survival of cells that line the lymphatic vessels (lymphatic endothelial cells). These mutations lead to the development of small or absent lymphatic vessels. If lymph fluid is not properly transported, it builds up in the body's tissues and causes lymphedema. It is not known how mutations in the FLT4 gene lead to the other features of this disorder. Many individuals with Milroy disease do not have a mutation in the FLT4 gene. In these individuals, the cause of the disorder is unknown. Milroy disease is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In many cases, an affected person inherits the mutation from one affected parent. Other cases may result from new mutations in the FLT4 gene. These cases occur in people with no history of the disorder in their family. About 10 percent to 15 percent of people with a mutation in the FLT4 gene do not develop the features of Milroy disease. Brice G, Child AH, Evans A, Bell R, Mansour S, Burnand K, Sarfarazi M, Jeffery S, Mortimer P. Milroy disease and the VEGFR-3 mutation phenotype. J Med Genet. 2005 Feb;42(2):98-102. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "Ellis-van Creveld syndrome (Description): Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems. The features of Ellis-van Creveld syndrome overlap with those of another, milder condition called Weyers acrofacial dysostosis. Like Ellis-van Creveld syndrome, Weyers acrofacial dysostosis involves tooth and nail abnormalities, although affected individuals have less pronounced short stature and typically do not have heart defects. The two conditions are caused by mutations in the same genes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "Ellis-van Creveld syndrome (Treatment): Treatment depends on which body system is affected and the severity of the problem. The condition itself is not treatable, but many of the complications can be treated. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "EVC gene: The EVC gene provides instructions for making a protein whose function is unclear. However, it appears to be important for normal growth and development, particularly the development of bones and teeth. The EVC protein is found in primary cilia, which are microscopic, finger-like projections that stick out from the surface of cells and are involved in signaling pathways that transmit information between cells. In particular, the EVC protein is thought to help regulate a signaling pathway known as Sonic Hedgehog, which plays roles in cell growth, cell specialization, and the normal shaping (patterning) of many parts of the body. EVC and another gene, EVC2, are located very close together on chromosome 4. Researchers believe that the two genes may have related functions and that their activity may be coordinated. More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. The mutations that cause this condition occur in both copies of the EVC gene in each cell. These genetic changes disrupt the normal function of the EVC protein or lead to the production of an abnormally small, nonfunctional version of the protein. Although it is unclear how the loss of this protein's function underlies the signs and symptoms of Ellis-van Creveld syndrome, researchers believe that it may prevent normal Sonic Hedgehog signaling in the developing embryo. Problems with this signaling pathway may ultimately lead to the abnormal bone growth and heart defects seen with this condition. More than 25 mutations in the EVC gene have been reported to cause Ellis-van Creveld syndrome, an inherited disorder characterized by dwarfism, abnormal nails and teeth, and heart defects. The mutations that cause this condition occur in both copies of the EVC gene in each cell. These genetic changes disrupt the normal function of the EVC protein or lead to the production of an abnormally small, nonfunctional version of the protein. Although it is unclear how the loss of this protein's function underlies the signs and symptoms of Ellis-van Creveld syndrome, researchers believe that it may prevent normal Sonic Hedgehog signaling in the developing embryo. Problems with this signaling pathway may ultimately lead to the abnormal bone growth and heart defects seen with this condition. At least one mutation in the EVC gene has been found to cause the characteristic features of Weyers acrofacial dysostosis, affecting the development of the teeth, nails, and bones. The signs and symptoms of Weyers acrofacial dysostosis are similar to, but typically milder than, those of Ellis-van Creveld syndrome. The EVC gene mutation that causes Weyers acrofacial dysostosis occurs in one copy of the gene in each cell. It changes a single protein building block (amino acid) in the EVC protein, replacing the amino acid serine with the amino acid proline at position 307 (written as Ser307Pro). It is unclear how this genetic change leads to the specific features of Weyers acrofacial dysostosis. Studies suggest that the abnormal protein interferes with Sonic Hedgehog signaling in the developing embryo, disrupting the normal formation and growth of the teeth, nails, and bones. Blair HJ, Tompson S, Liu YN, Campbell J, MacArthur K, Ponting CP, Ruiz-Perez VL, Goodship JA. Evc2 is a positive modulator of Hedgehog signalling that interacts with Evc at the cilia membrane and is also found in the nucleus. BMC Biol. 2011 Feb 28;9:14. doi: 10.1186/1741-7007-9-14. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "What causes Nephrotic syndrome?: Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults.In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: - Cancer - Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis - Genetic disorders - Immune disorders - Infections (such as strep throat, hepatitis, or mononucleosis) - Use of certain drugs It can occur with kidney disorders such as: - Focal and segmental glomerulosclerosis - Glomerulonephritis - Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "Nephrotic syndrome (Treatment): The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: - Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. - Corticosteroids and other drugs that suppress or quiet the immune system. - Treating high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. - A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. - Low-protein diets may be helpful. Your health care provider may suggest a moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day). - Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. - Taking blood thinner drugs to treat or prevent blood clots. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "Chemotherapy: The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to: - Cure the cancer - Shrink the cancer - Prevent the cancer from spreading - Relieve symptoms the cancer may be causing HOW CHEMOTHERAPY IS GIVEN Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including: - Injections or shots into the muscles - Injections or shots under the skin - Into an artery - Into a vein (intravenous, or IV) - Pills taken by mouth - Shots into the fluid around the spinal cord or brain When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery. There are many types of catheters, including: - Central venous catheter - Central venous catheter with a port - Percutaneously inserted central catheter (PICC) A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line. Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy. Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose. Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training. DIFFERENT TYPES OF CHEMOTHERAPY The different types of chemotherapy include: - Standard chemotherapy, which works by killing cancer cells and some normal cells. - Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells. SIDE EFFECTS OF CHEMOTHERAPY Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment. As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract. When this damage occurs, there can be side effects. Some people who receive chemotherapy: - Are more likely to have infections - Become tired more easily - Bleed too much, even during everyday activities - Feel pain or numbness from nerve damage - Have a dry mouth, mouth sores, or swelling in the mouth - Have a poor appetite or lose weight - Have an upset stomach, vomiting, or diarrhea - Lose their hair - Have problems with thinking and memory (\"chemo brain\") Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects. Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include: - Being careful with pets and other animals to avoid catching infections from them - Eating enough calories and protein to keep your weight up - Preventing bleeding, and what to do if bleeding occurs - Practicing safe eating and drinking habits - Washing your hands often with soap and water You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to: - Monitor how well the chemotherapy is working - Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists and Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "autosomal recessive congenital stationary night blindness: Autosomal recessive congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this condition typically have difficulty seeing and distinguishing objects in low light (night blindness). For example, they may not be able to identify road signs at night or see stars in the night sky. They also often have other vision problems, including loss of sharpness (reduced acuity), nearsightedness (myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus). The vision problems associated with this condition are congenital, which means they are present from birth. They tend to remain stable (stationary) over time. Autosomal recessive congenital stationary night blindness is likely a rare disease; however, its prevalence is unknown. Mutations in several genes can cause autosomal recessive congenital stationary night blindness. Each of these genes provide instructions for making proteins that are found in the retina. These proteins are involved in sending (transmitting) visual signals from cells called rods, which are specialized for vision in low light, to cells called bipolar cells, which relay the signals to other retinal cells. This signaling is an essential step in the transmission of visual information from the eyes to the brain. Mutations in two genes, GRM6 and TRPM1, cause most cases of this condition. These genes provide instructions for making proteins that are necessary for bipolar cells to receive and relay signals. Mutations in other genes involved in the same bipolar cell signaling pathway are likely responsible for a small percentage of cases of autosomal recessive congenital stationary night blindness. Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals. As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light. The cause of the other vision problems associated with this condition is unclear. It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments. Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes. The cause of the disorder in these individuals is unknown. This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Audo I, Bujakowska K, Orhan E, Poloschek CM, Defoort-Dhellemmes S, Drumare I, Kohl S, Luu TD, Lecompte O, Zrenner E, Lancelot ME, Antonio A, Germain A, Michiels C, Audier C, Letexier M, Saraiva JP, Leroy BP, Munier FL, Mohand-Saïd S, Lorenz B, Friedburg C, Preising M, Kellner U, Renner AB, Moskova-Doumanova V, Berger W, Wissinger B, Hamel CP, Schorderet DF, De Baere E, Sharon D, Banin E, Jacobson SG, Bonneau D, Zanlonghi X, Le Meur G, Casteels I, Koenekoop R, Long VW, Meire F, Prescott K, de Ravel T, Simmons I, Nguyen H, Dollfus H, Poch O, Léveillard T, Nguyen-Ba-Charvet K, Sahel JA, Bhattacharya SS, Zeitz C. Whole-exome sequencing identifies mutations in GPR179 leading to autosomal-recessive complete congenital stationary night blindness. Am J Hum Genet. 2012 Feb 10;90(2):321-30. doi: 10.1016/j.ajhg.2011.12.007. Erratum in: Am J Hum Genet. 2012 Jul 13;91(1):209. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "X-linked congenital stationary night blindness: X-linked congenital stationary night blindness (XLCSNB) is a disorder of the retina. People with this condition typically experience night blindness and other vision problems, including loss of sharpness ( reduced visual acuity), severe nearsightedness (myopia), nystagmus , and strabismus . Color vision is typically not affected. These vision problems are usually evident at birth, but tend to be stable (stationary) over time. There are two major types of XLCSNB: the complete form and the incomplete form. Both types have very similar signs and symptoms. However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness. The types are distinguished by their genetic cause. [1] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Abnormality of macular pigmentation Frequent Nyctalopia Frequent Optic disc hypoplasia Frequent Reduced visual acuity Frequent Severe Myopia Frequent Nystagmus Occasional Strabismus Occasional Congenital stationary night blindness - Hemeralopia - X-linked recessive inheritance - Yes. About 45% of individuals with XLCSNB have the complete form, which is caused by mutations in the NYX gene . The other 55% have the incomplete form, which is caused by mutations in the CACNA1F gene. [2] The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "autosomal recessive congenital stationary night blindness (Genetic Changes): Mutations in several genes can cause autosomal recessive congenital stationary night blindness. Each of these genes provide instructions for making proteins that are found in the retina. These proteins are involved in sending (transmitting) visual signals from cells called rods, which are specialized for vision in low light, to cells called bipolar cells, which relay the signals to other retinal cells. This signaling is an essential step in the transmission of visual information from the eyes to the brain. Mutations in two genes, GRM6 and TRPM1, cause most cases of this condition. These genes provide instructions for making proteins that are necessary for bipolar cells to receive and relay signals. Mutations in other genes involved in the same bipolar cell signaling pathway are likely responsible for a small percentage of cases of autosomal recessive congenital stationary night blindness. Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals. As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light. The cause of the other vision problems associated with this condition is unclear. It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments. Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes. The cause of the disorder in these individuals is unknown. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "Oleander poisoning: Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous ingredients include: - Digitoxigenin - Neriin - Oleandrin - Oleondroside Note: This list may not include all poisonous ingredients. The poisonous substances are found in all parts of the oleander plant: - Flowers - Leaves - Stems - Twigs Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases. Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Get the following information: - Person's age, weight, and condition - Name and part of the plant swallowed, if known - Time it was swallowed - Amount swallowed Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: - Activated charcoal - Blood and urine tests - Breathing support - Chest x-ray - EKG (electrocardiogram, or heart tracing) - Fluids through a vein (IV) - Medicines to treat symptoms including an antidote to reverse the effects of the poison - Tube through the mouth into the stomach to wash out the stomach (gastric lavage) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 10/26/2016. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "What are the symptoms of Oleander poisoning?: Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "Oleander poisoning (Outlook (Prognosis)): How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "Optic nerve atrophy: Optic nerve atrophy is damage to the optic nerve. The optic nerve carries images of what the eye sees to the brain. There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include: - Brain tumor - Cranial arteritis (sometimes called temporal arteritis) - Multiple sclerosis - Stroke There are also rare forms of hereditary optic nerve atrophy that affect children and young adults. Optic nerve atrophy causes vision to dim and reduces the field of vision. The ability to see fine detail will also be lost. Colors will seem faded. Over time, the pupil will be less able to react to light, and eventually, its ability to react to light may be lost. The health care provider will do a complete eye exam to look for the condition. The exam will include tests of: - Color vision - Pupil light reflex - Tonometry - Visual acuity You may also need a complete physical exam and other tests. Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye. People with this condition need to be checked regularly by an eye doctor with experience in nerve-related conditions. Tell your doctor right away about any change in vision. Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: - Older adults should have their provider carefully manage their blood pressure. - Use standard safety precautions to prevent injuries to the face. Most facial injuries are the result of car accidents. Wearing seat belts may help prevent these injuries. - Schedule a routine annual eye exam to check for glaucoma. - Never drink home-brewed alcohol and forms of alcohol that are not intended for drinking. Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes. Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "Optic atrophy 1: Optic atrophy 1 is a condition that mainly affects vision, but may include other features. Vision loss typically begins within the first decade of life; severity varies widely among affected people (from nearly normal vision to complete blindness), even among members of the same family. Vision problems may include difficulty distinguishing colors, progressive narrowing of the field of vision (tunnel vision) and an abnormally pale appearance (pallor) of the optic nerve. Additional, less common abnormalities may include sensorineural hearing loss , ataxia , myopathy (muscle disease) and other neurological findings. [1] It is usually caused by mutations in the OPA1 gene , although some individuals with optic atrophy 1 do not have identified mutations in this gene, in which case the cause of the condition is unknown. This condition is inherited in an autosomal dominant pattern but some cases result from a new mutation in the gene and occur in people with no history of the disorder in their family. [2] Treatment focuses on individual symptoms when possible. [1] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Ataxia Very rare Horizontal nystagmus Very rare Progressive external ophthalmoplegia Very rare Proximal muscle weakness Very rare Strabismus Very rare Abnormal amplitude of pattern reversal visual evoked potentials - Autosomal dominant inheritance - Central scotoma - Centrocecal scotoma - Incomplete penetrance - Insidious onset - Optic atrophy - Red-green dyschromatopsia - Reduced visual acuity - Tritanomaly - Visual impairment - View complete list of signs and symptoms... The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. A thorough search of available literature provided very limited information about how optic atrophy 1 may affect life expectancy. A recent study discussed how extra-ocular neurological complications may be more common than previously thought in individuals with an OPA1 gene mutation and may affect up to 20% of individuals. The authors of the study described new clinical features including spastic paraplegia (stiffness of the legs) and a multiple sclerosis-like illness. [3] Ongoing research and follow-up of individuals with the condition may provide specific information about life expectancy in the future. Vision loss alone is not expected to substantially shorten the life span; however, severe neurological symptoms, when present, theoretically may contribute to a shortened life span in some individuals. The following diseases are related to Optic atrophy 1. If you have a question about any of these diseases, you can contact GARD. Dominant optic atrophy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "optic atrophy type 1: Optic atrophy type 1 is a condition that often causes slowly worsening vision, usually beginning in childhood. People with optic atrophy type 1 typically experience a narrowing of their field of vision (tunnel vision). Affected individuals gradually lose their sight as their field of vision becomes smaller. Both eyes are usually affected equally, but the severity of the vision loss varies widely, even among affected members of the same family, ranging from nearly normal vision to complete blindness. In addition to vision loss, people with optic atrophy type 1 frequently have problems with color vision (color vision deficiency) that make it difficult or impossible to distinguish between shades of blue and green. In the early stages of the condition, individuals with optic atrophy type 1 experience a progressive loss of certain cells within the retina, which is a specialized light-sensitive tissue that lines the back of the eye. The loss of these cells (known as retinal ganglion cells) is followed by the degeneration (atrophy) of the nerves that relay visual information from the eye to the brain (optic nerves), which results in further vision loss. Atrophy causes these nerves to have an abnormally pale appearance (pallor), which can be seen during an eye examination. Optic atrophy type 1 is estimated to affect 1 in 35,000 people worldwide. This condition is more common in Denmark, where it affects approximately 1 in 10,000 people. Optic atrophy type 1 is caused by mutations in the OPA1 gene. The protein produced from this gene is made in cells and tissues throughout the body. The OPA1 protein is found within mitochondria, which are the energy-producing centers of cells. The protein plays a key role in the organization of the shape and structure of the mitochondria and in controlled cell death (apoptosis). The OPA1 protein is also involved in a process called oxidative phosphorylation, from which cells derive much of their energy. Additionally, the protein plays a role in the maintenance of the DNA within mitochondria, called mitochondrial DNA (mtDNA). Mutations in the OPA1 gene lead to problems with mitochondrial function. The mitochondria become misshapen and disorganized and have reduced energy-producing capabilities. The maintenance of mtDNA may also be impaired, resulting in mtDNA mutations that further interfere with mitochondrial energy production. Cells that contain these poorly functioning mitochondria are more susceptible to apoptosis. In particular, cells that have high energy demands, such as retinal ganglion cells, die over time. Specialized extensions of retinal ganglion cells, called axons, form the optic nerves, so when retinal ganglion cells die, the optic nerves atrophy and cannot transmit visual information to the brain. This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family. In rare cases, people who have an OPA1 gene mutation do not develop optic atrophy type 1, a situation known as reduced penetrance. Delettre-Cribaillet C, Hamel CP, Lenaers G. Optic Atrophy Type 1. 2007 Jul 13 [updated 2015 Nov 12]. In: Pagon RA, Adam MP, Ardinger HH, Wallace SE, Amemiya A, Bean LJH, Bird TD, Ledbetter N, Mefford HC, Smith RJH, Stephens K, editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available from http://www.ncbi.nlm.nih.gov/books/NBK1248/. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?", "response": "Rheumatoid Arthritis (What is it? Points To Remember About Rheumatoid Arthritis): - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body. If you have this disease, you also may feel sick and tired, and sometimes get fevers. - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. - Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in your joints. This disease often occurs in more than one joint and can affect any joint in the body. If you have this disease, you may feel sick and tired, and sometimes get fevers. - Anyone can get arthritis, but it occurs more often in women and is most common in older people. - Genes, environmental factors, and hormones may play roles in the development of rheumatoid arthritis. - Treatment may involve medicine, surgery, and alternative therapies. - Regular rest, joint care, activity, a healthy diet, and reduced stress can ease symptoms. Rheumatoid arthritis is a disease that affects your joints. Joints are where two or more bones join together, such as at your knees, hips, or shoulders. Rheumatoid arthritis causes pain, swelling, and stiffness. If joints on one side of your body have rheumatoid arthritis, usually those joints on the other side do too. This disease often occurs in more than one joint. It can affect any joint in the body. If you have this disease, you also may feel sick and tired, and sometimes get fevers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?", "response": "Rheumatoid arthritis (Symptoms): Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "Polycystic ovarian syndrome (Summary): Polycystic ovarian syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones , heart, blood vessels, and appearance. Women with this condition typically have high levels of hormones called androgens, missed or irregular periods, and many small cysts in their ovaries. The cause of PCOS is unknown, but probably involves a combination of genetic and environmental factors . Treatment for PCOS may involve birth control pills and medications for diabetes and infertility. Medicines called anti-androgens are also used to speed the growth of hair and clear acne. [1] [2]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "What is Polycystic ovary syndrome?: Polycystic ovary syndrome is a condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cysts in the ovaries, trouble getting pregnant, and other health problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "Polycystic ovary syndrome (What is polycystic ovary syndrome (PCOS)?): Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be. PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Polymicrogyria: Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Specifically, the surface of the brain develops too many folds which are unusually small. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems. Polymicrogyria can result from both genetic and environmental causes. It may occur as an isolated finding or as part of a syndrome . Treatment is based on the signs and symptoms present in each person. [1] [2] A wide variety of symptoms may be observed in people with polymicrogyria, depending on the areas of the brain implicated and whether or not it is part of a larger syndrome . Signs and symptoms may include: [3] [4] Developmental delay Crossed eyes Epilepsy Paralysis of the face, throat, and tongue Difficulty with speech and swallowing Drooling The diagnosis of polymicrogyria is made by imaging brain structures using MRI . Typical findings include areas of the cerebral cortex with a complex set of small gyri that appear fused to each other and separated by shallow sulci. These findings may be isolated to one side of the brain (unilateral) or may involve both sides of the brain (bilateral). [3] [4] The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The following diseases are related to Polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Bilateral frontal polymicrogyria Bilateral frontoparietal polymicrogyria Bilateral generalized polymicrogyria Bilateral parasagittal parieto-occipital polymicrogyria Bilateral perisylvian polymicrogyria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Bilateral generalized polymicrogyria: Bilateral generalized polymicrogyria is a rare neurological disorder that affects the cerebral cortex (the outer surface of the brain). [1] [2] [3] This is the most widespread form of polymicrogyria and typically affects the entire surface of the brain. [1] Signs and symptoms include severe intellectual disability , problems with movement, and seizures that are difficult or impossible to treat. [1] [2] While the exact cause of bilateral generalized polymicrogyria is not fully understood, it is thought to be due to improper brain development during embryonic growth. [2] Most cases appear to follow an autosomal recessive pattern of inheritance. Treatment is based on the signs and symptoms present in each person. [1] [2] [3] The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Although polymicrogyria as a broad category of disorders is collectively believed to be fairly common, each individual type (such as bilateral generalized polymicrogyria) is probably rare. [1] [2] Unfortunately for the rare diseases, there's often not a calculated incidence or prevalence; there is no official method for tracking these conditions. To our knowledge, the incidence and prevalence of bilateral generalized polymicrogyria remains unknown. [1] [2] [3] The following diseases are related to Bilateral generalized polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Polymicrogyria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Bilateral generalized polymicrogyria (Statistics): Although polymicrogyria as a broad category of disorders is collectively believed to be fairly common, each individual type (such as bilateral generalized polymicrogyria) is probably rare. [1] [2] Unfortunately for the rare diseases, there's often not a calculated incidence or prevalence; there is no official method for tracking these conditions. To our knowledge, the incidence and prevalence of bilateral generalized polymicrogyria remains unknown. [1] [2] [3]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia (Prevention): There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia (Causes): The exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta - the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta. In women with preeclampsia, these blood vessels don't seem to develop or function properly. They're narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them. Causes of this abnormal development may include: - Insufficient blood flow to the uterus - Damage to the blood vessels - A problem with the immune system - Certain genes Preeclampsia is classified as one of four high blood pressure disorders that can occur during pregnancy. The other three are: - Gestational hypertension. Women with gestational hypertension have high blood pressure but no excess protein in their urine or other signs of organ damage. Some women with gestational hypertension eventually develop preeclampsia. - Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood pressure usually doesn't have symptoms, it may be hard to determine when it began. - Chronic hypertension with superimposed preeclampsia. This condition occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia and Eclampsia (How many women are affected by or at risk of preeclampsia?): The exact number of women who develop preeclampsia is not known. Some estimates suggest that preeclampsia affects 2% to 8% of all pregnancies globally and about 3.4% in the United States.1,2The condition is estimated to account for 10% to 15% of maternal deaths worldwide.1 Disorders related to high blood pressure are the second leading cause of stillbirths and early neonatal deaths in developing nations.3In addition, HELLP syndrome occurs in about 10% to 20% of all women with severe preeclampsia or eclampsia.4Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy.6 - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia.17 Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "Leukemia (Treatment): Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: - Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein. - Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack leukemia cells. - Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease. - Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body. You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant. - Stem cell transplant. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow. You may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "Leukemia (Treatment Option Overview): - There are different types of treatment for children with acute myeloid leukemia (AML), chronic myelogenous leukemia (CML), juvenile myelomonocytic leukemia (JMML), or myelodysplastic syndromes (MDS). - Treatment is planned by a team of health care providers who are experts in treating childhood leukemia and other diseases of the blood. - Some cancer treatments cause side effects months or years after treatment has ended. - The treatment of childhood AML usually has two phases. - Seven types of standard treatment are used for childhood AML, childhood CML, JMML, or MDS. - Chemotherapy - Radiation therapy - Stem cell transplant - Targeted therapy - Other drug therapy - Watchful waiting - Supportive care - New types of treatment are being tested in clinical trials. - Biologic therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "Chronic myelogenous leukemia (CML) (Treatment): Medicines that target the abnormal protein made by the Philadelphia chromosome are often the first treatment for CML. These medicines can be taken as pills. Sometimes, chemotherapy is used first to reduce the white blood cell count if it is very high at diagnosis. The blast crisis phase is very difficult to treat. This is because there is a very high count of immature white blood cells (leukemia cells). The only known cure for CML is a bone marrow transplant, or stem cell transplant. Most people, though, do not need a transplant because the targeted medicines are successful. Discuss your options with your oncologist. You and your health care provider may need to manage many other issues or concerns during your leukemia treatment, including: - Managing your pets during chemotherapy - Bleeding problems - Eating enough calories when you are sick - Swelling and pain in your mouth - Safe eating during cancer treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?", "response": "what research (or clinical trials) is being done for Multiple Sclerosis?: The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models. In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research. To read or download the National Academies/Institute of Medicine report, go to: \"Multiple Sclerosis: Current Status and Strategies for the Future.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision", "response": "Who is at risk for Prostate Cancer??: Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?", "response": "Rubella (Lifestyle and home remedies): In rare instances when a child or adult is infected with rubella, simple self-care measures are required: - Rest in bed as necessary. - Take acetaminophen (Tylenol, others) to relieve discomfort from fever and aches. - Tell friends, family and co-workers - especially pregnant women - about your diagnosis if they may have been exposed to the disease. - Avoid people who have conditions that cause deficient or suppressed immune systems. - Tell your child's school or child care provider that your child has rubella. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?", "response": "Rubella (Treatment): No treatment will shorten the course of rubella infection, and symptoms are so mild that treatment usually isn't necessary. However, doctors often recommend isolation from others - especially pregnant women - during the infectious period. If you contract rubella while you're pregnant, discuss the risks to your baby with your doctor. If you wish to continue your pregnancy, you may be given antibodies called hyperimmune globulin that can fight off the infection. This can reduce your symptoms, but doesn't eliminate the possibility of your baby developing congenital rubella syndrome. Support of an infant born with congenital rubella syndrome varies depending on the extent of the infant's problems. Children with multiple complications may require early treatment from a team of specialists. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?", "response": "Rubella (Complications): Rubella is a mild infection. Once you've had the disease, you're usually permanently immune. Some women with rubella experience arthritis in the fingers, wrists and knees, which generally lasts for about one month. In rare cases, rubella can cause an ear infection (otitis media) or inflammation of the brain (encephalitis). However, if you're pregnant when you contract rubella, the consequences for your unborn child may be severe. Up to 90 percent of infants born to mothers who had rubella during the first 12 weeks of pregnancy develop congenital rubella syndrome. This syndrome can cause one or more problems, including: - Growth retardation - Cataracts - Deafness - Congenital heart defects - Defects in other organs - Mental retardation The highest risk to the fetus is during the first trimester, but exposure later in pregnancy also is dangerous. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "Skull fracture (When to Contact a Medical Professional): Get medical help right away if: - There are problems with breathing or circulation. - Direct pressure does not stop bleeding from the nose, ears, or wound. - There is drainage of clear fluid from the nose or ears. - There is facial swelling, bleeding, or bruising. - There is an object protruding from the skull. - The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "What to do for Skull fracture?: - Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "What to do for Skull fracture?: If you think someone has a skull fracture: - Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR. - Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance. - If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn. - Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury. - If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss. - If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure. - If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit. - If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the patient does not think medical help is needed). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem", "response": "Spina Bifida (Is there a cure?): There is no cure for spina bifida, but there are treatments for a wide array of related conditions. Visit the section on treatments for more information. « How is it diagnosed? Are there associated conditions? ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem", "response": "What are the treatments for spina bifida?: These resources address the diagnosis or management of spina bifida: - Benioff Children's Hospital, University of California, San Francisco: Treatment of Spina Bifida - Centers for Disease Control and Prevention: Living with Spina Bifida - GeneFacts: Spina Bifida: Diagnosis - GeneFacts: Spina Bifida: Management - Genetic Testing Registry: Neural tube defect - Genetic Testing Registry: Neural tube defects, folate-sensitive - Spina Bifida Association: Urologic Care and Management - University of California, San Francisco Fetal Treatment Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...", "response": "Limb-girdle muscular dystrophy (Treatment): Unfortunately, no definitive treatments for LGMD exist. Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: [5] [6] Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . [5] [6] While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach. [6] Management Guidelines The American Academy of Neurology (AAN), the medical specialty society of neurologists, offers a summary of recommended guidelines for Limb-girdle muscular dystrophy GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...", "response": "Limb-girdle muscular dystrophies (Treatment): There are no known treatments that reverse the muscle weakness. Gene therapy may become available in the future. Supportive treatment can decrease the complications of the disease. The condition is managed based on the person’s symptoms. It includes: - Heart monitoring - Mobility aids - Physical therapy - Respiratory care - Weight control Surgery is sometimes needed for any bone or joint problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "Bursitis of the heel (Treatment): Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "Bursitis of the heel: Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. It may be caused by too much walking, running, or jumping. This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Risks for this condition include: - Starting a very intense workout schedule - Suddenly increasing activity level without the right conditioning - Changes in activity level - History of arthritis that is caused by inflammation Symptoms include: - Pain in the heel, especially with walking, running, or when the area is touched - Pain may get worse when rising on the toes (standing on tiptoes) - Red, warm skin over the back of the heel Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel. The pain may be worse when your ankle is bent upward (dorsiflex). Or, the pain may be worse when you rise on your toes. Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments DO NOT lead to improvement. Inflammation may show on a MRI. Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. This condition most often gets better in several weeks with the proper treatment. Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. Things you can do to prevent the problem include: - Use proper form when exercising. - Maintain as good flexibility and strength around the ankle to help prevent this condition. - Stretch the Achilles tendon to help prevent injury. - Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa. Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "What to do for Contracture deformity?: Follow your health care provider's instructions for treating contracture at home.Treatments may include: - Doing exercises and stretches - Using braces and splints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "subjective vertigo Can macular degeneration in only one eye cause dizziness?", "response": "What is Macular Degeneration?: Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. There are two types: wet and dry. Wet AMD happens when abnormal blood vessels grow under the macula. These new blood vessels often leak blood and fluid. Wet AMD damages the macula quickly. Blurred vision is a common early symptom. Dry AMD happens when the light-sensitive cells in the macula slowly break down. Your gradually lose your central vision. A common early symptom is that straight lines appear crooked. Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision. NIH: National Eye Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "subjective vertigo Can macular degeneration in only one eye cause dizziness?", "response": "Dizziness (Lifestyle and home remedies): Dizziness usually goes away on its own. If you tend to experience repeated episodes of dizziness, consider these tips: - Be aware of the possibility of losing your balance, which can lead to falling and serious injury. - Avoid moving suddenly and walk with a cane for stability, if needed. - Fall-proof your home by removing tripping hazards such as area rugs and exposed electrical cords. Use nonslip mats on your bath and shower floors. Use good lighting. - Sit or lie down immediately when you feel dizzy. Lie still with your eyes closed in a darkened room if you're experiencing a severe episode of vertigo. - Avoid driving a car or operating heavy machinery if you experience frequent dizziness without warning. - Avoid using caffeine, alcohol, salt and tobacco. Excessive use of these substances can worsen your signs and symptoms. - Drink enough fluids, eat a healthy diet, get enough sleep and avoid stress. - If your dizziness is caused by a medication, talk with your doctor about discontinuing it or lowering the dose. - If your dizziness comes with nausea, try an over-the-counter (nonprescription) antihistamine, such as meclizine (Antivert) or one containing dimenhydrinate (Dramamine). These may cause drowsiness. Nondrowsy antihistamines aren't as effective. - If your dizziness is caused by overheating or dehydration, rest in a cool place and drink water or a sports drink (Gatorade, Powerade, others). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?", "response": "What are the symptoms of Dehydration?: Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?", "response": "Dehydration (Summary): Summary When you're dehydrated, your body doesn't have enough fluid and electrolytes to work properly. An average person on an average day needs about 3 quarts of water. But if you're out in the hot sun or are exercising a lot, you need a lot more than that. You can also become dehydrated if you are vomiting, have diarrhea, or are sweating a lot. People who are elderly, very young, taking certain medications, or have a chronic illness have a greater risk. Signs of dehydration in adults include - Being thirsty - Urinating less often than usual - Dark-colored urine - Dry skin - Feeling tired - Dizziness and fainting Signs of dehydration in babies and young children include a dry mouth and tongue, crying without tears, no wet diapers for 3 hours or more, a high fever and being unusually sleepy or drowsy. If you think you're dehydrated, drink small amounts of water over a period of time. Drinking too much all at once can overload your stomach and make you throw up. If you are exercising in the heat and losing a lot of minerals in sweat, sports drinks can be helpful. Avoid any drinks that have caffeine. NIH: National Institutes of Health. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?", "response": "Dehydration: Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how much of your body's fluid is lost or not replaced. Severe dehydration is a life-threatening emergency. You can become dehydrated if you lose too much fluid, do not drink enough water or fluids, or both. Your body may lose a lot of fluid from: - Sweating too much, for example, from exercising in hot weather - Fever - Vomiting or diarrhea - Urinating too much (uncontrolled diabetes or some medications, like diuretics, can cause you to urinate a lot) You might not drink enough fluids because: - You do not feel like eating or drinking because you are sick - You are nauseated - You have a sore throat or mouth sores Older adults and people with certain diseases, such as diabetes, are also at higher risk for dehydration. Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium Your health care provider will look for these signs of dehydration: - Low blood pressure - Blood pressure that drops when you stand up after lying down - White finger tips that do not return to a pink color after your doctor presses the fingertip - Skin that is not as elastic as normal. When the provider pinches it into a fold, it may slowly sag back into place. Normally, skin springs back right away. - Rapid heart rate Your doctor may do lab tests: - Blood tests to check kidney function - Urine tests to see what may be causing dehydration - Other tests to see what may be causing dehydration (blood sugar test for diabetes) To treat dehydration: - Try sipping water or sucking on ice cubes. - Try drinking water or sports drinks that contain electrolytes. - Do not take salt tablets. They can cause serious complications. - Ask your provider what you should eat if you have diarrhea. For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). The provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. If you notice signs of dehydration and treat it quickly, you should recover completely. Untreated severe dehydration may cause: - Death - Permanent brain damage - Seizures You should call 911 if: - The person loses consciousness at any time. - There is any other change in the person's alertness (for example, confusion or seizures). - The person has a fever over 102°F (38.8°C). - You notice symptoms of heatstroke (such as rapid pulse or rapid breathing). - The person's condition does not improve or gets worse despite treatment. To prevent dehydration: - Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. - If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. - Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. - If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /", "response": "Optic nerve atrophy (Treatment): Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /", "response": "Coloboma of optic nerve (Summary): Coloboma of the optic nerve is a congenital eye abnormality in which the optic nerve (which carries images of what the eye sees to the brain) is incompletely formed. The condition may occur in one or both eyes. The degree of visual impairment varies widely depending on the severity and structures involved. Serous detachments of the retina commonly occur in affected people, with a high risk for extensive retinal detachment. The coloboma may be associated with other features, such as a small eye (microphthalmia) with or without a cyst; small cornea (microcornea); or coloboma of other eye structures. Although the condition is present from birth, diagnosis may be delayed since the coloboma is inside the eye and not visible by simple inspection. Coloboma of the optic nerve may occur sporadically, may be due to a genetic mutation and be inherited , or may occur as a feature of an underlying syndrome or other genetic condition. There is no treatment to correct an optic nerve coloboma, but low vision aids may be helpful for some people. [1] [2] [3]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?", "response": "Migraine (Treatment): There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium is right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. The group of medicines most often used is called triptans. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is an herb for migraines. It can be effective for some people. Before using feverfew, make sure your provider approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?", "response": "Migraine (Treatment): There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes. Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin. The sooner these treatments are administered, the more effective they are. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?", "response": "What are the treatments for Typhoid fever?: Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?", "response": "Typhoid fever (Treatment): Antibiotic therapy is the only effective treatment for typhoid fever. Commonly prescribed antibiotics - Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults. - Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children. These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria. Problems with antibiotic resistance In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance. In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin. Other treatments Other treatments include: - Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you're severely dehydrated, you may need to receive fluids through a vein (intravenously). - Surgery. If your intestines become perforated, you'll need surgery to repair the hole. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "varicella shingles How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.", "response": "Chickenpox (Exams and Tests): Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "varicella shingles How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.", "response": "Chickenpox (Causes): Chickenpox is caused by the varicella-zoster virus. It is a member of the herpesvirus family. The same virus also causes shingles in adults. Chickenpox can be spread very easily to others from 1 to 2 days before blisters appear until all the blisters have crusted over. You may get chickenpox: - From touching the fluids from a chickenpox blister - If someone with the disease coughs or sneezes near you Most cases of chickenpox occur in children younger than age 10. The disease is most often mild, although serious complications may occur. Adults and older children get sicker than younger children in most cases. Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox. Severe chickenpox symptoms are more common in children whose immune system does not work well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.", "response": "Adult-onset vitelliform macular dystrophy (Treatment): There is no cure or known treatment to stop the progression of adult-onset vitelliform macular dystrophy. [2] Management usually includes a comprehensive eye examination once or twice a year to monitor progression of the disease and for complications such as choroidal neovascularization ( CNV ). [4] CNV is sometimes associated with adult-onset vitelliform macular dystrophy because macular degeneration can damage the retinal layers. When this happens, the vascular layer of the eye between the sclera and the retina known as the choroid may produce new blood vessels (neovascularization) which grow up through the damaged layers and leak or bleed into the retina. This can cause vision loss on its own. If CNV does develop, anti-VEGF therapy such as Ranibizumab or Bevacizumab can control and even reverse the CNV. However anti-VEGF therapy does not stop or reverse the vision loss caused by adult-onset vitelliform macular dystrophy, only the extra vision loss that is due to also developing CNV. [2] Although vision loss is usually slow, when vision is impaired significantly, people with adult-onset vitelliform macular dystrophy may be referred for low vision testing and rehabilitation. Low vision rehabilitation can help maintain and optimize reading ability and improve overall quality of life. [4] [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "Williams syndrome: Williams syndrome is a rare disorder that can lead to problems with development. It is passed down in families (inherited). Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder on to each of their children. It often occurs randomly. Williams syndrome occurs in about 1 in 8,000 births. One of the 25 missing genes is the gene that produces elastin, a protein that allows blood vessels and other tissues in the body to stretch. It is likely that missing a copy of this gene results in the narrowing of blood vessels, stretchy skin, and flexible joints seen in this condition. Symptoms of Williams syndrome are: - Delayed speech that may later turn into strong speaking ability and strong learning by hearing - Developmental delay - Easily distracted, attention deficit disorder (ADD) - Feeding problems including colic, reflux, and vomiting - Inward bend of the small finger - Learning disorders - Mild to moderate intellectual disability - Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music - Short, compared to the rest of the person's family - Sunken chest The face and mouth of someone with Williams syndrome may show: - A flattened nasal bridge with small upturned nose - Long ridges in the skin that run from the nose to the upper lip - Prominent lips with an open mouth - Skin that covers the inner corner of the eye - Partially missing teeth, defective tooth enamel, or small, widely spaced teeth Signs include: - Narrowing of some blood vessels - Farsightedness - High blood calcium level that may cause seizures and rigid muscles - High blood pressure - Slack joints that may change to stiffness as the person gets older - Unusual star-like pattern in iris of the eye Tests for Williams syndrome include: - Blood pressure check - Blood test for a missing piece of chromosome 7 (FISH test) - Echocardiography combined with Doppler ultrasound - Kidney ultrasound There is no cure for Williams syndrome. Avoid taking extra calcium and vitamin D. Treat high blood calcium, if it occurs. Blood vessel narrowing can be a major health problem. It is treated based on how severe it is. Physical therapy is helpful to people with joint stiffness. Developmental and speech therapy can also help. For example, having strong verbal skills can help make up for other weaknesses. Other treatments are based on the person's symptoms. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome. A support group can be helpful for emotional support and for giving and receiving practical advice. The following organization provides additional information about Williams Syndrome: Williams Syndrome Association -- www.williams-syndrome.org About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. Complications may include: - Calcium deposits in the kidney and other kidney problems - Death (in rare cases from anesthesia) - Heart failure due to narrowed blood vessels - Pain in the abdomen Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "Williams syndrome (Outlook (Prognosis)): About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "Williams syndrome (When to Contact a Medical Professional): Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "Lewy body dementia (Overview): Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control). Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia may experience visual hallucinations, and changes in alertness and attention. Other effects include Parkinson's disease-like symptoms such as rigid muscles, slow movement and tremors. Lewy body dementia care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "Lewy body dementia (Risk factors): A few factors seem to increase the risk of developing Lewy body dementia, including: - Being older than 60 - Being male - Having a family member with Lewy body dementia or Parkinson's disease Research has indicated that depression is also associated with Lewy body dementia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "Lewy body dementia (Treatment): Treatment can be challenging, and there's no cure for Lewy body dementia. Doctors treat the individual symptoms. Medications - Cholinesterase inhibitors. These Alzheimer's disease medications, such as rivastigmine (Exelon), work by increasing the levels of chemical messengers believed to be important for memory, thought and judgment (neurotransmitters) in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Possible side effects may include gastrointestinal upset, excessive salivation and tearing, and frequent urination. These are not FDA approved for Lewy body dementia. - Parkinson's disease medications. These medications, such as carbidopa-levodopa (Sinemet) may help reduce parkinsonian symptoms, such as rigid muscles and slow movement. However, these medications may also increase confusion, hallucinations and delusions. - Medications to treat other symptoms. Your doctor may prescribe medications to treat other symptoms associated with Lewy body dementia, such as sleep or movement problems. If possible, avoid medications with anticholinergic properties, which can worsen cognition or dopamine agonists, which can cause hallucinations. First-generation antipsychotic medications, such as haloperidol (Haldol), should not be used to treat Lewy body dementia. They may cause severe confusion, severe Parkinsonism, sedation and sometimes even death. Very rarely, certain second-generation antipsychotics may be prescribed for a short time at a low dose but only if the benefits outweigh the risks. Therapies Because antipsychotic drugs can worsen Lewy body dementia symptoms, it might be helpful to initially try nondrug approaches, such as: - Tolerating the behavior. Many times a person with Lewy body dementia isn't distressed by the hallucinations. In these cases, the side effects of medication may be worse than the hallucinations themselves. - Modifying the environment. Reducing clutter and distracting noise can make it easier for someone with dementia to function. - Offering soothing responses. A caregiver's response may worsen behavior. Avoid correcting and quizzing a person with dementia. Offer reassurance and validation of his or her concerns. - Creating daily routines and keeping tasks simple. Break tasks into easier steps and focus on successes, not failures. Structure and routine during the day can be less confusing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "Cri du chat syndrome (Summary): Cri du chat syndrome is a group of symptoms that result from missing a piece of chromosome number 5. The syndrome's name is based on the infant's cry, which is high-pitched and sounds like a cat. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "Cri du chat syndrome (Causes): Cri du chat syndrome is rare. It is caused by a missing piece of chromosome 5. Most cases are believed to occur during the development of the egg or sperm. A small number of cases occur when a parent passes a different, rearranged form of the chromosome to their child. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "cri-du-chat syndrome (Genetic Changes): Cri-du-chat syndrome is caused by a deletion of the end of the short (p) arm of chromosome 5. This chromosomal change is written as 5p-. The size of the deletion varies among affected individuals; studies suggest that larger deletions tend to result in more severe intellectual disability and developmental delay than smaller deletions. The signs and symptoms of cri-du-chat syndrome are probably related to the loss of multiple genes on the short arm of chromosome 5. Researchers believe that the loss of a specific gene, CTNND2, is associated with severe intellectual disability in some people with this condition. They are working to determine how the loss of other genes in this region contributes to the characteristic features of cri-du-chat syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is fragile x syndrome", "response": "What is fragile X syndrome?: Fragile X syndrome is a genetic condition that causes a range of developmental problems including learning disabilities and cognitive impairment. Usually, males are more severely affected by this disorder than females. Affected individuals usually have delayed development of speech and language by age 2. Most males with fragile X syndrome have mild to moderate intellectual disability, while about one-third of affected females are intellectually disabled. Children with fragile X syndrome may also have anxiety and hyperactive behavior such as fidgeting or impulsive actions. They may have attention deficit disorder (ADD), which includes an impaired ability to maintain attention and difficulty focusing on specific tasks. About one-third of individuals with fragile X syndrome have features of autism spectrum disorders that affect communication and social interaction. Seizures occur in about 15 percent of males and about 5 percent of females with fragile X syndrome. Most males and about half of females with fragile X syndrome have characteristic physical features that become more apparent with age. These features include a long and narrow face, large ears, a prominent jaw and forehead, unusually flexible fingers, flat feet, and in males, enlarged testicles (macroorchidism) after puberty. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is fragile x syndrome", "response": "Fragile X Syndrome (What are common symptoms?): People with Fragile X do not all have the same signs and symptoms, but they do have some things in common. Symptoms are often milder in females than in males. - Intelligence and learning. Many people with Fragile X have problems with intellectual functioning. - These problems can range from the mild, such as learning disorders or problems with mathematics, to the severe, such as an intellectual or developmental disability. - The syndrome may affect the ability to think, reason, and learn. - Because many people with Fragile X also have attention disorders, hyperactivity, anxiety, and language-processing problems, a person with Fragile X may have more capabilities than his or her IQ (intelligence quotient) score suggests. - Physical. Most infants and younger children with Fragile X don’t have any specific physical features of this syndrome. When these children start to go through puberty, however, many will begin to develop certain features that are typical of those with Fragile X. - These features include a narrow face, large head, large ears, flexible joints, flat feet, and a prominent forehead. - These physical signs become more obvious with age. - Behavioral, social, and emotional. Most children with Fragile X have some behavioral challenges. - They may be afraid or anxious in new situations. - They may have trouble making eye contact with other people. - Boys, especially, may have trouble paying attention or be aggressive. - Girls may be shy around new people. They may also have attention disorders and problems with hyperactivity. - Speech and language. Most boys with Fragile X have some problems with speech and language. - They may have trouble speaking clearly, may stutter, or may leave out parts of words. They may also have problems understanding other people’s social cues, such as tone of voice or specific types of body language. - Girls usually do not have severe problems with speech or language. - Some children with Fragile X begin talking later than typically developing children. Most will talk eventually, but a few might stay nonverbal throughout their lives. - Sensory. Many children with Fragile X are bothered by certain sensations, such as bright light, loud noises, or the way certain clothing feels on their bodies. - These sensory issues might cause them to act out or display behavior problems. « How many people are affected? How is it diagnosed? ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia (Prevention): Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: - Eating healthy foods - Exercising - Quitting smoking - Controlling high blood pressure - Managing diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia (Prognosis): There are many disorders that can cause dementia. Some, such as Alzheimer’s disease or Huntington’s disease, lead to a progressive loss of mental functions. But other types of dementia can be halted or reversed with appropriate treatment. People with moderate or advanced dementia typically need round-the-clock care and supervision to prevent them from harming themselves or others. They also may need assistance with daily activities such as eating, bathing, and dressing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia (Treatment): Most types of dementia can't be cured, but there are ways to manage your symptoms. Medications The following are used to temporarily improve dementia symptoms. - Cholinesterase inhibitors. These medications - including donepezil (Aricept), rivastigmine (Exelon) and galantamine (Razadyne) - work by boosting levels of a chemical messenger involved in memory and judgment. Although primarily used to treat Alzheimer's disease, these medications might also be prescribed for other dementias, including vascular dementia, Parkinson's disease dementia and Lewy body dementia. Side effects can include nausea, vomiting and diarrhea. - Memantine. Memantine (Namenda) works by regulating the activity of glutamate, another chemical messenger involved in brain functions, such as learning and memory. In some cases, memantine is prescribed with a cholinesterase inhibitor. A common side effect of memantine is dizziness. - Other medications. Your doctor might prescribe medications to treat other symptoms or conditions, such as depression, sleep disturbances or agitation. Therapies Several dementia symptoms and behavior problems might be treated initially using nondrug approaches, such as: - Occupational therapy. An occupational therapist can show you how to make your home safer and teach coping behaviors. The purpose is to prevent accidents, such as falls; manage behavior; and prepare you for the dementia progression. - Modifying the environment. Reducing clutter and noise can make it easier for someone with dementia to focus and function. You might need to hide objects that can threaten safety, such as knives and car keys. Monitoring systems can alert you if the person with dementia wanders. - Modifying tasks. Break tasks into easier steps and focus on success, not failure. Structure and routine also help reduce confusion in people with dementia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i stop using rasagiline", "response": "How should Rasagiline be used and what is the dosage?: Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body's response to this medication. Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i stop using rasagiline", "response": "Rasagiline (What should I do if I forget a dose?): Do not take a double dose to make up for a missed one. Skip the missed dose and take your next dose at the usual time the next day. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Diabetes (Causes): Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both. To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested: - A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. - An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be stored or used as fuel. People with diabetes have high blood sugar because their body cannot move sugar from the blood into muscle and fat cells to be burned or stored for energy, and/or because their liver makes too much glucose and releases it into the blood. This is because either: - Their pancreas does not make enough insulin - Their cells do not respond to insulin normally - Both of the above There are two major types of diabetes. The causes and risk factors are different for each type: - Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. This is because the pancreas cells that make insulin stop working. Daily injections of insulin are needed. The exact cause is unknown. - Type 2 diabetes is much more common. It most often occurs in adulthood, but because of high obesity rates, children and teens are now being diagnosed with this disease. Some people with type 2 diabetes do not know they have it. With type 2 diabetes, the body is resistant to insulin and doesn't use insulin as well as it should. - There are other causes of diabetes, and some people cannot be classified as type 1 or type 2. Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes. If your parent, brother, or sister has diabetes, you may be more likely to develop the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Diabetes (Symptoms): A high blood sugar level can cause several symptoms, including: - Blurry vision - Excess thirst - Fatigue - Frequent urination - Hunger - Weight loss Because type 2 diabetes develops slowly, some people with high blood sugar have no symptoms. Symptoms of type 1 diabetes develop over a short period. People may be very sick by the time they are diagnosed. After many years, diabetes can lead to other serious problems. These problems are known as diabetes complications, and include: - Eye problems, including trouble seeing (especially at night), light sensitivity, and blindness - Sores and infections of the leg or foot, which if untreated, can lead to amputation of the leg or foot - Damage to nerves in the body, causing pain, tingling, a loss of feeling, problems digesting food, and erectile dysfunction - Kidney problems, which can lead to kidney failure - Weakened immune system, which can lead to more frequent infections - Increased chance of having a heart attack or stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Diabetes - tests and checkups (Eye Exams): An eye doctor should check your eyes every year. See an eye doctor who takes care of people with diabetes. If you have eye problems because of diabetes, you will probably see your eye doctor more often. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "What to do for Radiation sickness?: - DO NOT remain in area where exposure occurred. - DO NOT apply ointments to burned areas. - DO NOT remain in contaminated clothing. - DO NOT hesitate to seek emergency medical treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "What to do for Radiation sickness?: Unfortunately, giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated as part of the resuscitation process so that they do not cause radiation injury to others. This may complicate the first aid and resuscitation process. - Check the person's breathing and pulse. - Start CPR, if necessary. - Remove the person's clothing and place the items in a sealed container. This stops ongoing contamination. - Vigorously wash the victim with soap and water. - Dry the victim and wrap with a soft, clean blanket. - Call for emergency medical help or take the person to nearest emergency medical facility if you can do so safely - REPORT EXPOSURE TO EMERGENCY OFFICIALS. If symptoms occur during or after medical radiation treatments: - Tell the provider or seek medical treatment. - Handle affected areas gently. - Treat symptoms or illnesses as recommended by the provider. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "Burns (Summary): Summary A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot liquids and steam, building fires and flammable liquids and gases are the most common causes of burns. Another kind is an inhalation injury, caused by breathing smoke. There are three types of burns: - First-degree burns damage only the outer layer of skin - Second-degree burns damage the outer layer and the layer underneath - Third-degree burns damage or destroy the deepest layer of skin and tissues underneath Burns can cause swelling, blistering, scarring and, in serious cases, shock, and even death. They also can lead to infections because they damage your skin's protective barrier. Treatment for burns depends on the cause of the burn, how deep it is, and how much of the body it covers. Antibiotic creams can prevent or treat infections. For more serious burns, treatment may be needed to clean the wound, replace the skin, and make sure the patient has enough fluids and nutrition. NIH: National Institute of General Medical Sciences. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you administer lanreotide", "response": "How should Lanreotide Injection be used and what is the dosage?: Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you administer lanreotide", "response": "Lanreotide Injection (What should I know about storage and disposal of this medication?): If you are storing the prefilled syringes in your home until it is time for it to be injected by your doctor or nurse, you should always store it in original carton in the refrigerator and protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your healthcare provider about the proper disposal of your medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you catch hepatitis c", "response": "Hepatitis: Hepatitis is an inflammation of the liver. Viruses are the most common cause of hepatitis, but the condition can also be caused by other infections, heavy alcohol use, toxins, certain medications, and autoimmune disease. There are five main virus types that cause hepatitis---type A, B, C, D and E. Hepatitis A and E are typically caused by ingesting contaminated food or water. Type B commonly occurs through contact with infected blood, semen or other bodily fluid through sex, sharing needles or other drug-injection equipment or from mother to baby at birth. Hepatitis type C is a blood-borne virus that is largely spread by sharing needles or other drug injection equipment. Hepatitis D, which is transmitted through contact with infectious blood, occurs only among people with hepatitis B infection. Hepatitis B, C, and D afflict more than half a billion people worldwide and are responsible for more than a million deaths a year. Chronic infection with these viruses can lead to cirrhosis of the liver, end-stage liver disease, and liver cancer. The NIAID Hepatitis Research Program supports research on all hepatitis viruses. However, commensurate with the magnitude of the medical burdens imposed by these viruses, the greatest emphasis is placed on the study of hepatitis C and hepatitis B viruses, which focuses on the understanding the pathogenesis and immunology of hepatitis viruses and developing novel therapeutics and vaccines against diseases caused by hepatitis viruses. Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; for example, hepatitis A, hepatitis B or hepatitis C. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver. Some people who have hepatitis have no symptoms. Others may have Loss of appetite Nausea and vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain Jaundice, yellowing of skin and eyes Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer. Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you catch hepatitis c", "response": "What is Hepatitis C?: Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If you do get symptoms, you may feel as if you have the flu. You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you catch hepatitis c", "response": "Hepatitis C (What is hepatitis C?): Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person’s blood.Hepatitis C can cause an acute or chronic infection.Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.Acute hepatitis CAcute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.Chronic hepatitis CChronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn’t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.13Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you check for lupus?", "response": "What is Lupus?: If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "Anxiety (Diagnosis): You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "Anxiety disorders (How are anxiety disorders diagnosed?): Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.2. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "Generalized anxiety disorder (Exams and Tests): There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "Anterior prolapse (cystocele) (Causes): Your pelvic floor consists of muscles, ligaments and connective tissues that support your bladder and other pelvic organs. The connections between your pelvic floor muscles and ligaments can weaken over time, as a result of trauma from childbirth or chronic straining of pelvic floor muscles. When this happens, your bladder can slip down lower than normal and bulge into your vagina (anterior prolapse). Possible causes of anterior prolapse include: - Pregnancy and vaginal childbirth - Being overweight or obese - Repeated heavy lifting - Straining with bowel movements - A chronic cough or bronchitis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "Pelvic organ prolapse: Pelvic organ prolapse happens when the muscles and tissues supporting the pelvic organs (the uterus, bladder, or rectum) become weak or loose. This allows one or more of the pelvic organs to drop or press into or out of the vagina. Many women are embarrassed to talk to their doctor about their symptoms or think that their symptoms are normal. But pelvic organ prolapse is treatable. The pelvic muscles and tissues support the pelvic organs like a hammock. The pelvic organs include the bladder, uterus and cervix, vagina, and rectum, which is part of the bowel. A prolapse happens when the pelvis muscles and tissues can no longer support these organs because the muscles and tissues are weak or damaged. This causes one or more pelvic organs to drop or press into or out of the vagina. Pelvic organ prolapse is a type of pelvic floor disorder. The most common pelvic floor disorders are: The different types of pelvic organ prolapse depend on the pelvic organ affected. The most common types include: Although it is rare, pelvic organ prolapse can also happen after a hysterectomy. Any part of the vaginal wall may drop, causing a bulge into or out of the vagina. Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect one in five women in the United States.1 Pelvic organ prolapse is less common than urinary or fecal incontinence but affects almost 3% of U.S. women.1 Pelvic organ prolapse happens more often in older women and in white and Hispanic women than in younger women or women of other racial and ethnic groups.2,3 Some women develop more than one pelvic floor disorder, such as pelvic organ prolapse with urinary incontinence. The pressure from prolapse can cause a bulge in the vagina that can sometimes be felt or seen. Women with pelvic organ prolapse may feel uncomfortable pressure during physical activity or sex. Other symptoms of pelvic organ prolapse include: Some women say that their symptoms are worse at certain times of the day, during physical activity, or after standing for a long time. Talk to your doctor or nurse about your symptoms. Pelvic organ prolapse happens when the muscles or connective tissues of the pelvis do not work as they should. The most common risk factors are: Your doctor will talk to you about your symptoms and do a pelvic exam. You may be asked to strain or cough during the exam so your doctor can see whether these actions cause prolapse or urine leakage. Your doctor may also do other tests to see whether you can completely empty your bladder when you go to the bathroom. Treatment for pelvic organ prolapse depends on the type of prolapse you have, your symptoms, your age, other health problems, and whether you are sexually active. Your treatment may include one or more of the following: Researchers are studying ways to prevent pelvic organ prolapse. The following steps may reduce your risk of getting a pelvic floor problem: For more information about pelvic organ prolapse, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "Uterine prolapse (Complications): Uterine prolapse is often associated with prolapse of other pelvic organs. You might experience: - Anterior prolapse (cystocele). Weakness of connective tissue separating the bladder and vagina may cause the bladder to bulge into the vagina. Anterior prolapse is also called prolapsed bladder. - Posterior vaginal prolapse (rectocele). Weakness of connective tissue separating the rectum and vagina may cause the rectum to bulge into the vagina. You might have difficulty having bowel movements. Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude outside the body. Vaginal tissue that rubs against clothing can lead to vaginal sores (ulcers.) Rarely, the sores can become infected. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get neuromuscular disorders", "response": "Neuromuscular Disorders (Summary): Summary Neuromuscular disorders affect the nerves that control your voluntary muscles. Voluntary muscles are the ones you can control, like in your arms and legs. Your nerve cells, also called neurons, send the messages that control these muscles. When the neurons become unhealthy or die, communication between your nervous system and muscles breaks down. As a result, your muscles weaken and waste away. The weakness can lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include - Amyotrophic lateral sclerosis - Multiple sclerosis - Myasthenia gravis - Spinal muscular atrophy Many neuromuscular diseases are genetic, which means they run in families or there is a mutation in your genes. Sometimes, an immune system disorder can cause them. Most of them have no cure. The goal of treatment is to improve symptoms, increase mobility and lengthen life. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get neuromuscular disorders", "response": "Myasthenia gravis (Causes): Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system). Myasthenia gravis can affect people at any age. It is most common in young women and older men. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get pulmonary hypertension", "response": "Pulmonary Hypertension (Causes): Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get pulmonary hypertension", "response": "Pulmonary hypertension (Causes): The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: - Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis - Birth defects of the heart - Blood clots in the lung (pulmonary embolism) - Heart failure - Heart valve disease - HIV infection - Low oxygen levels in the blood for a long time (chronic) - Lung disease, such as COPD or pulmonary fibrosis - Medicines (for example, certain diet drugs) - Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get pulmonary hypertension", "response": "Pulmonary hypertension (Causes): Your heart has two upper chambers (atria) and two lower chambers (ventricles). Each time blood passes through your heart, the lower right chamber (right ventricle) pumps blood to your lungs through a large blood vessel (pulmonary artery). In your lungs, the blood releases carbon dioxide and picks up oxygen. The oxygen-rich blood then flows through blood vessels in your lungs (pulmonary arteries, capillaries and veins) to the left side of your heart. Ordinarily, the blood flows easily through the vessels in your lungs, so blood pressure is usually much lower in your lungs. With pulmonary hypertension, the rise in blood pressure is caused by changes in the cells that line your pulmonary arteries. These changes can cause the walls of the arteries to become stiff and thick, and extra tissue may form. The blood vessels may also become inflamed and tight. These changes in the pulmonary arteries can reduce or block blood flow through the blood vessels. This makes it harder for blood to flow, raising the blood pressure in the pulmonary arteries. Pulmonary hypertension is classified into five groups, depending on the cause. Group 1: Pulmonary arterial hypertension - Cause unknown, known as idiopathic pulmonary arterial hypertension - A specific gene mutation that can cause pulmonary hypertension to develop in families, also called heritable pulmonary arterial hypertension - Certain drugs - such as certain prescription diet drugs or illegal drugs such as methamphetamines - or certain toxins - Heart abnormalities present at birth (congenital heart disease) - Other conditions, such as connective tissue disorders (scleroderma, lupus, others), HIV infection or chronic liver disease (cirrhosis) Group 2: Pulmonary hypertension caused by left-sided heart disease - Left-sided valvular heart disease, such as mitral valve or aortic valve disease - Failure of the lower left heart chamber (left ventricle) Group 3: Pulmonary hypertension caused by lung disease - Chronic obstructive pulmonary disease, such as emphysema - Lung disease such as pulmonary fibrosis, a condition that causes scarring in the tissue between the lungs' air sacs (interstitium) - Sleep apnea and other sleep disorders - Long-term exposure to high altitudes in people who may be at higher risk of pulmonary hypertension Group 4: Pulmonary hypertension caused by chronic blood clots - Chronic blood clots in the lungs (pulmonary emboli) Group 5: Pulmonary hypertension associated with other conditions that have unclear reasons why the pulmonary hypertension occurs - Blood disorders - Disorders that affect several organs in the body, such as sarcoidosis - Metabolic disorders, such as glycogen storage disease - Tumors pressing against pulmonary arteries Eisenmenger syndrome and pulmonary hypertension Eisenmenger syndrome, a type of congenital heart disease, causes pulmonary hypertension. It's most commonly caused by a large hole in your heart between the two lower heart chambers (ventricles), called a ventricular septal defect. This hole in your heart causes blood to circulate abnormally in your heart. Oxygen-carrying blood (red blood) mixes with oxygen-poor blood (blue blood). The blood then returns to your lungs instead of going to the rest of your body, increasing the pressure in the pulmonary arteries and causing pulmonary hypertension. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "High cholesterol (Diagnosis): A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken. Interpreting the numbers In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines. Children and cholesterol testing For most children, the National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, and another cholesterol screening test between the ages of 17 and 21. Cholesterol testing is usually avoided between the ages of 12 and 16 because false-negative results are more likely within this age group. If your child has a family history of early-onset heart disease or a personal history of obesity or diabetes, your doctor may recommend earlier or more frequent cholesterol testing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "How to diagnose High blood cholesterol levels?: A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.) It is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, it recommends different medicines and doses depending on a person's history and risk factor profile. General targets are: - LDL: 70 to 130 mg/dL (lower numbers are better) - HDL: more than 50 mg/dL (high numbers are better) - Total cholesterol: less than 200 mg/dL (lower numbers are better) - Triglycerides: 10 to 150 mg/dL (lower numbers are better) If your cholesterol results are abnormal, you may also have other tests such as: - Blood sugar (glucose) test to look for diabetes - Kidney function tests - Thyroid function tests to look for an underactive thyroid gland. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "Cholesterol testing and results (When Should You Be Tested?): Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20. You should have a cholesterol test done at an earlier age if you have: - Diabetes - Heart disease - Stroke - High blood pressure - A strong family history of heart disease Follow-up testing should be done: - Every 5 years if your results were normal - More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet - Every year or so if you are taking medicines to control high cholesterol. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "Heart attack (Lifestyle and home remedies): Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "Asthma (Diagnosis): Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma—that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. You may need to see an asthma specialist if: You need special tests to help diagnose asthma You've had a life-threatening asthma attack You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled You're thinking about getting allergy treatments Medical and Family Histories Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\" Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Physical Exam Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema). Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you. Diagnostic Tests Lung Function Test Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicine and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma. Other Tests Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include: Allergy testing to find out which allergens affect you, if any. A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in. A test to show whether you have another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it's hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions. Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin condition eczema The child has allergic reactions to pollens or other airborne allergens The child wheezes even when he or she doesn't have a cold or other infection The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "Asthma (Diagnosis): Physical exam To rule out other possible conditions - such as a respiratory infection or chronic obstructive pulmonary disease (COPD) - your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. Tests to measure lung function You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include: - Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out. - Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings. Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma. Additional tests Other tests to diagnose asthma include: - Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal. - Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed - a sign of asthma - you may have higher than normal nitric oxide levels. - Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems. - Allergy testing. This can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mold and pollen. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy. - Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin). - Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air. How asthma is classified To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. Asthma is classified into four general categories:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "Asthma (Exams and Tests): The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. Tests that may be ordered include: - Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances - Arterial blood gas (usually only done with people who are having a severe asthma attack) - Chest x-ray - Lung function tests, including peak flow measurements. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "Trisomy 18 (Exams and Tests): An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "Trisomy 18 (Exams and Tests): An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "Trisomy 18: Trisomy 18 is a genetic disorder in which a person has a third copy of material from chromosome 18, instead of the usual 2 copies. Trisomy 18 occurs in 1 in 6,000 live births. It is 3 times more common in girls than boys. The syndrome occurs when there is extra material from chromosome 18. The extra material affects normal development. Symptoms may include: - Clenched hands - Crossed legs - Feet with a rounded bottom (rocker-bottom feet) - Low birth weight - Low-set ears - Mental delay - Poorly developed fingernails - Small head (microcephaly) - Small jaw (micrognathia) - Undescended testicle - Unusual shaped chest (pectus carinatum) An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney There are no specific treatments for trisomy 18. Which treatments are used depend on the person's individual condition. Support groups include: - Support Organization for Trisomy 18, 13 and Related Disorders (SOFT): trisomy.org - Trisomy 18 Foundation: www.trisomy18.org - Hope for Trisomy 13 and 18: www.hopefortrisomy13and18.org Half of infants with this condition do not survive beyond the first week of life. Nine out of 10 children will die by 1 year of age. Some children have survived to the teenage years, but with serious medical and developmental problems. Complications depend on the specific defects and symptoms. Genetic counseling can help families understand the condition, the risks of inheriting it, and how to care for the person. Tests can be done during pregnancy to find out if the child has this syndrome. Genetic testing is recommended for parents who have a child with this syndrome and who want to have more children. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "Generalized anxiety disorder (Diagnosis): To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "Generalized anxiety disorder (Exams and Tests): There is no test that can make a diagnosis of GAD. The diagnosis is based on your answers to questions about the symptoms of GAD. Your health care provider will ask about these symptoms. You will also be asked about other aspects of your mental and physical health. A physical exam or lab tests may be done to rule out other conditions that cause similar symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "Generalized anxiety disorder (Risk factors): Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder: - Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are. - Genetics. Generalized anxiety disorder may run in families. - Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is gonorrhea diagnosed", "response": "Gonorrhea (Exams and Tests): Gonorrhea can be quickly detected by looking at a sample of discharge or tissue under the microscope. This is called a gram stain. This method is fast, but it is not the most certain. Gonorrhea is most accurately detected with DNA tests. DNA tests are useful for screening. The ligase chain reaction (LCR) test is one of the tests. DNA tests are quicker than cultures. These tests can be performed on urine samples, which are easier to collect than samples from the genital area. Prior to DNA tests, cultures (cells that grow in a lab dish) were used to provide proof of gonorrhea, but are less commonly used now. Samples for a culture are most often taken from the cervix, vagina, urethra, anus, or throat. - Rarely they are taken from joint fluid or blood - Cultures can often provide an early diagnosis within 24 hours. A confirmed diagnosis is available within 72 hours. If you have gonorrhea, you should ask to be tested for other sexually transmitted infections, including chlamydia, syphilis, and HIV herpes and hepatitis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is gonorrhea diagnosed", "response": "Gonorrhea (Diagnosis): To determine whether the gonorrhea bacterium is present in your body, your doctor will analyze a sample of cells. Samples can be collected by: - Urine test. This may help identify bacteria in your urethra. - Swab of affected area. A swab of your throat, urethra, vagina or rectum may collect bacteria that can be identified in a laboratory. For women, home test kits are available for gonorrhea. Home test kits include vaginal swabs for self-testing that are sent to a specified lab for testing. If you prefer, you can choose to be notified by email or text message when your results are ready. You may then view your results online or receive them by calling a toll-free hotline. Testing for other sexually transmitted infections Your doctor may recommend tests for other sexually transmitted infections. Gonorrhea increases your risk of these infections, particularly chlamydia, which often accompanies gonorrhea. Testing for HIV also is recommended for anyone diagnosed with a sexually transmitted infection. Depending on your risk factors, tests for additional sexually transmitted infections could be beneficial as well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is hemophilia treated", "response": "Hemophilia A (Treatment): Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: - Severity of bleeding - Site of bleeding - Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products. Some people with hemophilia A develop antibodies to factor VIII. These antibodies are called inhibitors. The inhibitors attack factor VIII so that it no longer works. In such cases, a man-made clotting factor called VIIa can be given. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is hemophilia treated", "response": "Hemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage. This is referred to as prophylactic therapy. People can be trained to give infusions at home. This is especially important for people with severe disease because the infusion works the best within one hour of a bleeding episode. In general, rapid treatment is important because it reduces pain and damage to the joints, muscles or other affected tissues or organs . [5] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The National Hemophilia Foundation Web site posts the guidelines for management of pregnancy and delivery of women with bleeding disorders and carriers of hemophilia A and B. Click on the link to view the guidelines. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is congenital heart disease passed down", "response": "critical congenital heart disease (Inheritance Pattern): Most cases of CCHD are sporadic, which means they occur in people with no history of the disorder in their family. However, close relatives (such as siblings) of people with CCHD may have an increased risk of being born with a heart defect compared with people in the general population. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is congenital heart disease passed down", "response": "critical congenital heart disease (Genetic Changes): In most cases, the cause of CCHD is unknown. A variety of genetic and environmental factors likely contribute to this complex condition. Changes in single genes have been associated with CCHD. Studies suggest that these genes are involved in normal heart development before birth. Most of the identified mutations reduce the amount or function of the protein that is produced from a specific gene, which likely impairs the normal formation of structures in the heart. Studies have also suggested that having more or fewer copies of particular genes compared with other people, a phenomenon known as copy number variation, may play a role in CCHD. However, it is unclear whether genes affected by copy number variation are involved in heart development and how having missing or extra copies of those genes could lead to heart defects. Researchers believe that single-gene mutations and copy number variation account for a relatively small percentage of all CCHD. CCHD is usually isolated, which means it occurs alone (without signs and symptoms affecting other parts of the body). However, the heart defects associated with CCHD can also occur as part of genetic syndromes that have additional features. Some of these genetic conditions, such as Down syndrome, Turner syndrome, and 22q11.2 deletion syndrome, result from changes in the number or structure of particular chromosomes. Other conditions, including Noonan syndrome and Alagille syndrome, result from mutations in single genes. Environmental factors may also contribute to the development of CCHD. Potential risk factors that have been studied include exposure to certain chemicals or drugs before birth, viral infections (such as rubella and influenza) that occur during pregnancy, and other maternal illnesses including diabetes and phenylketonuria. Although researchers are examining risk factors that may be associated with this complex condition, many of these factors remain unknown. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is congenital heart disease passed down", "response": "Congenital heart disease (Causes): Congenital heart disease can describe a number of different problems affecting the heart. It is the most common type of birth defect. CHD causes more deaths in the first year of life than any other birth defects. Congenital heart disease is often divided into 2 types: cyanotic (blue skin color caused by a lack of oxygen) and non-cyanotic. The following lists cover the most common congenital heart diseases: Cyanotic: - Ebstein's anomaly - Hypoplastic left heart - Pulmonary atresia - Tetralogy of Fallot - Total anomalous pulmonary venous return - Transposition of the great vessels - Tricuspid atresia - Truncus arteriosus Non-cyanotic: - Aortic stenosis - Atrial septal defect (ASD) - Atrioventricular canal (endocardial cushion defect) - Coarctation of the aorta - Patent ductus arteriosus (PDA) - Pulmonic stenosis - Ventricular septal defect (VSD) These problems may occur alone or together. Most children with CHD do not have other types of birth defects. However, heart defects may be part of genetic and chromosomal syndromes. Some of these syndromes may be passed down through families. Examples include: - DiGeorge syndrome - Down syndrome - Marfan syndrome - Noonan syndrome - Trisomy 13 - Turner syndrome Often, no cause for the heart disease can be found. Congenital heart diseases continue to be investigated and researched. Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems. Poorly controlled blood sugar in women who have diabetes during pregnancy has also been linked to a high rate of congenital heart defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "Spinal and epidural anesthesia: Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine. The doctor who gives you epidural or spinal anesthesia is called an anesthesiologist. First, the area of your back where the needle is inserted is cleaned with a special solution. The area may also be numbed with a local anesthetic. You'll likely receive fluids through an intravenous line (IV) in a vein. You may receive medicine through the IV to help you relax or sleep lightly. For an epidural: - The doctor injects medicine just outside of the sac of fluid around your spinal cord. This is called the epidural space. - The medicine numbs, or blocks feeling in a certain part of your body so that you cannot feel pain. The medicine begins to take effect in about 10 to 20 minutes. It works well for longer procedures. Women often have an epidural during childbirth. - A small tube (catheter) is often left in place. You can receive more medicine through the catheter to help control your pain during or after your procedure. For a spinal: - The doctor injects medicine into the fluid in your spinal cord. This is usually done only once, so you will not need to have a catheter placed. - The medicine begins to take effect right away. It works well for shorter and simpler procedures. Your pulse, blood pressure and oxygen level in your blood are checked during the procedure. After the procedure, you will have a bandage where the needle was inserted. Spinal and epidural anesthesia have fewer side effects and risks than general anesthesia (asleep and pain-free). People usually recover their senses much faster. Sometimes, they have to wait for the anesthetic to wear off so they can walk. Spinal anesthesia is often used for genital, urinary tract, or lower body procedures. Epidural anesthesia is often used during labor and delivery, and surgery in the pelvis and legs. Epidural and spinal anesthesia are often used when: - The procedure or labor is too painful without any pain medicine. - The procedure is in the belly, legs, or feet. - Your body can remain in a comfortable position during your procedure. - You want fewer systemic side effects and a shorter recovery than you would have from general anesthesia. Spinal and epidural anesthesia are generally safe. Ask your doctor about these possible complications: - Allergic reaction to the anesthesia used - Bleeding around the spinal column (hematoma) - Difficulty urinating - Drop in blood pressure - Infection in your spine (meningitis or abscess) - Nerve damage - Seizures (this is rare) - Severe headache Tell your health care provider: - If you are or could be pregnant - What medicines you are taking, including medicines, supplements, or herbs you bought without a prescription During the days before the procedure: - Tell your doctor about any allergies or health conditions you have, what medicines you are taking, and what anesthesia or sedation you have had before. - If your procedure is planned, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other blood thinners. - Ask your doctor which medicines you should still take on the day of your procedure. - Arrange for a responsible adult to drive you to and from the hospital or clinic. - If you smoke, try to stop. Ask your provider for help quitting. On the day of the procedure: - Follow instructions on when to stop eating and drinking. - Do not drink alcohol the night before and the day of your procedure. - Take the medicines your doctor told you to take with a small sip of water. - Follow instructions on when to arrive at the hospital. Be sure to arrive on time. After an epidural, the catheter in your back is removed. You lie in bed until you have feeling in your legs and can walk. You may feel sick to your stomach and be dizzy. You may be tired. After spinal anesthesia, you lie flat in bed for a few hours. This is to keep you from getting a headache. You may feel sick to your stomach and be dizzy. You may be tired. Most people feel no pain during spinal and epidural anesthesia and recover fully. Updated by: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "Epidural block - pregnancy (Is an Epidural Safe?): Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "Epidural block - pregnancy: An epidural block is a numbing medicine given by injection (shot) in the back. It numbs or causes a loss of feeling in the lower half your body. This lessens the pain of contractions during childbirth. An epidural block may also be used to reduce pain during surgery on the lower extremities. This article focuses on epidural blocks during childbirth. The block or shot is given into an area over your lower back or spine. - You may be asked to lie on your side, or you may sit up. - Either way, you will be asked to pull your stomach inwards and hunch your back outwards. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: - The provider inserts a needle into your lower back. - The needle is placed into a small space outside your spinal cord. - A small soft tube (catheter) is placed into your back, next to your spine. - The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks. Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down. - To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable. - If your blood pressure shows a drop, you may need to lie on your side to keep the blood moving throughout your body. - Your provider may also give you medicine to raise your blood pressure. An epidural block may change or alter labor and delivery. - If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal. - Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may even go faster. If your labor slows down, your doctor can give you medicine to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed. Other rare side effects are: - You may get a headache after your epidural but this is rare. - Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare. There are 2 types: - \"Walking\" epidural block. This type of epidural will lessen your pain, but you will still be able to move your legs. Most women are not really able to walk around, but they can move their legs. - Combined spinal epidural block. This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epilepsy diagnosed", "response": "Epilepsy - overview (Exams and Tests): The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, you may need to: - Wear an EEG recorder for days or weeks as you go about your everyday life. - Stay in a special hospital where brain activity can be recorded while video cameras capture what happens to you during the seizure. This is called video EEG. Tests that may be done include: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan is often done to find the cause and location of the problem in the brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epilepsy diagnosed", "response": "Epilepsy (Diagnosis): To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much ibuprofen is too much", "response": "How should Ibuprofen be used and what is the dosage?: Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time(s) every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor. Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen. If you are selecting a product to treat cough or cold symptoms, ask your doctor or pharmacist for advice on which product is best for you. Check nonprescription product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child. Nonprescription cough and cold combination products, including products that contain ibuprofen, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4 to 11 years of age, use caution and follow the package directions carefully. If you are giving ibuprofen or a combination product that contains ibuprofen to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give ibuprofen products that are made for adults to children. Before you give an ibuprofen product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child. Shake the suspension and drops well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the suspension, and use the dosing device provided to measure each dose of the drops. The chewable tablets may cause a burning feeling in the mouth or throat. Take the chewable tablets with food or water. Stop taking nonprescription ibuprofen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts more than 3 days. Stop giving nonprescription ibuprofen to your child and call your child's doctor if your child does not start to feel better during the first 24 hours of treatment. Also stop giving nonprescription ibuprofen to your child and call your child's doctor if your child develops new symptoms, including redness or swelling on the painful part of his body, or if your child's pain or fever get worse or lasts longer than 3 days. Do not give nonprescription ibuprofen to a child who has a sore throat that is severe or does not go away, or that comes along with fever, headache, nausea, or vomiting. Call the child's doctor right away, because these symptoms may be signs of a more serious condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much oxazepam could cause an overdose?", "response": "What is Oxazepam overdose?: Oxazepam is a medicine used to treat anxiety and symptoms of alcohol withdrawal. It belongs to the class of medicines known as benzodiazepines. Oxazepam overdose occurs when someone accidentally or intentionally takes too much of this medicine. Benzodiazepines are the most common prescription drugs used in suicide attempts. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much oxazepam could cause an overdose?", "response": "Oxazepam (In case of emergency/overdose): In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how nicotine effects the brain", "response": "Nicotine and tobacco: The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. - Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. - Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Nicotine use can have many different effects on the body. It can: - Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking - Boost mood, give people a sense of well-being, and possibly even relieve minor depression - Increase activity in the intestines - Create more saliva and phlegm - Increase the heart rate by around 10 to 20 beats per minute - Increase blood pressure by 5 to 10 mm Hg - Possibly cause sweating, nausea, and diarrhea - Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: - Intense craving for nicotine - Anxiety - Depression - Drowsiness or trouble sleeping - Bad dreams and nightmares - Feeling tense, restless, or frustrated - Headaches - Increased appetite and weight gain - Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: - Gum - Inhalers - Throat lozenges - Nasal spray - Skin patches You can buy many types of nicotine replacement without a prescription. The goal is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Your health care provider can also prescribe other types of medicines to help you quit and prevent you from starting again. Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta GA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how nicotine effects the brain", "response": "What are the side effects or risks of Nicotine Oral Inhalation?: Nicotine oral inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - irritation in the mouth and throat - cough - runny nose - taste changes - pain of the jaw, neck, or back - tooth problems - sinus pressure and pain - headache - pain, burning, or tingling in the hands or feet - gas Some side effects can be serious. If you experience the following symptom, call your doctor immediately: - rapid heart rate Nicotine inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "Cervical cancer - screening and prevention (Pap Smears): Cervical cancer usually develops slowly. It starts as precancerous changes called dysplasia. Dysplasia can be detected by a medical test called a Pap smear. Dysplasia is fully treatable. That is why it is important for women to get regular Pap smears, so that precancerous cells can be removed before they can become cancer. Pap smear screening should start at age 21. After the first test: - Women ages 21 through 29 should have a Pap smear every 3 years. - Women ages 30 through 65 should be screened with either a Pap smear every 3 years or a Pap smear and HPV test every 5 years. - If you or your sexual partner has other new partners, you should have a Pap smear every 3 years. - Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years. - Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer. Talk with your provider about how often you should have a Pap smear. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "Pap test: The Pap test checks for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. This test is sometimes called a Pap smear. You lie on a table and place your feet in stirrups. The health care provider gently places an instrument called a speculum into the vagina to open it slightly. This allows the provider to see inside the vagina and cervix. Cells are gently scraped from the cervix area. The sample of cells is sent to a lab for examination. Tell your provider about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results. Also tell your provider if you: - Have had an abnormal Pap test - Might be pregnant DO NOT do the following for 24 hours before the test: - Douche (douching should never be done) - Have intercourse - Use tampons Avoid scheduling your Pap test while you have your period (are menstruating). Blood may make the Pap test results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your provider will determine if the Pap test can still be done. Empty your bladder just before the test. A Pap test causes little to no discomfort for most women. It can cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may bleed a little bit after the test. The Pap test is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap tests. Screening should start at age 21. After the first test: - You should have a Pap test every 3 years to check for cervical cancer. - If you are over age 30 and you also have HPV testing done, and both the Pap test and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer). - Most women can stop having Pap tests after age 65 to 70 as long as they have had 3 negative tests within the past 10 years. You may not need to have a Pap test if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap test, cervical cancer, or other pelvic cancer. Discuss this with your provider. A normal result means there are no abnormal cells present. The Pap test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly, and follow-up Pap tests should find any changes in time for treatment. Abnormal results are grouped as follows: ASCUS or AGUS: - This result means there are atypical cells, but it is uncertain or unclear what these changes mean - The changes may be due to HPV - They may also mean there are changes that may lead to cancer LOW-GRADE DYSPLASIA (LSIL) OR HIGH-GRADE DYSPLASIA (HSIL): - This means changes that may lead to cancer are present - The risk of cervical cancer is greater with HSIL CARCINOMA IN SITU (CIS): - This result most often means the abnormal changes are likely to lead to cervical cancer if not treated ATYPICAL SQUAMOUS CELLS (ASC): - Abnormal changes have been found and may be HSIL ATYPICAL GLANDULAR CELLS (AGC): - Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus When a Pap test shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the Pap test, your previous history of Pap tests, and risk factors you may have for cervical cancer. For minor cell changes, doctors will recommend another Pap test in 6 to 12 months. Follow-up testing or treatment may include: - Colposcopy-directed biopsy - An HPV test to check for the presence of the HPV virus types most likely to cause cancer - Cervix cryosurgery - Cone biopsy Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "Cervical dysplasia: Cervical dysplasia refers to abnormal changes in the cells on the surface of the cervix. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. The changes are not cancer. But they are considered to be precancerous. This means they can lead to cancer of the cervix if not treated. Cervical dysplasia can develop at any age. However, follow up and treatment will depend on your age. Most often, cervical dysplasia is caused by the human papillomavirus (HPV). HPV is a common virus that is spread through sexual contact. There are many types of HPV. Some types lead to cervical dysplasia or cancer. Other types of HPV can cause genital warts. The following may increase your risk for cervical dysplasia: - Having sex before age 18 - Having a baby before age 16 - Having had multiple sexual partners - Having other illnesses, such as diabetes or HIV - Using medicines that suppress your immune system - Smoking Most of the time, there are no symptoms. You will have a pelvic exam. Cervical dysplasia that is seen on a Pap smear is called squamous intraepithelial lesion (SIL). On the Pap smear report, these changes will be described as: - Low-grade (LSIL) - High-grade (HSIL) - Possibly cancerous (malignant) - Atypical glandular cells (AGUS) - Atypical squamous cells You will need more tests if a Pap smear shows abnormal cells or cervical dysplasia. If the changes were mild, follow-up Pap smears may be all that is needed. A biopsy to confirm the condition is often needed, however. This may be done using colposcopy-directed biopsy. A colposcopy is a procedure performed in your health care provider's office. Any areas of concern will be biopsied. The biopsies are very small and most women feel only a small cramp. Dysplasia that is seen on a biopsy of the cervix is called cervical intraepithelial neoplasia (CIN). It is grouped into 3 categories: - CIN I -- mild dysplasia - CIN II -- moderate to marked dysplasia - CIN III -- severe dysplasia to carcinoma in situ Some strains of HPV are known to cause cervical cancer. An HPV DNA test can identify the high-risk types of HPV linked to this cancer. This test may be done: - As a screening test for women over age 30 - For women of any age who have a slightly abnormal Pap test result Treatment depends on the degree of dysplasia. Mild dysplasia (LSIL or CIN I) may go away without treatment. - You may only need careful follow-up by your provider with repeat Pap smears every 6 to 12 months. - If the changes do not go away or get worse, treatment is needed. Treatment for moderate-to-severe dysplasia or mild dysplasia that does not go away may include: - Cryosurgery to freeze abnormal cells - Laser therapy, which uses light to burn away abnormal tissue - LEEP (loop electrosurgical excision procedure), which uses electricity to remove abnormal tissue - Surgery to remove the abnormal tissue (cone biopsy) - Hysterectomy (in rare cases) If you have had dysplasia, you will need to have repeat exams every 12 months or as recommended by your provider. Make sure to get the HPV vaccine when it is offered to you. This vaccine prevents many cervical cancers. Early diagnosis and prompt treatment cures most cases of cervical dysplasia. However, the condition may return. Without treatment, severe cervical dysplasia may change into cervical cancer. Call your provider if your age is 21 or older and you have never had a pelvic exam and Pap smear. Ask your provider about the HPV vaccine. Girls who receive this vaccine before they become sexually active reduce their chance of getting cervical cancer. You can reduce your risk of developing cervical dysplasia by taking the following steps: - Do not smoke. Smoking increases your risk of developing more severe dysplasia and cancer. - Get vaccinated for HPV between ages 9 to 26. - Do not have sex until you are 18 or older. - Practice safe sex, and use a condom. - Practice monogamy. This means you have only one sexual partner at a time. Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the brain", "response": "Nicotine and tobacco: The nicotine in tobacco can be addictive like alcohol, cocaine, and morphine. Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. - Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. - Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. Nicotine use can have many different effects on the body. It can: - Decrease the appetite; fear of weight gain makes some people unwilling to stop smoking - Boost mood, give people a sense of well-being, and possibly even relieve minor depression - Increase activity in the intestines - Create more saliva and phlegm - Increase the heart rate by around 10 to 20 beats per minute - Increase blood pressure by 5 to 10 mm Hg - Possibly cause sweating, nausea, and diarrhea - Stimulate memory and alertness; people who use tobacco often depend on it to help them accomplish certain tasks and perform well Symptoms of nicotine withdrawal appear within 2 to 3 hours after you last use tobacco. People who smoked the longest or smoked a greater number of cigarettes each day are more likely to have withdrawal symptoms. For those who are quitting, symptoms peak about 2 to 3 days later. Common symptoms include: - Intense craving for nicotine - Anxiety - Depression - Drowsiness or trouble sleeping - Bad dreams and nightmares - Feeling tense, restless, or frustrated - Headaches - Increased appetite and weight gain - Problems concentrating You may notice some or all of these symptoms when switching from regular to low-nicotine cigarettes or reducing the number of cigarettes you smoke. It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: - Gum - Inhalers - Throat lozenges - Nasal spray - Skin patches You can buy many types of nicotine replacement without a prescription. The goal is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Your health care provider can also prescribe other types of medicines to help you quit and prevent you from starting again. Your provider can refer you to stop smoking programs. These are offered by hospitals, health departments, community centers, work sites, and national organizations. People who are trying to quit smoking often become discouraged when they do not succeed at first. Research shows that the more times you try, the more likely you are to succeed. If you start smoking again after you have tried to quit, do not give up. Look at what worked or did not work, think of new ways to quit smoking, and try again. There are many more reasons to quit using tobacco. Knowing the serious health risks from tobacco may help motivate you to quit. Tobacco and related chemicals can increase your risk of serious health problems such as cancer, lung disease, and heart attack. See your provider if you wish to stop smoking, or have already done so and are having withdrawal symptoms. Your provider can help recommend treatments. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta GA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the brain", "response": "Smoking and surgery: Quitting smoking and other tobacco products before surgery can improve your recovery and outcome after surgery. Most people who successfully quit smoking have tried and failed many times. DO NOT give up. Learning from your past tries can help you succeed. Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: - Blood clots and aneurysms in the brain, which can lead to strokes - Coronary artery disease, including chest pain (angina) and heart attacks - High blood pressure - Poor blood supply to the legs - Problems with erections Smoking also increases your risk for different types of cancer, including cancer of the: - Lungs - Mouth - Larynx - Esophagus - Bladder - Kidneys - Pancreas - Cervix Smoking also leads to lung problems, such as emphysema and chronic bronchitis, and makes asthma harder to control. Some smokers switch to smokeless tobacco instead of quitting tobacco completely. But using smokeless tobacco still carries health risks, such as: - Developing mouth or nasal cancer - Gum problems, tooth wear, and cavities - Worsening high blood pressure and chest pain Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and damage the lungs. Smoking decreases the amount of oxygen that reaches the cells in your surgical wound. As a result, your wound may heal more slowly and is more likely to become infected. All smokers carry an increased risk for heart and lung problems. Even when your surgery goes smoothly, smoking causes your body, heart, and lungs to work harder than if you did not smoke. Most doctors will tell you to stop using cigarettes and tobacco at least 4 weeks before your surgery. Stretching the time between quitting smoking and your surgery out to at least 10 weeks can decrease your risk of problems even more. Like any addiction, quitting tobacco is difficult. There are many ways to quit smoking and many resources to help you, such as: - Family members, friends, and coworkers may be supportive or encouraging. - Talk to your doctor about medicines, such as nicotine replacement and prescription medicines. - If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. Using nicotine gum around the time of surgery is not encouraged. The nicotine will still interfere with the healing of your surgical wound and have the same effect on your general health as using cigarettes and tobacco. Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "Benefits of quitting tobacco (Summary): If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. - Your breath, clothes, and hair will smell better. - Your sense of smell will return. Food will taste better. - Your fingers and fingernails will slowly appear less yellow. - Your stained teeth may slowly become whiter. - Your children will be healthier and will be less likely to start smoking. - It will be easier and cheaper to find an apartment or hotel room. - You may have an easier time getting a job. - Friends may be more willing to be in your car or home. - It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. - You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. - Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. - Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. - Within 24 hours of quitting: Your risk of a sudden heart attack goes down. - Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. - Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. - Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. - Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. - Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. - Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: - Lower chance of blood clots in the legs, which may travel to the lungs - Lower risk of erectile dysfunction - Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip - Lower risk of infertility due to damaged sperm - Healthier teeth, gums, and skin Infants and children who you live with will have: - Asthma that is easier to control - Fewer visits to the emergency room - Fewer colds, ear infections, and pneumonia - Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medications. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "Nicotine and tobacco (Causes): Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. - Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. - Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "What is Smoking?: There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "Social anxiety disorder (Treatment): The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: - Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. - Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. - Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. - These medicines should only be taken under a doctor's direction. - Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. - They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. - If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. - Get regular exercise, enough sleep, and regularly scheduled meals. - Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "Separation anxiety in children (Treatment): No treatment is needed for normal separation anxiety. Parents can help their infant or toddler adjust to their absence by letting trusted caregivers babysit the child. This helps the child learn to trust and bond with other adults and understand that their parents will return. During medical procedures, a parent should go with the child if possible. When a parent can't go with the child, exposing the child to the situation beforehand may be helpful, such as visiting the doctor's office before a test. Some hospitals have child life specialists who can explain procedures and medical conditions to children of all ages. If your child is very anxious and needs extended medical care, ask your provider about such services. When it's not possible for parents to be with the child, such as for surgery, explain the experience to the child. Reassure the child that a parent is waiting, and where. For older children who have not outgrown separation anxiety, treatments may include: - Anti-anxiety medicines - Changes in parenting techniques - Counseling for the parents and child Treatment for severe cases may include: - Family education - Family therapy - Talk therapy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Overweight, obesity, and weight loss (What is the best way for me to lose weight?): The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor. Safe weight-loss programs that work well:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Exercise and activity for weight loss (The Weight-loss Formula): Calories used in exercise > calories eaten = weight loss. This means that to lose weight, the number of calories you burn by exercising needs to be greater than the number of calories from the foods you eat and drink. Even if you work out a lot, if you eat more calories than you burn, you will gain weight. Another way to look at this is that a woman ages 30 to 50 years who does not exercise needs about 1,800 calories a day to maintain her normal weight. A man ages 30 to 50 years who does not exercise needs about 2,200 calories to maintain his normal weight. For every hour of exercise they do, they would burn: - 240 to 300 calories doing light activity such as cleaning house or playing baseball or golf. - 370 to 460 calories doing activity such as a brisk walk (3.5 mph), gardening, biking (5.5 mph), or dancing. - 580 to 730 calories doing activity such as jogging at a pace of 9 minutes per mile, playing football, or swimming laps. - 740 to 920 calories doing activity such as running at a pace of 7 minutes per mile, playing racquetball, and skiing. Even if you don't change the amount of calories in your diet, but you do add activity to your daily life, you'll lose weight or gain less weight. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Diet for rapid weight loss: Rapid weight loss diet is a type of diet in which you lose more than 2 pounds (1 kilogram, kg) a week over several weeks. To lose weight this quickly you eat very few calories. These diets are most often for obese people who need to lose weight quickly because of a health problem. People on these diets should be followed closely by a health care provider. Rapid weight loss is not safe for most people to do on their own. These diets are only to be used for a short time and are not recommended for more than several weeks. The types of rapid weight loss diets are described below. On a VLCD, you may have as few as 800 calories a day and may lose up to 3 to 5 pounds (1.5 to 2 kg) week. Most VLCDs use meal replacements, such as formulas, soups, shakes, and bars instead of regular meals. This helps ensure that you get all of the nutrients you need each day. A VLCD is only recommended for adults who are obese and need to lose weight for health reasons. These diets are often used before weight-loss surgery. You should only use a VLCD with the help of your health care provider. Most experts DO NOT recommend using a VLCD for more than 12 weeks. These diets usually allow about 1000 to 1200 calories a day for women and 1200 to 1600 calories a day for men. An LCD is a better choice than a VLCD for most people who want to lose weight quickly. But you should still be supervised by a provider. You will not lose weight as fast with an LCD, but you can lose just as much weight with a VLCD. An LCD may use a mix of meal replacements and regular food. This makes it easier to follow than a VLCD. Some fad diets also severely limit calories to achieve rapid weight loss. In many cases, these diets are not safe. Once you stop the diet, you are at risk for regaining the weight if you return to your old eating habits. For most people, it is safest to choose a diet in which you lose a 1/2 pound to 2 pounds (225 grams to 1 kg) a week. Rapid weight loss is more about cutting calories than exercising. Talk with your provider about what type of exercise you should do while you are on this type of diet. Your provider may suggest waiting until you are on a more long-term diet to start exercising. Rapid weight loss diet is usually for people who have health problems because of obesity. For these people, losing a lot of weight quickly can help improve: - Diabetes - High cholesterol - High blood pressure You should only follow one of these diets with the help of your provider. Losing more than one 1 or 2 pounds (0.5 to 1 kg) a week is not safe for most people. It can cause you to lose muscle, water, and bone density. Rapid weight loss can also cause some side effects including: - Gallstones - Gout - Fatigue - Constipation - Diarrhea - Nausea People who lose weight quickly are also more likely to gain back the weight quickly. This can lead to other health problems. In general, a rapid weight loss diet is not safe for children. It may also not be safe for teens, pregnant women or older adults unless a provider recommends it. If you have a health condition, it is a good idea to talk with your provider before starting this or any diet plan to lose weight. Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to manage prostate cancer", "response": "Prostate Cancer (Treatment Option Overview): - There are different types of treatment for patients with prostate cancer. - Seven types of standard treatment are used: - Watchful waiting or active surveillance - Surgery - Radiation therapy and radiopharmaceutical therapy - Hormone therapy - Chemotherapy - Biologic therapy - Bisphosphonate therapy - There are treatments for bone pain caused by bone metastases or hormone therapy. - New types of treatment are being tested in clinical trials. - Cryosurgery - High-intensity-focused ultrasound therapy - Proton beam radiation therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to manage prostate cancer", "response": "Prostate cancer - treatment (Hormonal Therapy): Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: - The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. - Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: - It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. - Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "Atherosclerosis (PREVENTION): Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "What is Atherosclerosis?: Espaol Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "Atherosclerosis (WHO IS AT RISK): The exact cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. You can control most risk factors and help prevent or delay atherosclerosis. Other risk factors can't be controlled. Major Risk Factors Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called \"bad\" cholesterol) and low HDL cholesterol (sometimes called \"good\" cholesterol). High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues. Insulin resistance. This condition occurs if the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used as an energy source. Insulin resistance may lead to diabetes. Diabetes. With this disease, the body's blood sugar level is too high because the body doesn't make enough insulin or doesn't use its insulin properly. Overweight or obesity. The terms \"overweight\" and \"obesity\" refer to body weight that's greater than what is considered healthy for a certain height. Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity. Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors. Older age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after age 45. In women, the risk increases after age 55. Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age. Although age and a family history of early heart disease are risk factors, it doesn't mean that you'll develop atherosclerosis if you have one or both. Controlling other risk factors often can lessen genetic influences and prevent atherosclerosis, even in older adults. Studies show that an increasing number of children and youth are at risk for atherosclerosis. This is due to a number of causes, including rising childhood obesity rates. Emerging Risk Factors Scientists continue to study other possible risk factors for atherosclerosis. High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for atherosclerosis and heart attack. High levels of CRP are a sign of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow. People who have low CRP levels may develop atherosclerosis at a slower rate than people who have high CRP levels. Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk for atherosclerosis. High levels of triglycerides (tri-GLIH-seh-rides) in the blood also may raise the risk for atherosclerosis, especially in women. Triglycerides are a type of fat. Studies are under way to find out whether genetics may play a role in atherosclerosis risk. Other Factors That Affect Atherosclerosis Other factors also may raise your risk for atherosclerosis, such as: Sleep apnea. Sleep apnea is a disorder that causes one or more pauses in breathing or shallow breaths while you sleep. Untreated sleep apnea can raise your risk for high blood pressure, diabetes, and even a heart attack or stroke. Stress. Research shows that the most commonly reported \"trigger\" for a heart attack is an emotionally upsetting event, especially one involving anger. Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for atherosclerosis. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "Conjunctivitis or pink eye (Prevention): Good hygiene can help prevent the spread of conjunctivitis. Things you can do include: - Change pillowcases often. - DO NOT share eye makeup and replace it regularly. - DO NOT share towels or handkerchiefs. - Handle and clean contact lenses properly. - Keep hands away from the eye. - Wash your hands often. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "How to prevent Vernal conjunctivitis?: Using air conditioning or moving to a cooler climate may help prevent the problem from getting worse in the future. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "Neonatal conjunctivitis (Prevention): Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into all infants' eyes in the delivery room right after birth can help prevent many infections. (Most states have laws requiring this treatment.) When a mother has active herpes sores at the time of delivery, a Cesarean section (C-section) is recommended to prevent serious illness in the baby. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "Diabetes (Prevention): Keeping an ideal body weight and an active lifestyle may prevent or delay the start of type 2 diabetes. If you're overweight, losing just 5% to 7% of your body weight even helps. Some medicines can also be used to delay or prevent the start of type 2 diabetes. At this time, type 1 diabetes cannot be prevented. But there is promising research that shows type 1 diabetes may be delayed in some high risk people. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "How to Prevent Diabetes (Summary): Summary What is type 2 diabetes? If you have diabetes, your blood sugar levels are too high. With type 2 diabetes, this happens because your body does not make enough insulin, or it does not use insulin well (this is called insulin resistance). If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it. Who is at risk for type 2 diabetes? Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include - Having prediabetes, which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes - Being overweight or having obesity - Being age 45 or older - A family history of diabetes - Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander - Having high blood pressure - Having a low level of HDL (good) cholesterol or a high level of triglycerides - A history of diabetes in pregnancy - Having given birth to a baby weighing 9 pounds or more - An inactive lifestyle - A history of heart disease or stroke - Having depression - Having polycystic ovary syndrome (PCOS) - Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits - Smoking How can I prevent or delay getting type 2 diabetes? If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are - Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10 percent of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back. - Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats. - Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal. - Don't smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit. - Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "How to prevent Type 1 diabetes?: Type 1 diabetes cannot be prevented. There is no screening test for type 1 diabetes in people who have no symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung cancer - small cell (Prevention): If you smoke, now is the time to quit. If you are having trouble quitting, talk with your provider. There are many methods to help you quit, from support groups to prescription medicines. Also try to avoid secondhand smoke. If you smoke or used to smoke, talk with your provider about getting screened for lung cancer. To get screened, you need to have a CT scan of the chest. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung cancer (Causes): Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than of breast, colon, and prostate cancers combined. Lung cancer is more common in older adults. It is rare in people under age 45. Cigarette smoking is the leading cause of lung cancer. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk. Lung cancer can also affect people who have never smoked. Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. The following may also increase your risk of lung cancer: - Exposure to asbestos. - Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust. - Exposure to radon gas. - Family history of lung cancer. - High levels of air pollution. - High levels of arsenic in drinking water. - Radiation therapy to the lungs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung Cancer (Treatment Options by Stage): Limited-Stage Small Cell Lung Cancer Treatment of limited-stage small cell lung cancer may include the following: - Combination chemotherapy and radiation therapy to the chest. Radiation therapy to the brain may later be given to patients with complete responses. - Combination chemotherapy alone for patients who cannot be given radiation therapy. - Surgery followed by chemotherapy. - Surgery followed by chemotherapy and radiation therapy. - Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain. - Clinical trials of new chemotherapy, surgery, and radiation treatments. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Extensive-Stage Small Cell Lung Cancer Treatment of extensive-stage small cell lung cancer may include the following: - Combination chemotherapy. - Radiation therapy to the brain, spine, bone, or other parts of the body where the cancer has spread, as palliative therapy to relieve symptoms and improve quality of life. - Radiation therapy to the chest may be given to patients who respond to chemotherapy. - Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain. - Clinical trials of new chemotherapy treatments. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent schizophrenia", "response": "Schizophrenia (Prevention): Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent schizophrenia", "response": "Childhood schizophrenia (Lifestyle and home remedies): Although childhood schizophrenia requires professional treatment, it's critical to be an active participant in your child's care. Here are ways to get the most out of the treatment plan. - Follow directions for medications. Try to make sure that your child takes medications as prescribed, even if he or she is feeling well and has no current symptoms. If medications are stopped or taken infrequently, the symptoms are likely to come back and your doctor will have a hard time knowing what the best and safest dose is. - Check first before taking other medications. Contact the doctor who's treating your child for schizophrenia before your child takes medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, minerals, herbs or other supplements. These can interact with schizophrenia medications. - Pay attention to warning signs. You and your child may have identified things that may trigger symptoms, cause a relapse or prevent your child from carrying out daily activities. Make a plan so that you know what to do if symptoms return. Contact your child's doctor or therapist if you notice any changes in symptoms, to prevent the situation from worsening. - Make physical activity and healthy eating a priority. Some medications for schizophrenia are associated with an increased risk of weight gain and high cholesterol in children. Work with your child's doctor to make a nutrition and physical activity plan for your child that will help manage weight and benefit heart health. - Avoid alcohol, street drugs and tobacco. Alcohol, street drugs and tobacco can worsen schizophrenia symptoms or interfere with antipsychotic medications. Talk to your child about avoiding drugs and alcohol and not smoking. If necessary, get appropriate treatment for a substance use problem. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "Heart attack (Lifestyle and home remedies): Your lifestyle affects your heart health. The following steps can help you not only prevent but also recover from a heart attack: - Avoid smoke. The most important thing you can do to improve your heart's health is to not smoke. Also, avoid being around secondhand smoke. If you need to quit, ask your doctor for help. - Control your blood pressure and cholesterol levels. If one or both of these is high, your doctor can prescribe changes to your diet and medications. Ask your doctor how often you need to have your blood pressure and cholesterol levels monitored. - Get regular medical checkups. Some of the major risk factors for heart attack - high blood cholesterol, high blood pressure and diabetes - cause no symptoms early on. Your doctor can perform tests to check for these conditions and help you manage them, if necessary. - Exercise regularly. Regular exercise helps improve heart muscle function after a heart attack and helps prevent a heart attack by helping you to control your weight, diabetes, cholesterol and blood pressure. Exercise needn't be vigorous. Walking 30 minutes a day, five days a week can improve your health. - Maintain a healthy weight. Excess weight strains your heart and can contribute to high cholesterol, high blood pressure and diabetes. - Eat a heart-healthy diet. Saturated fat, trans fats and cholesterol in your diet can narrow arteries to your heart, and too much salt can raise blood pressure. Eat a heart-healthy diet that includes lean proteins, such as fish and beans, plenty of fruits and vegetables and whole grains. - Manage diabetes. High blood sugar is damaging to your heart. Regular exercise, eating well and losing weight all help to keep blood sugar levels at more-desirable levels. Many people also need medication to manage their diabetes. - Control stress. Reduce stress in your day-to-day activities. Rethink workaholic habits and find healthy ways to minimize or deal with stressful events in your life. - If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women and men older than age 65, and up to two drinks a day for men age 65 and younger. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are autoimmune blood disorders", "response": "Autoimmune disorders: An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders. The blood cells in the body's immune system help protect against harmful substances. Examples include bacteria, viruses, toxins, cancer cells, and blood and tissue from outside the body. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances. When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues. The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders. An autoimmune disorder may result in: - The destruction of body tissue - Abnormal growth of an organ - Changes in organ function An autoimmune disorder may affect one or more organ or tissue types. Areas often affected by autoimmune disorders include: - Blood vessels - Connective tissues - Endocrine glands such as the thyroid or pancreas - Joints - Muscles - Red blood cells - Skin A person may have more than one autoimmune disorder at the same time. Common autoimmune disorders include: - Addison disease - Celiac disease - sprue (gluten-sensitive enteropathy) - Dermatomyositis - Graves disease - Hashimoto thyroiditis - Multiple sclerosis - Myasthenia gravis - Pernicious anemia - Reactive arthritis - Rheumatoid arthritis - Sjögren syndrome - Systemic lupus erythematosus - Type I diabetes Symptoms will vary based on the type and location of the faulty immune response. Common symptoms include: - Fatigue - Fever - General ill-feeling (malaise) - Joint pain - Rash The health care provider will do a physical exam. Signs depend on the type of disease. Tests that may be done to diagnose an autoimmune disorder include: - Antinuclear antibody tests - Autoantibody tests - CBC - Comprehensive metabolic panel - C-reactive protein (CRP) - Erythrocyte sedimentation rate (ESR) - Urinalysis The goals of treatment are to: - Reduce symptoms - Control the autoimmune process - Maintain the body's ability to fight disease Treatments will depend on your disease and symptoms. Types of treatments include: - Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease - Blood transfusions if blood is affected - Physical therapy to help with movement if the bones, joints, or muscles are affected Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs called tumor necrosis factor (TFN) blockers can be used for some diseases. The outcome depends on the disease. Most autoimmune diseases are chronic, but many can be controlled with treatment. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up. Complications depend on the disease. Medicines used to suppress the immune system can cause severe side effects, such as higher risk of infections. Call your health care provider if you develop symptoms of an autoimmune disorder. There is no known prevention for most autoimmune disorders. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are autoimmune blood disorders", "response": "Autoimmune disorders (Treatment): The goals of treatment are to: - Reduce symptoms - Control the autoimmune process - Maintain the body's ability to fight disease Treatments will depend on your disease and symptoms. Types of treatments include: - Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease - Blood transfusions if blood is affected - Physical therapy to help with movement if the bones, joints, or muscles are affected Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs called tumor necrosis factor (TFN) blockers can be used for some diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are autoimmune blood disorders", "response": "Autoimmune disorders (Outlook (Prognosis)): The outcome depends on the disease. Most autoimmune diseases are chronic, but many can be controlled with treatment. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are known causes of bipolar disorder", "response": "Bipolar disorder (Causes): The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are known causes of bipolar disorder", "response": "Bipolar disorder (Risk factors): Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are pancreatic enzymes?", "response": "Pancreatic cancer: Pancreatic cancer is cancer that starts in the pancreas. The pancreas is a large organ behind the stomach. It makes and releases enzymes into the intestines that help the body digest and absorb food, especially fats. The pancreas also makes and releases insulin and glucagon. These are hormones that help the body control blood sugar levels. There are different types of pancreatic cancers. The type depends on the cell the cancer develops in. Examples include: - Adenocarcinoma, the most common type of pancreatic cancer - Other more rare types include glucagonoma, insulinoma, islet cell tumor, VIPoma The exact cause of pancreatic cancer is unknown. It is more common in persons who: - Are obese - Have a diet high in fat and low in fruits and vegetables - Have diabetes - Have long-term exposure to certain chemicals - Have long-term inflammation of the pancreas (chronic pancreatitis) - Smoke Pancreatic cancer is slightly more common in women than in men. The risk increases with age. Family history of the disease also slightly increases the chance of developing this cancer. A tumor (cancer) in the pancreas may grow without any symptoms at first. This means the cancer is often advanced when it is first found. Symptoms of pancreatic cancer include: - Diarrhea - Dark urine and clay-colored stools - Fatigue and weakness - Sudden increase in blood sugar level (diabetes) - Jaundice (a yellow color in the skin, mucous membranes, or white part of the eyes) and itching of the skin - Loss of appetite and weight loss - Nausea and vomiting - Pain or discomfort in the upper part of the belly or abdomen The doctor will perform a physical exam and ask about your symptoms. During the exam, the doctor may feel a lump (mass) in your abdomen. Blood tests that may be ordered include: - Complete blood count (CBC) - Liver function tests - Serum bilirubin Imaging tests that may be ordered include: - CT scan of the abdomen - Endoscopic retrograde cholangiopancreatography (ERCP) - Endoscopic ultrasound - MRI of the abdomen Diagnosis of pancreatic cancer (and what type) is made by a pancreatic biopsy. If tests confirm you have pancreatic cancer, more tests will be done to see how far the cancer has spread within and outside the pancreas. This is called staging. Staging helps guide treatment and gives you an idea of what to expect. Treatment for adenocarcinoma depends on the stage of the tumor. Surgery may be done if the tumor has not spread or has spread very little. Along with surgery, chemotherapy or radiation therapy or both may be used before or after surgery. A small number of people can be cured with this treatment approach. When the tumor has not spread out of the pancreas but cannot be surgically removed, chemotherapy and radiation therapy together may be recommended. When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. With advanced cancer, the goal of treatment is to manage pain and other symptoms. For example, if the tube that carries bile is blocked by the pancreatic tumor, a procedure to place a tiny metal tube (stent) may be done to open the blockage. This can help relieve loss of appetite, jaundice, and itching of the skin. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Some people with pancreatic cancer that can be surgically removed are cured. But in most people, the tumor has spread and cannot be completely removed at the time of diagnosis. Chemotherapy and radiation are often given after surgery to increase the cure rate (this is called adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery or cancer that has spread beyond the pancreas, a cure is not possible. In this case, chemotherapy is given to improve and extend one's life. Call for an appointment with your health care provider if you have: - Abdominal pain that does not go away - Back pain - Loss of appetite - Unexplained fatigue or weight loss - Other symptoms of this disorder Preventive measures include: - If you smoke, now is the time to quit. - Keep a diet high in fruits, vegetables, and whole grains. - Exercise regularly to stay at a healthy weight. Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are pancreatic enzymes?", "response": "Pancreatic Islet Transplantation (What are pancreatic islets?): Pancreatic islets, also called islets of Langerhans, are tiny clusters of cells scattered throughout the pancreas. The pancreas is an organ about the size of a hand located behind the lower part of the stomach.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin. The pancreas also makes enzymes that help the body digest and use food.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.Pancreatic islets contain several types of cells, including beta cells, that produce the hormone insulin.When the level of blood glucose, also called blood sugar, rises after a meal, the pancreas responds by releasing insulin into the bloodstream. Insulin helps cells throughout the body absorb glucose from the bloodstream and use it for energy.Diabetes develops when the pancreas does not make enough insulin, the body's cells do not use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body.In type 1 diabetes, the beta cells of the pancreas no longer make insulin because the body's immune system has attacked and destroyed them. The immune system protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. A person who has type 1 diabetes must take insulin daily to live. Type 2 diabetes usually begins with a condition called insulin resistance, in which the body has trouble using insulin effectively. Over time, insulin production declines as well, so many people with type 2 diabetes eventually need to take insulin. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "What are the symptoms of Bulimia?: With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: - Forcing oneself to vomit - Excessive exercise - Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: - Spending a lot of time exercising - Suddenly eating large amounts of food or buying large amounts of food that disappear right away - Regularly going to the bathroom right after meals - Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "Bulimia nervosa (Symptoms): Bulimia signs and symptoms may include: - Being preoccupied with your body shape and weight - Living in fear of gaining weight - Feeling that you can't control your eating behavior - Eating until the point of discomfort or pain - Eating much more food in a binge episode than in a normal meal or snack - Forcing yourself to vomit or exercise too much to keep from gaining weight after bingeing - Misusing laxatives, diuretics or enemas after eating - Restricting calories or avoiding certain foods between binges - Using dietary supplements or herbal products excessively for weight loss If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment. If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along. Because most people with bulimia are normal weight or slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include: - Constantly worrying or complaining about being fat - Having a distorted, excessively negative body image - Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid - Not wanting to eat in public or in front of others - Going to the bathroom right after eating or during meals - Exercising too much - Having sores, scars or calluses on the knuckles or hands - Having damaged teeth and gums. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "Bulimia nervosa (What are the symptoms of bulimia?): Someone with bulimia may be thin, overweight, or have a normal weight. It can be difficult to tell based on a person's weight whether someone has bulimia. This is because binging and purging is most often done in private. However, family or friends may see empty food wrappers in unexpected places or vomit in the home. Over time, some symptoms of bulimia may include:5 Girls or women with bulimia may also have behavior changes such as: People with bulimia often have other mental health problems, including depression, anxiety, or substance abuse.6. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "Klinefelter syndrome (Treatment): If you or your son is diagnosed with Klinefelter syndrome, your health care team may include a doctor who specializes in diagnosing and treating disorders involving the body's glands and hormones (endocrinologist), a speech therapist, a pediatrician, a physical therapist, a genetic counselor, a reproductive medicine or infertility specialist, and a counselor or psychologist. Although there's no way to repair the sex chromosome changes due to Klinefelter syndrome, treatments can help minimize its effects. The earlier a diagnosis is made and treatment is started, the greater the benefits. But it's never too late to get help. Treatment for Klinefelter syndrome may include: - Testosterone replacement therapy. Starting at the time of the usual onset of puberty, testosterone replacement can be given to help stimulate changes that normally occur at puberty, such as developing a deeper voice, growing facial and body hair, and increasing muscle mass and penis size. Testosterone therapy can also improve bone density and reduce the risk of fractures. It will not result in testicle enlargement or improve infertility. - Breast tissue removal. In males who develop enlarged breasts, excess breast tissue can be removed by a plastic surgeon, leaving a more normal-looking chest. - Speech and physical therapy. These treatments can help boys with Klinefelter syndrome overcome problems with speech, language and muscle weakness. - Educational evaluation and support. Some boys with Klinefelter syndrome have trouble learning and socializing and can benefit from extra assistance. Talk to your child's teacher, school counselor or school nurse about what kind of support might help. - Fertility treatment. Most men with Klinefelter syndrome are unable to father children because few or no sperm are produced in the testicles. For some men with minimal sperm production, a procedure called intracytoplasmic sperm injection (ICSI) may help. During ICSI, sperm is removed from the testicle with a biopsy needle and injected directly into the egg. - Psychological counseling. Having Klinefelter syndrome can be a challenge, especially during puberty and young adulthood. For men with the condition, coping with infertility can be difficult. A family therapist, counselor or psychologist can help work through the emotional issues. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "What are the treatments for Klinefelter syndrome?: Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "What are the treatments for Klinefelter syndrome?: These resources address the diagnosis or management of Klinefelter syndrome: - Genetic Testing Registry: Klinefelter's syndrome, XXY - MedlinePlus Encyclopedia: Klinefelter Syndrome - MedlinePlus Encyclopedia: Testicular Failure These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are symptoms of a nonfunctioning gallbladder", "response": "Gallbladder removal - open (Why the Procedure is Performed): You may need this surgery if you have pain or other symptoms from gallstones. You may also need surgery if your gallbladder is not working normally. Common symptoms may include: - Indigestion, including bloating, heartburn, and gas - Nausea and vomiting - Pain after eating, usually in the upper right or upper middle area of your belly (epigastric pain) The most common way to remove the gallbladder is by using a medical instrument called a laparoscope (laparoscopic cholecystectomy). Open gallbladder surgery is used when laparoscopic surgery cannot be done safely. In some cases, the surgeon needs to switch to an open surgery if laparoscopic surgery cannot be successfully continued. Other reasons for removing the gallbladder by open surgery: - Unexpected bleeding during the laparoscopic operation - Obesity - Pancreatitis (inflammation in the pancreas) - Pregnancy (third trimester) - Severe liver problems - Past surgeries in the same area of your belly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are symptoms of a nonfunctioning gallbladder", "response": "What is Gallbladder Cancer?: Your gallbladder is a pear-shaped organ under your liver. It stores bile, a fluid made by your liver to digest fat. As your stomach and intestines digest food, your gallbladder releases bile through a tube called the common bile duct. The duct connects your gallbladder and liver to your small intestine. Cancer of the gallbladder is rare. It is more common in women and Native Americans. Symptoms include - Jaundice (yellowing of the skin and whites of the eyes) - Pain above the stomach - Fever - Nausea and vomiting - Bloating - Lumps in the abdomen It is hard to diagnose gallbladder cancer in its early stages. Sometimes doctors find it when they remove the gallbladder for another reason. But people with gallstones rarely have gallbladder cancer. Because it is often found late, it can be hard to treat gallbladder cancer. Treatment options include surgery, chemotherapy, radiation, or a combination. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are symptoms of a nonfunctioning gallbladder", "response": "Gallbladder cancer (Symptoms): Gallbladder cancer signs and symptoms may include: - Abdominal pain, particularly in the upper right portion of the abdomen - Abdominal bloating - Fever - Losing weight without trying - Nausea - Yellowing of the skin and whites of the eyes (jaundice) Make an appointment with your doctor if you experience any signs or symptoms that worry you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "Childhood obesity (Causes): Lifestyle issues - too little activity and too many calories from food and drinks - are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well. For example, recent research has found that changes in digestive hormones can affect the signals that let you know you're full. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "Childhood obesity (Risk factors): Many factors - usually working in combination - increase your child's risk of becoming overweight: - Diet. Regularly eating high-calorie foods, such as fast foods, baked goods and vending machine snacks, can easily cause your child to gain weight. Candy and desserts also can cause weight gain, and more and more evidence points to sugary drinks, including fruit juices, as culprits in obesity in some people. - Lack of exercise. Children who don't exercise much are more likely to gain weight because they don't burn as many calories. Too much time spent in sedentary activities, such as watching television or playing video games, also contributes to the problem. - Family factors. If your child comes from a family of overweight people, he or she may be more likely to put on weight. This is especially true in an environment where high-calorie foods are always available and physical activity isn't encouraged. - Psychological factors. Personal, parental and family stress can increase a child's risk of obesity. Some children overeat to cope with problems or to deal with emotions, such as stress, or to fight boredom. Their parents may have similar tendencies. - Socioeconomic factors. People in some communities have limited resources and limited access to supermarkets. As a result, they may opt for convenience foods that don't spoil quickly, such as frozen meals, crackers and cookies. In addition, people who live in lower income neighborhoods might not have access to a safe place to exercise. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "What causes Obesity?: Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of pulmonary hypertension", "response": "Pulmonary hypertension (Summary): Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of pulmonary hypertension", "response": "Pulmonary Hypertension (Causes): Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of pulmonary hypertension", "response": "Pulmonary Hypertension (Causes): Pulmonary hypertension (PH) begins with inflammation and changes in the cells that line your pulmonary arteries. Other factors also can affect the pulmonary arteries and cause PH. For example, the condition may develop if: The walls of the arteries tighten. The walls of the arteries are stiff at birth or become stiff from an overgrowth of cells. Blood clots form in the arteries. These changes make it hard for your heart to push blood through your pulmonary arteries and into your lungs. Thus, the pressure in the arteries rises, causing PH. Many factors can contribute to the process that leads to the different types of PH. Group 1 pulmonary arterial hypertension (PAH) may have no known cause, or the condition may be inherited. (\"Inherited\" means the condition is passed from parents to children through genes.) Some diseases and conditions also can cause group 1 PAH. Examples include HIV infection, congenital heart disease, and sickle cell disease. Also, the use of street drugs (such as cocaine) and certain diet medicines can lead to PAH. Many diseases and conditions can cause groups 2 through 5 PH (often called secondary PH), including: Mitral valve disease Lung diseases, such as COPD (chronic obstructive pulmonary disease) Sleep apnea Sarcoidosis For more information about the types of PH and the diseases, conditions, and factors that can cause them, go to \"Types of Pulmonary Hypertension.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Cavities/tooth decay (Complications): Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet. Complications of cavities may include: - Pain - Tooth abscess - Swelling or pus around a tooth - Damage or broken teeth - Chewing problems - Positioning shifts of teeth after tooth loss When cavities and decay become severe, you may have: - Pain that interferes with daily living - Weight loss or nutrition problems from painful or difficult eating or chewing - Tooth loss, which may affect your appearance, as well as your confidence and self-esteem - In rare cases, a tooth abscess - a pocket of pus that's caused by bacterial infection - which can lead to more serious or even life-threatening infections. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Tooth abscess: A tooth abscess is a buildup of infected material (pus) in the center of a tooth. It is an infection caused by bacteria. A tooth abscess may form if there is tooth decay. It may also occur when a tooth is broken, chipped, or injured in other ways. Openings in the tooth enamel allow bacteria to infect the center of the tooth (the pulp). Infection may spread from the root of the tooth to the bones supporting the tooth. Infection results in a buildup of pus and tissue swelling within the tooth. This causes a toothache. The toothache may stop if pressure is relieved. But the infection can remain active and continue to spread. This can cause more pain and can destroy tissue. The main symptom is a severe toothache. The pain is continuous. It does not stop. It can be described as gnawing, sharp, shooting, or throbbing. Other symptoms may include: - Bitter taste in the mouth - Breath odor - General discomfort, uneasiness, or ill feeling - Fever - Pain when chewing - Sensitivity of the teeth to hot or cold - Swelling of the gum over the infected tooth, which may look like a pimple - Swollen glands of the neck - Swollen area of the upper or lower jaw, which is a very serious symptom Your dentist will closely look at your teeth, mouth, and gums. It may hurt when the dentist taps the tooth. Biting or closing your mouth tightly also increases the pain. Your gums may be swollen and red, and may drain thick material. Dental x-rays and other tests can help your dentist determine which tooth or teeth are causing the problem. The goals of treatment are to cure the infection, save the tooth, and prevent complications. Your dentist might prescribe antibiotics to fight the infection. Warm saltwater rinses may help ease the pain. Over-the-counter pain relievers may relieve your toothache and fever. Do NOT place aspirin directly on your tooth or gums. This increases irritation of the tissues and can result in mouth ulcers. A root canal may be recommended in an attempt to save the tooth. If you have a severe infection, your tooth may be removed, or you may need surgery to drain the abscess. Some people may need to be admitted to the hospital. Untreated abscesses may get worse and can lead to life-threatening complications. Prompt treatment cures the infection in most cases. The tooth can often be saved. These complications can occur: - Loss of the tooth - Blood infection - Spread of infection to soft tissue - Spread of infection to the jaw bone - Spread of infection to other areas of the body, which can cause brain abscess, inflammation in the heart, pneumonia, or other complications Call your dentist if you have a throbbing toothache that does not go away, or if you notice a bubble (or “pimple”) on your gums. Prompt treatment of dental decay reduces the risk of tooth abscess. Have your dentist examine any broken or chipped teeth right away. Updated by: Michael Kapner, DDS, general and aesthetic dentistry, Norwalk Medical Center, Norwalk, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Impacted tooth (Treatment): No treatment may be needed if the impacted tooth is not causing any problems. Over-the-counter pain relievers may help if the impacted tooth causes discomfort. Warm saltwater (one-half teaspoon or 3 grams of salt in one cup or 240 milliliters of water) or over-the-counter mouthwashes may be soothing to the gums. Removal of the tooth is the usual treatment for an impacted tooth. This is done in the dentist's office. Most often, it will be done by an oral surgeon. Antibiotics may be prescribed before the extraction if the tooth is infected. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the risk factors of type ii diabetes", "response": "Risk Factors for Type 2 Diabetes: You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the risk factors of type ii diabetes", "response": "Who is at risk for Diabetes??: Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the risk factors of type ii diabetes", "response": "Type 2 diabetes (Risk factors): Researchers don't fully understand why some people develop type 2 diabetes and others don't. It's clear, however, that certain factors increase the risk, including: - Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue you have, the more resistant your cells become to insulin. However, you don't have to be overweight to develop type 2 diabetes. - Fat distribution. If your body stores fat primarily in your abdomen, your risk of type 2 diabetes is greater than if your body stores fat elsewhere, such as your hips and thighs. - Inactivity. The less active you are, the greater your risk of type 2 diabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. - Family history. The risk of type 2 diabetes increases if your parent or sibling has type 2 diabetes. - Race. Although it's unclear why, people of certain races - including blacks, Hispanics, American Indians and Asian-Americans - are more likely to develop type 2 diabetes than whites are. - Age. The risk of type 2 diabetes increases as you get older, especially after age 45. That's probably because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults. - Prediabetes. Prediabetes is a condition in which your blood sugar level is higher than normal, but not high enough to be classified as diabetes. Left untreated, prediabetes often progresses to type 2 diabetes. - Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds (4 kilograms), you're also at risk of type 2 diabetes. - Polycystic ovarian syndrome. For women, having polycystic ovarian syndrome - a common condition characterized by irregular menstrual periods, excess hair growth and obesity - increases the risk of diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for cystic fibrosis", "response": "Cystic fibrosis (Symptoms): Symptoms in newborns may include: - Delayed growth - Failure to gain weight normally during childhood - No bowel movements in first 24 to 48 hours of life - Salty-tasting skin Symptoms related to bowel function may include: - Belly pain from severe constipation - Increased gas, bloating, or a belly that appears swollen (distended) - Nausea and loss of appetite - Stools that are pale or clay-colored, foul smelling, have mucus, or that float - Weight loss Symptoms related to the lungs and sinuses may include: - Coughing or increased mucus in the sinuses or lungs - Fatigue - Nasal congestion caused by nasal polyps - Repeated episodes of pneumonia (symptoms of pneumonia in someone with cystic fibrosis include fever, increased coughing and shortness of breath, increased mucus, and loss of appetite) - Sinus pain or pressure caused by infection or polyps Symptoms that may be noticed later in life: - Infertility (in men) - Repeated inflammation of the pancreas (pancreatitis) - Respiratory symptoms - Clubbed fingers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for cystic fibrosis", "response": "Cystic fibrosis (Symptoms): Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "What are the symptoms of Prostate Cancer?: Symptoms Most cancers in their early, most treatable stages don't cause any symptoms. Early prostate cancer usually does not cause symptoms. However, if prostate cancer develops and is not treated, it can cause these symptoms: - a need to urinate frequently, especially at night - difficulty starting urination or holding back urine - inability to urinate - weak or interrupted flow of urine - painful or burning urination - difficulty in having an erection - painful ejaculation - blood in urine or semen - pain or stiffness in the lower back, hips, or upper thighs. a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen pain or stiffness in the lower back, hips, or upper thighs. Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If You Have Symptoms If you have any of these symptoms, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. The doctor will ask questions about your medical history and perform an exam to try to find the cause of the prostate problems. The PSA Test The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present. PSA screening for prostate cancer is not perfect. (Screening tests check for disease in a person who shows no symptoms.) Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers. Other Tests The doctor may order other exams, including ultrasound, MRI, or CT scans, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope. If Cancer is Present If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "What are the symptoms of Prostate Cancer?: Yes. Any of the symptoms caused by prostate cancer may also be due to enlargement of the prostate, which is not cancer. If you have any of the symptoms mentioned in question #10, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "Prostate cancer - resources (Summary): The following organizations are good resources for information on prostate cancer: - American Cancer Society -- www.cancer.org/cancer/prostatecancer/index - National Cancer Institute -- www.cancer.gov/cancertopics/types/prostate - Prostate Cancer Foundation -- www.pcf.org - U.S. Centers for Disease Control and Prevention -- www.cdc.gov/cancer/prostate - U.S. National Library of Medicine Genetics Home Reference -- ghr.nlm.nih.gov/condition/prostate-cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of headaches", "response": "Headache (Causes): The most common type of headache is tension headache. It is likely caused by tight muscles in your shoulders, neck, scalp, and jaw. A tension headache: - May be related to stress, depression, anxiety, a head injury, or holding your head and neck in an abnormal position. - Tends to be on both sides of your head. It often starts at the back of the head and spreads forward. The pain may feel dull or squeezing, like a tight band or vice. Your shoulders, neck, or jaw may feel tight or sore. A migraine headache involves severe pain. It usually occurs with other symptoms, such as vision changes, sensitivity to sound or light, or nausea. With a migraine: - The pain may be throbbing, pounding, or pulsating. It tends to begin on one side of your head. It may spread to both sides. - The headache may be associated with an aura. This is a group of warning symptoms that start before your headache. The pain usually gets worse as you try to move around. - Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, lack of sleep, and alcohol may also be triggers. Rebound headaches are headaches that keep coming back. They often occur from overuse of pain medicines. For this reason, these headaches are also called medicine overuse headaches. People who take pain medicine more than 3 days a week on a regular basis can develop this type of headache. Other types of headaches: - Cluster headache is a sharp, very painful headache that occurs daily, sometimes up to several times a day for months. It then goes away for weeks to months. In some people, the headaches never come back. The headache usually lasts less than an hour. It tends to occur at the same times every day. - Sinus headache causes pain in the front of the head and face. It is due to swelling in the sinus passages behind the cheeks, nose, and eyes. The pain is worse when you bend forward and when you first wake up in the morning. - Headaches may occur if you have a cold, the flu, a fever, or premenstrual syndrome. - Headache due to a disorder called temporal arteritis. This is a swollen, inflamed artery that supplies blood to part of the head, temple, and neck area. In rare cases, a headache can be a sign of something more serious, such as: - Bleeding in the area between the brain and the thin tissue that covers the brain (subarachnoid hemorrhage) - Blood pressure that is very high - Brain infection, such as meningitis or encephalitis, or abscess - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) - Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudotumor cerebri) - Carbon monoxide poisoning - Lack of oxygen during sleep (sleep apnea) - Problems with the blood vessels and bleeding in the brain, such as arteriovenous malformation (AVM), brain aneurysm, or stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of headaches", "response": "What causes Headaches - danger signs?: Problems with blood vessels and bleeding in the brain cancause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain. This iscalled a subarachnoid hemorrhage Other causes of headaches that should be checked by a doctor right awayinclude: - Blood pressure that is very high - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) - Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudomotor cerebri) - Carbon monoxide poisoning - Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess - Swollen, inflamed arterythat supplies blood to part of the head, temple, and neck area (temporal arteritis). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what blood tests confirm celiac disease", "response": "Celiac Disease (What tests do doctors use to diagnose celiac disease?): A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.4 You are very unlikely to have celiac disease if these gene variants are not present. Having these variants alone is not enough to diagnose celiac disease because they also are common in people without the disease. In fact, most people with these genes will never get celiac disease.If blood tests suggest you have celiac disease, your doctor will perform a biopsy to be sure. During a biopsy, the doctor takes a small piece of tissue from your small intestine during a procedure called an upper GI endoscopy.If a doctor suspects you have dermatitis herpetiformis, he or she will perform a skin biopsy. For a skin biopsy, the doctor removes tiny pieces of skin tissue to examine with a microscope.A doctor examines the skin tissue and checks the tissue for antibodies common in celiac disease. If the skin tissue has the antibodies, a doctor will perform blood tests to confirm celiac disease. If the skin biopsy and blood tests both suggest celiac disease, you may not need an intestinal biopsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what blood tests confirm celiac disease", "response": "Celiac disease - sprue (Exams and Tests): The following tests may be performed: - Bone density - Cholesterol (may be low) - Complete blood count (CBC - test for anemia) - Comprehensive metabolic panel - Folate level (serum) - Iron level (serum) - Prothrombin time - Vitamin B12 level (serum) - Vitamin D level Blood tests can detect antibodies, called antitissue transglutaminase antibodies (tTGA) or anti-endomysial antibodies (EMA) which may help detect the condition. The health care provider will order these antibody tests if celiac disease is suspected. If the tests are positive, upper endoscopy is often performed to sample a piece of tissue (biopsy) from the first part of the small intestine (duodenum). The biopsy may show a flattening of the villi in the parts of the intestine below the duodenum. Genetic testing of the blood can also be done to help determine who may be at risk for celiac disease. A follow-up biopsy or blood test may be ordered several months after the diagnosis and treatment. These tests assess how well treatment is working. Normal results mean that you have responded to treatment. This confirms the diagnosis. However, this does not mean that the disease has been cured. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "Hypoglycemia (Causes): Hypoglycemia occurs when your blood sugar (glucose) level falls too low. There are several reasons why this may happen, the most common is a side effect of drugs used to treat diabetes. Blood sugar regulation But to understand how hypoglycemia happens, it helps to know how your body normally processes blood sugar. When you eat, your body breaks down carbohydrates from foods - such as bread, rice, pasta, vegetables, fruit and milk products - into various sugar molecules, including glucose. Glucose is the main energy source for your body, but it can't enter the cells of most of your tissues without the help of insulin - a hormone secreted by your pancreas. When glucose levels rise, certain cells (beta cells) in your pancreas release insulin. This allows glucose to enter the cells and provide the fuel your cells need to function properly. Any extra glucose is stored in your liver and muscles in the form of glycogen. If you haven't eaten for several hours and your blood sugar level drops, another hormone from your pancreas called glucagon signals your liver to break down the stored glycogen and release glucose back into your bloodstream. This keeps your blood sugar level within a normal range until you eat again. Aside from your liver breaking down glycogen into glucose, your body also has the ability to manufacture glucose. This process occurs primarily in your liver, but also in your kidneys. Possible causes, with diabetes People with diabetes may not make enough insulin (type 1 diabetes) or may be less responsive to it (type 2 diabetes). As a result, glucose tends to build up in the bloodstream and may reach dangerously high levels. To correct this problem, someone with diabetes may take insulin or other drugs to lower blood sugar levels. But too much insulin or other diabetes medications may cause your blood sugar level to drop too low, causing hypoglycemia. Hypoglycemia may also happen if you don't eat as much food as usual after taking diabetes medication, or if you exercise more than you normally would. Possible causes, without diabetes Hypoglycemia in people without diabetes is much less common. Causes may include the following: - Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications may cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), which is used to treat malaria. - Excessive alcohol consumption. Drinking heavily without eating can block your liver from releasing stored glucose into your bloodstream, causing hypoglycemia. - Some critical illnesses. Severe illnesses of the liver, such as severe hepatitis, can cause hypoglycemia. Disorders of the kidney, which can keep your body from properly excreting medications, can affect glucose levels due to a buildup of those medications. Long-term starvation, as may occur in the eating disorder anorexia nervosa, can result in the depletion of substances your body needs to generate glucose (gluconeogenesis), causing hypoglycemia. - Insulin overproduction. A rare tumor of the pancreas (insulinoma) may cause overproduction of insulin, resulting in hypoglycemia. Other tumors may result in excessive production of insulin-like substances. Enlargement of beta cells of the pancreas that produce insulin (nesidioblastosis) may result in excessive insulin release, causing hypoglycemia. - Hormone deficiencies. Certain disorders of the adrenal glands and the pituitary gland can result in a deficiency of key hormones that regulate glucose production. Children may experience hypoglycemia if they have a deficiency of growth hormone. Hypoglycemia after meals Hypoglycemia usually occurs when you haven't eaten (when you're in a fasting state), but that's not always the case. Sometimes hypoglycemia occurs after meals because the body produces more insulin than is needed. This type of hypoglycemia, called reactive or postprandial hypoglycemia, may occur in people who have had stomach surgery. It may also occur in people who haven't had this surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "congenital hyperinsulinism (Description): Congenital hyperinsulinism is a condition that causes individuals to have abnormally high levels of insulin, which is a hormone that helps control blood sugar levels. People with this condition have frequent episodes of low blood sugar (hypoglycemia). In infants and young children, these episodes are characterized by a lack of energy (lethargy), irritability, or difficulty feeding. Repeated episodes of low blood sugar increase the risk for serious complications such as breathing difficulties, seizures, intellectual disability, vision loss, brain damage, and coma. The severity of congenital hyperinsulinism varies widely among affected individuals, even among members of the same family. About 60 percent of infants with this condition experience a hypoglycemic episode within the first month of life. Other affected children develop hypoglycemia by early childhood. Unlike typical episodes of hypoglycemia, which occur most often after periods without food (fasting) or after exercising, episodes of hypoglycemia in people with congenital hyperinsulinism can also occur after eating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "Hypoglycemia (Symptoms): If blood sugar levels become too low, signs and symptoms may include: - An irregular heart rhythm - Fatigue - Pale skin - Shakiness - Anxiety - Sweating - Hunger - Irritability - Tingling sensation around the mouth - Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: - Confusion, abnormal behavior or both, such as the inability to complete routine tasks - Visual disturbances, such as blurred vision - Seizures - Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. When to see a doctor Seek a doctor's help immediately if: - You have what may be symptoms of hypoglycemia and you don't have diabetes. - You have diabetes and hypoglycemia isn't responding to treatment. Initial treatment of hypoglycemia is drinking juice or regular soft drinks, eating candy or taking glucose tablets. If this treatment doesn't raise your blood sugar and improve your symptoms, contact your doctor right away. Seek emergency help if: - Someone with diabetes or a history of recurring hypoglycemia has symptoms of severe hypoglycemia or loses consciousness. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes bipolar disorder", "response": "Bipolar disorder (Causes): The exact cause of bipolar disorder is unknown, but several factors may be involved, such as: - Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. - Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes bipolar disorder", "response": "Bipolar disorder (Risk factors): Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes fungal pneumonia", "response": "Pneumonia (Causes): Bacteria, viruses, and fungi infections can cause pneumonia. These infections cause inflammation in the air sacs, or alveoli, of the lungs. This inflammation causes the air sacs to fill with fluid and pus. Bacteria Bacteria are the most common cause of pneumonia in adults. Many types of bacteria can cause bacterial pneumonia. Streptococcus pneumoniae or pneumococcus bacteria are the most common cause of bacterial pneumonia in the United States. If your pneumonia is caused by one of the following types of bacteria, it is called atypical pneumonia. Legionella pneumophila. This type of pneumonia sometimes is called Legionnaire's disease, and it has caused serious outbreaks. Outbreaks have been linked to exposure to cooling towers, whirlpool spas, and decorative fountains. Mycoplasma pneumoniae. This is a common type of pneumonia that usually affects people younger than 40 years old. People who live or work in crowded places like schools, homeless shelters, and prisons are at higher risk for this type of pneumonia. It's usually mild and responds well to treatment with antibiotics. However, Mycoplasma pneumoniae can be very serious. It may be associated with a skin rash and hemolysis. This type of bacteria is a common cause of “walking pneumonia”. Chlamydia pneumoniae. This type of pneumonia can occur all year and often is mild. The infection is most common in people 65 to 79 years old. Bacterial pneumonia can occur on its own or develop after you've had a viral cold or the flu. Bacterial pneumonia often affects just one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. Read more Most of the time, the body filters bacteria out of the air that we breathe to protect the lungs from infection. Your immune system, the shape of your nose and throat, your ability to cough, and fine, hair-like structures called cilia help stop the germs from reaching your lungs. Read How the Lungs Work for more information. Sometimes bacteria manage to enter the lungs and cause infections. This is more likely to occur if: Your immune system is weak A germ is very strong Your body fails to filter out the bacteria from the air that you breathe. For example, if you can't cough because you've had a stroke or are sedated, bacteria may remain in your airways. When bacteria reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the bacteria. These cells cause inflammation in alveoli (air sacs) and can cause these spaces to fill up with fluid and pus. This causes the symptoms of pneumonia. Viruses Viruses that infect the respiratory tract may cause pneumonia. The influenza or flu virus is the most common cause of viral pneumonia in adults. Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in children younger than one year old. Other viruses can cause pneumonia such as the common cold virus known as rhinovirus, human parainfluenza virus (HPIV), and human metapneumovirus (HMPV). Most cases of viral pneumonia are mild. They get better in about one to three weeks without treatment. Some cases are more serious and may require treatment in a hospital. If you have viral pneumonia, you run the risk of getting bacterial pneumonia. Fungi Pneumocystis pneumonia is a serious fungal infection caused by Pneumocystis jirovecii. It occurs in people who have weak immune systems due to HIV/AIDS or the long-term use of medicines that suppress their immune systems, such as those used to treat cancer or as part of organ or blood and marrow stem cell transplant procedures. Other fungal infections also can lead to pneumonia. The following are three fungi that occur in the soil in some parts of the United States and can cause some people to get pneumonia. Coccidioidomycosis. This fungus is found in Southern California and the desert Southwest. It is the cause of valley fever. Histoplasmosis. This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus. This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes fungal pneumonia", "response": "What causes Pneumonia?: Many germs can cause pneumonia. Examples include different kinds of bacteria, viruses, and, less often, fungi. Most of the time, the body filters germs out of the air that we breathe to protect the lungs from infection. Your immune system, the shape of your nose and throat, your ability to cough, and fine, hair-like structures called cilia (SIL-e-ah) help stop the germs from reaching your lungs. (For more information, go to the Diseases and Conditions Index How the Lungs Work article.) Sometimes, though, germs manage to enter the lungs and cause infections. This is more likely to occur if: Your immune system is weak A germ is very strong Your body fails to filter germs out of the air that you breathe For example, if you can't cough because you've had a stroke or are sedated, germs may remain in your airways. (\"Sedated\" means you're given medicine to make you sleepy.) When germs reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the germs. These cells cause the alveoli (air sacs) to become red and inflamed and to fill up with fluid and pus. This causes the symptoms of pneumonia. Germs That Can Cause Pneumonia Bacteria Bacteria are the most common cause of pneumonia in adults. Some people, especially the elderly and those who are disabled, may get bacterial pneumonia after having the flu or even a common cold. Many types of bacteria can cause pneumonia. Bacterial pneumonia can occur on its own or develop after you've had a cold or the flu. This type of pneumonia often affects one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. The most common cause of pneumonia in the United States is the bacterium Streptococcus (strep-to-KOK-us) pneumoniae, or pneumococcus (nu-mo-KOK-us). Lobar Pneumonia Another type of bacterial pneumonia is called atypical pneumonia. Atypical pneumonia includes: Legionella pneumophila. This type of pneumonia sometimes is called Legionnaire's disease, and it has caused serious outbreaks. Outbreaks have been linked to exposure to cooling towers, whirlpool spas, and decorative fountains. Mycoplasma pneumonia. This is a common type of pneumonia that usually affects people younger than 40 years old. People who live or work in crowded places like schools, homeless shelters, and prisons are at higher risk for this type of pneumonia. It's usually mild and responds well to treatment with antibiotics. However, mycoplasma pneumonia can be very serious. It may be associated with a skin rash and hemolysis (the breakdown of red blood cells). Chlamydophila pneumoniae. This type of pneumonia can occur all year and often is mild. The infection is most common in people 65 to 79 years old. Viruses Respiratory viruses cause up to one-third of the pneumonia cases in the United States each year. These viruses are the most common cause of pneumonia in children younger than 5 years old. Most cases of viral pneumonia are mild. They get better in about 1 to 3 weeks without treatment. Some cases are more serious and may require treatment in a hospital. If you have viral pneumonia, you run the risk of getting bacterial pneumonia as well. The flu virus is the most common cause of viral pneumonia in adults. Other viruses that cause pneumonia include respiratory syncytial virus, rhinovirus, herpes simplex virus, severe acute respiratory syndrome (SARS), and more. Fungi Three types of fungi in the soil in some parts of the United States can cause pneumonia. These fungi are: Coccidioidomycosis (kok-sid-e-OY-do-mi-KO-sis). This fungus is found in Southern California and the desert Southwest. Histoplasmosis (HIS-to-plaz-MO-sis). This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus (krip-to-KOK-us). This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. Most people exposed to these fungi don't get sick, but some do and require treatment. Serious fungal infections are most common in people who have weak immune systems due to the long-term use of medicines to suppress their immune systems or having HIV/AIDS. Pneumocystis jiroveci (nu-mo-SIS-tis ye-RO-VECH-e), formerly Pneumocystis carinii, sometimes is considered a fungal pneumonia. However, it's not treated with the usual antifungal medicines. This type of infection is most common in people who: Have HIV/AIDS or cancer Have had an organ transplant and/or blood and marrow stem cell transplant Take medicines that affect their immune systems Other kinds of fungal infections also can lead to pneumonia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes fungal pneumonia", "response": "Sputum fungal smear (Risks): There are no risks associated with a sputum fungal smear. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what does kidney disease look like", "response": "Kidney disease - resources: The following organizations are good resources for information on kidney disease: - National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease - National Kidney Foundation -- www.kidney.org - American Kidney Fund -- www.kidneyfund.org - American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is acute diverticulitis", "response": "What is Diverticulitis?: Diverticulitis occurs when small, bulging sacs or pouches that form on the inner wall of the intestine (diverticula) become inflamed or infected. Most often, these pouches are in the large intestine (colon). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is acute diverticulitis", "response": "Diverticulitis (Diagnosis): Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms. Your doctor will likely start with a physical examination, including checking your abdomen for tenderness. Women, in addition, generally have a pelvic examination to rule out pelvic disease. After that, your doctor will likely recommend: - Blood and urine tests, to check for signs of infection. - Pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain. - Liver function tests, to rule out other causes of abdominal pain. - Stool test, to rule out infection in people who have diarrhea. - CT scan, which can indicate inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment. Diagnosis at Mayo Clinic Diverticulitis can be difficult to diagnose because abdominal pain is a symptom of many digestive disorders. Mayo Clinic has radiologists who specialize in digestive disorders and have experience distinguishing diverticulitis from other conditions. Mayo's digestive disease specialists (gastroenterologists) have experience diagnosing the severity of diverticulitis. Precise diagnosis is important for appropriate treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is binge eating disorder", "response": "Binge eating disorder (How does binge eating disorder affect pregnancy?): Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is binge eating disorder", "response": "Binge eating disorder (How is binge eating disorder diagnosed?): Your doctor or nurse will ask you questions about your symptoms and medical history. It may be difficult to talk to a doctor or nurse about secret eating behaviors. But doctors and nurses want to help you be healthy. Being honest about your eating behaviors with a doctor or nurse is a good way to ask for help. Your doctor may also do blood, urine, or other tests for other health problems, such as heart problems or gallbladder disease, that can be caused by binge eating disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "COPD: Español Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airways. Within the lungs, your bronchial tubes branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called capillaries run along the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, a waste product, called carbon dioxide (CO2) gas, moves from the capillaries into the air sacs. This process, called gas exchange, brings in oxygen for the body to use for vital functions and removes the CO2. The airways and air sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual and can become clogged. Normal Lungs and Lungs With COPD In the United States, the term COPD includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate. Outlook COPD is a major cause of disability, and it is the third leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older adults. The disease is not contagious, meaning it cannot be passed from person to person. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "What is COPD?: COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include - A cough that produces a lot of mucus - Shortness of breath, especially with physical activity - Wheezing - Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD. NIH: National Heart, Lung, and Blood Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is epilepsy", "response": "Epilepsy: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is epilepsy", "response": "What is Epilepsy?: Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of congenital heart defects", "response": "Congenital Heart Defects (CAUSES): If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur. Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect. Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects. Researchers continue to search for the causes of congenital heart defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of congenital heart defects", "response": "Congenital heart defects in children (Risk factors): Most congenital heart defects result from problems early in your child's heart development, the cause of which is unknown. However, certain environmental and genetic risk factors may play a role. They include: - Rubella (German measles). Having rubella during pregnancy can cause problems in your baby's heart development. Your doctor can test you for immunity to this viral disease before pregnancy and vaccinate you against it if you aren't immune. - Diabetes. You can reduce the risk of congenital heart defects by carefully controlling your diabetes before attempting to conceive and during pregnancy. Gestational diabetes generally doesn't increase your baby's risk of developing a heart defect. - Medications. Certain medications taken during pregnancy may cause birth defects, including congenital heart defects. Give your doctor a complete list of medications you take before attempting to become pregnant. Medications known to increase the risk of congenital heart defects include thalidomide (Thalomid), angiotensin-converting enzyme (ACE) inhibitors, statins, the acne medication isotretinoin (Absorica, Amnesteem, Claravis) and lithium. - Drinking alcohol during pregnancy. Avoid alcohol during pregnancy because it increases the risk of congenital heart defects. - Smoking. Smoking during pregnancy increases the likelihood of a congenital heart defect in the baby. - Heredity. Congenital heart defects sometimes run in families and may be associated with a genetic syndrome. Many children with Down syndrome - which is caused by an extra 21st chromosome (trisomy 21) - have heart defects. A missing piece (deletion) of genetic material on chromosome 22 also causes heart defects. Genetic testing can detect such disorders during fetal development. If you already have a child with a congenital heart defect, a genetic counselor can estimate the odds that your next child will have one. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of congenital heart defects", "response": "How to diagnose Congenital Heart Defects?: Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older. Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason. Specialists Involved Pediatric cardiologists are doctors who specialize in the care of babies and children who have heart problems. Cardiac surgeons are specialists who repair heart defects using surgery. Physical Exam During a physical exam, the doctor will: Listen to your child's heart and lungs with a stethoscope Look for signs of a heart defect, such as cyanosis (a bluish tint to the skin, lips, or fingernails), shortness of breath, rapid breathing, delayed growth, or signs of heart failure Diagnostic Tests Echocardiography Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen. Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working. Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed. During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb. Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born. EKG (Electrocardiogram) An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can detect if one of the heart's chambers is enlarged, which can help diagnose a heart problem. Chest X Ray A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged. It also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure. Pulse Oximetry For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of how much oxygen is in the blood. Cardiac Catheterization During cardiac catheterization (KATH-e-ter-ih-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart. Special dye is injected through the catheter into a blood vessel or one of the hearts chambers. The dye allows the doctor to see blood flowing through the heart and blood vessels on an x-ray image. The doctor also can use cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart. Cardiac catheterization also is used to repair some heart defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-compulsive disorder (OCD) (Causes): The cause of obsessive-compulsive disorder isn't fully understood. Main theories include: - Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. - Genetics. OCD may have a genetic component, but specific genes have yet to be identified. - Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-compulsive disorder (OCD) (Risk factors): Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include: - Family history. Having parents or other family members with the disorder can increase your risk of developing OCD. - Stressful life events. If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD. - Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-Compulsive Disorder (Summary): Summary Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. If you have OCD, you have frequent, upsetting thoughts called obsessions. To try to control the thoughts, you feel an overwhelming urge to repeat certain rituals or behaviors. These are called compulsions. Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions include washing your hands, counting, checking on things, or cleaning. With OCD, the thoughts and rituals cause distress and get in the way of your daily life. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens. Treatments include therapy, medicines, or both. One type of therapy, cognitive behavioral therapy, is useful for treating OCD. NIH: National Institute of Mental Health. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "What is Coffin Lowry Syndrome?: Coffin-Lowry syndrome is a rare genetic disorder characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. Characteristic facial features may include an underdeveloped upper jaw bone (maxillary hypoplasia), a broad nose, protruding nostrils (nares), an abnormally prominent brow, down-slanting eyelid folds (palpebral fissures), widely spaced eyes (hypertelorism), large low-set ears, and unusually thick eyebrows. Skeletal abnormalities may include abnormal front-to-back and side-to-side curvature of the spine (kyphoscoliosis), unusual prominence of the breastbone (pigeon chest, or pectus carinatum), dental abnormalities, and short, hyperextensible, tapered fingers. Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. The disorder affects males and females in equal numbers, but symptoms are usually more severe in males. The disorder is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1). Thus, the syndrome is typically more severe in males because males have only one X chromosome, while females have two. It is unclear how changes (mutations) in the DNA structure of the gene lead to the clinical findings. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "Coffin-Lowry syndrome (Genetic Changes): Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "Coffin-Lowry syndrome: Coffin-Lowry syndrome is a condition that affects many parts of the body. The signs and symptoms are usually more severe in males than in females, although the features of this disorder range from very mild to severe in affected women. Males with Coffin-Lowry syndrome typically have severe to profound intellectual disability and delayed development. Affected women may be cognitively normal, or they may have intellectual disability ranging from mild to profound. Beginning in childhood or adolescence, some people with this condition experience brief episodes of collapse when excited or startled by a loud noise. These attacks are called stimulus-induced drop episodes (SIDEs). Most affected males and some affected females have distinctive facial features including a prominent forehead, widely spaced and downward-slanting eyes, a short nose with a wide tip, and a wide mouth with full lips. These features become more pronounced with age. Soft hands with short, tapered fingers are also characteristic of Coffin-Lowry syndrome. Additional features of this condition include short stature, an unusually small head (microcephaly), progressive abnormal curvature of the spine (kyphoscoliosis), and other skeletal abnormalities. The incidence of this condition is uncertain, but researchers estimate that the disorder affects 1 in 40,000 to 50,000 people. Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. This gene provides instructions for making a protein that is involved in signaling within cells. Researchers believe that this protein helps control the activity of other genes and plays an important role in the brain. The protein is involved in cell signaling pathways that are required for learning, the formation of long-term memories, and the survival of nerve cells. Gene mutations result in the production of little or no RPS6KA3 protein, but it is unclear how a lack of this protein causes the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause of the condition is unknown. This condition is inherited in an X-linked dominant pattern. A condition is considered X-linked if the mutated gene that causes the disorder is located on the X chromosome, one of the two sex chromosomes. The inheritance is dominant if one copy of the altered gene in each cell is sufficient to cause the condition. In most cases, males (who have one X chromosome in each cell) experience more severe signs and symptoms of the disorder than females (who have two X chromosomes in each cell). A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons. Between 70 percent and 80 percent of people with Coffin-Lowry syndrome have no history of the condition in their families. These cases are caused by new mutations in the RPS6KA3 gene. The remaining 20 percent to 30 percent of affected individuals have other family members with Coffin-Lowry syndrome. Hanauer A, Young ID. Coffin-Lowry syndrome: clinical and molecular features. J Med Genet. 2002 Oct;39(10):705-13. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "What is Achondroplasia?: Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence. Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. Achondroplasia is caused by mutations in the FGFR3 gene. It is inherited in an autosomal dominant fashion. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "Achondroplasia: Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Achondroplasia is one of a group of disorders called chondrodystrophies, or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder. If 1 parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that 2 parents without achondroplasia may give birth to a baby with the condition. The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: - Abnormal hand appearance with persistent space between the long and ring fingers - Bowed legs - Decreased muscle tone - Disproportionately large head-to-body size difference - Prominent forehead (frontal bossing) - Shortened arms and legs (especially the upper arm and thigh) - Short stature (significantly below the average height for a person of the same age and sex) - Narrowing of the spinal column spinal stenosis - Spine curvatures called kyphosis and lordosis During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus (\"water on the brain\"). X-rays of the long bones can reveal achondroplasia in the newborn. There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Health problems that may develop include: - Breathing problems from a small upper airway and from pressure on the area of the brain that controls breathing - Lung problems from a small ribcage If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider. Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "Achondroplasia (Prevention): Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "Lymphoma (Treatment): Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition. - Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive. - Other drug therapy. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "Hodgkin lymphoma (Treatment): Treatment depends on the following: - The type of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma) - The stage (where the disease has spread) - Whether the tumor is more than 4 inches (10 cm) wide - Your age and other medical issues - Other factors, including weight loss, night sweats, and fever You may receive chemotherapy, radiation therapy, or both. Your doctor can tell you more about your specific treatment. High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant that uses your own stem cells. You and your health care provider may need to manage other concerns during your leukemia treatment, including: - Having chemotherapy at home - Managing your pets during chemotherapy - Bleeding problems - Dry mouth - Eating enough calories - Safe eating during cancer treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "What are the treatments for Primary lymphoma of the brain?: Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV, may also be tried. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "Brucellosis (Treatment): Treatment for brucellosis aims to relieve symptoms, prevent a relapse of the disease and avoid complications. You'll need to take antibiotics for at least six weeks, and your symptoms may not go away completely for several months. The disease can also return and may become chronic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "Brucellosis (Overview): Brucellosis is a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. More rarely, the bacteria that cause brucellosis can spread through the air or through direct contact with infected animals. Brucellosis symptoms may include fever, joint pain and fatigue. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common. While brucellosis is uncommon in the United States, the disease affects hundreds of thousands of people and animals worldwide. Avoiding unpasteurized dairy products and taking precautions when working with animals or in a laboratory can help prevent brucellosis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "What is Brucellosis?: Brucellosis is an infectious disease that occurs from contact with animals carrying brucella bacteria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what test do you do for rheumatoid \"arthritis?\"", "response": "Rheumatoid Arthritis (Is there a test?): Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what test do you do for rheumatoid \"arthritis?\"", "response": "Rheumatoid arthritis (Diagnosis): Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she may also check your reflexes and muscle strength. Blood tests People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Imaging tests Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what the treatment for bronchitis", "response": "What are the treatments for Bronchitis - acute?: Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: - Drink plenty of fluids. - If you have asthma or another chronic lung condition, use your inhaler. - Get plenty of rest. - Take aspirin or acetaminophen (Tylenol and other brands) if you have a fever. Do not give aspirin to children. - Use a humidifier or steam in the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. Ask the pharmacist if you need help finding it. If your symptoms do not improve or if you are wheezing, your doctor may prescribe an inhaler to open your airways. If your doctor thinks you also have bacteria in your airways, he or she may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. A bacterial infection is more common if you also have a chronic lung disease like COPD. Sometimes, bacteria may infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Other tips include: - Do not smoke. - Avoid secondhand smoke and air pollution. - Wash your hands (and your children's hands) often to avoid spreading viruses and other germs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what treatment do you use to cure chickenpox", "response": "What are the treatments for Chickenpox?: Treatment involves keeping the person as comfortable as possible. Here are things to try: - Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. - Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. - Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. - Apply a soothing moisturizer after bathing to soften and cool the skin. - Avoid prolonged exposure to excessive heat and humidity. - Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. - Try over-the-counter hydrocortisone cream on itchy areas. Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. - Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. - Antiviral medicine may be very important forthose who have skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or who have recently taken steroids. - Some providers also give antiviral medicines to people in the same household who also develop chickenpox, because they will most often develop more severe symptoms. Do NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used. A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule while considering when to return to work or be around others. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what treatment do you use to cure chickenpox", "response": "Chickenpox (Treatment): In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome. Treating complications If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what treatment do you use to cure chickenpox", "response": "Chickenpox (Lifestyle and home remedies): To help ease the symptoms of an uncomplicated case of chickenpox, follow these self-care measures. Don't scratch Scratching can cause scarring, slow healing and increase the risk that the sores will become infected. If your child can't stop scratching: - Put gloves on his or her hands, especially at night - Trim his or her fingernails Relieve the itch and other symptoms The chickenpox rash can be very itchy, and broken vesicles sometimes sting. These discomforts, along with fever, headache and fatigue, can make anyone miserable. For relief, try: - A cool bath with added baking soda, uncooked oatmeal or colloidal oatmeal - a finely ground oatmeal that is made for soaking. - Calamine lotion dabbed on the spots. - A soft, bland diet if chickenpox sores develop in the mouth. - Antihistamines such as diphenhydramine (Benadryl, others) for itching. Check with your doctor to make sure your child can safely take antihistamines. - Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, Children's Motrin, others) for a mild fever. Don't give aspirin to anyone with chickenpox because it can lead to a serious condition called Reye's syndrome. And don't treat a high fever without consulting your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "Calcium carbonate overdose: Calcium carbonate is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone takes more than the normal or recommended amount of a product containing this substance. This can be by accident or on purpose. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Calcium carbonate can be dangerous in large amounts. Some products that contain calcium carbonate are certain: - Antacids (Tums, Chooz) - Mineral supplements - Hand lotions - Vitamin and mineral supplements Other products may also contain calcium carbonate. Symptoms of a calcium carbonate overdose include: - Abdominal pain - Bone pain - Coma - Confusion - Constipation - Depression - Diarrhea - Headache - Irregular heartbeat - Muscle twitching - Nausea - Vomiting Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to. Have this information ready: - Person's age, weight, and condition - The name of the product (ingredients and strength, if known) - When it was swallowed - The amount swallowed Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. Take the container with you to the hospital, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood tests may be done. Symptoms will be treated. The person may receive: - Activated charcoal - Blood and urine tests - Breathing support - Chest x-ray - EKG (electrocardiogram, or heart tracing) - Intravenous fluids (through a vein) - Laxative - Medicine to treat symptoms - Tube through the mouth into the stomach to empty the stomach (gastric lavage) Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out of the reach of children. Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "Calcium Carbonate: Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium is needed by the body for healthy bones, muscles, nervous system, and heart. Calcium carbonate also is used as an antacid to relieve heartburn, acid indigestion, and upset stomach. It is available with or without a prescription. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Calcium carbonate comes as a tablet, chewable tablet, capsule, and liquid to take by mouth. It is usually taken three or four times a day. Follow the directions on your prescription or package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take calcium carbonate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. When using this medicine as a dietary supplement, take it with food or following meals. Chewable tablets should be chewed thoroughly before being swallowed; do not swallow them whole. Drink a full glass of water after taking either the regular or chewable tablets or capsules. Some liquid forms of calcium carbonate must be shaken well before use. Do not take calcium carbonate as an antacid for more than 2 weeks unless your doctor tells you to. Before taking calcium carbonate, - tell your doctor and pharmacist if you are allergic to calcium carbonate or any other drugs. - tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially digoxin (Lanoxin), etidronate (Didronel), phenytoin (Dilantin), tetracycline (Sumycin), and vitamins. Do not take calcium carbonate within 1-2 hours of taking other medicines. Calcium may decrease the effectiveness of the other medicine. - tell your doctor if you have or have ever had kidney disease or stomach conditions. - tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking calcium carbonate, call your doctor. If you are taking calcium carbonate on a regular schedule, take the missed dose as soon you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Calcium carbonate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - upset stomach - vomiting - stomach pain - belching - constipation - dry mouth - increased urination - loss of appetite - metallic taste Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911. If this medicine has been prescribed for you, keep all appointments with your doctor so that your response to calcium carbonate can be checked. Do not let anyone else take your medicine. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. - Alka-Mints® - Calel-D® - Calcid® - Caltrate 600® - Chooz® - Miralac® - Os-Cal 500® - Rolaids® - Titralac® - Tums® - Gas-X® with Maalox® (containing Calcium Carbonate, Simethicone) - Rolaids® Plus Gas Relief (containing Calcium Carbonate, Simethicone) - Titralac® Plus (containing Calcium Carbonate, Simethicone). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "Calcium, vitamin D, and your bones (How Much Calcium and Vitamin D do I Need?): Amounts of calcium are given in milligrams (mg), and vitamin D is given in international units (IU). All children ages 9 to 18 should have: - 1300 mg of calcium daily - 600 IU of vitamin D daily All adults under age 50 should have: - 1000 mg of calcium daily - 400 to 800 IU of vitamin D daily Adults age 51 and older should have: - Women: 1200 mg of calcium daily - Men: 1000 mg of calcium daily Men and women: 800 to 1000 IU of vitamin D daily Too much calcium or vitamin D can lead to problems such as an increased risk for kidney stones. - Total calcium should not exceed 2000 mg per day - Total vitamin D should not exceed 4000 IU per day. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "Dengue (Summary): Summary Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found - Wear insect repellent with DEET - Wear clothes that cover your arms, legs and feet - Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "Dengue Fever: Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called \"break-bone\" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Health experts have known about dengue fever for more than 200 years. Worldwide, about 50 million cases of dengue infection occur each year, with 22,000 deaths, mostly in children. This includes 100 to 200 cases in the United States, mostly in people who have recently traveled abroad. Many more cases likely go unreported because some healthcare providers do not recognize the disease. In the Western hemisphere, the estimated economic burden of dengue is about $2.1 billion per year. Recognizing the threat to public health posed by dengue, NIAID is funding nearly 60 dengue research projects, including studies on dengue hemorrhagic fever and dengue shock syndrome, the most severe forms of the disease. NIAID research priorities include effective community-based prevention programs, improved laboratory-based international surveillance, rapid diagnostic tests and therapies, and development of and clinical trials for dengue vaccines. Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found Wear insect repellent with DEET Wear clothes that cover your arms, legs and feet Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases Dengue has emerged as a global health threat, while scientists still know little about how the virus infects cells and causes the disease. To answer these questions, NIAID supports a wide-range of basic research activities aimed at better understanding the biology of the dengue virus, the progression of disease in infected people, and the interactions between the virus and the immune system. New research findings are shedding light on the mechanisms of dengue infection, such as how the virus enters the cells and how the human immune system responds to dengue infection. Other NIAID projects are identifying the human and viral factors that determine and contribute to the severity and transmissibility of this disease. NIAID researchers are actively engaged in the search for an effective vaccine against dengue fever. The vaccine approach that is currently been evaluated at NIAID for efficacy against dengue animal models and human trials is a weakened recombinant version (live-attenuated) of the dengue virus. Other NIAID-funded investigators are working to develop dengue vaccines using different live-attenuated dengue viruses, recombinant proteins, viral vectors, and DNA. NIAID-supported scientists are working to understand the pathology of dengue disease and to develop cost-effective, sensitive, and specific diagnostic tests for use in dengue-endemic countries. The goal of these tests is to provide early detection of the disease, distinguish between the different viral dengue, and predict which people are at highest risk of developing the more severe forms of the disease, dengue hemorrhagic fever and dengue shock syndrome. Quick and effective diagnosis of dengue is critical to effectively control outbreaks, treat the disease, and reduce mortality. In one project supported by NIAID, researchers are developing an automated, portable, point-of-care machine for rapid dengue diagnosis NIAID-supported investigators are pursuing several approaches to treat dengue infection. Some scientists are working to identify cellular and viral proteins to use as targets for drug intervention. In other studies, researchers are generating and evaluating neutralizing monoclonal antibodies and small molecule drugs in animal models. Results from these animal trials may result in new treatment options for people with dengue. In one NIAID-funded contract, researchers evaluated about 7,500 antiviral compounds in vitro to test their efficacy against dengue. So far, 49 have been identified for further evaluation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "Dengue fever (Summary): The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 99828 Disease definition Dengue fever (DF), caused by dengue virus , is an arboviral disease characterized by an initial non-specific febrile illness that can sometimes progress to more severe forms manifesting capillary leakage and hemorrhage (dengue hemorrhagic fever, or DHF) and shock (dengue shock syndrome , or DSS). Epidemiology DF is found in the tropics worldwide, especially in Southeast Asia, the Pacific region, and the Americas, with 40% of the global population at risk. An estimated 50 to 100 million cases of DF, 500,000 hospitalizations, and 20,000 deaths occur yearly worldwide. Clinical description The vast majority of dengue virus infections result in DF, which is characterized by sudden onset of fever, malaise, headache (classically retro-orbital), and myalgia/arthralgia, often followed soon after by a petechial rash, which may be pruritic. In most cases, symptoms will resolve within 7 days without further complications. However, in a small minority of patients, a brief period of deffervescence is followed by worsening abdominal symptoms (pain, nausea, vomiting, diarrhea), thrombocytopenia , hemorrhage (DHF: epistaxis, bleeding gums, gastrointestinal bleeding) and a capillary leak syndrome (DSS: hemoconcentration, hypoalbuminemia, pleural effusion, shock). DHF/DSS are seen most often in children under the age of 15 years. Risk is greater with secondary heterologous infection by one of the four dengue virus serotypes, but severe disease may be seen with first infections. Etiology Over 25 different viruses cause viral hemorrhagic fever. Dengue virus belongs to the Flaviviridae family, genus Flavivirus. Four distinct serotypes, with significant strain variation, are recognized. Dengue viruses are maintained in humans and transmitted between them by the bite of infected mosquitoes, most commonly Aedes aegypti but also Aedes albopictus). Person-to-person transmission has not been reported. Diagnostic methods Common diagnostic modalities include serologic testing by enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR). Virus isolation may also be performed in specialized laboratories. The viremic phase of DF/DHF is usually brief (first 3-5 days of illness), after which time detection of anti-dengue IgM antibodies , which appear as early as 2-4 days after disease onset, is the mainstay. Numerous commercial ELISA assays are available with varying degrees of sensitivity and specificity. Differential diagnosis DF is difficult to distinguish from a host of other febrile illnesses such as malaria and typhoid fever (see these terms), especially early in the course of disease before the rash appears. For DHF/DSS, other viral hemorrhagic fevers, leptospirosis, rickettsial infection (see these terms) and meningococcemia need to be excluded. Management and treatment As there is presently no antiviral drug available for DF/DHF, treatment is supportive, following the guidelines for treatment of severe septicemia. Insecticide-treated bed nets, room screens and elimination of larval development sites should be used in open-air settings to prevent further transmission. Prognosis Case-fatality rates for DF are less than 1% but may rise to as high as 40% in DHF/DSS, largely dependent upon whether access to advanced medical care exists. Children and persons with underlying chronic diseases such as diabetes, heart disease, and asthma are at increased risk. The most severe phase of disease usually lasts only a few days and survivors generally have no lasting sequelae. Visit the Orphanet disease page for more resources. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "why can you not take grapefruit with felodipine", "response": "Felodipine (What special dietary instructions should I follow?): Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can i take keflex to cure staph?", "response": "Staph infections (Treatment): Treatment of a staph infection may include: - Antibiotics. Your doctor may perform tests to identify of the staph bacteria behind your infection, and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin. Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines. But vancomycin and some other antibiotics have to be given intravenously. If you're given an oral antibiotic, be sure to take it as directed, and to finish all of the medication prescribed by your doctor. Ask your doctor what signs and symptoms you should watch for that might indicate your infection is worsening. - Wound drainage. If you have a skin infection, your doctor will likely make an incision into the sore to drain fluid that has collected there. - Device removal. If your infection involves a device or prosthetic, prompt removal of the device is needed. For some devices, removal might require surgery. Antibiotic resistance Staph bacteria are very adaptable, and many varieties have become resistant to one or more antibiotics. For example, only about 10 percent of today's staph infections can be cured with penicillin. The emergence of antibiotic-resistant strains of staph bacteria - often described as methicillin-resistant Staphylococcus aureus (MRSA) strains - has led to the use of IV antibiotics, such as vancomycin, with the potential for more side effects, such as vancomycin. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can i take keflex to cure staph?", "response": "What are the treatments for Staph infections - self-care at home?: If test results show you have a staph infection, treatment may include: - Taking antibiotics - Cleaning and draining the wound - Surgery to remove an infected device. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "could tetanus be a cause of death?", "response": "Tetanus (Complications): Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection may include: - Broken bones. The severity of spasms may cause the spine and other bones to break. - Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "could tetanus be a cause of death?", "response": "What is Tetanus?: Tetanus is aninfection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C. tetani). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks", "response": "abetalipoproteinemia: Abetalipoproteinemia is an inherited disorder that affects the absorption of dietary fats, cholesterol, and fat-soluble vitamins. People affected by this disorder are not able to make certain lipoproteins, which are particles that carry fats and fat-like substances (such as cholesterol) in the blood. Specifically, people with abetalipoproteinemia are missing a group of lipoproteins called beta-lipoproteins. An inability to make beta-lipoproteins causes severely reduced absorption (malabsorption) of dietary fats and fat-soluble vitamins (vitamins A, D, E, and K) from the digestive tract into the bloodstream. Sufficient levels of fats, cholesterol, and vitamins are necessary for normal growth, development, and maintenance of the body's cells and tissues, particularly nerve cells and tissues in the eye. The signs and symptoms of abetalipoproteinemia appear in the first few months of life. They can include failure to gain weight and grow at the expected rate (failure to thrive); diarrhea; abnormal star-shaped red blood cells (acanthocytosis); and fatty, foul-smelling stools (steatorrhea). Other features of this disorder may develop later in childhood and often impair the function of the nervous system. Disturbances in nerve function may cause affected people to eventually develop poor muscle coordination and difficulty with balance and movement (ataxia). Individuals with this condition may also develop an eye disorder called retinitis pigmentosa, in which progressive degeneration of the light-sensitive layer (retina) at the back of the eye can cause vision loss. Adults in their thirties or forties may have increasing difficulty with balance and walking. Many of the signs and symptoms of abetalipoproteinemia result from a severe vitamin deficiency, especially a deficiency of vitamin E. Abetalipoproteinemia is a rare disorder with approximately 100 cases described worldwide. Mutations in the MTTP gene cause abetalipoproteinemia. The MTTP gene provides instructions for making a protein called microsomal triglyceride transfer protein, which is essential for creating beta-lipoproteins. These lipoproteins are necessary for the absorption of fats, cholesterol, and fat-soluble vitamins from the diet and the efficient transport of these substances in the bloodstream. Most of the mutations in the MTTP gene lead to the production of an abnormally short microsomal triglyceride transfer protein, which prevents the normal creation of beta-lipoproteins in the body. A lack of beta-lipoproteins causes the nutritional and neurological problems seen in people with abetalipoproteinemia. This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Berriot-Varoqueaux N, Aggerbeck LP, Samson-Bouma M, Wetterau JR. The role of the microsomal triglygeride transfer protein in abetalipoproteinemia. Annu Rev Nutr. 2000;20:663-97. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks", "response": "abetalipoproteinemia (Frequency): Abetalipoproteinemia is a rare disorder with approximately 100 cases described worldwide. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "abetalipoproteimemia hi, I would like to know if there is any support for those suffering with abetalipoproteinemia? I am not diagnosed but have had many test that indicate I am suffering with this, keen to learn how to get it diagnosed and how to manage, many thanks", "response": "abetalipoproteinemia (Genetic Changes): Mutations in the MTTP gene cause abetalipoproteinemia. The MTTP gene provides instructions for making a protein called microsomal triglyceride transfer protein, which is essential for creating beta-lipoproteins. These lipoproteins are necessary for the absorption of fats, cholesterol, and fat-soluble vitamins from the diet and the efficient transport of these substances in the bloodstream. Most of the mutations in the MTTP gene lead to the production of an abnormally short microsomal triglyceride transfer protein, which prevents the normal creation of beta-lipoproteins in the body. A lack of beta-lipoproteins causes the nutritional and neurological problems seen in people with abetalipoproteinemia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Thalassemia (Treatment): Treatment for thalassemia depends on which type you have and how severe it is. Treatments for mild thalassemia Signs and symptoms are usually mild with thalassemia minor and little, if any, treatment is needed. Occasionally, you may need a blood transfusion, particularly after surgery, after having a baby or to help manage thalassemia complications. People with severe beta-thalassemia will need blood transfusions. And because this treatment can cause iron overload, they will also need treatment to remove excess iron. An oral medication called deferasirox (Exjade, Jadenu) can help remove the excess iron. Treatments for moderate to severe thalassemia Treatments for moderate to severe thalassemia may include: - Frequent blood transfusions. More-severe forms of thalassemia often require frequent blood transfusions, possibly every few weeks. Over time, blood transfusions cause a buildup of iron in your blood, which can damage your heart, liver and other organs. To help your body get rid of the extra iron, you may need to take medications that rid your body of extra iron. - Stem cell transplant. Also called a bone marrow transplant, a stem cell transplant may be an option in select cases, including children born with severe thalassemia. It can eliminate the need for lifelong blood transfusions and drugs to control iron overload. During this procedure, you receive infusions of stem cells from a compatible donor, usually a sibling. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Sickle beta thalassemia (Treatment): Treatment for sickle beta thalassemia is supportive and usually depends on the signs and symptoms present in each person. It is generally recommended that all affected people drink plenty of water; avoid climate extremes, activities that lead to inflammation and extreme fatigue; and stay up-to-date on all immunizations. Because sickle beta thalassemia is associated with a variety of health problems, affected people are usually followed closely by their healthcare provider with regular physical examinations that may include specialized laboratory tests and imaging studies (i.e. chest X-ray, transcranial doppler ultrasound, ECG). Blood transfusions may be prescribed on a regular basis for affected people with a history of or risk factors for stroke and other specific health problems, such as pulmonary hypertension. Hydroxyurea, a drug approved by the U.S. Food and Drug Administration for the treatment of sickle cell disease, can decrease the frequency and severity of pain episodes; reduce the need of blood transfusions; and increase life span. [1] [3] For more information regarding the treatment of sickle beta thalassemia and other sickle cell diseases, please click here. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "about thalassemia treatment sir,my friend is suffering from thalassemia ,in that majorly red blood anemia,white blood anemia and the blood is comming out from mouth when she got cough .her condition is very severe .in her body the red ,white blood cells are abscent .so that blood transfusion is doing for every 16-20days.then in the recent days the blood also comming out from mouth please tell me where can i get the treatment for this disease .we can travel around the world for treatment please reply me as soon as possible. thank you sir.", "response": "Chemotherapy: The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to: - Cure the cancer - Shrink the cancer - Prevent the cancer from spreading - Relieve symptoms the cancer may be causing HOW CHEMOTHERAPY IS GIVEN Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including: - Injections or shots into the muscles - Injections or shots under the skin - Into an artery - Into a vein (intravenous, or IV) - Pills taken by mouth - Shots into the fluid around the spinal cord or brain When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery. There are many types of catheters, including: - Central venous catheter - Central venous catheter with a port - Percutaneously inserted central catheter (PICC) A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line. Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy. Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose. Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training. DIFFERENT TYPES OF CHEMOTHERAPY The different types of chemotherapy include: - Standard chemotherapy, which works by killing cancer cells and some normal cells. - Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells. SIDE EFFECTS OF CHEMOTHERAPY Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment. As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract. When this damage occurs, there can be side effects. Some people who receive chemotherapy: - Are more likely to have infections - Become tired more easily - Bleed too much, even during everyday activities - Feel pain or numbness from nerve damage - Have a dry mouth, mouth sores, or swelling in the mouth - Have a poor appetite or lose weight - Have an upset stomach, vomiting, or diarrhea - Lose their hair - Have problems with thinking and memory (\"chemo brain\") Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects. Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include: - Being careful with pets and other animals to avoid catching infections from them - Eating enough calories and protein to keep your weight up - Preventing bleeding, and what to do if bleeding occurs - Practicing safe eating and drinking habits - Washing your hands often with soap and water You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to: - Monitor how well the chemotherapy is working - Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists and Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Absence seizures Does any damage occurre from these spells. Mental or physical", "response": "What is Absence seizure?: An absence seizure is the term given to a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Absence seizures Does any damage occurre from these spells. Mental or physical", "response": "Absence seizure: An absence seizure is the term for a type of seizure involving staring spells. This type of seizure is a brief (usually less than 15 seconds) disturbance of brain function due to abnormal electrical activity in the brain. Absence seizures occur most often in people under age 20, usually in children ages 6 to 12. In some cases, the seizures are triggered by flashing lights or when the person breathes faster and more deeply than usual (hyperventilates). They may occur with other types of seizures, such as generalized tonic-clonic seizures (grand mal seizures), twitches or jerks (myoclonus), or sudden loss of muscle strength (atonic seizures). Most absence seizures last only a few seconds. They often involve staring episodes. The episodes may: - Occur many times a day - Occur for weeks to months before being noticed - Interfere with school and learning - Be mistaken for lack of attention, daydreaming or other misbehavior Unexplained difficulties in school and learning difficulties may be the first sign of absence seizures. During the seizure, the person may: - Stop walking and start again a few seconds later - Stop talking in mid-sentence and start again a few seconds later The person usually does not fall during the seizure. Right after the seizure, the person is usually: - Wide awake - Thinking clearly - Unaware of the seizure Specific symptoms of typical absence seizures may include: - Changes in muscle activity, such as no movement, hand fumbling, fluttering eyelids, lip smacking, chewing - Changes in alertness (consciousness), such as staring episodes, lack of awareness of surroundings, sudden halt in movement, talking, and other awake activities Some absence seizures begin slower and last longer. These are called atypical absence seizures. Symptoms are similar to regular absence seizures, but muscle activity changes may be more noticeable. The doctor will perform a physical exam. This will include a detailed look at the brain and nervous system. An EEG (electroencephalogram) will be done to check the electrical activity in the brain. People with seizures often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. Blood tests may also be ordered to check for other health problems that may be causing the seizures. Head CT or MRI scan may be done to find the cause and location of the problem in the brain. Treatment for absence seizures includes medicines, changes in lifestyle for adults and children, such as activity and diet, and sometimes surgery. Your doctor can tell you more about these options. Updated by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "Adrenoleukodystrophy (Treatment): Adrenal dysfunction may be treated with steroids (such as cortisol) if the adrenal gland is not producing enough hormones. A specific treatment for X-linked adrenoleukodystrophy is not available. A bone marrow transplant can cure a people of the condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "What is Adrenoleukodystrophy?: X-linked Adrenoleukodystrophy (ALD) is one of a group of genetic disorders called the leukodystrophies that cause damage to the myelin sheath, an insulating membrane that surrounds nerve cells in the brain. Women have two X chromosomes and are the carriers of the disease, but since men only have one X chromosome and lack the protective effect of the extra X chromosome, they are more severely affected. People with X-ALD accumulate high levels of saturated, very long chain fatty acids (VLCFA) in the brain and adrenal cortex. The loss of myelin and the progressive dysfunction of the adrenal gland are the primary characteristics of X-ALD. While nearly all patients with X-ALD suffer from adrenal insufficiency, also known as Addison's disease, the neurological symptoms can begin either in childhood or in adulthood. The childhood cerebral form is the most severe, with onset between ages 4 and 10. The most common symptoms are usually behavioral changes such as abnormal withdrawal or aggression, poor memory, and poor school performance. Other symptoms include visual loss, learning disabilities, seizures, poorly articulated speech, difficulty swallowing, deafness, disturbances of gait and coordination, fatigue, intermittent vomiting, increased skin pigmentation, and progressive dementia. The milder adult-onset form is also known as adrenomyeloneuropathy (AMN), which typically begins between ages 21 and 35. Symptoms may include progressive stiffness, weakness or paralysis of the lower limbs, and ataxia. Although adult-onset ALD progresses more slowly than the classic childhood form, it can also result in deterioration of brain function. Almost half the women who are carriers of X-ALS will develop a milder form of AMN but almost never will develop symptoms seen in boys the X-ALD. X-ALD should not be confused with neonatal adrenoleukodsystrophy, which is a disease of newborns and young infants and belongs to the group of peroxisomal biogenesis disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "adrenoleukodystrophy A child I have been asked to work with has been diagnosed with this condition.I am so far unable to find info pertaining to this illness. Can you help??", "response": "What is Adrenoleukodystrophy?: Adrenoleukodystrophy describes several closely related disorders that disrupt the breakdown of certain fats. These disorders are passed down (inherited) in families. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.", "response": "Anal fissure (Complications): Complications of anal fissure can include: - Failure to heal. An anal fissure that fails to heal within six weeks is considered chronic and may need further treatment. - Recurrence. Once you've experienced an anal fissure, you are prone to having another one. - A tear that extends to surrounding muscles. An anal fissure may extend into the ring of muscle that holds your anus closed (internal anal sphincter), making it more difficult for your anal fissure to heal. An unhealed fissure can trigger a cycle of discomfort that may require medications or surgery to reduce the pain and to repair or remove the fissure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Anal Fissure I may have a couple anal fissures and looking to speak with someone to get some information and support.", "response": "Do you have information about Nutritional Support: Summary : Nutritional support is therapy for people who cannot get enough nourishment by eating or drinking. You may need it if you - Can't swallow - Have problems with your appetite - Are severely malnourished - Can't absorb nutrients through your digestive system You receive nutritional support through a needle or catheter placed in your vein or with a feeding tube, which goes into your stomach. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?", "response": "Angelman syndrome: Angelman syndrome is a complex genetic disorder that primarily affects the nervous system. Characteristic features of this condition include delayed development, intellectual disability, severe speech impairment, and problems with movement and balance (ataxia). Most affected children also have recurrent seizures (epilepsy) and a small head size (microcephaly). Delayed development becomes noticeable by the age of 6 to 12 months, and other common signs and symptoms usually appear in early childhood. Children with Angelman syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand-flapping movements. Hyperactivity, a short attention span, and a fascination with water are common. Most affected children also have difficulty sleeping and need less sleep than usual. With age, people with Angelman syndrome become less excitable, and the sleeping problems tend to improve. However, affected individuals continue to have intellectual disability, severe speech impairment, and seizures throughout their lives. Adults with Angelman syndrome have distinctive facial features that may be described as \"coarse.\" Other common features include unusually fair skin with light-colored hair and an abnormal side-to-side curvature of the spine (scoliosis). The life expectancy of people with this condition appears to be nearly normal. Angelman syndrome affects an estimated 1 in 12,000 to 20,000 people. Many of the characteristic features of Angelman syndrome result from the loss of function of a gene called UBE3A. People normally inherit one copy of the UBE3A gene from each parent. Both copies of this gene are turned on (active) in many of the body's tissues. In certain areas of the brain, however, only the copy inherited from a person's mother (the maternal copy) is active. This parent-specific gene activation is caused by a phenomenon called genomic imprinting. If the maternal copy of the UBE3A gene is lost because of a chromosomal change or a gene mutation, a person will have no active copies of the gene in some parts of the brain. Several different genetic mechanisms can inactivate or delete the maternal copy of the UBE3A gene. Most cases of Angelman syndrome (about 70 percent) occur when a segment of the maternal chromosome 15 containing this gene is deleted. In other cases (about 11 percent), Angelman syndrome is caused by a mutation in the maternal copy of the UBE3A gene. In a small percentage of cases, Angelman syndrome results when a person inherits two copies of chromosome 15 from his or her father (paternal copies) instead of one copy from each parent. This phenomenon is called paternal uniparental disomy. Rarely, Angelman syndrome can also be caused by a chromosomal rearrangement called a translocation, or by a mutation or other defect in the region of DNA that controls activation of the UBE3A gene. These genetic changes can abnormally turn off (inactivate) UBE3A or other genes on the maternal copy of chromosome 15. The causes of Angelman syndrome are unknown in 10 to 15 percent of affected individuals. Changes involving other genes or chromosomes may be responsible for the disorder in these cases. In some people who have Angelman syndrome, the loss of a gene called OCA2 is associated with light-colored hair and fair skin. The OCA2 gene is located on the segment of chromosome 15 that is often deleted in people with this disorder. However, loss of the OCA2 gene does not cause the other signs and symptoms of Angelman syndrome. The protein produced from this gene helps determine the coloring (pigmentation) of the skin, hair, and eyes. Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next. Buiting K. Prader-Willi syndrome and Angelman syndrome. Am J Med Genet C Semin Med Genet. 2010 Aug 15;154C(3):365-76. doi: 10.1002/ajmg.c.30273. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Angelman syndrome. Can a person with Angelman Syndrome have children? If so, can the disorder be passed on to offspring?", "response": "Is Angelman syndrome inherited?: Most cases of Angelman syndrome are not inherited, particularly those caused by a deletion in the maternal chromosome 15 or by paternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family. Rarely, a genetic change responsible for Angelman syndrome can be inherited. For example, it is possible for a mutation in the UBE3A gene or in the nearby region of DNA that controls gene activation to be passed from one generation to the next. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Treatment): Treatment isn't always necessary for people with hairy cell leukemia. Because this cancer progresses very slowly and sometimes doesn't progress at all, some people prefer to wait to treat their cancer only if it causes signs and symptoms. The majority of people with hairy cell leukemia eventually need treatment. If your hairy cell leukemia causes signs and symptoms, you may decide to undergo treatment. There is no cure for hairy cell leukemia. But treatments are effective at putting hairy cell leukemia in remission for years. Chemotherapy Doctors consider chemotherapy drugs the first line of treatment for hairy cell leukemia. The great majority of people will experience complete or partial remission through the use of chemotherapy. Two chemotherapy drugs are used in hairy cell leukemia: - Cladribine. Treatment for hairy cell leukemia typically begins with cladribine. You receive a continuous infusion of the drug into a vein over several days. Most people who receive cladribine experience a complete remission that can last for several years. If your hairy cell leukemia returns, you can be treated with cladribine again. Side effects of cladribine may include infection and fever. - Pentostatin (Nipent). Pentostatin causes remission rates similar to cladribine, but it's given on a different schedule. People who take pentostatin receive infusions every other week for three to six months. Side effects of pentostatin may include fever, nausea and infection. Biological treatments Biological therapy attempts to make cancer cells more recognizable to your immune system. Once your immune system identifies cancer cells as intruders, it can set about destroying your cancer. Two types of biological treatments are used in hairy cell leukemia: - Interferon. Currently, the role of interferon in hairy cell leukemia treatment is limited. You might receive interferon if chemotherapy hasn't been effective or if you can't take chemotherapy. Most people experience partial remission with interferon, which is taken for a year. Side effects include flu-like symptoms, such as fever and fatigue. - Rituximab (Rituxan). Rituximab is a monoclonal antibody approved to treat non-Hodgkin lymphoma and chronic lymphocytic leukemia, though it's sometimes used in hairy cell leukemia. If chemotherapy drugs haven't worked for you or you can't take chemotherapy, your doctor might consider rituximab. Side effects of rituximab include fever and infection. Surgery Surgery to remove your spleen (splenectomy) might be an option if your spleen ruptures or if it's enlarged and causing pain. Though removing your spleen can't cure hairy cell leukemia, it can usually restore normal blood counts. Splenectomy isn't commonly used to treat hairy cell leukemia, but it may be helpful in certain situations. Any surgery carries a risk of bleeding and infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Symptoms): Some people have no signs or symptoms of hairy cell leukemia, but a blood test for another disease or condition may inadvertently reveal hairy cell leukemia. Other times people with hairy cell leukemia experience signs and symptoms common to a number of diseases and conditions, such as: - A feeling of fullness in your abdomen that may make it uncomfortable to eat more than a little at a time - Fatigue - Easy bruising - Recurring infections - Weakness - Weight loss When to see a doctor Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Asking about Hairy cell leukemia I get report for my father from hospital it is saying that he have Hairy cell leukemia i am here to ask if this dissease dangerous and there is treatment for it Also if The one who have it will live for long or not ? My father age is 55 We discover the dissease by blood test", "response": "Hairy cell leukemia (Diagnosis): To diagnose hairy cell leukemia, your doctor may recommend tests and procedures that include: - Physical exam. By feeling your spleen - an oval-shaped organ on the left side of your upper abdomen - your doctor can determine if it's enlarged. An enlarged spleen may cause a sensation of fullness in your abdomen that makes it uncomfortable to eat. Your doctor may also check for enlarged lymph nodes that may contain leukemia cells. - Blood tests. Your doctor uses blood tests, such as the complete blood count, to monitor the levels of blood cells in your blood. People with hairy cell leukemia have low levels of all three types of blood cells - red blood cells, white blood cells and platelets. Another blood test called a peripheral blood smear looks for hairy cell leukemia cells in a sample of your blood. - Bone marrow biopsy. During a bone marrow biopsy, a small amount of bone marrow is removed from your hip area. This sample is used to look for hairy cell leukemia cells and to monitor your healthy blood cells. - Computerized tomography (CT) scan. A CT scan shows detailed images of the inside of your body. Your doctor may order a CT scan to detect enlargement of your spleen and your lymph nodes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Asthma (How is asthma treated?): Asthma is a chronic disease. This means that it can be treated but not cured. However, some people are able to manage asthma so that symptoms do not happen again or happen rarely. You can take steps to control asthma and prevent problems by:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Do I need to see a doctor for Occupational asthma?: Call your provider if you have symptoms of asthma. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "asthma Question. What is the consensus of medical doctors as to whether asthma can be cured? And do you have an article discussing whether asthma can be cured?", "response": "Asthma (Overview): Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "Breath odor (Summary): Breath odor is the scent of the air you breathe out of your mouth. Unpleasant breath odor is commonly called bad breath. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "What is Bad Breath?: There are many reasons why you might have bad breath. You can get it if you don't brush and floss regularly. Bacteria that build up in your mouth and between your teeth produce the bad odor. Other problems in your mouth, such as gum disease, dry mouth or cavities, may also cause it. Sinusitis or problems with your nose may be to blame. You can also have bad breath if you eat some foods, like raw onions, garlic or cabbage. And of course smoking causes its own bad aroma. Some diseases and medicines are associated with a specific breath odor. Having good dental habits, like brushing and flossing regularly, help fight bad breath. Mouthwashes, mints or chewing gum may make your breath fresher. If you have an underlying disorder, treating it may help eliminate the breath odor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bad Breath I have very bad breath and at times it can make myself and others sick. I need some advice as to what I need to do.", "response": "Breath odor (Home Care): Use proper dental hygiene, especially flossing. Remember that mouthwashes are not effective in treating the underlying problem. Fresh parsley or a strong mint is often an effective way to fight temporary bad breath. Avoid smoking. Otherwise, follow your health care provider's instructions to treat any underlying cause of bad breath. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "Generalized anxiety disorder (Treatment): Treatment decisions are based on how significantly generalized anxiety disorder is affecting your ability to function in your daily life. The two main treatments for generalized anxiety disorder are psychotherapy and medications. You may benefit most from a combination of the two. It may take some trial and error to discover which treatments work best for you. Psychotherapy Also known as talk therapy or psychological counseling, psychotherapy involves working with a therapist to reduce your anxiety symptoms. Cognitive behavioral therapy is the most effective form of psychotherapy for generalized anxiety disorder. Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to directly manage your worries and help you gradually return to the activities you've avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success. Medications Several types of medications are used to treat generalized anxiety disorder, including those below. Talk with your doctor about benefits, risks and possible side effects. - Antidepressants. Antidepressants, including medications in the selective serotonin reuptake inhibitor (SSRI) and serotonin and norepinephrine reuptake inhibitor (SNRI) classes, are the first line medication treatments. Examples of antidepressants used to treat generalized anxiety disorder include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR) and paroxetine (Paxil, Pexeva). Your doctor also may recommend other antidepressants. - Buspirone. An anti-anxiety medication called buspirone may be used on an ongoing basis. As with most antidepressants, it typically takes up to several weeks to become fully effective. - Benzodiazepines. In limited circumstances, your doctor may prescribe a benzodiazepine for relief of anxiety symptoms. These sedatives are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these medications aren't a good choice if you have or had problems with alcohol or drug abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "What are the treatments for Generalized anxiety disorder - self-care?: Taking medicine and going to talk therapy can get you started on the road to feeling better. It can also help you take care of your body and relationships. To help improve your condition: - Get enough sleep. - Eat healthy foods. - Keep a regular daily schedule. - Get out of the house every day. - Exercise every day. Even a little bit of exercise, such as a 15-minute walk, can help. - Stay away from alcohol and street drugs. - Talk with family or friends when you feel nervous or frightened. - Find out about different types of group activities you can join. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Bipolar and Generalized Anxiety Disorder I read about TMS Therapy. Do you know anything about it? Has it had success? Also wondering about ECT? Finally, I've been told acupuncture can help for mood disorders. Is that true for mixed bipolar and generalized anxiety disorder along with meds? Have you ever heard of this?", "response": "Generalized anxiety disorder (Complications): Having generalized anxiety disorder can be disabling. It can: - Impair your ability to perform tasks quickly and efficiently because you have trouble concentrating - Take your time and focus from other activities - Sap your energy - Increase your risk of depression Generalized anxiety disorder can also lead to or worsen other physical health conditions, such as: - Digestive or bowel problems, such as irritable bowel syndrome or ulcers - Headaches and migraines - Chronic pain and illness - Sleep problems and insomnia - Heart-health issues Generalized anxiety disorder often occurs along with other mental health problems, which can make diagnosis and treatment more challenging. Some mental health disorders that commonly occur with generalized anxiety disorder include: - Phobias - Panic disorder - Post-traumatic stress disorder (PTSD) - Obsessive-compulsive disorder (OCD) - Depression - Suicidal thoughts or suicide - Substance abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.", "response": "Recurrent breast cancer (Treatment): Your treatment options will depend on several factors, including the extent of the disease, its hormone receptor status, the type of treatment you received for your first breast cancer and your overall health. Your doctor also considers your goals and your preferences for treatment. Treating a local recurrence Treatment for a local recurrence typically starts with an operation and may include radiation if you haven't had it before. Chemotherapy and hormone therapy may also be recommended. - Surgery. For recurrent breast cancer that's confined to the breast, treatment usually involves removing any remaining breast tissue. If your first cancer was treated with lumpectomy, your doctor may recommend a mastectomy to remove all of your breast tissue - lobules, ducts, fatty tissue, skin and nipple. If your first breast cancer was treated with mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the new cancer along with a margin of normal tissue. A local recurrence may be accompanied by hidden cancer in nearby lymph nodes. For this reason, the surgeon may remove some or all of the nearby lymph nodes if they weren't removed during your initial treatment. - Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. If you didn't have radiation therapy for your first breast cancer, your doctor may recommend it now. But if you had radiation after a lumpectomy, radiation to treat the recurrence isn't usually recommended because of the risk of side effects. - Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Your doctor may recommend chemotherapy after surgery to reduce your risk of another cancer recurrence. - Hormone therapy. Medications that block the growth-promoting effects of the hormones estrogen and progesterone may be recommended if your cancer is hormone receptor positive. Treating a regional recurrence Treatments for a regional breast cancer recurrence include: - Surgery. If it's possible, surgery to remove the cancer is the recommended treatment for a regional recurrence. Your surgeon may also remove the lymph nodes under your arm if they're still present. - Radiation therapy. Sometimes radiation therapy may be used after surgery. If surgery isn't possible, radiation therapy may be used as the main treatment for a regional breast cancer recurrence. - Drug treatments. Chemotherapy, targeted therapy or hormone therapy also may be recommended as the main treatment or may follow surgery or radiation. Treating a metastatic recurrence Many treatments exist for metastatic breast cancer. Your options will depend on where your cancer has spread. If one treatment doesn't work or stops working, you may be able to try other treatments. In general, the goal of treatment for a metastatic breast cancer isn't to cure the disease. Treatment may allow you to live longer and can help relieve symptoms the cancer is causing. Your doctor works to achieve a balance between controlling your symptoms while minimizing toxic effects from treatment. The aim is to help you live as well as possible for as long as possible. Treatments may include: - Hormone therapy. If your cancer is hormone receptor positive, you may benefit from hormone therapy. In general, hormone therapy has fewer side effects than chemotherapy, so in many cases it's the first treatment used for metastatic breast cancer. - Chemotherapy. Your doctor may recommend chemotherapy if your cancer is hormone receptor negative or if hormone therapy is no longer working. - Targeted therapy. If your cancer cells have certain characteristics that make them vulnerable to targeted therapy, your doctor may recommend these medications. - Bone-building drugs. If cancer has spread to your bones, your doctor may recommend a bone-building drug to reduce your risk of broken bones or reduce bone pain you may experience. - Other treatments. Radiation therapy and surgery may be used in certain situations to control signs and symptoms of advanced breast cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Breast cancer at 84. My mother was just diagnost with breast cancer. She is 84 years old, her tumor started in the milk duct and is small in size, their is a mass as well in the same breast. He is scheduled for a lumpectomy to remove both. Because of age we would like suggestions on treatment options after surgery.", "response": "Breast cancer (Treatment): Treatment is based on many factors, including: - Type of breast cancer - Stage of the cancer (staging is a tool your providers use to find out how advanced the cancer is) - Whether the cancer is sensitive to certain hormones - Whether the cancer overproduces (overexpresses) the HER2/neu protein Cancer treatments may include: - Hormone therapy. - Chemotherapy, which uses medicines to kill cancer cells. - Radiation therapy, which is used to destroy cancerous tissue. - Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery. - Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth. Cancer treatment can be local or systemic: - Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when the cancer has not spread outside the breast. - Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment. Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat the cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured. - Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment. - Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery. - Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy. - Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments. After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer. Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "Peripheral neuropathy (Overview): Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body. Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy. Peripheral neuropathy care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "How to diagnose Peripheral neuropathy?: The doctor or nurse will examine you and ask questions about your health history and symptoms. Blood tests may be done to look for causes of nerve damage. Your doctor may also recommend: - Electromyography-- to check activity in muscles - Nerve conduction studies-- to see how fast signals travel along nerves - Nerve biopsy-- to look at a sample of a nerve under a microscope. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Causes of Peripheral Neuropathy What information does the National Library of Medicine have that states causes of peripheral neuropathy?", "response": "Peripheral neuropathy (Summary): Peripheral nerves carry information to and from the brain. They also carry signals to and from the spinal cord to the rest of the body. Peripheral neuropathy means these nerves don't work properly. Peripheral neuropathy may occur because of damage to a single nerve or a group of nerves. It may also affect nerves in the whole body. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Pneumonia (Treatment): Treatment for pneumonia involves curing the infection and preventing complications. People who have community-acquired pneumonia usually can be treated at home with medication. Although most symptoms ease in a few days or weeks, the feeling of tiredness can persist for a month or more. Specific treatments depend on the type and severity of your pneumonia, your age and your overall health. The options include: - Antibiotics. These medicines are used to treat bacterial pneumonia. It may take time to identify the type of bacteria causing your pneumonia and to choose the best antibiotic to treat it. If your symptoms don't improve, your doctor may recommend a different antibiotic. - Cough medicine. This medicine may be used to calm your cough so that you can rest. Because coughing helps loosen and move fluid from your lungs, it's a good idea not to eliminate your cough completely. In addition, you should know that very few studies have looked at whether over-the-counter cough medicines lessen coughing caused by pneumonia. If you want to try a cough suppressant, use the lowest dose that helps you rest. - Fever reducers/pain relievers. You may take these as needed for fever and discomfort. These include drugs such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others). Hospitalization You may need to be hospitalized if: - You are older than age 65 - You are confused about time, people or places - Your kidney function has declined - Your systolic blood pressure is below 90 millimeters of mercury (mm Hg) or your diastolic blood pressure is 60 mm Hg or below - Your breathing is rapid (30 breaths or more a minute) - You need breathing assistance - Your temperature is below normal - Your heart rate is below 50 or above 100 You may be admitted to the intensive care unit if you need to be placed on a breathing machine (ventilator) or if your symptoms are severe. Children may be hospitalized if: - They are younger than age 2 months - They are lethargic or excessively sleepy - They have trouble breathing - They have low blood oxygen levels - They appear dehydrated. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Chemotherapy: The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to: - Cure the cancer - Shrink the cancer - Prevent the cancer from spreading - Relieve symptoms the cancer may be causing HOW CHEMOTHERAPY IS GIVEN Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including: - Injections or shots into the muscles - Injections or shots under the skin - Into an artery - Into a vein (intravenous, or IV) - Pills taken by mouth - Shots into the fluid around the spinal cord or brain When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery. There are many types of catheters, including: - Central venous catheter - Central venous catheter with a port - Percutaneously inserted central catheter (PICC) A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line. Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy. Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose. Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training. DIFFERENT TYPES OF CHEMOTHERAPY The different types of chemotherapy include: - Standard chemotherapy, which works by killing cancer cells and some normal cells. - Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells. SIDE EFFECTS OF CHEMOTHERAPY Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment. As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract. When this damage occurs, there can be side effects. Some people who receive chemotherapy: - Are more likely to have infections - Become tired more easily - Bleed too much, even during everyday activities - Feel pain or numbness from nerve damage - Have a dry mouth, mouth sores, or swelling in the mouth - Have a poor appetite or lose weight - Have an upset stomach, vomiting, or diarrhea - Lose their hair - Have problems with thinking and memory (\"chemo brain\") Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects. Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include: - Being careful with pets and other animals to avoid catching infections from them - Eating enough calories and protein to keep your weight up - Preventing bleeding, and what to do if bleeding occurs - Practicing safe eating and drinking habits - Washing your hands often with soap and water You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to: - Monitor how well the chemotherapy is working - Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists and Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "CURE FOR PNEUMONIA Dear DR, please i have a friend that has the above illness..I want to find out...since i want to marry her...is it an infectious illness,,and can it be totally cured. And how can i help her to get this cured..Please i really need your reply urgently", "response": "Atypical pneumonia (Treatment): To feel better, you can take these self-care measures at home: - Control your fever with aspirin, NSAIDs (such as ibuprofen or naproxen), or acetaminophen. DO NOT give aspirin to children because it may cause a dangerous illness called Reye syndrome. - DO NOT take cough medicines without first talking to your provider. Cough medicines may make it harder for your body to cough up the extra sputum. - Drink plenty of fluids to help loosen secretions and bring up phlegm. - Get a lot of rest. Have someone else do household chores. Antibiotics are used to treat atypical pneumonia. - You may be able to take antibiotics by mouth at home. - If your condition is severe, you will likely be admitted to a hospital. There, you will be given antibiotics through a vein (intravenously), as well as oxygen. - Antibiotics might be used for 2 weeks or more. - Finish all the antibiotics you've been prescribed, even if you feel better. If you stop the medicine too soon, the pneumonia can return and may be harder to treat. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, and so on", "response": "Fibromyalgia (Treatment): In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: - Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. - Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. - Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia. Therapy A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: - Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. - Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. - Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cushing, fybromyaglia, Chronic fatigue my main concern is no treatment and the musclar distrophy effecting my heart, legs feet, shoulders, arms, and so on", "response": "Fibromyalgia (Who treats it?): Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. Many family physicians, general internists, or rheumatologists can treat fibromyalgia. Rheumatologists are doctors who specialize in arthritis and other conditions that affect the joints or soft tissues. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?", "response": "What are the complications of Cervical cancer?: Complications can include: - Risk of the cancer coming back in women who have treatment to save the uterus - Problems with sexual, bowel, and bladder function after surgery or radiation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Cervical Cancer Can a long term untreated bladder infection aid in the cause of cervical cancer? And can the fact that my mom has cervical cancer aid in my chance of getting cervical cancer?", "response": "Cervical cancer (Prevention): Cervical cancer can be prevented by doing the following: - Get the HPV vaccine. The vaccine prevents most types of HPV infection that cause cervical cancer. Your provider can tell you if the vaccine is right for you. - Practice safer sex. Using condoms during sex reduces the risk for HPV and other sexually transmitted infections (STIs). - Limit the number of sexual partners you have. Avoid partners who are active in high-risk sexual behaviors. - Get Pap smears as often as your provider recommends. Pap smears can help detect early changes, which can be treated before they turn into cervical cancer. - Get the HPV test if recommended by your provider. It can be used along with the Pap test to screen for cervical cancer in women 30 years and older. - If you smoke, quit. Smoking increases your chance of getting cervical cancer. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.", "response": "Diabetes (Exams and Tests): A urine analysis may show high blood sugar. But a urine test alone does not diagnose diabetes. Your health care provider may suspect that you have diabetes if your blood sugar level is higher than 200 mg/dL (11.1 mmol/L). To confirm the diagnosis, one or more of the following tests must be done. Blood tests: - Fasting blood glucose level. Diabetes is diagnosed if the fasting glucose level is higher than 126 mg/dL (7.0 mmol/L) on two different tests. Levels between 100 and 126 mg/dL (5.5 and 7.0 mmol/L) are called impaired fasting glucose or prediabetes. These levels are risk factors for type 2 diabetes. - Hemoglobin A1c (A1C) test. Normal is less than 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or higher. - Oral glucose tolerance test. Diabetes is diagnosed if the glucose level is higher than 200 mg/dL (11.1 mmol/L) 2 hours after drinking a sugar drink (this test is used more often for type 2 diabetes). Screening for type 2 diabetes in people who have no symptoms is recommended for: - Overweight children who have other risk factors for diabetes, starting at age 10 and repeated every 3 years. - Overweight adults (BMI of 25 or higher) who have other risk factors such as having high blood pressure, or having a mother, father, sister or brother with diabetes. - Adults over age 45, repeated every 3 years. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.", "response": "Diabetes Type 2 (Summary): Summary Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, obese, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include - Being very thirsty - Urinating often - Feeling very hungry or tired - Losing weight without trying - Having sores that heal slowly - Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Diabetes Type 2 I test before going to bed and the reading is 94 but when I test again in the morning, the reading is 165. How can I lower it? I eat dinner around 8PM and nothing until the next morning.", "response": "Diabetes type 2 - meal planning (Summary): When you have type 2 diabetes, taking time to plan your meals goes a long way toward controlling your blood sugar and weight. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Leber congenital amaurosis: Leber congenital amaurosis is an eye disorder that primarily affects the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this disorder typically have severe visual impairment beginning in infancy. The visual impairment tends to be stable, although it may worsen very slowly over time. Leber congenital amaurosis is also associated with other vision problems, including an increased sensitivity to light (photophobia), involuntary movements of the eyes (nystagmus), and extreme farsightedness (hyperopia). The pupils, which usually expand and contract in response to the amount of light entering the eye, do not react normally to light. Instead, they expand and contract more slowly than normal, or they may not respond to light at all. Additionally, the clear front covering of the eye (the cornea) may be cone-shaped and abnormally thin, a condition known as keratoconus. A specific behavior called Franceschetti's oculo-digital sign is characteristic of Leber congenital amaurosis. This sign consists of poking, pressing, and rubbing the eyes with a knuckle or finger. Researchers suspect that this behavior may contribute to deep-set eyes and keratoconus in affected children. In rare cases, delayed development and intellectual disability have been reported in people with the features of Leber congenital amaurosis. However, researchers are uncertain whether these individuals actually have Leber congenital amaurosis or another syndrome with similar signs and symptoms. At least 13 types of Leber congenital amaurosis have been described. The types are distinguished by their genetic cause, patterns of vision loss, and related eye abnormalities. Leber congenital amaurosis occurs in 2 to 3 per 100,000 newborns. It is one of the most common causes of blindness in children. Leber congenital amaurosis can result from mutations in at least 14 genes, all of which are necessary for normal vision. These genes play a variety of roles in the development and function of the retina. For example, some of the genes associated with this disorder are necessary for the normal development of light-detecting cells called photoreceptors. Other genes are involved in phototransduction, the process by which light entering the eye is converted into electrical signals that are transmitted to the brain. Still other genes play a role in the function of cilia, which are microscopic finger-like projections that stick out from the surface of many types of cells. Cilia are necessary for the perception of several types of sensory input, including vision. Mutations in any of the genes associated with Leber congenital amaurosis disrupt the development and function of the retina, resulting in early vision loss. Mutations in the CEP290, CRB1, GUCY2D, and RPE65 genes are the most common causes of the disorder, while mutations in the other genes generally account for a smaller percentage of cases. In about 30 percent of all people with Leber congenital amaurosis, the cause of the disorder is unknown. Leber congenital amaurosis usually has an autosomal recessive pattern of inheritance. Autosomal recessive inheritance means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. When Leber congenital amaurosis is caused by mutations in the CRX or IMPDH1 genes, the disorder has an autosomal dominant pattern of inheritance. Autosomal dominant inheritance means one copy of the altered gene in each cell is sufficient to cause the disorder. In most of these cases, an affected person inherits a gene mutation from one affected parent. Other cases result from new mutations and occur in people with no history of the disorder in their family. Bainbridge JW, Smith AJ, Barker SS, Robbie S, Henderson R, Balaggan K, Viswanathan A, Holder GE, Stockman A, Tyler N, Petersen-Jones S, Bhattacharya SS, Thrasher AJ, Fitzke FW, Carter BJ, Rubin GS, Moore AT, Ali RR. Effect of gene therapy on visual function in Leber's congenital amaurosis. N Engl J Med. 2008 May 22;358(21):2231-9. doi: 10.1056/NEJMoa0802268. Epub 2008 Apr 27. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Leber hereditary optic neuropathy (Treatment): Currently, there is no cure for this disease but there are several ongoing studies aiming to find an effective treatment. Management of affected individuals is usually supportive, with provision of visual aids. [2] High-dose oral idebenone may be considered as a treatment option, especially for individuals with LHON with relatively recent disease onset. Some studies have reported a benefit from using idebenone with quinone analogues, such as ubiquinone (Coenzyme Q10) and with vitamin C and vitamin B12. [2] In an open-label study of five individuals with acute LHON treated within 90 days of disease onset, the antioxidant α-tocotrienol-quinone (EPI-743), a vitamin E derivative, showed good results. [2] Those with established LHON mitochondrial DNA mutations are advised not to smoke and to limit their alcohol intake. People with Leber hereditary optic neuropathy may also find it helpful to speak with other affected individuals and to seek extra psychosocial or counseling support. [2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My cousin she is leber amaurosis she need help I don't know where to start from", "response": "Chemotherapy: The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to: - Cure the cancer - Shrink the cancer - Prevent the cancer from spreading - Relieve symptoms the cancer may be causing HOW CHEMOTHERAPY IS GIVEN Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including: - Injections or shots into the muscles - Injections or shots under the skin - Into an artery - Into a vein (intravenous, or IV) - Pills taken by mouth - Shots into the fluid around the spinal cord or brain When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery. There are many types of catheters, including: - Central venous catheter - Central venous catheter with a port - Percutaneously inserted central catheter (PICC) A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line. Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy. Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose. Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training. DIFFERENT TYPES OF CHEMOTHERAPY The different types of chemotherapy include: - Standard chemotherapy, which works by killing cancer cells and some normal cells. - Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells. SIDE EFFECTS OF CHEMOTHERAPY Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment. As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract. When this damage occurs, there can be side effects. Some people who receive chemotherapy: - Are more likely to have infections - Become tired more easily - Bleed too much, even during everyday activities - Feel pain or numbness from nerve damage - Have a dry mouth, mouth sores, or swelling in the mouth - Have a poor appetite or lose weight - Have an upset stomach, vomiting, or diarrhea - Lose their hair - Have problems with thinking and memory (\"chemo brain\") Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects. Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include: - Being careful with pets and other animals to avoid catching infections from them - Eating enough calories and protein to keep your weight up - Preventing bleeding, and what to do if bleeding occurs - Practicing safe eating and drinking habits - Washing your hands often with soap and water You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to: - Monitor how well the chemotherapy is working - Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists and Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "Stiff-Person Syndrome: Stiff-person syndrome (SPS) is a rare neurological disorder with features of an autoimmune disease. SPS is characterized by fluctuating muscle rigidity in the trunk and limbs and a heightened sensitivity to stimuli such as noise, touch, and emotional distress, which can set off muscle spasms. Abnormal postures, often hunched over and stiffened, are characteristic of the disorder. People with SPS can be too disabled to walk or move, or they are afraid to leave the house because street noises, such as the sound of a horn, can trigger spasms and falls. SPS affects twice as many women as men. It is frequently associated with other autoimmune diseases such as diabetes, thyroiditis, vitiligo, and pernicious anemia. Scientists don’t yet understand what causes SPS, but research indicates that it is the result of an autoimmune response gone awry in the brain and spinal cord. The disorder is often misdiagnosed as Parkinson’s disease, multiple sclerosis, fibromyalgia, psychosomatic illness, or anxiety and phobia. A definitive diagnosis can be made with a blood test that measures the level of glutamic acid decarboxylase (GAD) antibodies in the blood. People with SPS have elevated levels of GAD, an antibody that works against an enzyme involved in the synthesis of an important neurotransmitter in the brain. People with SPS respond to high doses of diazepam and several anti-convulsants, gabapentin and tiagabine. A recent study funded by the NINDS demonstrated the effectiveness of intravenous immunoglobulin (IVIg) treatment in reducing stiffness and lowering sensitivity to noise, touch, and stress in people with SPS. Treatment with IVIg, anti-anxiety drugs, muscle relaxants, anti-convulsants, and pain relievers will improve the symptoms of SPS, but will not cure the disorder. Most individuals with SPS have frequent falls and because they lack the normal defensive reflexes; injuries can be severe. With appropriate treatment, the symptoms are usually well controlled. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "What are the symptoms of Hereditary angiopathy with nephropathy, aneurysms, and muscle cramps syndrome?: What are the signs and symptoms of Hereditary angiopathy with nephropathy, aneurysms, and muscle cramps syndrome? The Human Phenotype Ontology provides the following list of signs and symptoms for Hereditary angiopathy with nephropathy, aneurysms, and muscle cramps syndrome. If the information is available, the table below includes how often the symptom is seen in people with this condition. You can use the MedlinePlus Medical Dictionary to look up the definitions for these medical terms. Signs and Symptoms Approximate number of patients (when available) Stroke 5% Autosomal dominant inheritance - Cerebral aneurysm - Hematuria - Leukoencephalopathy - Muscle cramps - Nephropathy - Renal cyst - Renal insufficiency - Retinal arteriolar tortuosity - Retinal hemorrhage - Supraventricular arrhythmia - The Human Phenotype Ontology (HPO) has collected information on how often a sign or symptom occurs in a condition. Much of this information comes from Orphanet, a European rare disease database. The frequency of a sign or symptom is usually listed as a rough estimate of the percentage of patients who have that feature. The frequency may also be listed as a fraction. The first number of the fraction is how many people had the symptom, and the second number is the total number of people who were examined in one study. For example, a frequency of 25/25 means that in a study of 25 people all patients were found to have that symptom. Because these frequencies are based on a specific study, the fractions may be different if another group of patients are examined. Sometimes, no information on frequency is available. In these cases, the sign or symptom may be rare or common. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stiff person Syndrome. Please can you tell me what are the early symptoms I have severe cramps in my feet which are twisting into an arc,muscle spasms slowly getting worse and my muscles particularly in my legs are cramping like someone has pushed a knitting needle into them. Started off at night but now happening through the day my back and neck and voice box are also effected and my chest area has now seized to the point of restricting my breathing to very shallow at times I find that I am stretching out involuntarily right through my body and this is becoming more frequent", "response": "Stiff person syndrome (Treatment): Treatment of stiff person syndrome (SPS) focuses on the specific symptoms present in each person. Benzodiazepines, diazepam, or baclofen may be used to treat muscle stiffness and spasms. Anti-seizure medications and pain medications may also be effective for some people. [2] Recently, studies have shown that intravenous immunoglobulin (IVIG) or plasmapheresis may be effective in improving some of the symptoms of SPS. [2] For some people, autologous stem cell transplants have been shown to successfully treat SPS. [7] Clinical trials are being completed to confirm if this may be an effective treatment. Physical and occupational therapy may help to slow the progression of stiff person syndrome, but should be completed by someone who is familiar with the condition so as not to make symptoms worse. [2] [4] Additional information about the treatment of stiff person syndrome can be viewed on Medscape Reference's Web site. Management Guidelines Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "Locked-In Syndrome (Treatment): There is no cure for locked-in syndrome, nor is there a standard course of treatment. A therapy called functional neuromuscular stimulation, which uses electrodes to stimulate muscle reflexes, may help activate some paralyzed muscles. Several devices to help communication are available. Other treatment is symptomatic and supportive. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "What is Locked-In Syndrome?: Locked-in syndrome is a rare neurological disorder characterized by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. It may result from traumatic brain injury, diseases of the circulatory system, diseases that destroy the myelin sheath surrounding nerve cells, or medication overdose. Individuals with locked-in syndrome are conscious and can think and reason, but are unable to speak or move. The disorder leaves individuals completely mute and paralyzed. Communication may be possible with blinking eye movements. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please help me with my brother with locked-in syndrome in for 3 years.Somebody please help. God bless .", "response": "Locked-In Syndrome (Prognosis): While in rare cases some patients may regain certain functions, the chances for motor recovery are very limited. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "congenital diaphragmatic hernia: Congenital diaphragmatic hernia is a defect in the diaphragm. The diaphragm, which is composed of muscle and other fibrous tissue, separates the organs in the abdomen from those in the chest. Abnormal development of the diaphragm before birth leads to defects ranging from a thinned area in the diaphragm to its complete absence. An absent or partially formed diaphragm results in an abnormal opening (hernia) that allows the stomach and intestines to move into the chest cavity and crowd the heart and lungs. This crowding can lead to underdevelopment of the lungs (pulmonary hypoplasia), potentially resulting in life-threatening breathing difficulties that are apparent from birth. In 5 to 10 percent of affected individuals, signs and symptoms of congenital diaphragmatic hernia appear later in life and may include breathing problems or abdominal pain from protrusion of the intestine into the chest cavity. In about 1 percent of cases, congenital diaphragmatic hernia has no symptoms; it may be detected incidentally when medical imaging is done for other reasons. Congenital diaphragmatic hernias are often classified by their position. A Bochdalek hernia is a defect in the side or back of the diaphragm. Between 80 and 90 percent of congenital diaphragmatic hernias are of this type. A Morgnani hernia is a defect involving the front part of the diaphragm. This type of congenital diaphragmatic hernia, which accounts for approximately 2 percent of cases, is less likely to cause severe symptoms at birth. Other types of congenital diaphragmatic hernia, such as those affecting the central region of the diaphragm, or those in which the diaphragm muscle is absent with only a thin membrane in its place, are rare. Congenital diaphragmatic hernia affects approximately 1 in 2,500 newborns. Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. Isolated congenital diaphragmatic hernia is rarely inherited. In almost all cases, there is only one affected individual in a family. When congenital diaphragmatic hernia occurs as a feature of a genetic syndrome or chromosomal abnormality, it may cluster in families according to the inheritance pattern for that condition. Bielinska M, Jay PY, Erlich JM, Mannisto S, Urban Z, Heikinheimo M, Wilson DB. Molecular genetics of congenital diaphragmatic defects. Ann Med. 2007;39(4):261-74. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "Do you have information about Diaphragmatic hernia repair - congenital: Summary : Diaphragmatic hernia repair is surgery to correct an opening or space in a baby's diaphragm. This opening is called a hernia. It is a rare type of birth defect. (Congenital means the problem is present at birth.) Description : Before this surgery, nearly all infants need a breathing device to improve their oxygen levels. The surgery is done while your child is under general anesthesia (asleep and not able to feel pain). The surgeon makes a cut (incision) in the belly under the upper ribs. This allows the organs in the area to be reached. The surgeon gently pulls these organs down into place through the opening in the diaphragm and into the abdominal cavity. The surgeon repairs the hole in the diaphragm. If the hole is small, it may be repaired with stitches. In most cases, a piece of plastic patch is used to cover the hole. Why the Procedure is Performed : The diaphragm is a muscle. It is important for breathing. It separates the chest cavity (where the heart and lungs are) from the belly area. In a child born with a diaphragmatic hernia, the diaphragm muscle is not completely formed. So, organs from the belly (stomach, spleen, liver, and intestines) may go up into the chest cavity where the lungs are. This prevents the lung(s) from growing normally. The lungs stay too small for babies to breathe on their own when they are born. A diaphragmatic hernia can be life-threatening. Surgery to repair it must be done in the first few days or weeks of a child's life. Risks : Risks for this surgery include: - Breathing problems, which may be severe - Bleeding - Collapsed lung - Lung problems that do not go away - Infection - Reactions to medicines Before the Procedure : Infants with a diaphragmatic hernia are admitted to a neonatal intensive care unit (NICU). It may be days or weeks before the baby is stable enough for surgery. - In the NICU, your baby will probably need a breathing machine (mechanical ventilator) before the surgery. This helps the baby breathe. - If your child is very sick, a heart-lung bypass machine (ECMO) may be needed to do the work of the heart and lungs. - Before surgery, your baby will have x-rays and regular blood tests to see how well the lungs are working. A light sensor (called a pulse oximeter) is taped to baby's skin to monitor the oxygen level in the blood. - Your baby may be given medicines to control blood pressure and keep him or her comfortable. Your baby will have tubes placed: - From the mouth or nose to the stomach to keep air out of the stomach - In an artery to monitor blood pressure - In a vein to deliver nutrients and medicines After the Procedure : Your baby will be on a breathing machine after the surgery and will stay in the hospital for several weeks. Once the baby is taken off the breathing machine, they may still need oxygen and some medicine for a while. Feedings will start after your baby's bowels start working. Feedings are usually given through a small, soft feeding tube from the mouth or nose into the stomach or small intestines until your baby can take all the milk they need by mouth. Most infants with diaphragmatic hernias have reflux when they eat. This means the food or acid in their stomach moves up into their esophagus, the tube that leads from the throat to the stomach. This can be uncomfortable for your baby. It also leads to frequent spitting up, vomiting, and pneumonia, which makes feedings more difficult once your baby is taking food by mouth. The nurses and feeding specialists will teach you ways to hold and feed your baby to prevent reflux. Some babies need to be on a feeding tube for a long time to get enough food to grow. Outlook (Prognosis) : The outcome of this surgery depends on how well your baby's lungs have developed. Some babies have other medical problems, including problems with the brain, muscles, and joints, which may slow recovery. Usually, the outlook is good for infants who have well-developed lung tissue. Most babies who are born with a diaphragmatic hernia are very ill and will stay in the hospital for a long time. With advances in medicine, the outlook for these infants is gradually improving. All babies who have had diaphragmatic hernia repairs will need to be watched closely to make sure the hole in their diaphragm does not open up again as they grow. Babies who had a large opening or defect in the diaphragm, or who had more problems with their lungs after birth, may have lung disease after they leave the hospital. They may need oxygen, medicines, and a feeding tube for months or years. Some babies will have problems crawling, walking, talking, and eating. They will need to see physical or occupational therapists to help them develop muscles and strength. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "congenital diaphragmatic hernia I need to know if CDH can be passed down to future generations. I just learned that this condition most likely caused the death of my first child back in 1971. I was then told it was merely a fluke. I had NO trauma during the full-term pregnancy, and I and my then husband were in very good health. Now my son (from a different husband) and his wife are due to have fraternal twins in 2015. Does the term 'congenital' mean that it could be passed down to another generation? I do not want to alarm my son and his wife. I just would like to inform whatever pediatrician is caring for these babies as to my experience. Unfortunately my son and I are estranged. And I do not know who is their pediatrician. My child's CDH was very severe. I know there are far less severe cases that can go undetected &/or undiagnosed unless there is a reason to suspect such a condition. Please respond to my concerns.", "response": "congenital diaphragmatic hernia (Genetic Changes): Congenital diaphragmatic hernia has many different causes. In 10 to 15 percent of affected individuals, the condition appears as a feature of a disorder that affects many body systems, called a syndrome. Donnai-Barrow syndrome, Fryns syndrome, and Pallister-Killian mosaic syndrome are among several syndromes in which congenital diaphragmatic hernia may occur. Some of these syndromes are caused by changes in single genes, and others are caused by chromosomal abnormalities that affect several genes. About 25 percent of individuals with congenital diaphragmatic hernia that is not associated with a known syndrome also have abnormalities of one or more major body systems. Affected body systems can include the heart, brain, skeleton, intestines, genitals, kidneys, or eyes. In these individuals, the multiple abnormalities likely result from a common underlying disruption in development that affects more than one area of the body, but the specific mechanism responsible for this disruption is not clear. Approximately 50 to 60 percent of congenital diaphragmatic hernia cases are isolated, which means that affected individuals have no other major malformations. More than 80 percent of individuals with congenital diaphragmatic hernia have no known genetic syndrome or chromosomal abnormality. In these cases, the cause of the condition is unknown. Researchers are studying changes in several genes involved in the development of the diaphragm as possible causes of congenital diaphragmatic hernia. Some of these genes are transcription factors, which provide instructions for making proteins that help control the activity of particular genes (gene expression). Others provide instructions for making proteins involved in cell structure or the movement (migration) of cells in the embryo. Environmental factors that influence development before birth may also increase the risk of congenital diaphragmatic hernia, but these environmental factors have not been identified. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Colon cancer cure seen on tv. My father has colon cancer and said he saw a commercial on tv about a cure for colon cancer. He cannot remember any details about it. I was wondering if you know anything about something like this. Please let me know. Thank you,", "response": "Understanding your colon cancer risk (How to Reduce Your Risk): Some risk factors are in your control, and some are not. Many of the risk factors above, such as age and family history, can't be changed. But just because you have risk factors you can't control doesn't mean you can't take steps to lower your risk. Start by getting colon cancer screenings starting at age 50. You may want to start screening earlier if you have a family history. Screening can help prevent colon cancer, and it is one of the best things you can do to lower your risk. Certain lifestyle habits also may help lower your risk: - Maintain a healthy weight - Eat a low-fat foods with plenty of vegetables and fruits - Limit red meat and processed meat - Get regular exercise - Limit alcohol to no more than 1 drink per day for women and 2 drinks per day for men - DO NOT smoke You can also have genetic testing done to assess your risk for colon cancer. If you have a strong family history of the disease, talk with your health care provider about testing. Low-dose aspirin may be recommended for some people who are at very high risk for colon cancer found with genetic testing. It is NOT recommended for most people because of side effects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "Diarrhea (Treatment): Most cases of diarrhea clear on their own within a couple of days without treatment. If you've tried lifestyle changes and home remedies for diarrhea without success, your doctor might recommend medications or other treatments. Antibiotics Antibiotics might help treat diarrhea caused by bacteria or parasites. If a virus is causing your diarrhea, antibiotics won't help. Treatment to replace fluids Your doctor likely will advise you to replace the fluids and salts. For most adults, that means drinking water, juice or broth. If drinking liquids upsets your stomach or causes diarrhea, your doctor might recommend getting fluids through a vein in your arm (intravenously). Water is a good way to replace fluids, but it doesn't contain the salts and electrolytes - minerals such as sodium and potassium - you need to maintain the electric currents that keep your heart beating. You can help maintain your electrolyte levels by drinking fruit juices for potassium or eating soups for sodium. Certain fruit juices, such as apple juice, might make diarrhea worse. For children, ask your doctor about using an oral rehydration solution, such as Pedialyte, to prevent dehydration or replace lost fluids. Adjusting medications you're taking If your doctor determines that an antibiotic caused your diarrhea, your doctor might lower your dose or switch to another medication. Treating underlying conditions If your diarrhea is caused by a more serious condition, such as inflammatory bowel disease, your doctor will work to control that condition. You might be referred to a specialist, such as a gastroenterologist, who can help devise a treatment plan for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "What is Drug-induced diarrhea?: Drug-induced diarrhea is loose, watery stools that occurs when you take certain medicines. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "diarrhea i had bad diarrhea over the weekend and though how my mother used paregoric, went to the drug store to get some, he said they dont sell it any more HELP", "response": "Trichohepatoenteric syndrome (Treatment): Trichohepatoenteric syndrome is treated symptomatically, meaning it is focused on treating the symptoms of the disease. Treating the chronic diarrhea is often the biggest concern, as chronic diarrhea can prevent people with trichohepatoenteric syndrome from getting enough nutrients. In most cases, treatment requires nutrition through an intravenous line, or IV. This is also called parenteral nutrition. [1] If the liver disease associated with trichohepatoenteric syndrome permanently damages the liver, a partial or complete liver transplant may be required. [2] It may also be necessary to treat the weakened immune system associated with trichohepatoenteric syndrome. People with the condition may need treatment such as immunoglobulin infusions to boost the immune system. [4]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.", "response": "Duchenne muscular dystrophy (Causes): Duchenne muscular dystrophy is a form of muscular dystrophy. It worsens quickly. Other muscular dystrophies (including Becker's muscular dystrophy) get worse much more slowly. Duchenne muscular dystrophy is caused by a defective gene for dystrophin (a protein in the muscles). However, it often occurs in people without a known family history of the condition. The condition most often affects boys due to the way the disease is inherited. The sons of women who are carriers of the disease (women with a defective gene, but no symptoms themselves) each have a 50% chance of having the disease. The daughters each have a 50% chance of being carriers. Very rarely, a female can be affected by the disease. Duchenne muscular dystrophy occurs in about 1 out of every 3,600 male infants. Because this is an inherited disorder, risks include a family history of Duchenne muscular dystrophy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Duchenne Muscular Dystrophy. I am doing a research project on this genetic disease and I would like to know more about it from a professional. I am researching the mode of inheritance, symptoms, treatments/ support groups, and relative cost to family.", "response": "Duchenne muscular dystrophy (When to Contact a Medical Professional): Call your health care provider if: - Your child has symptoms of Duchenne muscular dystrophy. - Symptoms get worse or new symptoms develop, particularly fever with cough or breathing problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Esophageal cancer: Esophageal cancer is cancer that starts in the esophagus. This is the tube that moves food from the mouth to the stomach. Esophageal cancer is not common in the United States. It occurs most often in men over 50 years old. There are two main types of esophageal cancer: squamous cell carcinoma and adenocarcinoma. These two types look different from each other under the microscope. Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk of this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. Symptoms may include any of the following: - Backward movement of food through the esophagus and possibly mouth (regurgitation) - Chest pain not related to eating - Difficulty swallowing solids or liquids - Heartburn - Vomiting blood - Weight loss Tests used to help diagnose esophageal cancer may include: - Barium swallow - Chest MRI or thoracic CT (usually used to help determine the stage of the disease) - Endoscopic ultrasound (also sometimes used to determine the stage of disease) - Esophagogastroduodenoscopy (EGD) and biopsy - PET scan (sometimes useful for determining the stage of disease, and whether surgery is possible) Stool testing may show small amounts of blood in the stool. Upper endoscopy (EGD) will be used to obtain a tissue sample from the esophagus to diagnose cancer. When the cancer is only in the esophagus and has not spread, surgery will be done. The cancer and part, or all, of the esophagus is removed. The surgery may be done using: - Open surgery, during which one or two larger incisions are made. - Minimally invasive surgery, during which a 2 to 4 small incisions are made in the belly. A laparoscope with a tiny camera is inserted into the belly through one of the incisions. Radiation therapy may also be used instead of surgery in some cases when the cancer has not spread outside the esophagus. Either chemotherapy, radiation, or both may be used to shrink the tumor and make surgery easier to perform. If the person is too ill to have major surgery or the cancer has spread to other organs, chemotherapy or radiation may be used to help reduce symptoms. This is called palliative therapy. In such cases, the disease is usually not curable. Beside a change in diet, other treatments that may be used to help the patient swallow include: - Dilating (widening) the esophagus using an endoscope. Sometimes a stent is placed to keep the esophagus open. - A feeding tube into the stomach. - Photodynamic therapy, in which a special drug is injected into the tumor and is then exposed to light. The light activates the medicine that attacks the tumor. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone When the cancer has not spread outside the esophagus, surgery may improve the chance of survival. When the cancer has spread to other areas of the body, a cure is generally not possible. Treatment is directed toward relieving symptoms. Complications may include: - Pneumonia - Severe weight loss from not eating enough Call your health care provider if you have difficulty swallowing with no known cause and it does not get better. Also call if you have other symptoms of esophageal cancer. To reduce your risk of cancer of the esophagus: - DO NOT smoke - Limit or DO NOT drink alcoholic beverages - Get checked by your doctor if you have severe GERD - Get regular checkups if you have Barrett esophagus Updated by: Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Do you have information about D and C: Summary : D and C is a procedure to scrape and collect the tissue (endometrium) from inside the uterus. - Dilation (\"D\") is a widening of the cervix to allow instruments into the uterus. - Curettage (\"C\") is the scraping of the walls of the uterus. Description : D and C, also called uterine scraping, may be performed in the hospital or in a clinic while you are under general or local anesthesia. The health care provider will insert an instrument called a speculum into the vagina. This holds open the vaginal canal. Numbing medicine may be applied to the opening to the uterus (cervix). The cervical canal is widened, and a curette (a metal loop on the end of a long, thin handle) is passed through the opening into the uterus cavity. The health care provider gently scrapes the inner layer of tissue, called the endometrium. The tissue is collected for examination. Why the Procedure is Performed : This procedure may be done to: - Diagnose or rule out conditions such as uterine cancer - Remove tissue after a miscarriage - Treat heavy menstrual bleeding, irregular periods, or bleeding between periods - Perform a therapeutic or elective abortion Your health care provider may also recommend a D and C if you have: - Abnormal bleeding while you are on hormone replacement therapy - An embedded intrauterine device (IUD) - Bleeding after menopause - Endometrial polyps (small lumps of tissue on the endometrium) - Thickening of the uterus This list may not include all possible reasons for a D and C. Risks : Risks related to D and C include: - Puncture of the uterus - Scarring of the uterine lining (Asherman syndrome, may lead to infertility later) - Tear of the cervix Risks due to anesthesia include: - Reactions to medications - Problems breathing Risks of any surgery include: - Bleeding - Infection After the Procedure : A D and C has few risks. It can provide relief from bleeding, and can help diagnose infection, cancer, and other diseases. You may return to your normal activities as soon as you feel better, possibly even the same day. You may have vaginal bleeding, pelvic cramps, and back pain for a few days after the procedure. You can usually manage pain well with medications. Avoid using tampons and having sexual intercourse for 1 - 2 weeks after the procedure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am looking for information about Cancer of the Esophagus and I'm not finding anything on your website.", "response": "Esophageal cancer: Esophageal cancer is a cancer of the esophagus, the hollow tube that carries food and liquids from the throat to the stomach. As the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood. The exact cause is usually not known, but both environmental and genetic factors are throught to play a role in the development of this condition. In the United States, risk factors for developing esophageal cancer include smoking, heavy drinking, obesity, and damage from acid reflux. Treatments include surgery, radiation, chemotherapy , and laser therapy. Some patients may also need nutritional support, since the cancer or treatment may make it hard to swallow. [1] [2] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Squamous cell carcinoma - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "Hiatal hernia (Treatment): The goals of treatment are to relieve symptoms and prevent complications. Treatments may include: - Medicines to control stomach acid - Surgery to repair the hiatal hernia and prevent reflux Other measures to reduce symptoms include: - Avoiding large or heavy meals - Not lying down or bending over right after a meal - Reducing weight and not smoking - Raising the head of the bed 4 to 6 inches (10 to 15 centimeters) If medicines and lifestyle measures do not help control symptoms, you may need surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "What is Hernia?: A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. This layer is called the fascia. Which type of hernia you have depends on where it is: - Femoral hernia is a bulge in the upper thigh, just below the groin. This type is more common in women than men. - Hiatal hernia occurs in the upper part of the stomach. Part of the upper stomach pushes into the chest. - Incisional hernia can occur through a scar if you have had abdominal surgery in the past. - Umbilical hernia is a bulge around the belly button. It occurs when the muscle around the belly button does not close completely after birth. - Inguinal hernia is a bulge in the groin. It is more common in men. It may go all the way down into the scrotum. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have an hernia I would love to take care off it ASAP I was wondering if you guys could help me . Thanks", "response": "Hernia (Treatment): Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for people with serious medical problems. Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed with stitches and sometimes with mesh patches to plug the hole. An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be repaired. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (Treatment): Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems. You may have to try a few treatments to see what works best for you. Your doctor can help you find the right treatment plan.Changes in eating, diet, and nutrition, such as following a FODMAP diet, can help treat your symptoms.Your doctor may recommend medicine to relieve your symptoms.Fiber supplements to relieve constipation when increasing fiber in your diet doesn’t help. Laxatives to help with constipation. Laxatives work in different ways, and your doctor can recommend a laxative that’s right for you. Loperamide to reduce diarrhea by slowing the movement of stool through your colon. Loperamide is an antidiarrheal that reduces diarrhea in people with IBS, though it doesn’t reduce pain, bloating, or other symptoms. Antispasmodics, such as hyoscine, cimetropium, and pinaverium, help to control colon muscle spasms and reduce pain in your abdomen. Antidepressants, such as low doses of tricyclic antidepressants and selective serotonin reuptake inhibitors, to relieve IBS symptoms, including abdominal pain. In theory, because of their effect on colon transit, tricyclic antidepressants should be better for people with IBS with diarrhea, or IBS-D, and selective serotonin reuptake inhibitors should be better for people with IBS with constipation, or IBS-C, although studies haven’t confirmed this theory. Tricyclic antidepressants work in people with IBS by reducing their sensitivity to pain in the gastrointestinal (GI) tract as well as normalizing their GI motility and secretion. Lubiprostone (Amitiza) for people who have IBS-C to improve abdominal pain or discomfort and constipation symptoms. Linaclotide (Linzess) for people who have IBS-C to relieve abdominal pain and increase how often you have bowel movements. The antibiotic rifaximin to reduce bloating by treating small intestinal bacterial overgrowth. However, experts are still debating and researching the use of antibiotics to treat IBS. Coated peppermint oil capsules to reduce IBS symptoms.Follow your doctor’s instructions when you use medicine to treat IBS. Talk with your doctor about possible side effects and what to do if you have them.Some medicines can cause side effects. Ask your doctor and your pharmacist about side effects before taking any medicine. MedlinePlus maintains the latest information about side effects and drug warnings.Your doctor may also recommend probiotics. Probiotics are live microorganisms—tiny organisms that can be seen only with a microscope. These microorganisms, most often bacteria, are like the microorganisms that are normally present in your GI tract. Studies have found that taking large enough amounts of probiotics, specifically Bifidobacteria and certain probiotic combinations, can improve symptoms of IBS. However, researchers are still studying the use of probiotics to treat IBS.You can find probiotics in dietary supplements, such as capsules, tablets, and powders, and in some foods, such as yogurt.Discuss your use of complementary and alternative medical practices, including probiotics and dietary supplements, with your doctor.Psychological therapies may improve your IBS symptoms.Managing StressLearning to reduce stress can help improve IBS. With less stress, you may find you have less cramping and pain. You may also find it easier to manage your symptoms.Some options for managing stress includetaking part in stress reduction and relaxation therapies such as meditation getting counseling and support taking part in regular exercise such as walking or yoga reducing stressful life situations as much as possible getting enough sleepTalk TherapyTalk therapy may reduce stress and improve your IBS symptoms. Two types of talk therapy that health care professionals use to treat IBS are cognitive behavioral therapy and psychodynamic, or interpersonal, therapy. Cognitive behavioral therapy focuses on your thoughts and actions. Psychodynamic therapy focuses on how your emotions affect your IBS symptoms. This type of therapy often involves relaxation and stress management techniques.Gut-Directed HypnotherapyIn gut-directed hypnotherapy, a therapist uses hypnosis to help you relax the muscles in the colon.Mindfulness TrainingMindfulness training can teach you to focus your attention on sensations occurring at the moment and to avoid catastrophizing, or worrying about the meaning of those sensations. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable Bowel Syndrome (IBS) (How can my diet treat the symptoms of IBS?): Eating smaller meals more often, or eating smaller portions, may help your irritable bowel syndrome (IBS) symptoms. Large meals can cause cramping and diarrhea if you have IBS.Eating foods that are low in fat and high in carbohydrates, such as pasta, rice, whole-grain breads and cereals, fruits, and vegetables, may help.Fiber may improve constipation symptoms caused by IBS because it makes stool soft and easier to pass. Fiber is a part of foods such as whole-grain breads and cereals, beans, fruits, and vegetables. The U.S. Department of Agriculture and U.S. Department of Health and Human Services state in its Dietary Guidelines for Americans, 2010 (PDF, 2.963 MB) that adults should get 22 to 34 grams of fiber a day.3While fiber may help constipation, it may not reduce the abdominal discomfort or pain of IBS. In fact, some people with IBS may feel a bit more abdominal discomfort after adding more fiber to their diet. Add foods with fiber to your diet a little at a time to let your body get used to them. Too much fiber at once can cause gas, which can trigger symptoms in people with IBS. Adding fiber to your diet slowly, by 2 to 3 grams a day, may help prevent gas and bloating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My father is suffering from IBS and is loosing weight day by day.sometimes he even faints due to weakness.He cannot digest food .please help us and suggest us upon this problem.", "response": "Irritable bowel syndrome - aftercare (Diet): Changes in your diet may be helpful. However, IBS varies from person to person. So the same changes may not work for everyone. - Keep track of your symptoms and the foods you are eating. This will help you look for a pattern of foods that may make your symptoms worse. - Avoid foods that cause symptoms. These may include fatty or fried foods, dairy products, caffeine, sodas, alcohol, chocolate, and grains such as wheat, rye, and barley. - Eat 4 to 5 smaller meals a day, rather than 3 larger ones. Increase the fiber in your diet to relieve symptoms of constipation. Fiber is found in whole grain breads and cereals, beans, fruits, and vegetables. Since fiber may cause gas, it is best to add these foods to your diet slowly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?", "response": "What are the complications of Frozen shoulder?: Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "We have 14 siblings in our family , at least 10 of us has had a frozen shoulder. We are wondering why? should we be concerned?", "response": "Frozen shoulder: Frozen shoulder is a condition in which the shoulder is painful and loses motion because of inflammation. The capsule of the shoulder joint has ligaments that hold the shoulder bones to each other. When the capsule becomes inflamed, the shoulder bones are unable to move freely in the joint. Most of the time, there is no cause for frozen shoulder. Risk factors include: - Diabetes - Thyroid problems - Changes in your hormones, such as during menopause - Shoulder injury - Shoulder surgery - Open heart surgery - Cervical disk disease of the neck - Women 40 to 70 years old are most affected Main symptoms of a frozen shoulder are: - Decreased motion of the shoulder - Pain - Stiffness Frozen shoulder without any known cause starts with pain. This pain prevents you from moving your arm. This lack of movement can lead to stiffness and even less motion. Over time, you are not able to do movements such as reaching over your head or behind you. Your health care provider will ask about your symptoms and examine your shoulder. A diagnosis is often made when you are not able to rotate your shoulder. You may have x-rays of the shoulder. This is to make sure there is no other problem, such as arthritis or calcium deposits. Sometimes, an MRI exam shows inflammation, but these types of imaging tests are not needed to diagnose frozen shoulder. Pain is treated with NSAIDs and steroid injections. Steroid injections and physical therapy can improve your motion. It can take a few weeks to see progress. It may take as long as 6 to 9 months for complete recovery. Physical therapy is intense and needs to be done every day. Left untreated, the condition often gets better by itself within 2 years with little loss of motion. Risk factors for frozen shoulder, such as diabetes or thyroid problems, should also be treated. Surgery is recommended if nonsurgical treatment is not effective. This procedure (shoulder arthroscopy) is done under anesthesia. During surgery the scar tissue is released (cut) by bringing the shoulder through a full range of motion. Arthroscopic surgery can also be used to cut the tight ligaments and remove the scar tissue from the shoulder. After surgery, you may receive pain blocks (shots) so you can do physical therapy. Follow instructions on caring for your shoulder at home. Treatment with physical therapy and NSAIDs often restores motion and function of the shoulder within a year. Even untreated, the shoulder may get better by itself in 2 years. After surgery restores motion, you must continue physical therapy for several weeks or months. This is to prevent the frozen shoulder from returning. If you do not keep up with physical therapy, the frozen shoulder may come back. Complications may include: - Stiffness and pain continue even with therapy - The arm can break if the shoulder is moved forcefully during surgery If you have shoulder pain and stiffness and think you have a frozen shoulder, contact your provider for referral and treatment. Early treatment may help prevent stiffness. Call your provider if you develop shoulder pain that limits your range of motion for an extended period. People who have diabetes or thyroid problems will be less likely to get frozen shoulder if they keep their condition under control. Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am a current Gastroparesis fighter with a GJ feeding tube. I am also one of the admins for a GP support group and an advocacy group. I have become a volunteer advocater. I would appreciate any info you can share about Gastroparesis, Feeding tubes, and even TPN. Thanks", "response": "Do you have information about Nasogastric feeding tube: Summary : A nasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose. It can be used for all feedings or for giving a person extra calories. It is important to take good care of the feeding bag and tubing so that they work properly. It is also important to take good care of the skin around the nostrils so that it does not get irritated. If your child has an NG tube, try to keep your child from touching or pulling on the tube. Follow any specific instructions your nurse gives you. Use the information below as a reminder or what to do. Flushing the Tube : Flushing the tube will help release any formula stuck to the inside of the tube. Flush the tube after each feeding, or as often as your nurse recommends. - First, wash your hands well with soap and water. - After the feeding is finished, add warm water to the feeding syringe and let it flow by gravity. - If the water does not go through, try changing positions a bit or attach the plunger to the syringe, and gently push the plunger part-way. DO NOT press all the way down or press fast. - Remove the syringe. - Close the NG tube cap. Taking Care of the Skin : Follow these general guidelines: - Clean the skin around the tube with warm water and a clean washcloth after each feeding. Remove any crust or secretions in the nose. - When removing a bandage or dressing from the nose, loosen it first with a bit of mineral oil or other lubricant. Then gently remove the bandage or dressing. Afterward, wash the mineral oil off the nose. - If you notice redness or irritation, try putting the tube in the other nostril. When to Call the Doctor : Call your child's health care provider if you notice: - There is redness, swelling and irritation in both nostrils - The tube keeps getting clogged and you are unable to unclog it with water - The tube falls out Alternate Names : Feeding - nasogastric tube; NG tube; Bolus feeding; Continuous pump feeding; Gavage tube. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Gastritis (Treatment): Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Medications used to treat gastritis include: - Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days. - Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix). Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk. - Medications to reduce acid production. Acid blockers - also called histamine (H-2) blockers - reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR). - Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Do I need to see a doctor for Diverticulosis?: Call your health care provider if symptoms of diverticulitis occur. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I'm a 72 year old female, and have diverticulosis,gastritis, and esophagitis. I tried to see three different doctors today, but all were booked. I honestly don't know what to do. It hurts in my chest, and I can hardly talk.", "response": "Gastritis (Treatment): Treatment depends on what is causing the problem. Some of the causes will go away over time. You may need to stop taking aspirin, ibuprofen, naproxen, or other medicines that may be causing gastritis. Always talk to your health care provider before stopping any medicine. You may use other over-the-counter and prescription drugs that decrease the amount of acid in the stomach, such as: - Antacids - H2 antagonists: famotidine (Pepsid), cimetidine (Tagamet), ranitidine (Zantac), and nizatidine (Axid) - Proton pump inhibitors (PPIs): omeprazole (Prilosec), esomeprazole (Nexium), iansoprazole (Prevacid), rabeprazole (AcipHex), and pantoprazole (Protonix) Antibiotics may be used to treat chronic gastritis caused by infection with Helicobacter pylori bacteria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.", "response": "Facts About Glaucoma (How is glaucoma detected?): Glaucoma is detected through a comprehensive dilated eye exam that includes the following: Visual acuity test. This eye chart test measures how well you see at various distances. Visual field test. This test measures your peripheral (side vision). It helps your eye care professional tell if you have lost peripheral vision, a sign of glaucoma. Dilated eye exam. In this exam, drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours. Tonometry is the measurement of pressure inside the eye by using an instrument called a tonometer. Numbing drops may be applied to your eye for this test. A tonometer measures pressure inside the eye to detect glaucoma. Pachymetry is the measurement of the thickness of your cornea. Your eye care professional applies a numbing drop to your eye and uses an ultrasonic wave instrument to measure the thickness of your cornea. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.", "response": "Do you have information about Patient Rights: Summary : As a patient, you have certain rights. Some are guaranteed by federal law, such as the right to get a copy of your medical records, and the right to keep them private. Many states have additional laws protecting patients, and healthcare facilities often have a patient bill of rights. An important patient right is informed consent. This means that if you need a treatment, your health care provider must give you the information you need to make a decision. Many hospitals have patient advocates who can help you if you have problems. Many states have an ombudsman office for problems with long term care. Your state's department of health may also be able to help. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Can you mail me patient information about Glaucoma, I was recently diagnosed and want to learn all I can about the disease.", "response": "Glaucoma (Exams and Tests): The only way to diagnose glaucoma is by having a complete eye exam. - You will be given a test to check your eye pressure. This is called tonometry. - In most cases, you will be given eye drops to widen (dilate) your pupil. - When your pupil is dilated, your eye doctor will look at the inside of your eye and the optic nerve. Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include: - Using a special lens to look at the angle of the eye (gonioscopy). - Photographs or laser scanning images of the inside of your eye (optic nerve imaging). - Checking your retina. The retina is the light-sensitive tissue at the back of your eye. - Checking how your pupil responds to light (pupillary reflex response). - 3-D view of your eye (slit lamp examination). - Testing the clearness of your vision (visual acuity). - Testing your field of vision (visual field measurement). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Hair loss (Treatment): Effective treatments for some types of hair loss are available. But some hair loss is permanent. With some conditions, such as patchy alopecia, hair may regrow without treatment within a year. Treatments for hair loss include medications, surgery, laser therapy, and wigs or hairpieces. Your doctor may suggest a combination of these approaches in order to get the best results. The goals of treatment are to promote hair growth, slow hair loss or hide hair loss. Medication If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. This may include drugs to reduce inflammation and suppress your immune system, such as prednisone. If a certain medication is causing the hair loss, your doctor may advise you to stop using it for at least three months. Medications are available to treat pattern baldness. Two medications approved by the Food and Drug Administration (FDA) to treat hair loss are: - Minoxidil (Rogaine). Minoxidil is an over-the-counter liquid or foam that you rub into your scalp twice a day to grow hair and to prevent further hair loss. It may be used by men and women. With this treatment, some people experience hair regrowth, a slower rate of hair loss or both. The effect peaks at 16 weeks and you need to keep applying the medication to retain benefits. Possible side effects include scalp irritation, unwanted hair growth on the adjacent skin of the face and hands, and rapid heart rate (tachycardia). - Finasteride (Propecia). This prescription drug is available only to men. It's taken daily in pill form. Many men taking finasteride experience a slowing of hair loss, and some may show some new hair growth. You need to keep taking it to retain benefits. Rare side effects of finasteride include diminished sex drive and sexual function and an increased risk of prostate cancer. Women who are or may be pregnant need to avoid touching crushed or broken tablets. Surgery In the most common type of permanent hair loss, only the top of the head is affected. Hair transplant or restoration surgery can make the most of the hair you have left. During this procedure, your surgeon removes tiny plugs of skin, each containing a few hairs, from the back or sides of your scalp. He or she then implants the plugs into the bald sections of your scalp. You may be asked to take a hair loss medication before and after surgery to improve results. Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring. Wigs and hairpieces You may want to try a wig or a hairpiece as an alternative to medical treatment or if you don't respond to treatment. It can be used to cover either permanent or temporary hair loss. Quality, natural-looking wigs and hairpieces are available. If your hair loss is due to a medical condition, the cost of a wig may be covered by insurance. You'll need a prescription for the wig from your doctor. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Do you have information about Spitting up - self-care: Summary : Spitting up is common with babies. Babies may spit up when they burp or with their drool. Spitting up should not cause your baby any distress. Usually babies stop spitting up when they are about 7 to 12 months old. Why Babies Spit up : Your baby is spitting up because: - The muscle at the top of your baby's stomach may not be fully developed. So baby's stomach cannot hold in milk. - The valve at the bottom of the stomach may be too tight. So the stomach gets too full and milk comes out. - Your baby may drink too much milk too fast, and take in a lot of air in the process. These air bubbles fill up the stomach and milk comes out. - Overfeeding causes your baby to get too full. So milk comes up. Spitting up is usually not due to a formula intolerance or an allergy to something in the nursing mother's diet. Spitting up is Usually Normal : If your baby is healthy, happy, and growing well, you don't need to worry. Babies that are growing well usually gain at least 6 ounces a week and have wet diapers at least every 6 hours. How to Reduce Spitting up : - Burp your baby several times during and after feeding. To do so sit the baby upright with your hand supporting the head. Let the baby lean forward slightly, bending at the waist. Gently pat your baby's back. (Burping your baby over your shoulder puts pressure on the stomach. This might cause more spitting up.) - If you are breastfeeding, try nursing with just one breast per feeding. - If you are bottle feeding, feed smaller amounts of formula more frequently. Avoid large amounts at one time. Be sure that the hole in the nipple is not too large. - Hold your baby upright for 15 to 30 minutes after feedings. - Avoid a lot of movement during and immediately after feeding. - Slightly elevate the head of babies' cribs so babies can sleep with their heads slightly up. - Talk to your doctor about trying a different formula or removing certain foods from the mother's diet (usually cow's milk). When to Call the Doctor : If your baby's spit up is forceful, call your baby's doctor. You want to make sure your baby does not have pyloric stenosis, a problem where the valve at the bottom of the stomach is too tight and needs to be fixed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hair loss Information Required Can you provide something to help grow my hair back? I need my hair back as im the spitting double of Dr evil with no hair.", "response": "Female pattern baldness (Treatment): Untreated, hair loss in female pattern baldness is permanent. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance. MEDICINES The only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil: - It is applied to the scalp. - For women, the 2% solution or 5% foam is recommended. - Minoxidil may help hair grow in about 1 in 4 or 5 of women. In most women, it may slow or stop hair loss. - You must continue to use this medicine for a long time. Hair loss starts again when you stop using it. Also, the hair that it helps grow will fall out. If minoxidil does not work, your provider may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. Your provider can tell you more about these if needed. HAIR TRANSPLANT During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed (transplanted) in areas that are balding. Minor scarring may occur where hair is removed. There is a slight risk of skin infection. You will likely need many transplants, which can be expensive. However, the results are often excellent and permanent. OTHER SOLUTIONS Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Scoliosis (Treatment): Treatment depends on many things: - The cause of scoliosis - Where the curve is in your spine - How big the curve is - If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: - Surgery is done with a cut through the back, belly area, or beneath the ribs. - The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. - After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: - Emotional support: Some children, especially teens, may be self-conscious when using a back brace. - Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Scoliosis (Treatment): Most children with scoliosis have mild curves and probably won't need treatment with a brace or surgery. Children who have mild scoliosis may need checkups every four to six months to see if there have been changes in the curvature of their spines. While there are guidelines for mild, moderate and severe curves, the decision to begin treatment is always made on an individual basis. Factors to be considered include: - Sex. Girls have a much higher risk of progression than do boys. - Severity of curve. Larger curves are more likely to worsen with time. - Curve pattern. Double curves, also known as S-shaped curves, tend to worsen more often than do C-shaped curves. - Location of curve. Curves located in the center (thoracic) section of the spine worsen more often than do curves in the upper or lower sections of the spine. - Maturity. If a child's bones have stopped growing, the risk of curve progression is low. That also means that braces have the most effect in children whose bones are still growing. Braces If your child's bones are still growing and he or she has moderate scoliosis, your doctor may recommend a brace. Wearing a brace won't cure scoliosis or reverse the curve, but it usually prevents further progression of the curve. The most common type of brace is made of plastic and is contoured to conform to the body. This close-fitting brace is almost invisible under the clothes, as it fits under the arms and around the rib cage, lower back and hips. Most braces are worn day and night. A brace's effectiveness increases with the number of hours a day it's worn. Children who wear braces can usually participate in most activities and have few restrictions. If necessary, kids can take off the brace to participate in sports or other physical activities. Braces are discontinued after the bones stop growing. This typically occurs: - About two years after girls begin to menstruate - When boys need to shave daily - When there are no further changes in height Surgery Severe scoliosis typically progresses with time, so your doctor might suggest scoliosis surgery to reduce the severity of the spinal curve and to prevent it from getting worse. The most common type of scoliosis surgery is called spinal fusion. In spinal fusion, surgeons connect two or more of the bones in the spine (vertebrae) together, so they can't move independently. Pieces of bone or a bone-like material are placed between the vertebrae. Metal rods, hooks, screws or wires typically hold that part of the spine straight and still while the old and new bone material fuses together. If the scoliosis is progressing rapidly at a young age, surgeons can install a rod that can adjust in length as the child grows. This growing rod is attached to the top and bottom sections of the spinal curvature, and is usually lengthened every six months. Complications of spinal surgery may include bleeding, infection, pain or nerve damage. Rarely, the bone fails to heal and another surgery may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Hello, I have a scoliosis problem plz help me I want its treatment I can send my x.ray also", "response": "Adolescent idiopathic scoliosis (Treatment): Treatment of adolescent idiopathic scoliosis may involve observation, bracing and/or surgery. Treatment recommendations are generally dependent upon the risk of curve progression. Curves progress most during the rapid growth period of the patient (adolescent or pre-adolescent growth spurt). The potential for growth is evaluated by taking into consideration the patient's age, the status of whether females have had their first menstrual period, and radiographic parameters ( x-ray studies). [2] Detailed information about these treatment options can be accessed through the Scoliosis Research Society. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "help with obesity I would like help on my obesity problem and if I can get help", "response": "What is Obesity?: Obesity means having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle or water, as well as from having too much fat. Both terms mean that a person's weight is higher than what is thought to be healthy for his or her height. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi my name is I'm currently working with and I was wondering I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment", "response": "HIV/AIDS - pregnancy and infants (Treatment): HIV/AIDS is treated with antiretroviral therapy (ART). These medicines stop the virus from multiplying. TREATING PREGNANT WOMEN Treating pregnant women with HIV prevents children from becoming infected. - If a woman tests positive during pregnancy, she will receives ART while pregnant. Most often she will receive a three-drug regimen. - The risk of these ART drugs for the baby in the womb is low. The mother may have another ultrasound at the second trimester. - HIV may be found in a woman when she goes into labor, especially if she has not previously received prenatal care. If so, she will be treated with antiretroviral drugs right away. Sometimes these drugs will be given through a vein (IV). - If the first positive test is during labor, receiving ART right away during labor can reduce the rate of infection in children to about 10%. TREATING BABIES AND INFANTS Infants born to infected mothers start receiving ART within 6 to 12 hours after birth. One or more antiretroviral drugs should be continued for at least 6 weeks after birth. BREASTFEEDING HIV-positive women should not breastfeed. This holds true even for women who are taking HIV medicines. Doing so may pass HIV to the baby through breast milk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "hi my name is I'm currently working with and I was wondering I came across some of you healthy tip fliers for HIV/Aids treatment .at the moment we have a study going on that helps HIV positive transgender women into HIV quality care .so it would be great to have some more information on HIV/Aids treatment", "response": "HIV/AIDS (Treatment): One of NIAID’s greatest success stories is that its research led to the development of numerous antiretroviral drugs to treat HIV/AIDS, turning what was once a uniformly fatal disease into a manageable chronic condition for many. NIAID is working to find new and more effective therapeutic products, drug classes, and combinations as well as safe and effective treatments for dangerous related co-infections and complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "Living with endometriosis (Summary): You have a condition called endometriosis. Symptoms of endometriosis include: - Heavy menstrual bleeding - Bleeding between periods - Problems getting pregnant Having this condition can interfere with your social and work life. No one knows what causes endometriosis. There is also no cure. However, there are different ways to treat the symptoms. These treatments can also help relieve menstrual pain. Learning how to manage your symptoms can make it easier to live with endometriosis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "What is Endometriosis?: Endometriosis occurs when cells from the lining of your womb (uterus) grow in other areas of your body. This can cause pain, heavy bleeding, bleeding between periods, and problems getting pregnant (infertility). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "How bad can endometriosis get?", "response": "Endometriosis (Causes): Every month, a woman's ovaries produce hormones that tell the cells lining the uterus to swell and get thicker. Your uterus sheds these cells along with blood and tissue through your vagina when you have your period. Endometriosis occurs when these cells grow outside the uterus in other parts of your body. This tissue may attach on your: - Ovaries - Bowel - Rectum - Bladder - Lining of your pelvic area It can grow in other areas of the body, too. These growths stay in your body, they do not shed when you have your period. But, like the cells in your uterus, these growths react to the hormones from your ovaries. They grow and bleed when you get your period. Over time, the growths may add more tissue and blood. The buildup of blood and tissue in your body leads to pain and other symptoms. No one knows what causes endometriosis. One idea is that when you get your period, the cells may travel backwards through the fallopian tubes into the pelvis. Once there, the cells attach and grow. However, this backward period flow occurs in many women. Researchers think that the immune system in women with endometriosis may cause the condition. Endometriosis is common. Sometimes, it may run in families. Endometriosis probably starts when a woman begins having periods. However, it usually is not diagnosed until ages 25 to 35. You are more likely to develop endometriosis if you: - Have a mother or sister with endometriosis - Started your period at a young age - Never had children - Have frequent periods, or they last 7 or more days - Have a closed hymen, which blocks the flow of menstrual blood during the period. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees (Treatment): Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees: Knock knees are condition in which the knees touch, but the ankles do not touch. The legs turn inward. Infants start out with bowlegs because of their folded position while in their mother's womb. The legs begin to straighten once the child starts to walk (at about 12 to 18 months). By age 3, the child becomes knock-kneed. When the child stands, the knees touch but the ankles are apart. By puberty, the legs straighten out and most children can stand with the knees and ankles touching (without forcing the position). Knock knees can also develop as a result of a medical problem or disease, such as: - Injury of the shinbone (only one leg will be knock-kneed) - Osteomyelitis (bone infection) - Overweight or obesity - Rickets (a disease caused by a lack of vitamin D) A health care provider will examine your child. Tests will be done if there are signs that knock knees are not a part of normal development. Knock knees are not treated in most cases. If the problem continues after age 7, the child may use a night brace. This brace is attached to a shoe. Surgery may be considered for knock knees that are severe and continue beyond late childhood. Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. Complications may include: - Difficulty walking (very rare) - Self-esteem changes related to cosmetic appearance of knock knees - If left untreated, knock knees can lead to early arthritis of the knee Call your provider if you think your child has knock knees. There is no known prevention for normal knock knees. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am 23yr boy,i have knock knees i want treatment. Please help me.", "response": "Knock knees (Outlook (Prognosis)): Children normally outgrow knock knees without treatment, unless it is caused by a disease. If surgery is needed, the results are most often good. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a fractured nose i need it fixed. its been broke for 3 years now", "response": "Nose fracture: A nose fracture is a break in the bone or cartilage over the bridge, or in the sidewall or septum (structure that divides the nostrils) of the nose. A fractured nose is the most common fracture of the face. It most often occurs after an injury and often occurs with other fractures of the face. Nose injuries and neck injuries are often seen together. A blow that is forceful enough to injure the nose may be hard enough to injure the neck. Serious nose injuries cause problems that need a health care provider's attention right away. For example, damage to the cartilage can cause a collection of blood to form inside the nose. If this blood is not drained right away, it can cause an abscess or a permanent deformity that blocks the nose. It may lead to tissue death and cause the nose to collapse. For minor nose injuries, the provider may want to see the person within the first week after the injury to see if the nose has moved out of its normal shape. Sometimes, surgery may be needed to correct a nose or septum that has been bent out of shape by an injury. Symptoms may include: - Blood coming from the nose - Bruising around the eyes - Difficulty breathing through the nose - Misshapen appearance (may not be obvious until the swelling goes down) - Pain - Swelling The bruised appearance most often disappears after 2 weeks. If a nose injury happens: - Try to stay calm. - Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat. - Squeeze the nostrils closed and hold pressure to stop the bleeding. - Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose. - To help relieve pain, try acetaminophen (Tylenol). - DO NOT try to straighten a broken nose - DO NOT move the person if there is reason to suspect a head or neck injury Get medical help right away if: - Bleeding will not stop - Clear fluid keeps draining from the nose - You suspect a blood clot in the septum - You suspect a neck or head injury - The nose looks deformed or out of its usual shape - The person is having difficulty breathing Wear protective headgear while playing contact sports, or riding bicycles, skateboards, roller skates, or rollerblades. Use seat belts and appropriate car seats when driving. Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a fractured nose i need it fixed. its been broke for 3 years now", "response": "Foreign body in the nose: This article discusses first aid for a foreign object placed into the nose. Curious young children may insert small objects into their nose in a normal attempt to explore their own bodies. Potential objects placed in the nose may include food, seeds, dried beans, small toys (such as marbles), crayon pieces, erasers, paper wads, cotton, and beads. A foreign body in a child's nose can be there for awhile without a parent being aware of the problem. The object may only be discovered when visiting a health care provider to find the cause of irritation, bleeding, infection, or difficulty breathing. Symptoms that your child may have a foreign body in his or her nose include: - Difficulty breathing through the affected nostril - Feeling of something in the nose - Foul-smelling or bloody nasal discharge - Irritability, particularly in infants - Irritation or pain in the nose - DO NOT search the nose with cotton swabs or other tools. This may push the object further into the nose. - DO NOT use tweezers or other tools to remove an object that is stuck deep inside the nose. - DO NOT try to remove an object that you cannot see or one that is not easy to grasp. This can push the object farther in or cause damage. - Have the person breathe through the mouth. The person should not breathe in sharply. This may force the object in further. - Gently press and close the nostril that does NOT have the object in it. Ask the person to blow gently. This may help push the object out. Avoid blowing the nose too hard or repeatedly. - If this method fails, get medical help. Get medical help right away if: - The person cannot breathe well - Bleeding occurs and continues for more than 2 or 3 minutes after you remove the foreign object, despite placing gentle pressure on the nose - An object is stuck in both nostrils - You cannot easily remove a foreign object from the person's nose - You think an infection has developed in the nostril where the object is stuck Prevention measures may include: - Cut food into appropriate sizes for small children. - Discourage talking, laughing, or playing while food is in the mouth. - Do not give foods such as hot dogs, whole grapes, nuts, popcorn, or hard candy to children under age 3. - Keep small objects out of the reach of young children. - Teach children to avoid placing foreign objects into their noses and other body openings. Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a fractured nose i need it fixed. its been broke for 3 years now", "response": "What to do for Nose fracture?: - Try to stay calm. - Breathe through your mouth and lean forward in a sitting position to keep blood from going down the back of your throat. - Apply cold compresses to your nose to reduce swelling. If possible, hold the compress so that there isn't too much pressure on the nose. - To help relieve pain, try acetaminophen (Tylenol). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks", "response": "Anal fissure (Treatment): Anal fissures often heal within a few weeks if you take steps to keep your stool soft, such as increasing your intake of fiber and fluids. Soaking in warm water for 10 to 20 minutes several times a day, especially after bowel movements, can help relax the sphincter and promote healing. If your symptoms persist, you'll likely need further treatment. Nonsurgical treatments Your doctor may recommend: - Externally applied nitroglycerin (Rectiv), to help increase blood flow to the fissure and promote healing and to help relax the anal sphincter. Nitroglycerin is generally considered the medical treatment of choice when other conservative measures fail. Side effects may include headache, which can be severe. - Topical anesthetic creams such as lidocaine hydrochloride (Xylocaine) may be helpful for pain relief. - Botulinum toxin type A (Botox) injection, to paralyze the anal sphincter muscle and relax spasms. - Blood pressure medications, such as oral nifedipine (Procardia) or diltiazem (Cardizem) can help relax the anal sphincter. These medications may be taken by mouth or applied externally and may be used when nitroglycerin is not effective or causes significant side effects. Surgery If you have a chronic anal fissure that is resistant to other treatments, or if your symptoms are severe, your doctor may recommend surgery. Doctors usually perform a procedure called lateral internal sphincterotomy (LIS), which involves cutting a small portion of the anal sphincter muscle to reduce spasm and pain, and promote healing. Studies have found that for chronic fissure, surgery is much more effective than any medical treatment. However, surgery has a small risk of causing incontinence. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks", "response": "How to diagnose Anal fissure?: The health care provider will perform a rectal exam and look at the anal tissue. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been battling Anal fissure for close to two years now and it has refused to heal all these while. Please what do you suggest i do? Thanks", "response": "Anal fissure (Treatment): Most fissures heal on their own and do not need treatment. To prevent or treat anal fissures in infants, be sure to change diapers often and clean the area gently. CHILDREN AND ADULTS Worrying about pain during a bowel movement may cause a person to avoid them. But not having bowel movements will only cause the stools to become even harder, which can make anal fissure worse. Prevent hard stools and constipation by: - Making dietary changes -- eating more fiber or bulk, such as fruits, vegetables, and grains - Drinking more fluids - Using stool softeners Ask your provider about the following ointments or creams to help soothe the affected skin: - Numbing cream, if pain interferes with normal bowel movements - Petroleum jelly - Zinc oxide, 1% hydrocortisone cream, Preparation H, and other products A sitz bath is a warm water bath used for healing or cleansing. Sit in the bath 2 to 3 times a day. The water should cover only the hips and buttocks. If the anal fissures do not go away with home care methods, treatment may involve: - Botox injections into the muscle in the anus (anal sphincter) - Minor surgery to relax the anal muscle - Prescription creams such as nitrates or calcium channel blockers, applied over the fissure to help relax the muscles. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "Ingrown toenail (Treatment): If you have diabetes, nerve problem in the leg or foot, poor blood circulation to your foot, or an infection around the nail, see a provider right away. Don't try to treat an ingrown nail at home. Otherwise, to treat an ingrown nail at home: - Soak the foot in warm water 3 to 4 times a day if possible. After soaking, keep the toe dry. - Gently massage over the inflamed skin. - Place a small piece of cotton or dental floss under the nail. Wet the cotton or floss with water or antiseptic. When trimming your toenails: - Briefly soak your foot in warm water to soften the nails. - Use a clean, sharp trimmer. - Trim toenails straight across the top. Do not taper or round the corners or trim too short. - Do not try to cut out the ingrown portion of the nail yourself. This will only make the problem worse. Consider wearing sandals until the problem goes away. Over-the-counter medicine that is applied to the ingrown toenail may help with the pain, but it does not treat the problem. If this doesn't work and the ingrown nail gets worse, see your family doctor, a foot specialist (podiatrist), or a skin specialist (dermatologist). If the ingrown nail doesn't heal or keeps coming back, your provider may remove part of the nail: - Numbing medicine is first injected into the toe. - The ingrown part of the nail is removed. This procedure is called a partial nail avulsion. - It takes 2 to 4 months for the nail to regrow. If the toe is infected, your doctor may prescribe antibiotics. After the procedure, follow any instructions for helping your nail heal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "What is Ingrown toenail?: An ingrown toenail occurs when the edge of the nail grows down and into the skin of the toe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have no help its about 4 years now I have ingrown toenail i have a problem of ingrown toenail its about 4 years now I have this problem i need help", "response": "Ingrown toenail removal – discharge (Summary): You had surgery to remove part or all of your toenail. This was done to relieve pain and discomfort due to an ingrown toenail. Ingrown toenails can occurs when the edge of your toenail grows into the skin of the toe. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am suffering from Kartagener's syndrome and wanted information from you or from doctor . for this syndrome. (About fertility) and if possible other symptoms. Thank you.", "response": "Do you have information about Enterotoxin: Summary : An enterotoxin is a substance that is harmful to your digestive system. It is produced by certain bacteria. The enterotoxin enters your stomach and intestines if you eat contaminated food or water. This causes symptoms such as cramps, nausea, vomiting, or diarrhea. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I am suffering from Kartagener's syndrome and wanted information from you or from doctor . for this syndrome. (About fertility) and if possible other symptoms. Thank you.", "response": "Kartagener syndrome (Cause): Kartagener syndrome can be caused by changes ( mutations ) in many different genes . These genes encode proteins that are important to the structure and function of cilia. Cilia are tiny, hair-like structures that are found on the surface of cells in various parts of the body such as the lining of the airway, the reproductive system, and other organs . The coordinated movement of cilia in wave-like motions is important to the normal functioning of certain organs and tissues throughout the body and ensures the proper placement of organs in the developing embryo. Mutations in these genes cause the cilia to be either immotile (unable to move) or dysmotile (they move incorrectly), which leads to the many signs and symptoms of Kartagener syndrome. [1] [4] [3] Scientists have identified several different genes that are associated with Kartagener syndrome; however, the genetic cause is unknown in some cases. [1] [4] [3]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "SLC4A1-associated distal renal tubular acidosis (Related Diseases): The following diseases are related to SLC4A1-associated distal renal tubular acidosis. If you have a question about any of these diseases, you can contact GARD. Distal renal tubular acidosis with hemolytic anemia Renal tubular acidosis Renal tubular acidosis, distal, autosomal dominant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "Do I need to see a doctor for Distal renal tubular acidosis?: Call your health care provider if you have symptoms of distal renal tubular acidosis. Get medical help right away if you develop emergency symptoms such as: - Decreased consciousness - Seizures - Severe decrease in alertness or orientation. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "know more about My Daughter have Distal renal tubular acidosis. we are from Mexico, and we ae woundering if can send to us more infomation. maybe you can reccommend to us a association???? i don?t know", "response": "SLC4A1-associated distal renal tubular acidosis (Description): SLC4A1-associated distal renal tubular acidosis is a kidney (renal) disorder that sometimes includes blood cell abnormalities. The kidneys normally filter fluid and waste products from the body and remove them in urine; however, in people with distal renal tubular acidosis, the kidneys are unable to remove enough acid from the body, and the blood becomes too acidic. This chemical imbalance is called metabolic acidosis. The inability to remove acids from the body often results in slowed growth and may also lead to softening and weakening of the bones, called rickets in children and osteomalacia in adults. This bone disorder is characterized by bone pain, bowed legs, and difficulty walking. In addition, most children and adults with SLC4A1-associated distal renal tubular acidosis have excess calcium in the urine (hypercalciuria), calcium deposits in the kidneys (nephrocalcinosis), and kidney stones (nephrolithiasis). In rare cases, these kidney abnormalities lead to life-threatening kidney failure. Affected individuals may also have low levels of potassium in the blood (hypokalemia). Individuals with the features described above have complete distal renal tubular acidosis, which usually becomes apparent in childhood. Some people do not develop metabolic acidosis even though their kidneys have trouble removing acids; these individuals are said to have incomplete distal renal tubular acidosis. Additionally, these individuals may have other features of distal renal tubular acidosis, such as bone problems and kidney stones. Often, people who initially have incomplete distal renal tubular acidosis develop metabolic acidosis later in life. Some people with SLC4A1-associated distal renal tubular acidosis also have blood cell abnormalities. These can vary in severity from no symptoms to a condition called hemolytic anemia, in which red blood cells prematurely break down (undergo hemolysis), causing a shortage of red blood cells (anemia). Hemolytic anemia can lead to unusually pale skin (pallor), extreme tiredness (fatigue), shortness of breath (dyspnea), and an enlarged spleen (splenomegaly). There are two forms of SLC4A1-associated distal renal tubular acidosis; they are distinguished by their inheritance pattern. The autosomal dominant form is more common and is usually less severe than the autosomal recessive form. The autosomal dominant form can be associated with incomplete or complete distal renal tubular acidosis and is rarely associated with blood cell abnormalities. The autosomal recessive form is always associated with complete distal renal tubular acidosis and is more commonly associated with blood cell abnormalities, although not everyone with this form has abnormal blood cells. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia: Lewy body dementia is one of the most common forms of progressive dementia. People affected by this condition may experience a variety of symptoms such as changes in alertness and attention; hallucinations; problems with movement and posture; muscle stiffness; confusion; and/or memory loss. Although the exact cause of Lewy body dementia is poorly understood, symptoms are thought to result when clumps of a protein called alpha-synuclein (\"Lewy bodies\") accumulate in the brain. Lewy body dementia usually occurs sporadically in people with no family history of the condition. Rarely, more than one family member may be affected. There is currently no cure for Lewy body dementia; however, medications may be available to help manage the associated symptoms. [1] [2] [3] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Delusions - Dementia - Fluctuations in consciousness - Parkinsonism - Visual hallucinations - The exact underlying cause of Lewy body dementia is poorly understood. The symptoms of the condition are thought to occur when clumps of a protein called alpha-synuclein accumulate in the regions of the brain involved in thinking, memory and movement. The build-up of these clumps (which are called \"Lewy bodies\") appears to be associated with a loss of certain neurons (nerve cells ) in the brain that produce two important neurotransmitters (chemicals that act as messengers between brain cells). The neurotransmitter, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood. [4] Although Lewy body dementia usually occurs sporadically, more than one family member can rarely be affected. Studies of these families suggest that there may be a genetic component to the condition in some cases. For example, copy number variants or changes ( mutations ) in the SNCA gene have been reported in a few affected families. [5] [6] The APOE ε4 allele and mutations in the GBA gene have been associated with an increased risk of Lewy body dementia and the APOE ε2 allele with a decreased risk. [5] [7] [2] Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5] Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. The Lewy Body Dementia Association offers detailed and up-to-date information regarding the treatment and management of Lewy body dementia . Please click on the link to access this resource. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia (Inheritance): Most cases of Lewy body dementia are not thought to be inherited . The condition generally occurs sporadically in people with no family history of the condition. [4] Rarely, the condition can affect more than one family member. Some of these cases appear to be due to single gene changes ( mutations ) that follow an autosomal dominant pattern of inheritance. Other familial cases do not follow a specific pattern of inheritance and likely have a multifactorial cause (associated with the effects of multiple genes in combination with lifestyle and environmental factors ). [6] [5]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have been researching Lewy Body Disease and have a few questions.1) Is this disease hereditary2) Does alcoholism play a role in the beginning process of this disease3) What are the initial symptoms of the diseaseAny information you could forward would be greatly appreciated.", "response": "Lewy body dementia (Diagnosis): Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "Tay-Sachs disease (Treatment): There is no cure for Tay-Sachs disease, but some treatments can help in managing symptoms. The goal of treatment is support and comfort. Supportive treatments include: - Medication. To reduce your child's symptoms, a number of prescription medications are available, including anti-seizure medications. - Respiratory care. Children who have Tay-Sachs disease are at high risk of lung infections that cause breathing problems and frequently accumulate mucus in their lungs. Your child may need the mucus using chest physiotherapy (CPT) to help remove mucus from the lungs. - Feeding tubes. Your child may have trouble swallowing, or develop respiratory problems by inhaling food or liquid into the lungs while eating. To prevent those problems, your doctor may recommend an assistive feeding device such as a gastrostomy tube, which is inserted through your child's nose and goes to your child's stomach. Or, a doctor trained in stomach surgery may surgically insert an esophagogastrostomy tube. - Physical therapy. As the disease progresses, your child may benefit from physical therapy to help keep joints flexible and maintain as much ability to move (range of motion) as possible. Physical therapy can delay joint stiffness and reduce or delay the loss of function and pain that can result from shortened muscles. Potential future treatments Gene therapy or enzyme replacement therapy research may eventually lead to a cure or treatment to slow the progression of Tay-Sachs disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "How many people are affected by critical congenital heart disease?: Heart defects are the most common type of birth defect, accounting for more than 30 percent of all infant deaths due to birth defects. CCHD represents some of the most serious types of heart defects. About 7,200 newborns, or 18 per 10,000, in the United States are diagnosed with CCHD each year. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "I have a list of questions about Tay sachs disease and clubfoot 1. what is TSD/Clubfoot, and how does it effect a baby 2. what causes both? can it be prevented, treated, or cured 3. How common is TSD? how common is Clubfoot 4. How can your "agency" help a women/couple who are concerned about this congenital condition, and is there a cost? If you can answer these few questions I would be thankful, please get back as soon as you can.", "response": "Tay-Sachs Disease: Tay-Sachs disease is a inherited metabolic disease caused by the harmful buildup of lipids (fatty materials such as oils and acids) in various cells and tissues in the body. It is part of a group of genetic disorders called the GM2 gangliosidoses. Tay-Sachs and its variant form are caused by a deficiency in the enzyme hexosaminidase A. Affected children appear to develop normally until about age 6 months. Then, symptoms begin and include progressive loss of mental ability, dementia, blindness, increased startle reflex to noise, progressive loss of hearing leading to deafness, and difficulty with swallowing. Seizures may begin in the child's second year. Persons with Tay-Sachs also have \"cherry-red\" spots in their eyes. A much rarer form of the disorder, called late-onset Tay-Sachs disease, occurs in individuals in their twenties and early thirties and is characterized by an unsteady gait and progressive neurological deterioration. The incidence of Tay-Sachs has been particularly high among people of Eastern European and Askhenazi Jewish descent., as well as in certain French Canadians and Louisiana Cajuns. Affected individuals and carriers of Tay-Sachs disease can be identified by a blood test that measures hexosaminidase A activity. Both parents must carry the mutated gene in order to have an affected child. In these instances, there is a 25 percent chance with each pregnancy that the child will be affected with Tay-Sachs disease. Prenatal diagnosis is available if desired. A very severe form of Tay-Sachs disease is know as Sandhoff disease, which is not limited to any ethnic group. Presently there is no specific treatment for Tay-Sachs disease. Anticonvulsant medicine may initially control seizures. Other supportive treatment includes proper nutrition and hydration and techniques to keep the airway open. Children may eventually need a feeding tube. Even with the best of care, children with Tay-Sachs disease usually die by age 4, from recurring infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "Menkes syndrome: In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. It is one of several conditions called an \"inborn error of metabolism.\" Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute copper in food from the intestines into the bloodstream for use in other areas. As a result, the brain and other parts of the body do not get enough copper. Copper can build up in the small intestine and kidneys, but low copper levels in other areas can affect the structure of bone, skin, hair, and blood vessels, and interfere with nerve function. Menkes syndrome is inherited, which means it runs in families. The gene is on the X-chromosome, so if a mother carries the defective gene, each of her sons has a 50% (1 in 2) chance of developing the disease, and 50% of her daughters will be a carrier of the disease. Symptoms of Menkes syndrome are: - Bone spurs - Brittle, kinky hair - Feeding difficulties - Irritability - Lack of muscle tone, floppiness - Low body temperature - Mental deterioration - Pudgy, rosy cheeks - Seizures - Skeletal changes There is often a history of Menkes syndrome in a male relative. Signs include: - Abnormal appearance of the hair under a microscope - Abnormally low body temperature - Bleeding in the brain - Slow growth in the womb In males, all of the hairs will be abnormal. In females who carry this trait, half of them may have areas of abnormal hair. Tests may include: - Serum ceruloplasmin (substance that transports copper in the blood) - Serum copper level - Skin cell culture - X-ray of the skeleton or x-ray of the skull Genetic testing may show a change (mutation) in the ATP7A gene. Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results. Most people with this condition die within the first few years of life. - Seizures - Death Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy. See a genetic counselor if you want to have children and you have a family history of Menkes syndrome. Maternal relatives (relatives on the mother's side of the family) of a boy with this syndrome should be seen by a geneticist to find out if they are carriers. Updated by: Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "What is Menkes syndrome?: Menkes syndrome is a disorder that affects copper levels in the body. It is characterized by sparse, kinky hair; failure to gain weight and grow at the expected rate (failure to thrive); and deterioration of the nervous system. Additional signs and symptoms include weak muscle tone (hypotonia), sagging facial features, seizures, developmental delay, and intellectual disability. Children with Menkes syndrome typically begin to develop symptoms during infancy and often do not live past age 3. Early treatment with copper may improve the prognosis in some affected individuals. In rare cases, symptoms begin later in childhood. Occipital horn syndrome (sometimes called X-linked cutis laxa) is a less severe form of Menkes syndrome that begins in early to middle childhood. It is characterized by wedge-shaped calcium deposits in a bone at the base of the skull (the occipital bone), coarse hair, and loose skin and joints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "My daughter has menkes syndrome and would like to know how to go about. Thx", "response": "What is Menkes syndrome?: In Menkes syndrome, cells in the body can absorb copper, but they are unable to release it. It is one of several conditions called an \"inborn error of metabolism.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "Cardiac amyloidosis (Causes): Amyloidosis is a group of diseases in which clumps of proteins called amyloids build up in body tissues. Over time, these proteins replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis. Cardiac amyloidosis (\"stiff heart syndrome\") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical type of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical signals move through the heart (conduction system). This can lead to abnormal heartbeats (arrhythmias) and faulty heart signals (heart block). The condition can be inherited. This is called familial cardiac amyloidosis. It can also develop as the result of another disease such as a type of bone and blood cancer, or as the result of another medical problem causing inflammation. Cardiac amyloidosis is more common in men than in women. The disease is rare in people under age 40. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "What are the complications of Cardiac amyloidosis?: - Atrial fibrillation or ventricular arrhythmias - Congestive heart failure - Fluid buildup in the abdomen (ascites) - Increased sensitivity to digoxin - Low blood pressure and dizziness from excessive urination (due to medication) - Sick sinus syndrome - Symptomatic cardiac conduction system disease (arrhythmias related to abnormal conduction of impulses through the heart muscle). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Please let me know where I can get literature on Cardiac amyloidosis. My uncle died yesterday from this disorder. Since this is such a rare disorder, and to honor his memory, I would like to distribute literature at his funeral service.", "response": "Cardiac amyloidosis (Summary): Cardiac amyloidosis is a disorder caused by deposits of an abnormal protein (amyloid) in the heart tissue. These deposits make it hard for the heart to work properly. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "Milroy disease (Treatment): There is currently no cure for Milroy disease. Management is typically conservative and usually successful in most people. [3] Management of lymphedema should be guided by a lymphedema therapist. Some improvement is usually possible with the use of properly fitted compression hosiery or bandaging and well fitting, supportive shoes. Good skin care is essential. These measures may improve the cosmetic appearance of the affected areas, decrease their size, and reduce the risk of complications. [2] Decongestive physiotherapy , which combines compression bandaging, manual lymphatic drainage (a specialized massage technique), exercise, breathing exercises, dietary measures and skin care, has become the standard of care for primary lymphedema. [3] People with recurrent cellulitis may benefit from prophylactic antibiotics . [2] [3] Surgical intervention is considered a last option when other medical management fails. [3] When possible, people with Milroy disease should avoid: wounds to swollen areas (because of their reduced resistance to infection) long periods of immobility prolonged standing elevation of the affected limb certain medications (particularly calcium channel-blocking drugs that can cause increased leg swelling in some people)[2] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "What are the treatments for Peripheral artery disease - legs?: Things you can do to control PAD include: - Balance exercise with rest. Walk or do another activity to the point of pain and alternate it with rest periods. Over time, your circulation may improve as new, small (collateral) blood vessels form. Always talk to the doctor before starting an exercise program. - Stop smoking. Smoking narrows the arteries, decreases the blood's ability to carry oxygen, and increases the risk of forming clots (thrombi and emboli). - Take care of your feet, especially if you also have diabetes. Wear shoes that fit properly. Pay attention to any cuts, scrapes, or injuries, and see your doctor right away. Tissues heal slowly and are more likely to get infected when there is decreased circulation. - Make sure your blood pressure is well-controlled. - If you are overweight, reduce your weight. - If your cholesterol is high, eat a low-cholesterol and low-fat diet. - Monitor your blood sugar level if you have diabetes, and keep it under control. Medicines may be needed to control the disorder, including: - Aspirin or a medicine called clopidogrel (Plavix), which keeps your blood from forming clots in your arteries. DO NOT stop taking these medications without first talking with your doctor. - Cilostazol, a drug that works to enlarge (dilate) the affected artery or arteries for moderate-to-severe cases that are not candidates for surgery. - Medicine to help lower your cholesterol. - Pain relievers. If you are taking medicines for high blood pressure or diabetes, take them as your doctor has prescribed. Surgery may be performed if the condition is severe and is affecting your ability to work or do important activities, or you are having pain at rest. Options are: - Angioplasty and stent placement of the peripheral arteries (this is similar to the technique used to open the coronary arteries, but it is performed on the blood vessels of the affected leg) - Peripheral artery bypass surgery of the leg Some people with PAD may need to have the limb removed (amputated). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "milroy disease hello , my daughter has lymph edema her both legs and left hand is swelling , this problem started when she was of 3 months now she is 16 months , her swelling is growing day by day , im clue less what to do and what kind of treatment i should do plz help and suggest us", "response": "Milroy disease: Milroy disease is a condition that affects the normal function of the lymphatic system. The lymphatic system produces and transports fluids and immune cells throughout the body. Impaired transport with accumulation of lymph fluid can cause swelling (lymphedema). Individuals with Milroy disease typically have lymphedema in their lower legs and feet at birth or develop it in infancy. The lymphedema typically occurs on both sides of the body and may worsen over time. Milroy disease is associated with other features in addition to lymphedema. Males with Milroy disease are sometimes born with an accumulation of fluid in the scrotum (hydrocele). Males and females may have upslanting toenails, deep creases in the toes, wart-like growths (papillomas), and prominent leg veins. Some individuals develop non-contagious skin infections called cellulitis that can damage the thin tubes that carry lymph fluid (lymphatic vessels). Episodes of cellulitis can cause further swelling in the lower limbs. Milroy disease is a rare disorder; its incidence is unknown. Mutations in the FLT4 gene cause some cases of Milroy disease. The FLT4 gene provides instructions for producing a protein called vascular endothelial growth factor receptor 3 (VEGFR-3), which regulates the development and maintenance of the lymphatic system. Mutations in the FLT4 gene interfere with the growth, movement, and survival of cells that line the lymphatic vessels (lymphatic endothelial cells). These mutations lead to the development of small or absent lymphatic vessels. If lymph fluid is not properly transported, it builds up in the body's tissues and causes lymphedema. It is not known how mutations in the FLT4 gene lead to the other features of this disorder. Many individuals with Milroy disease do not have a mutation in the FLT4 gene. In these individuals, the cause of the disorder is unknown. Milroy disease is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In many cases, an affected person inherits the mutation from one affected parent. Other cases may result from new mutations in the FLT4 gene. These cases occur in people with no history of the disorder in their family. About 10 percent to 15 percent of people with a mutation in the FLT4 gene do not develop the features of Milroy disease. Brice G, Child AH, Evans A, Bell R, Mansour S, Burnand K, Sarfarazi M, Jeffery S, Mortimer P. Milroy disease and the VEGFR-3 mutation phenotype. J Med Genet. 2005 Feb;42(2):98-102. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "Ellis-van Creveld syndrome (Description): Ellis-van Creveld syndrome is an inherited disorder of bone growth that results in very short stature (dwarfism). People with this condition have particularly short forearms and lower legs and a narrow chest with short ribs. Ellis-van Creveld syndrome is also characterized by the presence of extra fingers and toes (polydactyly), malformed fingernails and toenails, and dental abnormalities. More than half of affected individuals are born with a heart defect, which can cause serious or life-threatening health problems. The features of Ellis-van Creveld syndrome overlap with those of another, milder condition called Weyers acrofacial dysostosis. Like Ellis-van Creveld syndrome, Weyers acrofacial dysostosis involves tooth and nail abnormalities, although affected individuals have less pronounced short stature and typically do not have heart defects. The two conditions are caused by mutations in the same genes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "Do you have information about Understanding Medical Research: Summary : It seems to happen almost every day - you hear about the results of a new medical research study. Sometimes the results of one study seem to disagree with the results of another study. It's important to be critical when reading or listening to reports of new medical findings. Some questions that can help you evaluate health information include: - Was the study in animals or people? - Does the study include people like you? - How big was the study? - Was it a randomized controlled clinical trial? - Where was the research done? - If a new treatment was being tested, were there side effects? - Who paid for the research? - Who is reporting the results? NIH: National Institutes of Health. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "more information in relation to Ellis van creveld syndrome Specifically in later life can they have children has it ever been reported any researchcarried out and just as much information as possible to help my understanding of what I have Many thanks", "response": "Ellis-van Creveld syndrome (Frequency): In most parts of the world, Ellis-van Creveld syndrome occurs in 1 in 60,000 to 200,000 newborns. It is difficult to estimate the exact prevalence because the disorder is very rare in the general population. This condition is much more common in the Old Order Amish population of Lancaster County, Pennsylvania, and in the indigenous (native) population of Western Australia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "Nephrotic syndrome (Treatment): The goals of treatment are to relieve symptoms, prevent complications, and delay kidney damage. To control nephrotic syndrome, the disorder that is causing it must be treated. You may need treatment for life. Treatments may include any of the following: - Keeping blood pressure at or below 130/80 mm Hg to delay kidney damage. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the medicines most often used. ACE inhibitors and ARBs may also help decrease the amount of protein lost in the urine. - Corticosteroids and other drugs that suppress or quiet the immune system. - Treating high cholesterol to reduce the risk of heart and blood vessel problems. A low-fat, low-cholesterol diet is usually not enough for people with nephrotic syndrome. Medicines to reduce cholesterol and triglycerides (usually statins) may be needed. - A low-salt diet may help with swelling in the hands and legs. Water pills (diuretics) may also help with this problem. - Low-protein diets may be helpful. Your health care provider may suggest a moderate-protein diet (1 gram [gm] of protein per kilogram [kg] of body weight per day). - Taking vitamin D supplements if nephrotic syndrome is long-term and is not responding to treatment. - Taking blood thinner drugs to treat or prevent blood clots. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "What causes Nephrotic syndrome?: Nephrotic syndrome is caused by different disorders that damage the kidneys. This damage leads to the release of too much protein in the urine. The most common cause in children is minimal change disease. Membranous glomerulonephritis is the most common cause in adults.In both diseases, the glomeruli in the kidneys are damaged. Glomeruli are the structures that help filter wastes and fluids. This condition can also occur from: - Cancer - Diseases such as diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis - Genetic disorders - Immune disorders - Infections (such as strep throat, hepatitis, or mononucleosis) - Use of certain drugs It can occur with kidney disorders such as: - Focal and segmental glomerulosclerosis - Glomerulonephritis - Mesangiocapillary glomerulonephritis Nephrotic syndrome can affect all age groups. In children, it is most common between ages 2 and 6. This disorder occurs slightly more often in males than females. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "What is Nephrotic Syndrome. What are its causes and cures?", "response": "Chemotherapy: The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to: - Cure the cancer - Shrink the cancer - Prevent the cancer from spreading - Relieve symptoms the cancer may be causing HOW CHEMOTHERAPY IS GIVEN Depending on the type of cancer and where it is found, chemotherapy drugs may be given different ways, including: - Injections or shots into the muscles - Injections or shots under the skin - Into an artery - Into a vein (intravenous, or IV) - Pills taken by mouth - Shots into the fluid around the spinal cord or brain When chemotherapy is given over a longer period, a thin catheter can be placed into a large vein near the heart. This is called a central line. The catheter is placed during a minor surgery. There are many types of catheters, including: - Central venous catheter - Central venous catheter with a port - Percutaneously inserted central catheter (PICC) A central line can stay in the body over a long period of time. It will need to be flushed on a weekly to monthly basis to prevent blood clots from forming inside the central line. Different chemotherapy drugs may be given at the same time or after each other. Radiation therapy may be received before, after, or during chemotherapy. Chemotherapy is most often given in cycles. These cycles may last 1 day, several days, or a few weeks or more. There will usually be a rest period when no chemotherapy is given between each cycle. A rest period may last for days, weeks, or months. This allows the body and blood counts to recover before the next dose. Often, chemotherapy is given at a special clinic or at the hospital. Some people are able to receive chemotherapy in their home. If home chemotherapy is given, home health nurses will help with the medicine and IVs. The person getting the chemotherapy and their family members will receive special training. DIFFERENT TYPES OF CHEMOTHERAPY The different types of chemotherapy include: - Standard chemotherapy, which works by killing cancer cells and some normal cells. - Targeted treatment and immunotherapy zero in on specific targets (molecules) in or on cancer cells. SIDE EFFECTS OF CHEMOTHERAPY Because these medicines travel through the blood to the entire body, chemotherapy is described as a bodywide treatment. As a result, chemotherapy may damage or kill some normal cells. These include bone marrow cells, hair follicles, and cells in the lining of the mouth and the digestive tract. When this damage occurs, there can be side effects. Some people who receive chemotherapy: - Are more likely to have infections - Become tired more easily - Bleed too much, even during everyday activities - Feel pain or numbness from nerve damage - Have a dry mouth, mouth sores, or swelling in the mouth - Have a poor appetite or lose weight - Have an upset stomach, vomiting, or diarrhea - Lose their hair - Have problems with thinking and memory (\"chemo brain\") Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects. Your health care provider will explain what you can do at home to prevent or treat side effects. These measures include: - Being careful with pets and other animals to avoid catching infections from them - Eating enough calories and protein to keep your weight up - Preventing bleeding, and what to do if bleeding occurs - Practicing safe eating and drinking habits - Washing your hands often with soap and water You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to: - Monitor how well the chemotherapy is working - Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body Updated by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists and Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "autosomal recessive congenital stationary night blindness: Autosomal recessive congenital stationary night blindness is a disorder of the retina, which is the specialized tissue at the back of the eye that detects light and color. People with this condition typically have difficulty seeing and distinguishing objects in low light (night blindness). For example, they may not be able to identify road signs at night or see stars in the night sky. They also often have other vision problems, including loss of sharpness (reduced acuity), nearsightedness (myopia), involuntary movements of the eyes (nystagmus), and eyes that do not look in the same direction (strabismus). The vision problems associated with this condition are congenital, which means they are present from birth. They tend to remain stable (stationary) over time. Autosomal recessive congenital stationary night blindness is likely a rare disease; however, its prevalence is unknown. Mutations in several genes can cause autosomal recessive congenital stationary night blindness. Each of these genes provide instructions for making proteins that are found in the retina. These proteins are involved in sending (transmitting) visual signals from cells called rods, which are specialized for vision in low light, to cells called bipolar cells, which relay the signals to other retinal cells. This signaling is an essential step in the transmission of visual information from the eyes to the brain. Mutations in two genes, GRM6 and TRPM1, cause most cases of this condition. These genes provide instructions for making proteins that are necessary for bipolar cells to receive and relay signals. Mutations in other genes involved in the same bipolar cell signaling pathway are likely responsible for a small percentage of cases of autosomal recessive congenital stationary night blindness. Gene mutations that cause autosomal recessive congenital stationary night blindness disrupt the transmission of visual signals between rod cells and bipolar cells or interfere with the bipolar cells' ability to pass on these signals. As a result, visual information received by rod cells cannot be effectively transmitted to the brain, leading to difficulty seeing in low light. The cause of the other vision problems associated with this condition is unclear. It has been suggested that the mechanisms that underlie night blindness can interfere with other visual systems, causing myopia, reduced visual acuity, and other impairments. Some people with autosomal recessive congenital stationary night blindness have no identified mutation in any of the known genes. The cause of the disorder in these individuals is unknown. This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition. Audo I, Bujakowska K, Orhan E, Poloschek CM, Defoort-Dhellemmes S, Drumare I, Kohl S, Luu TD, Lecompte O, Zrenner E, Lancelot ME, Antonio A, Germain A, Michiels C, Audier C, Letexier M, Saraiva JP, Leroy BP, Munier FL, Mohand-Saïd S, Lorenz B, Friedburg C, Preising M, Kellner U, Renner AB, Moskova-Doumanova V, Berger W, Wissinger B, Hamel CP, Schorderet DF, De Baere E, Sharon D, Banin E, Jacobson SG, Bonneau D, Zanlonghi X, Le Meur G, Casteels I, Koenekoop R, Long VW, Meire F, Prescott K, de Ravel T, Simmons I, Nguyen H, Dollfus H, Poch O, Léveillard T, Nguyen-Ba-Charvet K, Sahel JA, Bhattacharya SS, Zeitz C. Whole-exome sequencing identifies mutations in GPR179 leading to autosomal-recessive complete congenital stationary night blindness. Am J Hum Genet. 2012 Feb 10;90(2):321-30. doi: 10.1016/j.ajhg.2011.12.007. Erratum in: Am J Hum Genet. 2012 Jul 13;91(1):209. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "X-linked congenital stationary night blindness: X-linked congenital stationary night blindness (XLCSNB) is a disorder of the retina. People with this condition typically experience night blindness and other vision problems, including loss of sharpness ( reduced visual acuity), severe nearsightedness (myopia), nystagmus , and strabismus . Color vision is typically not affected. These vision problems are usually evident at birth, but tend to be stable (stationary) over time. There are two major types of XLCSNB: the complete form and the incomplete form. Both types have very similar signs and symptoms. However, everyone with the complete form has night blindness, while not all people with the incomplete form have night blindness. The types are distinguished by their genetic cause. [1] The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Abnormality of macular pigmentation Frequent Nyctalopia Frequent Optic disc hypoplasia Frequent Reduced visual acuity Frequent Severe Myopia Frequent Nystagmus Occasional Strabismus Occasional Congenital stationary night blindness - Hemeralopia - X-linked recessive inheritance - Yes. About 45% of individuals with XLCSNB have the complete form, which is caused by mutations in the NYX gene . The other 55% have the incomplete form, which is caused by mutations in the CACNA1F gene. [2] The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "When and how do you know when you have congenital night blindness?", "response": "Vision - night blindness: Night blindness is poor vision at night or in dim light. Night blindness may cause problems with driving at night. People with night blindness often have trouble seeing stars on a clear night or walking through a dark room, such as a movie theater. These problems are often worse just after a person is in a brightly lit environment. Milder cases may just have a harder time adapting to darkness. The causes of night blindness fall into 2 categories: treatable and nontreatable. Treatable causes: - Cataracts - Nearsightedness - Use of certain drugs - Vitamin A deficiency (rare) Nontreatable causes: - Birth defects - Retinitis pigmentosa Take safety measures to prevent accidents in areas of low light. Avoid driving a car at night, unless you get your eye doctor's approval. Vitamin A supplements may be helpful if you have a vitamin A deficiency. Ask your health care provider. It is important to have a complete eye exam to determine the cause, which may be treatable. Call your eye doctor if symptoms of night blindness persist or significantly affect your life. Your provider will examine you and your eyes. The goal of the medical exam is to determine if the problem can be corrected (for example, with new glasses or cataract removal), or if the problem is due to something that is not treatable. The provider may ask you questions, including: - How severe is the night blindness? - When did your symptoms start? - Did it occur suddenly or gradually? - Does it happen all the time? - Does using corrective lenses improve night vision? - Have you ever had eye surgery? - What medicines do you use? - How is your diet? - Have you recently injured your eyes or head? - Do you have a family history of diabetes? - Do you have other vision changes? - What other symptoms do you have? - Do you have unusual stress, anxiety, or a fear of the dark? The eye exam will include: - Color vision testing - Pupil light reflex - Refraction - Retinal exam - Slit lamp examination - Visual acuity Other tests may be done: - Electroretinogram (ERG) - Visual field Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "Oleander poisoning: Oleander poisoning occurs when someone eats the flowers or chews the leaves or stems of the oleander plant (Nerium oleander), or its relative, the yellow oleander (Cascabela thevetia). This article is for information only. DO NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Poisonous ingredients include: - Digitoxigenin - Neriin - Oleandrin - Oleondroside Note: This list may not include all poisonous ingredients. The poisonous substances are found in all parts of the oleander plant: - Flowers - Leaves - Stems - Twigs Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases. Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care provider. Get the following information: - Person's age, weight, and condition - Name and part of the plant swallowed, if known - Time it was swallowed - Amount swallowed Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does not need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The person may receive: - Activated charcoal - Blood and urine tests - Breathing support - Chest x-ray - EKG (electrocardiogram, or heart tracing) - Fluids through a vein (IV) - Medicines to treat symptoms including an antidote to reverse the effects of the poison - Tube through the mouth into the stomach to wash out the stomach (gastric lavage) How well you do depends on the amount of poison swallowed and how quickly treatment is received. The faster you get medical help, the better the chance for recovery. Symptoms last for 1 to 3 days and may require a hospital stay. Death is unlikely. DO NOT touch or eat any plant with which you are not familiar. Wash your hands after working in the garden or walking in the woods. Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 10/26/2016. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "What are the symptoms of Oleander poisoning?: Oleander poisoning can affect many parts of the body. HEART AND BLOOD - Irregular or slow heartbeat - Low blood pressure - Weakness EYES, EARS, NOSE, MOUTH, AND THROAT - Blurred vision - Vision disturbances, including halos STOMACH AND INTESTINES - Diarrhea - Loss of appetite - Nausea and vomiting - Stomach pain NERVOUS SYSTEM - Confusion - Death - Depression - Disorientation - Dizziness - Drowsiness - Fainting - Headache - Lethargy SKIN - Hives - Rash Note: Depression, loss of appetite, and halos are most often seen in chronic overdose cases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "If oleandor was ingested by touching the plant stems inner part and then directly eating without washing hands, how long would u exspect symptoms would start? And how severe would you say symptoms may get.", "response": "Oleander poisoning (Where Found): The poisonous substances are found in all parts of the oleander plant: - Flowers - Leaves - Stems - Twigs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "Optic nerve atrophy: Optic nerve atrophy is damage to the optic nerve. The optic nerve carries images of what the eye sees to the brain. There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma. Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include: - Brain tumor - Cranial arteritis (sometimes called temporal arteritis) - Multiple sclerosis - Stroke There are also rare forms of hereditary optic nerve atrophy that affect children and young adults. Optic nerve atrophy causes vision to dim and reduces the field of vision. The ability to see fine detail will also be lost. Colors will seem faded. Over time, the pupil will be less able to react to light, and eventually, its ability to react to light may be lost. The health care provider will do a complete eye exam to look for the condition. The exam will include tests of: - Color vision - Pupil light reflex - Tonometry - Visual acuity You may also need a complete physical exam and other tests. Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye. People with this condition need to be checked regularly by an eye doctor with experience in nerve-related conditions. Tell your doctor right away about any change in vision. Many causes of optic nerve atrophy cannot be prevented. Prevention steps include: - Older adults should have their provider carefully manage their blood pressure. - Use standard safety precautions to prevent injuries to the face. Most facial injuries are the result of car accidents. Wearing seat belts may help prevent these injuries. - Schedule a routine annual eye exam to check for glaucoma. - Never drink home-brewed alcohol and forms of alcohol that are not intended for drinking. Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes. Updated by: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "What are the genetic changes related to optic atrophy type 1?: Optic atrophy type 1 is caused by mutations in the OPA1 gene. The protein produced from this gene is made in many types of cells and tissues throughout the body. The OPA1 protein is found inside mitochondria, which are the energy-producing centers of cells. The OPA1 protein plays a key role in the organization of the shape and structure of the mitochondria and in the self-destruction of cells (apoptosis). The OPA1 protein is also involved in a process called oxidative phosphorylation, from which cells derive much of their energy. Additionally, the protein plays a role in the maintenance of the small amount of DNA within mitochondria, called mitochondrial DNA (mtDNA). Mutations in the OPA1 gene lead to overall dysfunction of mitochondria. The structure of the mitochondria become disorganized and cells are more susceptible to self-destruction. OPA1 gene mutations lead to mitochondria with reduced energy-producing capabilities. The maintenance of mtDNA is also sometimes impaired, resulting in mtDNA mutations. The vision problems experienced by people with optic atrophy type 1 are due to mitochondrial dysfunction, leading to the breakdown of structures that transmit visual information from the eyes to the brain. Affected individuals first experience a progressive loss of nerve cells within the retina, called retinal ganglion cells. The loss of these cells is followed by the degeneration (atrophy) of the optic nerve. The optic nerve is partly made up of specialized extensions of retinal ganglion cells called axons; when the retinal ganglion cells die, the optic nerve cannot transmit visual information to the brain normally. It is unclear why the OPA1 gene mutations that cause optic atrophy type 1 only affect the eyes. Retinal ganglion cells have many mitochondria and especially high energy requirements, which researchers believe may make them particularly vulnerable to mitochondrial dysfunction and decreases in energy production. Some individuals with optic atrophy type 1 do not have identified mutations in the OPA1 gene. In these cases, the cause of the condition is unknown. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is optic atrophy ginetic and what cause it?", "response": "Optic nerve atrophy (Treatment): Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?", "response": "Rheumatoid arthritis (Symptoms): Signs and symptoms of rheumatoid arthritis may include: - Tender, warm, swollen joints - Joint stiffness that is usually worse in the mornings and after inactivity - Fatigue, fever and weight loss Early rheumatoid arthritis tends to affect your smaller joints first - particularly the joints that attach your fingers to your hands and your toes to your feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body. About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including: - Skin - Eyes - Lungs - Heart - Kidneys - Salivary glands - Nerve tissue - Bone marrow - Blood vessels Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission - when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place. Make an appointment with your doctor if you have persistent discomfort and swelling in your joints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Are there any researches indicating how early an individual may experience any signs or symptoms of Rheumatoid Arthritis?", "response": "What are the symptoms of Rheumatoid Arthritis?: Swelling and Pain in the Joints Different types of arthritis have different symptoms. In general, people with most forms of arthritis have pain and stiffness in their joints. Rheumatoid arthritis is characterized by inflammation of the joint lining. This inflammation causes warmth, redness, swelling, and pain around the joints. A person also feels sick, tired, and sometimes feverish. Rheumatoid arthritis generally occurs in a symmetrical pattern. If one knee or hand is affected, the other one is also likely to be affected. Diagnostic Tests Rheumatoid arthritis can be difficult to diagnose in its early stages for several reasons. There is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. Common tests for rheumatoid arthritis include - The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. The rheumatoid factor test. Rheumatoid factor is an antibody that is present eventually in the blood of most people with rheumatoid arthritis However, not all people with rheumatoid arthritis test positive for rheumatoid factor, especially early in the disease. Also, some people who do test positive never develop the disease. - The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. The citrulline antibody test. This blood test detects antibodies to cyclic citrullinated peptide (anti-CCP). This test is positive in most people with rheumatoid arthritis and can even be positive years before rheumatoid arthritis symptoms develop. When used with the rheumatoid factor test, the citrulline antibody test results are very useful in confirming a rheumatoid arthritis diagnosis. Other common tests for rheumatoid arthritis include - the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body - a test for white blood cell count and - a blood test for anemia. the erythrocyte sedimentation rate, which indicates the presence of inflammation in the body a test for white blood cell count and a blood test for anemia. Diagnosis Can Take Time Symptoms of rheumatoid arthritis can be similar to those of other types of arthritis and joint conditions, and it may take some time to rule out other conditions. The full range of symptoms develops over time, and only a few symptoms may be present in the early stages. Learn more about how rheumatoid arthritis is diagnosed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "Polycystic ovarian syndrome (Summary): Polycystic ovarian syndrome (PCOS) is a health problem that can affect a woman's menstrual cycle, ability to have children, hormones , heart, blood vessels, and appearance. Women with this condition typically have high levels of hormones called androgens, missed or irregular periods, and many small cysts in their ovaries. The cause of PCOS is unknown, but probably involves a combination of genetic and environmental factors . Treatment for PCOS may involve birth control pills and medications for diabetes and infertility. Medicines called anti-androgens are also used to speed the growth of hair and clear acne. [1] [2]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "What is Polycystic ovary syndrome?: Polycystic ovary syndrome is a condition in which a woman has an imbalance of female sex hormones. This may lead to changes in the menstrual cycle, cysts in the ovaries, trouble getting pregnant, and other health problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Polycystic ovarian syndrome Is it possible for parents to pass this on in the genes to their children - is there any other way this can be acquired?", "response": "Fragile X-Associated Primary Ovarian Insufficiency (FXPOI) (How do genes cause it?): Fragile X syndrome and its associated conditions are caused by mutations, or changes, in the FMR1 gene. The mutation affects how the body can use the gene to make the Fragile X mental retardation protein, or FMRP. On a gene, the information for making a protein has two parts: the introduction and the instructions for making the protein itself. Researchers call the introduction the promoter because of how it helps start the process of building the protein. The promoter part of the FMR1 gene normally includes many repeats—repeated instances of a trio of DNA bases called a triplet repeat—in this case, many copies of the CGG triplet repeat—to help build the protein. The number of repeats in the promoter varies from person to person. - People who do not have the FMR1 triplet repeat expansion usually have between 6 and 40 repeats in the promoter; the average is 30 repeats. - People whose FMR1 gene has between 55 and 200 repeats have a premutation. - People whose FMR1 gene has more than 200 repeats have a full mutation. Effects of Premutations Versus Full Mutations Premutations and full mutations in the promoter region of the FMR1 gene can have different effects. Premutations can cause specific disorders taht aren't found in people with the full mutation: - Women with a premutation may have Fragile X-associated primary ovarian insufficiency (FXPOI). - People with a premutation may also have Fragile X-associated tremor and ataxia syndrome. The number of repeats in the promoter region also affects the severity of a person’s symptoms of Fragile X syndrome: - People with a premutation may have milder symptoms of Fragile X syndrome, or they may have no symptoms at all. - People with a full mutation are more likely to have intellectual and developmental disabilities and other symptoms of Fragile X syndrome. Parents who have a FMR1 premutation may have no symptoms but still pass along the premutation to their children. That means their children could have Fragile X-associated disorders, including FXPOI. Also, the premutation can expand when it's passed along, so that a child of a parent with a premutation could have Fragile X syndrome. « What causes it? What are common symptoms? » ​​. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Polymicrogyria: Polymicrogyria is a condition characterized by abnormal development of the brain before birth. Specifically, the surface of the brain develops too many folds which are unusually small. The signs and symptoms associated with the condition vary based on how much of the brain and which areas of the brain are affected; however, affected people may experience recurrent seizures ( epilepsy ); delayed development; crossed eyes ; problems with speech and swallowing; and muscle weakness or paralysis. Bilateral forms (affecting both sides of the brain) tend to cause more severe neurological problems. Polymicrogyria can result from both genetic and environmental causes. It may occur as an isolated finding or as part of a syndrome . Treatment is based on the signs and symptoms present in each person. [1] [2] A wide variety of symptoms may be observed in people with polymicrogyria, depending on the areas of the brain implicated and whether or not it is part of a larger syndrome . Signs and symptoms may include: [3] [4] Developmental delay Crossed eyes Epilepsy Paralysis of the face, throat, and tongue Difficulty with speech and swallowing Drooling The diagnosis of polymicrogyria is made by imaging brain structures using MRI . Typical findings include areas of the cerebral cortex with a complex set of small gyri that appear fused to each other and separated by shallow sulci. These findings may be isolated to one side of the brain (unilateral) or may involve both sides of the brain (bilateral). [3] [4] The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The following diseases are related to Polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Bilateral frontal polymicrogyria Bilateral frontoparietal polymicrogyria Bilateral generalized polymicrogyria Bilateral parasagittal parieto-occipital polymicrogyria Bilateral perisylvian polymicrogyria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Bilateral generalized polymicrogyria: Bilateral generalized polymicrogyria is a rare neurological disorder that affects the cerebral cortex (the outer surface of the brain). [1] [2] [3] This is the most widespread form of polymicrogyria and typically affects the entire surface of the brain. [1] Signs and symptoms include severe intellectual disability , problems with movement, and seizures that are difficult or impossible to treat. [1] [2] While the exact cause of bilateral generalized polymicrogyria is not fully understood, it is thought to be due to improper brain development during embryonic growth. [2] Most cases appear to follow an autosomal recessive pattern of inheritance. Treatment is based on the signs and symptoms present in each person. [1] [2] [3] The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Although polymicrogyria as a broad category of disorders is collectively believed to be fairly common, each individual type (such as bilateral generalized polymicrogyria) is probably rare. [1] [2] Unfortunately for the rare diseases, there's often not a calculated incidence or prevalence; there is no official method for tracking these conditions. To our knowledge, the incidence and prevalence of bilateral generalized polymicrogyria remains unknown. [1] [2] [3] The following diseases are related to Bilateral generalized polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Polymicrogyria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "polymicrogyria. My 16 month old son has this. Does not sit up our crawl yet but still trying and is improving in grabbing things etc and so on Have read about other cases that seem 10000 time worse. It's it possible for this post of his brain to grown to normal and he grow out of it?", "response": "Polymicrogyria (Related Diseases): The following diseases are related to Polymicrogyria. If you have a question about any of these diseases, you can contact GARD. Bilateral frontal polymicrogyria Bilateral frontoparietal polymicrogyria Bilateral generalized polymicrogyria Bilateral parasagittal parieto-occipital polymicrogyria Bilateral perisylvian polymicrogyria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia (Prevention): There is no known way to prevent preeclampsia. It is important for all pregnant women to start prenatal care early and continue it through the pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia and Eclampsia (How many women are affected by or at risk of preeclampsia?): The exact number of women who develop preeclampsia is not known. Some estimates suggest that preeclampsia affects 2% to 8% of all pregnancies globally and about 3.4% in the United States.1,2The condition is estimated to account for 10% to 15% of maternal deaths worldwide.1 Disorders related to high blood pressure are the second leading cause of stillbirths and early neonatal deaths in developing nations.3In addition, HELLP syndrome occurs in about 10% to 20% of all women with severe preeclampsia or eclampsia.4Although preeclampsia occurs primarily in first pregnancies, a woman who had preeclampsia in a previous pregnancy is seven times more likely to develop preeclampsia in a later pregnancy.5Other factors that can increase a woman's risk include:5- Chronic high blood pressure or kidney disease before pregnancy - High blood pressure or preeclampsia in an earlier pregnancy - Obesity. Overweight or obese women are also more likely to have preeclampsia in more than one pregnancy.6 - Age. Women older than 40 are at higher risk. - Multiple gestation (being pregnant with more than one fetus) - African American ethnicity. Also, among women who have had preeclampsia before, non-white women are more likely than white women to develop preeclampsia again in a later pregnancy.6 - Family history of preeclampsia. According to the World Health Organization, among women who have had preeclampsia, about 20% to 40% of their daughters and 11% to 37% of their sisters also will get the disorder.7Preeclampsia is also more common among women who have histories of certain health conditions, such as migraines,8 diabetes,9 rheumatoid arthritis,10 lupus,11 scleroderma,12 urinary tract infections,13 gum disease,14 polycystic ovary syndrome,15 multiple sclerosis, gestational diabetes, and sickle cell disease.16Preeclampsia is also more common in pregnancies resulting from egg donation, donor insemination, or in vitro fertilization.The U.S. Preventative Services Task Force recommends that women who are at high risk for preeclampsia take low-dose aspirin starting after 12 weeks of pregnancy to prevent preeclampsia.17 Women who are pregnant or who are thinking about getting pregnant should talk with their health care provider about preeclampsia risk and ways to reduce the risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prevention of preeclampsia I know that the jury is out on the exact causes of preeclampsia, but I am looking for some of the ways that the chances of acquiring it can be minimized.", "response": "Preeclampsia (Causes): The exact cause of preeclampsia involves several factors. Experts believe it begins in the placenta - the organ that nourishes the fetus throughout pregnancy. Early in pregnancy, new blood vessels develop and evolve to efficiently send blood to the placenta. In women with preeclampsia, these blood vessels don't seem to develop or function properly. They're narrower than normal blood vessels and react differently to hormonal signaling, which limits the amount of blood that can flow through them. Causes of this abnormal development may include: - Insufficient blood flow to the uterus - Damage to the blood vessels - A problem with the immune system - Certain genes Preeclampsia is classified as one of four high blood pressure disorders that can occur during pregnancy. The other three are: - Gestational hypertension. Women with gestational hypertension have high blood pressure but no excess protein in their urine or other signs of organ damage. Some women with gestational hypertension eventually develop preeclampsia. - Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy. But because high blood pressure usually doesn't have symptoms, it may be hard to determine when it began. - Chronic hypertension with superimposed preeclampsia. This condition occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "Leukemia (Treatment): Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: - Chemotherapy. Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein. - Biological therapy. Biological therapy works by using treatments that help your immune system recognize and attack leukemia cells. - Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities within your cancer cells. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. This can help control the disease. - Radiation therapy. Radiation therapy uses X-rays or other high-energy beams to damage leukemia cells and stop their growth. During radiation therapy, you lie on a table while a large machine moves around you, directing the radiation to precise points on your body. You may receive radiation in one specific area of your body where there is a collection of leukemia cells, or you may receive radiation over your whole body. Radiation therapy may be used to prepare for a stem cell transplant. - Stem cell transplant. A stem cell transplant is a procedure to replace your diseased bone marrow with healthy bone marrow. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Then you receive an infusion of blood-forming stem cells that help to rebuild your bone marrow. You may receive stem cells from a donor, or in some cases you may be able to use your own stem cells. A stem cell transplant is very similar to a bone marrow transplant. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "How to prevent Cancer treatment: preventing infection?: There are many things you can do to help prevent infection. Here are some tips: - Wash your hands often. Hand washing is especially important after using the bathroom, before eating or cooking, after touching animals, and after blowing your nose or coughing. Carry hand sanitizer for times when you cannot wash. - Take care of your mouth. Brush your teeth often with a soft toothbrush and use a mouth rinse that does not contain alcohol. - Stay away from sick people. It is easy to catch a cold, the flu, chicken pox, or other infection from someone who has it. You should also avoid anyone who has had a live vaccine. - Clean yourself carefully after bowel movements. Use baby wipes or water instead of toilet paper and let your doctor know if you have any bleeding or hemorrhoids. - Make sure your food and drinks are safe. DO NOT eat fish, eggs, or meat that is raw or undercooked. And DO NOT eat anything that is spoiled or past the freshness date. - Ask someone else to clean up after pets. DO NOT pick up pet waste or clean fish tanks or birdcages. - Carry sanitizing wipes. Use them before touching public surfaces such as doorknobs, ATM machines, and railings. - Guard against cuts. Use an electric razor to avoid nicking yourself while shaving and do not tear at nail cuticles. Also be careful when using knives, needles, and scissors. If you do get a cut, clean it right away with soap, warm water, and an antiseptic. Clean your cut this way every day until it forms a scab. - Use gloves when gardening. There are often bacteria in soil. - Stay away from crowds. Plan your outings and errands for times that are less crowded. Wear a mask when you have to be around lots of people. - Be gentle with your skin. Use a towel to gently pat dry your skin after a shower or bath, and use lotion to keep it soft. DO NOT pick at pimples or other spots on your skin. - Ask about getting a flu shot. DO NOT get any vaccines without first talking to your provider. You should NOT receive any vaccines that contain a live virus. - Skip the nail salon and care for your nails at home. Make sure you use tools that have been cleaned well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Project. Hi my name is and I'm doing a school project about leukemia and I was wondering if you can anwser some of my questions please.1. What cause leukemia cancer?2. Can you survive leukemia?3. How does leukemia affect your body?4. Is leukemia inherited?5. What is advanced leukemia?6. How long can someone with leukemia expect to live?7. Can you tell if you have leukemia?8. What treatments do you need to take?9. What are the signs of leukemia?10. What is the difference between AML and CML ?", "response": "Leukemia (Treatment Option Overview): - There are different types of treatment for children with acute myeloid leukemia (AML), chronic myelogenous leukemia (CML), juvenile myelomonocytic leukemia (JMML), or myelodysplastic syndromes (MDS). - Treatment is planned by a team of health care providers who are experts in treating childhood leukemia and other diseases of the blood. - Some cancer treatments cause side effects months or years after treatment has ended. - The treatment of childhood AML usually has two phases. - Seven types of standard treatment are used for childhood AML, childhood CML, JMML, or MDS. - Chemotherapy - Radiation therapy - Stem cell transplant - Targeted therapy - Other drug therapy - Watchful waiting - Supportive care - New types of treatment are being tested in clinical trials. - Biologic therapy - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.", "response": "Psoriasis (What are the types?): There are several different types of psoriasis. Here are a few examples: - Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales. - Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat. - Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals. - Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse. - Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately. There are several different types of psoriasis. Here are a few examples: - Plaque psoriasis, which causes patches of skin that are red at the base and covered by silvery scales. - Guttate psoriasis, which causes small, drop-shaped lesions on your trunk, limbs, and scalp. This type of psoriasis is most often triggered by upper respiratory infections, such as strep throat. - Pustular psoriasis, which causes pus-filled blisters. Attacks or flares can be caused by medications, infections, stress, or certain chemicals. - Inverse psoriasis, which causes smooth, red patches in folds of skin near the genitals, under the breasts or in the armpits. Rubbing and sweating can make this type of psoriasis worse. - Erythrodermic psoriasis, which causes red and scaly skin over much of your body. This can be a reaction to a bad sunburn or taking certain medications, such as corticosteroids. It can also happen if you have a different type of psoriasis that is not well controlled. This type of psoriasis can be very serious, so if you have it, you should see a doctor immediately. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Psoriasis for past 7-8 years I had psoriasis on my scalp for nearly 10 years. Please give suggestions and medications.", "response": "How to diagnose Psoriasis?: In most cases, your primary care doctor can diagnose psoriasis simply by examining your skin. If your doctor isn't sure if you have psoriasis, he or she may order a biopsy. This involves removing a small sample of skin and looking at it under a microscope. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?", "response": "what research (or clinical trials) is being done for Multiple Sclerosis?: The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models. In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research. To read or download the National Academies/Institute of Medicine report, go to: \"Multiple Sclerosis: Current Status and Strategies for the Future.\". If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Research assignment Hi, I am a grade 12 student who is doing a research assignment on neurological disorders. Do you believe that there will ever be a bonafide cure for Multiple Sclerosis? If so, what kind of time frame would put on this cure?", "response": "Multiple sclerosis (Treatment): The resources below provide information about treatment options for this condition. If you have questions about which treatment is right for you, talk to your healthcare professional. Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision", "response": "Who is at risk for Prostate Cancer??: Scientists don't know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease. Age Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65. Race Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men. Family History A man's risk for developing prostate cancer is higher if his father or brother has had the disease. Other Risk Factors Scientists have wondered whether obesity, lack of exercise, smoking, radiation exposure, might increase risk. But at this time, there is no firm evidence that these factors contribute to an increased risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "prostate cancer using seeds aimed at maligmem tumors is this a safe decision", "response": "Who is at risk for Prostate Cancer??: Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 60 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 65. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?", "response": "Congenital rubella (Summary): Congenital rubella refers to the group of birth defects that occur in an infant whose mother is infected with the virus that causes German measles (rubella) during pregnancy. Congenital rubella occurs when the rubella virus in the mother affects the developing baby in the first 3 months of pregnancy. After the fourth month, if the mother has a rubella infection, it is less likely to harm the developing baby. [1] The most common problems are hearing loss due to damage to the nerve pathways from the inner ear to the brain ( sensorineural hearing loss ), ocular abnormalities ( cataract , infantile glaucoma , and pigmentary retinopathy) and heart problems. Other symptoms and signs may include intrauterine growth retardation, prematurity, stillbirth, miscarriage, neurological problems ( intellectual disability , low muscle tone, very small head), liver and spleen enlargement ( hepatosplenomegaly ), jaundice , skin problems, anemia , hormonal problems, and other issues. [2] The number of babies born with congenital rubella is much less since the rubella vaccine was developed. Pregnant women who are not vaccinated for rubella and who have not had the disease in the past risk infecting themselves and their unborn baby. [1] [2] Please visit the link from the Centers for Diseases Control and Prevention (CDC) to learn more about rubella vaccination: Rubella (German Measles) Vaccination. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Rubella My grandson (4 yrs old) has contracted Rubella. I know for sure he has had at least one of the vaccines. They are living in Mexico right now. Should we be worried?", "response": "What are the complications of Rubella?: Complications can occur in the unborn baby if the mother becomes infected during pregnancy. A miscarriage or stillbirth may occur. The child may be born with birth defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "Skull fracture: A skull fracture is a fracture or break in the cranial (skull) bones. Skull fractures may occur with head injuries. The skull provides good protection for the brain. However, a severe impact or blow can cause the skull to break. It may be accompanied by concussion or other injury to the brain. The brain can be affected directly by damage to the nervous system tissue and bleeding. The brain can also be affected by bleeding under the skull . This can compress the underlying brain tissue (subdural or epidural hematoma). A simple fracture is a break in the bone without damage to the skin. A linear skull fracture is a break in a cranial bone resembling a thin line, without splintering, depression, or distortion of bone. A depressed skull fracture is a break in a cranial bone (or \"crushed\" portion of skull) with depression of the bone in toward the brain. A compound fracture involves a break in, or loss of, skin and splintering of the bone. Causes of skull fracture can include: - Head trauma - Falls, automobile accidents, physical assault, and sports Symptoms may include: - Bleeding from wound, ears, nose, or around eyes - Bruising behind the ears or under the eyes - Changes in pupils (sizes unequal, not reactive to light) - Confusion - Convulsions - Difficulties with balance - Drainage of clear or bloody fluid from ears or nose - Drowsiness - Headache - Loss of consciousness - Nausea and vomiting - Restlessness, irritability - Slurred speech - Stiff neck - Swelling - Visual disturbances In some cases, the only symptom may be a bump on the head. A bump or bruise may take up to 24 hours to develop. Take the following steps if you think someone has a skull fracture: - Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR. - Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance. - If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn. - Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury. - If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss. - If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure. - If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit. - If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the person does not think medical help is needed). Follow these precautions: - Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems. Get medical help right away if: - There are problems with breathing or circulation. - Direct pressure does not stop bleeding from the nose, ears, or wound. - There is drainage of clear fluid from the nose or ears. - There is facial swelling, bleeding, or bruising. - There is an object protruding from the skull. - The person is unconscious, is experiencing convulsions, has multiple injuries, appears to be in any distress, or cannot think clearly. Not all head injuries can be prevented. The following simple steps can help keep you and your child safe: - Always use safety equipment during activities that could cause a head injury. These include seat belts, bicycle or motorcycle helmets, and hard hats. - Learn and follow bicycle safety recommendations. - Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "What to do for Skull fracture?: If you think someone has a skull fracture: - Check the airways, breathing, and circulation. If necessary, begin rescue breathing and CPR. - Avoid moving the person (unless absolutely necessary) until medical help arrives. Have someone to call 911 (or the local emergency number) for medical assistance. - If the person must be moved, take care to stabilize the head and neck. Place your hands on both sides of the head and under the shoulders. Do not allow the head to bend forward or backward, or to twist or turn. - Carefully check the site of injury, but do not probe in or around the site with a foreign object. It can be hard to know if the skull is fractured or depressed (dented in) at the site of injury. - If there is bleeding, apply firm pressure with a clean cloth over a broad area to control blood loss. - If blood soaks through, do not remove the original cloth. Instead, apply more cloths on top, and continue to apply pressure. - If the person is vomiting, stabilize the head and neck, and carefully turn the victim to the side to prevent choking on vomit. - If the person is conscious and experiencing any of the previously listed symptoms, transport to the nearest emergency medical facility (even if the patient does not think medical help is needed). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Is it necessary to go to the doctor when getting a skull fracture?", "response": "What to do for Skull fracture?: - Do NOT move the person unless absolutely necessary. Head injuries may be associated with spinal injuries. - Do NOT remove protruding objects. - Do NOT allow the person to continue with physical activities. - Do NOT forget to watch the person closely until medical help arrives. - Do NOT give the person any medicines before talking to a doctor. - Do NOT leave the person alone, even if there are no obvious problems. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem", "response": "What are the treatments for spina bifida?: These resources address the diagnosis or management of spina bifida: - Benioff Children's Hospital, University of California, San Francisco: Treatment of Spina Bifida - Centers for Disease Control and Prevention: Living with Spina Bifida - GeneFacts: Spina Bifida: Diagnosis - GeneFacts: Spina Bifida: Management - Genetic Testing Registry: Neural tube defect - Genetic Testing Registry: Neural tube defects, folate-sensitive - Spina Bifida Association: Urologic Care and Management - University of California, San Francisco Fetal Treatment Center These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "spina bifida; vertbral fusion;syrinx tethered cord. can u help for treatment of these problem", "response": "Spina Bifida (Is there a cure?): There is no cure for spina bifida, but there are treatments for a wide array of related conditions. Visit the section on treatments for more information. « How is it diagnosed? Are there associated conditions? ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...", "response": "Limb-girdle muscular dystrophy (Treatment): Unfortunately, no definitive treatments for LGMD exist. Management depends on each individual and the specific type of LGMD that the individual has. However, the American Academy of Neurology has developed guidelines for treatment of LGMD including: [5] [6] Weight control to avoid obesity Physical therapy and stretching exercises to promote mobility and prevent contractures (fixed tightening of the muscles) Use of mechanical aids such as canes, walkers, orthotics, and wheelchairs as needed to help ambulation and mobility Monitoring and surgical intervention as needed for orthopedic complications, such as foot deformity and scoliosis cardiomyopathy A team approach to treatment is recommended including a neurologist , pulmonologist , cardiologist , orthopedic surgeon, physiatrist , physical/occupational/ speech therapist , nutritionist , orthopedist , mental health counselors, and geneticist / genetic counselor . [5] [6] While not a currently available treatment option, some studies have shown promising results with the use of gene therapy . More research is needed to prove the safety and efficacy of this treatment approach. [6] Management Guidelines The American Academy of Neurology (AAN), the medical specialty society of neurologists, offers a summary of recommended guidelines for Limb-girdle muscular dystrophy GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. Project OrphanAnesthesia is a project whose aim is to create peer-reviewed, readily accessible guidelines for patients with rare diseases and for the anesthesiologists caring for them. The project is a collaborative effort of the German Society of Anesthesiology and Intensive Care, Orphanet, the European Society of Pediatric Anesthesia, anesthetists and rare disease experts with the aim to contribute to patient safety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Stem Cell Therapy for Muccular Dystrophy I have read the Medline Abstracts 98,99 of 'Limb-girdle muscular dystrophy'. Please could you tell me how I contact a specialist to enquire further with this...Thank you...", "response": "What are the treatments for limb-girdle muscular dystrophy?: These resources address the diagnosis or management of limb-girdle muscular dystrophy: - Cleveland Clinic - Gene Review: Gene Review: Limb-Girdle Muscular Dystrophy Overview - Genetic Testing Registry: Limb-girdle muscular dystrophy - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1A - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1B - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1C - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1E - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1F - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1G - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 1H - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2A - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2B - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2D - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2E - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2F - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2G - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2J - Genetic Testing Registry: Limb-girdle muscular dystrophy, type 2L - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C1 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C2 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C3 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C4 - Genetic Testing Registry: Limb-girdle muscular dystrophy-dystroglycanopathy, type C5 - Johns Hopkins Medicine - LGMD-Diagnosis.org These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "Bursitis of the heel (Treatment): Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "What to do for Contracture deformity?: Follow your health care provider's instructions for treating contracture at home.Treatments may include: - Doing exercises and stretches - Using braces and splints. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Subcutaneous retrocalcaneal bursitis Haglund's deformity of the calcaneum. I have this problem. Can you please help to overcome this?", "response": "Bursitis of the heel: Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone. A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. It may be caused by too much walking, running, or jumping. This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis. Risks for this condition include: - Starting a very intense workout schedule - Suddenly increasing activity level without the right conditioning - Changes in activity level - History of arthritis that is caused by inflammation Symptoms include: - Pain in the heel, especially with walking, running, or when the area is touched - Pain may get worse when rising on the toes (standing on tiptoes) - Red, warm skin over the back of the heel Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel. The pain may be worse when your ankle is bent upward (dorsiflex). Or, the pain may be worse when you rise on your toes. Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments DO NOT lead to improvement. Inflammation may show on a MRI. Your provider may recommend that you do the following: - Avoid activities that cause pain. - Put ice on the heel several times a day. - Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. - Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel. - Try ultrasound treatment during physical therapy to reduce inflammation. Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back. If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture). If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa. This condition most often gets better in several weeks with the proper treatment. Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest. Things you can do to prevent the problem include: - Use proper form when exercising. - Maintain as good flexibility and strength around the ankle to help prevent this condition. - Stretch the Achilles tendon to help prevent injury. - Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa. Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "subjective vertigo Can macular degeneration in only one eye cause dizziness?", "response": "What is Macular Degeneration?: Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. There are two types: wet and dry. Wet AMD happens when abnormal blood vessels grow under the macula. These new blood vessels often leak blood and fluid. Wet AMD damages the macula quickly. Blurred vision is a common early symptom. Dry AMD happens when the light-sensitive cells in the macula slowly break down. Your gradually lose your central vision. A common early symptom is that straight lines appear crooked. Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision. NIH: National Eye Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "subjective vertigo Can macular degeneration in only one eye cause dizziness?", "response": "Dizziness (Lifestyle and home remedies): Dizziness usually goes away on its own. If you tend to experience repeated episodes of dizziness, consider these tips: - Be aware of the possibility of losing your balance, which can lead to falling and serious injury. - Avoid moving suddenly and walk with a cane for stability, if needed. - Fall-proof your home by removing tripping hazards such as area rugs and exposed electrical cords. Use nonslip mats on your bath and shower floors. Use good lighting. - Sit or lie down immediately when you feel dizzy. Lie still with your eyes closed in a darkened room if you're experiencing a severe episode of vertigo. - Avoid driving a car or operating heavy machinery if you experience frequent dizziness without warning. - Avoid using caffeine, alcohol, salt and tobacco. Excessive use of these substances can worsen your signs and symptoms. - Drink enough fluids, eat a healthy diet, get enough sleep and avoid stress. - If your dizziness is caused by a medication, talk with your doctor about discontinuing it or lowering the dose. - If your dizziness comes with nausea, try an over-the-counter (nonprescription) antihistamine, such as meclizine (Antivert) or one containing dimenhydrinate (Dramamine). These may cause drowsiness. Nondrowsy antihistamines aren't as effective. - If your dizziness is caused by overheating or dehydration, rest in a cool place and drink water or a sports drink (Gatorade, Powerade, others). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?", "response": "Dehydration (Prevention): To prevent dehydration: - Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. - If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. - Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. - If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "symptoms of dehydration When a person is very dehydrated do they sometimes get a tight pain in their chest (right below the breasts) right before they faint/pass out?", "response": "What are the symptoms of Dehydration?: Signs of mild to moderate dehydration: - Thirst - Dry or sticky mouth - Not urinating much - Darker yellow urine - Dry, cool skin - Headache - Muscle cramps Signs of severe dehydration: - Not urinating, or very dark yellow or amber-colored urine - Dry, shriveled skin - Irritability or confusion - Dizziness or light-headedness - Rapid heartbeat - Rapid breathing - Sunken eyes - Listlessness - Shock (not enough blood flow through the body) - Unconsciousness or delirium. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /", "response": "Optic nerve atrophy (Treatment): Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue. Rarely, conditions that lead to optic atrophy may be treatable. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Treatment for optic nerve atrophy. Hello Name's case : Sex : Male Date of Birth : 1964 Nationality : X Diagnosis : optic nerve atrophy . i am suffering from optic atrophy, which led to loss of vision and inability to see, I suffer from this case from 1998 saluting suffered a fall on the head, which led to began this case even lost look, and have been performed process surgery in in 1998-1999 . And then in 2009 cured by reactive optic nerve by Russian Professor . i want know you hospital have treatment for optic nerve atrophy , and what this treatment i need more information about treatment of optic nerve because now 16 years old I can not vision, and I wish could belive hope for treatment of my case. And i want know the cost of treatment . Thank you Regards /", "response": "Coloboma of optic nerve (Summary): Coloboma of the optic nerve is a congenital eye abnormality in which the optic nerve (which carries images of what the eye sees to the brain) is incompletely formed. The condition may occur in one or both eyes. The degree of visual impairment varies widely depending on the severity and structures involved. Serous detachments of the retina commonly occur in affected people, with a high risk for extensive retinal detachment. The coloboma may be associated with other features, such as a small eye (microphthalmia) with or without a cyst; small cornea (microcornea); or coloboma of other eye structures. Although the condition is present from birth, diagnosis may be delayed since the coloboma is inside the eye and not visible by simple inspection. Coloboma of the optic nerve may occur sporadically, may be due to a genetic mutation and be inherited , or may occur as a feature of an underlying syndrome or other genetic condition. There is no treatment to correct an optic nerve coloboma, but low vision aids may be helpful for some people. [1] [2] [3]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?", "response": "Migraine (Treatment): There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Prevention involves the use of medications and behavioral changes. Drugs originally developed for epilepsy, depression, or high blood pressure to prevent future attacks have been shown to be extremely effective in treating migraine. Botulinum toxin A has been shown to be effective in prevention of chronic migraine. Behaviorally, stress management strategies, such as exercise, relaxation techniques, biofeedback mechanisms, and other therapies designed to limit daily discomfort, may reduce the number and severity of migraine attacks. Making a log of personal triggers of migraine can also provide useful information for trigger-avoiding lifestyle changes, including dietary considerations, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. A weight loss program is recommended for obese individuals with migraine. Relief of symptoms, or acute treatments, during attacks consists of sumatriptan, ergotamine drugs, and analgesics such as ibuprofen and aspirin. The sooner these treatments are administered, the more effective they are. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "treatment options versus migraine types Migraine seems to be a spectrum of conditions rather than only one easily diagnosed affliction. Many innovative migraine treatments are now in use, but it seems that each treatment only addresses a narrow set of conditions; for example, my daughter has tried many different treatment options (QEEG, HEG, TMS, topamax, ...) without success. Has any research been done to characterize which treatment types are effective against which migraine types?", "response": "Migraine (Treatment): There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers. A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers. If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include: - Antidepressants - Blood pressure medicines - Seizure medicines Botulinum toxin type A (Botox) injections may also help reduce migraine attacks if they occur more than 15 days a month. Some people find relief with minerals and vitamins. Check with your doctor to see if riboflavin or magnesium is right for you. TREATING AN ATTACK Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that: - Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine. - Taking too much acetaminophen can damage your liver. - Too much ibuprofen or aspirin can irritate your stomach or kidneys. If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections. The group of medicines most often used is called triptans. Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant. Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself. Feverfew is an herb for migraines. It can be effective for some people. Before using feverfew, make sure your provider approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?", "response": "Typhoid fever (Treatment): Antibiotic therapy is the only effective treatment for typhoid fever. Commonly prescribed antibiotics - Ciprofloxacin (Cipro). In the United States, doctors often prescribe this for nonpregnant adults. - Ceftriaxone (Rocephin). This injectable antibiotic is an alternative for people who may not be candidates for ciprofloxacin, such as children. These drugs can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria. Problems with antibiotic resistance In the past, the drug of choice was chloramphenicol. Doctors no longer commonly use it, however, because of side effects, a high rate of health deterioration after a period of improvement (relapse) and widespread bacterial resistance. In fact, the existence of antibiotic-resistant bacteria is a growing problem in the treatment of typhoid fever, especially in the developing world. In recent years, S. typhi also has proved resistant to trimethoprim-sulfamethoxazole and ampicillin. Other treatments Other treatments include: - Drinking fluids. This helps prevent the dehydration that results from a prolonged fever and diarrhea. If you're severely dehydrated, you may need to receive fluids through a vein (intravenously). - Surgery. If your intestines become perforated, you'll need surgery to repair the hole. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "typhoid fever Hi, My name is from X i have suffering from typhoid please give me solution i have one question i had got treatment from one year but i am not well now give me solution?", "response": "What are the treatments for Typhoid fever?: Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets. Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "varicella shingles How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.", "response": "Chickenpox (Exams and Tests): Your health care provider can most often diagnose chickenpox by looking at the rash and asking questions about the person's medical history. Small blisters on the scalp confirm the diagnosis in most cases. Lab tests can help confirm the diagnosis, if needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "varicella shingles How can I determine whether or not I've had chicken pox. If there is a test for it, what are the results of the tests I need to know that will tell me whether or not I have had chicken pox? I want to know this to determine if I should have shingles vaccine (Zostavax) Thank you.", "response": "Chickenpox (Causes): Chickenpox is caused by the varicella-zoster virus. It is a member of the herpesvirus family. The same virus also causes shingles in adults. Chickenpox can be spread very easily to others from 1 to 2 days before blisters appear until all the blisters have crusted over. You may get chickenpox: - From touching the fluids from a chickenpox blister - If someone with the disease coughs or sneezes near you Most cases of chickenpox occur in children younger than age 10. The disease is most often mild, although serious complications may occur. Adults and older children get sicker than younger children in most cases. Children whose mothers have had chickenpox or have received the chickenpox vaccine are not very likely to catch it before they are 1 year old. If they do catch chickenpox, they often have mild cases. This is because antibodies from their mothers' blood help protect them. Children under 1 year old whose mothers have not had chickenpox or the vaccine can get severe chickenpox. Severe chickenpox symptoms are more common in children whose immune system does not work well. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.", "response": "vitelliform macular dystrophy: Vitelliform macular dystrophy is a genetic eye disorder that can cause progressive vision loss. This disorder affects the retina, the specialized light-sensitive tissue that lines the back of the eye. Specifically, vitelliform macular dystrophy disrupts cells in a small area near the center of the retina called the macula. The macula is responsible for sharp central vision, which is needed for detailed tasks such as reading, driving, and recognizing faces. Vitelliform macular dystrophy causes a fatty yellow pigment (lipofuscin) to build up in cells underlying the macula. Over time, the abnormal accumulation of this substance can damage cells that are critical for clear central vision. As a result, people with this disorder often lose their central vision, and their eyesight may become blurry or distorted. Vitelliform macular dystrophy typically does not affect side (peripheral) vision or the ability to see at night. Researchers have described two forms of vitelliform macular dystrophy with similar features. The early-onset form (known as Best disease) usually appears in childhood; the onset of symptoms and the severity of vision loss vary widely. The adult-onset form begins later, usually in mid-adulthood, and tends to cause vision loss that worsens slowly over time. The two forms of vitelliform macular dystrophy each have characteristic changes in the macula that can be detected during an eye examination. Vitelliform macular dystrophy is a rare disorder; its incidence is unknown. Mutations in the BEST1 and PRPH2 genes cause vitelliform macular dystrophy. BEST1 mutations are responsible for Best disease and for some cases of the adult-onset form of vitelliform macular dystrophy. Changes in the PRPH2 gene can also cause the adult-onset form of vitelliform macular dystrophy; however, less than a quarter of all people with this form of the condition have mutations in the BEST1 or PRPH2 gene. In most cases, the cause of the adult-onset form is unknown. The BEST1 gene provides instructions for making a protein called bestrophin. This protein acts as a channel that controls the movement of charged chlorine atoms (chloride ions) into or out of cells in the retina. Mutations in the BEST1 gene probably lead to the production of an abnormally shaped channel that cannot properly regulate the flow of chloride. Researchers have not determined how these malfunctioning channels are related to the buildup of lipofuscin in the macula and progressive vision loss. The PRPH2 gene provides instructions for making a protein called peripherin 2. This protein is essential for the normal function of light-sensing (photoreceptor) cells in the retina. Mutations in the PRPH2 gene cause vision loss by disrupting structures in these cells that contain light-sensing pigments. It is unclear why PRPH2 mutations affect only central vision in people with adult-onset vitelliform macular dystrophy. Best disease is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person has one parent with the condition. The inheritance pattern of adult-onset vitelliform macular dystrophy is uncertain. Some studies have suggested that this disorder may be inherited in an autosomal dominant pattern. It is difficult to be sure, however, because many affected people have no history of the disorder in their family, and only a small number of affected families have been reported. Boon CJ, Klevering BJ, Leroy BP, Hoyng CB, Keunen JE, den Hollander AI. The spectrum of ocular phenotypes caused by mutations in the BEST1 gene. Prog Retin Eye Res. 2009 May;28(3):187-205. doi: 10.1016/j.preteyeres.2009.04.002. Epub 2009 Apr 16. Review. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Vitelliform Macular Dystrophy Would like to obtain more info on possible treatments.", "response": "What are the treatments for vitelliform macular dystrophy?: These resources address the diagnosis or management of vitelliform macular dystrophy: - Gene Review: Gene Review: Best Vitelliform Macular Dystrophy - Genetic Testing Registry: Macular dystrophy, vitelliform, adult-onset - Genetic Testing Registry: Vitelliform dystrophy - MedlinePlus Encyclopedia: Macula (image) These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "Williams syndrome: Williams syndrome is a rare disorder that can lead to problems with development. It is passed down in families (inherited). Williams syndrome is caused by not having a copy of several genes. Parents may not have any family history of the condition. However, people with Williams syndrome have a 50% chance of passing the disorder on to each of their children. It often occurs randomly. Williams syndrome occurs in about 1 in 8,000 births. One of the 25 missing genes is the gene that produces elastin, a protein that allows blood vessels and other tissues in the body to stretch. It is likely that missing a copy of this gene results in the narrowing of blood vessels, stretchy skin, and flexible joints seen in this condition. Symptoms of Williams syndrome are: - Delayed speech that may later turn into strong speaking ability and strong learning by hearing - Developmental delay - Easily distracted, attention deficit disorder (ADD) - Feeding problems including colic, reflux, and vomiting - Inward bend of the small finger - Learning disorders - Mild to moderate intellectual disability - Personality traits including being very friendly, trusting strangers, fearing loud sounds or physical contact, and being interested in music - Short, compared to the rest of the person's family - Sunken chest The face and mouth of someone with Williams syndrome may show: - A flattened nasal bridge with small upturned nose - Long ridges in the skin that run from the nose to the upper lip - Prominent lips with an open mouth - Skin that covers the inner corner of the eye - Partially missing teeth, defective tooth enamel, or small, widely spaced teeth Signs include: - Narrowing of some blood vessels - Farsightedness - High blood calcium level that may cause seizures and rigid muscles - High blood pressure - Slack joints that may change to stiffness as the person gets older - Unusual star-like pattern in iris of the eye Tests for Williams syndrome include: - Blood pressure check - Blood test for a missing piece of chromosome 7 (FISH test) - Echocardiography combined with Doppler ultrasound - Kidney ultrasound There is no cure for Williams syndrome. Avoid taking extra calcium and vitamin D. Treat high blood calcium, if it occurs. Blood vessel narrowing can be a major health problem. It is treated based on how severe it is. Physical therapy is helpful to people with joint stiffness. Developmental and speech therapy can also help. For example, having strong verbal skills can help make up for other weaknesses. Other treatments are based on the person's symptoms. It can help to have treatment coordinated by a geneticist who is experienced with Williams syndrome. A support group can be helpful for emotional support and for giving and receiving practical advice. The following organization provides additional information about Williams Syndrome: Williams Syndrome Association -- www.williams-syndrome.org About 75% of people with Williams syndrome have some intellectual disability. Most people will not live as long as normal due to the various medical issues and other possible complications. Most people require full-time caregivers and often live in supervised group homes. Complications may include: - Calcium deposits in the kidney and other kidney problems - Death (in rare cases from anesthesia) - Heart failure due to narrowed blood vessels - Pain in the abdomen Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. There is no known way to prevent the genetic problem that causes Williams syndrome. Prenatal testing is available for couples with a family history of Williams syndrome who wish to conceive. Updated by: Chad Haldeman-Englert, MD, FACMG, Fullerton Genetics Center, Asheville, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "What are the complications of Williams syndrome?: - Calcium deposits in the kidney and other kidney problems - Death (in rare cases from anesthesia) - Heart failure due to narrowed blood vessels - Pain in the abdomen. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "williams sydrome conditon. i need to send me more information about Williams Syndrome and some tips how to educate people with this disorder.I hope having news from you soon!!thank you", "response": "Williams syndrome (When to Contact a Medical Professional): Many of the symptoms and signs of Williams syndrome may not be obvious at birth. Call your health care provider if your child has features similar to those of Williams syndrome. Seek genetic counseling if you have a family history of Williams syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "Lewy body dementia (Overview): Lewy body dementia, also known as dementia with Lewy bodies, is the second most common type of progressive dementia after Alzheimer's disease dementia. Protein deposits, called Lewy bodies, develop in nerve cells in the brain regions involved in thinking, memory and movement (motor control). Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia may experience visual hallucinations, and changes in alertness and attention. Other effects include Parkinson's disease-like symptoms such as rigid muscles, slow movement and tremors. Lewy body dementia care at Mayo Clinic. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "What are the treatments for Dementia With Lewy Bodies?: There is no cure for DLB. Treatments are aimed at controlling the cognitive, psychiatric, and motor symptoms of the disorder. Acetylcholinesterase inhibitors, such as donepezil and rivastigmine, are primarily used to treat the cognitive symptoms of DLB, but they may also be of some benefit in reducing the psychiatric and motor symptoms. Doctors tend to avoid prescribing antipsychotics for hallucinatory symptoms of DLB because of the risk that neuroleptic sensitivity could worsen the motor symptoms. Some individuals with DLB may benefit from the use of levodopa for their rigidity and loss of spontaneous movement. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "Would appreciate any good info on Lewy Body Dementia, we need to get people aware of this dreadful disease, all they talk about is alzheimers. Thank you", "response": "Lewy body dementia (Risk factors): A few factors seem to increase the risk of developing Lewy body dementia, including: - Being older than 60 - Being male - Having a family member with Lewy body dementia or Parkinson's disease Research has indicated that depression is also associated with Lewy body dementia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "Cri du chat syndrome (Summary): Cri du chat syndrome is a group of symptoms that result from missing a piece of chromosome number 5. The syndrome's name is based on the infant's cry, which is high-pitched and sounds like a cat. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "Cri du chat syndrome (Causes): Cri du chat syndrome is rare. It is caused by a missing piece of chromosome 5. Most cases are believed to occur during the development of the egg or sperm. A small number of cases occur when a parent passes a different, rearranged form of the chromosome to their child. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "would you help me to fine article or jurnal about Cri du chat syndrome", "response": "cri-du-chat syndrome (Genetic Changes): Cri-du-chat syndrome is caused by a deletion of the end of the short (p) arm of chromosome 5. This chromosomal change is written as 5p-. The size of the deletion varies among affected individuals; studies suggest that larger deletions tend to result in more severe intellectual disability and developmental delay than smaller deletions. The signs and symptoms of cri-du-chat syndrome are probably related to the loss of multiple genes on the short arm of chromosome 5. Researchers believe that the loss of a specific gene, CTNND2, is associated with severe intellectual disability in some people with this condition. They are working to determine how the loss of other genes in this region contributes to the characteristic features of cri-du-chat syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is cystic fibrosis", "response": "Cystic fibrosis - resources: The following organizations are good resources for information on cystic fibrosis: - Cystic Fibrosis Foundation -- www.cff.org - March of Dimes -- www.marchofdimes.org/baby/cystic-fibrosis-and-your-baby.aspx - National Heart, Lung, and Blood Institute -- www.nhlbi.nih.gov/health/health-topics/topics/cf - US National Library of Medicine, Genetics Home Reference -- ghr.nlm.nih.gov/condition/cystic-fibrosis Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is cystic fibrosis", "response": "What is cystic fibrosis?: Cystic fibrosis is an inherited disease characterized by the buildup of thick, sticky mucus that can damage many of the body's organs. The disorder's most common signs and symptoms include progressive damage to the respiratory system and chronic digestive system problems. The features of the disorder and their severity varies among affected individuals. Mucus is a slippery substance that lubricates and protects the linings of the airways, digestive system, reproductive system, and other organs and tissues. In people with cystic fibrosis, the body produces mucus that is abnormally thick and sticky. This abnormal mucus can clog the airways, leading to severe problems with breathing and bacterial infections in the lungs. These infections cause chronic coughing, wheezing, and inflammation. Over time, mucus buildup and infections result in permanent lung damage, including the formation of scar tissue (fibrosis) and cysts in the lungs. Most people with cystic fibrosis also have digestive problems. Some affected babies have meconium ileus, a blockage of the intestine that occurs shortly after birth. Other digestive problems result from a buildup of thick, sticky mucus in the pancreas. The pancreas is an organ that produces insulin (a hormone that helps control blood sugar levels). It also makes enzymes that help digest food. In people with cystic fibrosis, mucus blocks the ducts of the pancreas, reducing the production of insulin and preventing digestive enzymes from reaching the intestines to aid digestion. Problems with digestion can lead to diarrhea, malnutrition, poor growth, and weight loss. In adolescence or adulthood, a shortage of insulin can cause a form of diabetes known as cystic fibrosis-related diabetes mellitus (CFRDM). Cystic fibrosis used to be considered a fatal disease of childhood. With improved treatments and better ways to manage the disease, many people with cystic fibrosis now live well into adulthood. Adults with cystic fibrosis experience health problems affecting the respiratory, digestive, and reproductive systems. Most men with cystic fibrosis have congenital bilateral absence of the vas deferens (CBAVD), a condition in which the tubes that carry sperm (the vas deferens) are blocked by mucus and do not develop properly. Men with CBAVD are unable to father children (infertile) unless they undergo fertility treatment. Women with cystic fibrosis may experience complications in pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is fragile x syndrome", "response": "What is fragile X syndrome?: Fragile X syndrome is a genetic condition that causes a range of developmental problems including learning disabilities and cognitive impairment. Usually, males are more severely affected by this disorder than females. Affected individuals usually have delayed development of speech and language by age 2. Most males with fragile X syndrome have mild to moderate intellectual disability, while about one-third of affected females are intellectually disabled. Children with fragile X syndrome may also have anxiety and hyperactive behavior such as fidgeting or impulsive actions. They may have attention deficit disorder (ADD), which includes an impaired ability to maintain attention and difficulty focusing on specific tasks. About one-third of individuals with fragile X syndrome have features of autism spectrum disorders that affect communication and social interaction. Seizures occur in about 15 percent of males and about 5 percent of females with fragile X syndrome. Most males and about half of females with fragile X syndrome have characteristic physical features that become more apparent with age. These features include a long and narrow face, large ears, a prominent jaw and forehead, unusually flexible fingers, flat feet, and in males, enlarged testicles (macroorchidism) after puberty. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how common is fragile x syndrome", "response": "Fragile X Syndrome (How is the FMR1 mutation related to Fragile X-associated disorders?): Fragile X syndrome and its associated conditions are caused by changes (mutations) in the FMR1 gene found on the X chromosome. This mutation affects how the body makes the Fragile X Mental Retardation Protein, or FMRP. The mutation causes the body to make only a little bit or none of the protein, which can cause the symptoms of Fragile X. In a gene, the information for making a protein has two parts: the introduction, and the instructions for making the protein itself. Researchers call the introduction the promoter because of how it helps to start the process of building the protein. The promoter part of the FMR1 gene includes many repeats—repeated instances of a specific DNA sequence called the CGG sequence. A normal FMR1 gene has between 6 and 40 repeats in the promoter; the average is 30 repeats. People with between 55 and 200 repeats have a premutation of the gene. The premutation may cause the gene to not work properly, but it does not cause intellectual and developmental disability (IDD). The premutation is linked to the disorders FXPOI and FXTAS. However, not all people with the premutation show symptoms of FXPOI or FXTAS. People with 200 or more repeats in the promoter part of the gene have a full mutation, meaning the gene might not work at all. People with a full mutation often have Fragile X syndrome. The number of repeats, also called the “size of the mutation,” affects the type of symptoms and how serious the symptoms of Fragile X syndrome will be. Inheriting Fragile X Syndrome Fragile X syndrome is inherited, which means it is passed down from parents to children. Anyone with the FMR1 gene mutation can pass it to their children. However, a person who inherits the gene mutation may not develop Fragile X syndrome. Males will pass it down to all of their daughters and not their sons. Females have a 50/50 chance to pass it along to both their sons and daughters. In some cases, an FMR1 premutation can change to a full mutation when it is passed from parent to child. Read more about how FMR1 changes as it is passed from parent to child. « Condition Information What causes it? ». If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia (Prevention): Most causes of dementia are not preventable. The risk of vascular dementia may be reduced by preventing strokes through: - Eating healthy foods - Exercising - Quitting smoking - Controlling high blood pressure - Managing diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia - home care (Information): A loved one with dementia will need support in the home as the disease gets worse. You can help by trying to understand how the person with dementia perceives his or her world. Give the person a chance to talk about any challenges and take part in his or her own daily care. Start by talking with your loved one's health care provider. Ask how you can: - Help the person stay calm and oriented - Make dressing and grooming easier - Talk to the person - Help with memory loss - Manage behavior and sleep problems Tips for reducing confusion in people with dementia include: - Have familiar objects and people around. - Keep lights on at night. - Use reminders, notes, lists of routine tasks, or directions for daily activities. - Stick to a simple activity schedule. Taking regular walks with a caregiver can help improve communication skills and prevent wandering. Calming music may reduce wandering and restlessness, ease anxiety, and improve sleep and behavior. People with dementia should have their eyes and ears checked. If problems are found, hearing aids, glasses, or cataract surgery may be needed. People with dementia should also have regular driving tests. At some point, it won't be safe for them to continue to drive. This may not be an easy conversation, so seek help from their provider and other family members. State laws vary on the ability of a person with dementia to continue to drive. Supervised meals can help with feeding. People with dementia often forget to eat and drink, and can become dehydrated as a result. Talk to the provider about the need for extra calories due to increased physical activity from restlessness and wandering. Also talk to the provider about: - Watching for risk of choking and what to do if choking occurs - How to increase safety in the home - How to prevent falls - Ways to improve bathroom safety The Alzheimer's Association's Safe Return Program requires people with dementia to wear an identification bracelet. If they wander, their caregiver can contact the police and the national Safe Return office, where information about them is stored and shared nationwide. Eventually, people with dementia may need 24-hour monitoring and assistance to provide a safe environment, control aggressive or agitated behavior, and meet their needs. LONG-TERM CARE A person with dementia may need monitoring and help at home or in an institution. Possible options include: - Adult day care - Boarding homes - Nursing homes - In-home care Many organizations are available to help you care for a person with dementia. They include: - Adult protective services - Community resources - Local or state government departments of aging - Visiting nurses or aides - Volunteer services In some communities, dementia-related support groups may be available. Family counseling can help family members cope with home care. Advance directives, power of attorney, and other legal actions may make it easier to decide on care for the person with dementia. Seek legal advice early, before the person is unable to make these decisions. There are support groups that can provide information and resources for people with Alzheimer disease and their caregivers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i prevent myself from having dementia", "response": "Dementia - home care: Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, and behavior. A loved one with dementia will need support in the home as the disease gets worse. You can help by trying to understand how the person with dementia perceives his or her world. Give the person a chance to talk about any challenges and take part in his or her own daily care. Start by talking with your loved one's health care provider. Ask how you can: - Help the person stay calm and oriented - Make dressing and grooming easier - Talk to the person - Help with memory loss - Manage behavior and sleep problems Tips for reducing confusion in people with dementia include: - Have familiar objects and people around. - Keep lights on at night. - Use reminders, notes, lists of routine tasks, or directions for daily activities. - Stick to a simple activity schedule. Taking regular walks with a caregiver can help improve communication skills and prevent wandering. Calming music may reduce wandering and restlessness, ease anxiety, and improve sleep and behavior. People with dementia should have their eyes and ears checked. If problems are found, hearing aids, glasses, or cataract surgery may be needed. People with dementia should also have regular driving tests. At some point, it won't be safe for them to continue to drive. This may not be an easy conversation, so seek help from their provider and other family members. State laws vary on the ability of a person with dementia to continue to drive. Supervised meals can help with feeding. People with dementia often forget to eat and drink, and can become dehydrated as a result. Talk to the provider about the need for extra calories due to increased physical activity from restlessness and wandering. Also talk to the provider about: - Watching for risk of choking and what to do if choking occurs - How to increase safety in the home - How to prevent falls - Ways to improve bathroom safety The Alzheimer's Association's Safe Return Program requires people with dementia to wear an identification bracelet. If they wander, their caregiver can contact the police and the national Safe Return office, where information about them is stored and shared nationwide. Eventually, people with dementia may need 24-hour monitoring and assistance to provide a safe environment, control aggressive or agitated behavior, and meet their needs. LONG-TERM CARE A person with dementia may need monitoring and help at home or in an institution. Possible options include: - Adult day care - Boarding homes - Nursing homes - In-home care Many organizations are available to help you care for a person with dementia. They include: - Adult protective services - Community resources - Local or state government departments of aging - Visiting nurses or aides - Volunteer services In some communities, dementia-related support groups may be available. Family counseling can help family members cope with home care. Advance directives, power of attorney, and other legal actions may make it easier to decide on care for the person with dementia. Seek legal advice early, before the person is unable to make these decisions. There are support groups that can provide information and resources for people with Alzheimer disease and their caregivers. Updated by: Daniel Kantor, MD, Kantor Neurology, Coconut Creek, FL and Immediate Past President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i stop using rasagiline", "response": "How should Rasagiline be used and what is the dosage?: Rasagiline comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take rasagiline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take rasagiline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of rasagiline and may increase your dose based upon your body's response to this medication. Do not stop taking rasagiline without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking rasagiline, you may experience withdrawal symptoms such as a fever; muscle stiffness; unsteadiness, wobbliness, or lack of coordination; or changes in consciousness. Tell your doctor if you experience any of these symptoms when your dose of rasagiline is decreased. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do i stop using rasagiline", "response": "Rasagiline (What special precautions should I follow?): Before taking rasagiline, - tell your doctor and pharmacist if you are allergic to rasagiline, any other medications, or any of the ingredients in rasagiline tablets. Ask your pharmacist for a list of the ingredients. - tell your doctor if you are taking cough and cold products containing dextromethorphan (DM; Delsym, Hold, Robitussin CoughGels, Vicks 44 Cough Relief, in Robitussin DM, others), cyclobenzaprine (Flexeril), meperidine (Demerol), methadone (Dolophine, Methadose), propoxyphene (Darvon, in Darvocet-N, others), St. John's wort, or tramadol (Ultram, in Ultracet). Also tell your doctor if you are taking MAO inhibitors such as phenelzine (Nardil), selegiline (Eldepryl), or tranylcypromine (Parnate) or have stopped taking them within the past two weeks. Your doctor may tell you not to take rasagiline if you are taking one or more of these medications. - tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphetamines (Adderall, Dexedrine, DextroStat); antidepressants; cimetidine (Tagamet); decongestants placed in the eye or nose; diet or weight-control products containing ephedrine; fluoroquinolone antibiotics including ciprofloxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), norfloxacin (Noroxin), and ofloxacin (Floxin); fluvoxamine (Luvox); medications to treat asthma; medications to treat high blood pressure; medications to treat mental illness; medications to treat pain; phenylpropanolamine (not available in the U.S.); pseudoephedrine (PediaCare, Sudafed, Suphedrine, others); and ticlopidine (Ticlid). Tell your doctor if you are taking fluoxetine (Prozac, Sarafem) or have stopped taking it within the past 5 weeks. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. - tell your doctor if you have or have ever had high blood pressure, mental illness or psychosis;kidney, or liver disease. - tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking rasagiline, call your doctor. - you should know that rasagiline may cause dizziness, lightheadedness, nausea, sweating, and fainting when you get up too quickly from a lying position. This is more common during the first 2 months of taking rasagiline. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. - you should know that rasagiline may cause serious, life-threatening high blood pressure when taken with certain medications or foods. Carefully follow your doctor's instructions about medications and foods to be avoided. Call your doctor right away if you have a severe headache, blurred vision, or any of the other symptoms listed below as serious side effects. - you should know that people who have Parkinson's disease have a higher risk of melanoma (a type of skin cancer) than people who do not have Parkinson's disease. It is not known whether this increased risk is caused by Parkinson's disease, medications used for Parkinson's disease such as rasagiline, or other factors. You should have regular visits with a dermatologist to examine your skin for melanoma. - you should know that some people who took rasagiline or similar medications to treat Parkinson's disease experienced intense urges to gamble, increased sexual urges, and other urges that they were unable to control. Tell your doctor if you experience new or increased gambling urges, increased sexual urges, or other intense urges while taking rasagiline. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Drugs and Young People (Summary): Summary Drug abuse is a serious public health problem. It affects almost every community and family in some way. Drug abuse in children and teenagers may pose a greater hazard than in older people. This is because their brains are not yet fully developed. As a result, the brains of young people may be more susceptible to drug abuse and addiction than adult brains. Abused drugs include - Amphetamines - Anabolic steroids - Club drugs - Cocaine - Heroin - Inhalants - Marijuana - Prescription drugs There are different types of treatment for drug abuse. But it is better to prevent drug abuse in the first place. NIH: National Institute on Drug Abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Where to find support for people with Diabetes?: Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do people get diabetes", "response": "Diabetes and nerve damage (Causes): In people with diabetes, the body's nerves can be damaged by decreased blood flow and a high blood sugar level. This condition is more likely when the blood sugar level is not well controlled. About one half of people with diabetes develop nerve damage. Symptoms often do not begin until many years after diabetes has been diagnosed. Some people who have diabetes that develops slowly already have nerve damage when they are first diagnosed. People with diabetes are also at higher risk for other nerve problems not caused by their diabetes. These other nerve problems won't have the same symptoms and will progress in a different manner than nerve damage caused by diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "Burns (Treatment): Treatment of burns depends on the type and extent of the injuries. Most minor burns can be treated at home using over-the-counter products or aloe. They usually heal within a few weeks. For serious burns, after appropriate first aid care and wound assessment, your treatment may involve medications, wound dressings, therapy and surgery. The goals of treatment are to control pain, remove dead tissue, prevent infection, reduce scarring, regain function and address emotional needs. You may need months of additional treatments and therapy. This may be done during a hospital stay, on an outpatient basis or at home. Factors affecting this choice include your wishes, other conditions and abilities, such as whether you're able to change bandages. Medications and wound healing products For major burns, various medications and products are used to encourage healing. - Water-based treatments. Your care team may use techniques such as ultrasound mist therapy to clean and stimulate the wound tissue. - Fluids to prevent dehydration. You may need intravenous (IV) fluids to prevent dehydration and organ failure. - Pain and anxiety medications. Healing burns can be incredibly painful. You may need morphine and anti-anxiety medications - particularly for dressing changes. - Burn creams and ointments. Your care team can select from a variety of topical products for wound healing. These help keep the wound moist, reduce pain, prevent infection and speed healing. - Dressings. Your care team may also use various specialty wound dressings. These create a moist environment that fights infection and helps the burn heal. - Drugs that fight infection. If you develop an infection, you may need IV antibiotics. - Tetanus shot. Your doctor might recommend a tetanus shot after a burn injury. Physical and occupational therapy If the burned area is large, especially if it covers any joints, you may need physical therapy exercises. These can help stretch the skin so the joints can remain flexible. Other types of exercises can improve muscle strength and coordination. And occupational therapy may help if you have difficulty doing your normal daily activities. Surgical and other procedures You may need one or more of the following procedures: - Breathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs. - Tube feeding. Your metabolism goes into overdrive when your body starts trying to heal your burns. To provide adequate nutrition for this task, you doctor may thread a feeding tube through your nose to your stomach. - Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. A scab (eschar) that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar in several places to relieve this pressure. This procedure is called decompression. - Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from cadavers or pigs can be used as a temporary solution. - Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "What to do for Radiation sickness?: Radiation sickness results when humans (or other animals) are exposed to very large doses of ionizing radiation. Radiation exposure can occur as a single large exposure (acute), or a series of small exposures spread over time (chronic). Exposure may be accidental or intentional (as in radiation therapy). Radiation sickness is generally associated with acute exposure and has a characteristic set of symptoms that appear in an orderly fashion. Chronic exposure is usually associated with delayed medical problems such as cancer and premature aging, which may happen over a long period of time. The risk of cancer depends on the dose and begins to build up, even with very low doses. There is no \"minimum threshold\". Exposure from x-rays or gamma rays is measured in units of roentgens. For example: - Total body exposure of 100 roentgens/rad or 1 Gray unit (Gy) causes radiation sickness. - Total body exposure of 400 roentgens/rad (or 4 Gy) causes radiation sickness and death in half of the individuals who are exposed. Without medical treatment, nearly everyone who receives more than this amount of radiation will die within 30 days. - 100,000 roentgens/rad (1,000 Gy) causes almost immediate unconsciousness and death within an hour. The severity of symptoms and illness (acute radiation sickness) depends on the type and amount of radiation, how long you were exposed, and which part of the body was exposed. Symptoms of radiation sickness may occur immediately after exposure, or over the next few days, weeks, or months. Bone marrow and the gastrointestinal tract are especially sensitive to radiation injury. Children and babies still in the womb are more likely to be severely injured by radiation. Because it is difficult to determine the amount of radiation exposure from nuclear accidents, the best signs of the severity of the exposure are: the length of time between the exposure and the onset of symptoms, the severity of symptoms, and severity of changes in white blood cells. If a person vomits less than an hour after being exposed, that usually means the radiation dose received is very high and death may be expected. Children who receive radiation treatments or who are accidentally exposed to radiation will be treated based on their symptoms and their blood cell counts. Frequent blood studies are necessary and require a small puncture through the skin into a vein to obtain blood samples. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do we treat the burns caused by radiation?", "response": "What to do for Radiation sickness?: Unfortunately, giving first aid to radiation victims may expose rescue personnel to radiation unless they are properly protected. Victims must be decontaminated as part of the resuscitation process so that they do not cause radiation injury to others. This may complicate the first aid and resuscitation process. - Check the person's breathing and pulse. - Start CPR, if necessary. - Remove the person's clothing and place the items in a sealed container. This stops ongoing contamination. - Vigorously wash the victim with soap and water. - Dry the victim and wrap with a soft, clean blanket. - Call for emergency medical help or take the person to nearest emergency medical facility if you can do so safely - REPORT EXPOSURE TO EMERGENCY OFFICIALS. If symptoms occur during or after medical radiation treatments: - Tell the provider or seek medical treatment. - Handle affected areas gently. - Treat symptoms or illnesses as recommended by the provider. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you administer lanreotide", "response": "How should Lanreotide Injection be used and what is the dosage?: Lanreotide comes as a long-acting solution (liquid) to be injected subcutaneously (under the skin) into the upper outer area of your buttock by a doctor or nurse. Lanreotide long-acting injection is usually injected once every 4 weeks. Ask your doctor or pharmacist to explain any part you do not understand. Your doctor will probably adjust your dose or the length of time between doses depending on your lab results. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you administer lanreotide", "response": "Lanreotide Injection (What special precautions should I follow?): Before receiving lanreotide injection, - tell your doctor and pharmacist if you are allergic to lanreotide injection, any other medications, or any of the ingredients in lanreotide injection. Ask your pharmacist for a list of the ingredients. - tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); bromocriptine (Cycloset, Parlodel); cyclosporine (Gengraf, Neoral, Sandimmune); insulin and oral medications for diabetes; quinidine (in Nuedexta), or terfenadine (no longer available in the U.S.). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. - tell your doctor if you have or have ever had diabetes, or gallbladder, heart, kidney, thyroid, or liver disease. - tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving lanreotide injection, call your doctor. - you should know that lanreotide injection may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you catch hepatitis c", "response": "What is Hepatitis C?: Hepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include: - Hepatitis A - Hepatitis B - Hepatitis D. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you catch hepatitis c", "response": "What is Hepatitis C?: Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. One type, hepatitis C, is caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth. Most people who are infected with hepatitis C don't have any symptoms for years. If you do get symptoms, you may feel as if you have the flu. You may also have jaundice, a yellowing of skin and eyes, dark-colored urine, and pale bowel movements. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you check for lupus?", "response": "Lupus: Lupus is an autoimmune disease that can affect almost every organ in the body. Symptoms of lupus can range from very mild to life-threatening. There are three main types of lupus; systemic lupus erythematosus, discoid lupus, and drug-induced lupus. [1] Symptoms may include pain or swelling in joints, muscle pain, fever, red rashes, most often on the face (also called the \"butterfly rash\"), hair loss, chest pain, sensitivity to the sun, swelling in legs or around the eyes, and feeling tired. [2] Genetics is thought to play a role in the development of lupus along with other lifestyle and environmental factors . Studies suggest that a number of different genes may be involved in determining a person’s likelihood of developing the disease, which tissues and organs are affected, and the severity of disease. Lupus is more common in young women. The treatment of lupus depends on the severity of the condition and what parts of the body are affected. Treatment may include acetaminophen, ibuprofen, antimalarial drugs, anti-inflammatory steroids, immunosuppressive drugs, and other such as BLyS-specific inhibitors ( Belimumab). [1] You can read about the signs and symptoms of lupus from MedlinePlus and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Antinuclear antibody positivity - Antiphospholipid antibody positivity - Arthritis - Autosomal dominant inheritance - Cutaneous photosensitivity - Hemolytic anemia - Leukopenia - Nephritis - Pericarditis - Pleuritis - Psychosis - Seizures - Systemic lupus erythematosus - Thrombocytopenia - View complete list of signs and symptoms... The Lupus Foundation of American has a page called Is lupus hereditary? that provides a good overview. They also have a Genetics page for all of their content tagged as related to genetics. Medscape Reference has an in-depth review of the genetics of lupus that was written for healthcare professionals but can be useful to anyone looking for detailed information. You may have to register to view the article, but registration is free. For information on the treatment of lupus, you can read the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) publication called Handout on Health: Systemic Lupus Erythematosus. NIAMS is the primary NIH organization for research and information on lupus. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you check for lupus?", "response": "What is Lupus?: If you have lupus, your immune system attacks healthy cells and tissues by mistake. This can damage your joints, skin, blood vessels and organs. There are many kinds of lupus. The most common type, systemic lupus erythematosus, affects many parts of the body. Discoid lupus causes a rash that doesn't go away. Subacute cutaneous lupus causes sores after being out in the sun. Another type can be caused by medication. Neonatal lupus, which is rare, affects newborns. Anyone can get lupus, but women are most at risk. Lupus is also more common in African American, Hispanic, Asian and Native American women. The cause of lupus is not known. Lupus has many symptoms. Some common ones are - Joint pain or swelling - Muscle pain - Fever with no known cause - Fatigue - Red rashes, often on the face (also called the \"butterfly rash\") There is no one test to diagnose lupus, and it may take months or years to make the diagnosis. There is no cure for lupus, but medicines and lifestyle changes can help control it. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "Anxiety (Diagnosis): You may start by seeing your primary care doctor to find out if your anxiety could be related to your physical health. Your doctor can check for signs of an underlying medical condition that may need treatment. However, you may need to see a mental health specialist if you have severe anxiety. A psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions. A psychologist and certain other mental health professionals can diagnose anxiety and provide counseling (psychotherapy). To help diagnose an anxiety disorder and rule out other conditions, your provider may: - Give you a psychological evaluation. This involves describing your thoughts, feelings and behavior to help pinpoint a diagnosis and check for related complications. Anxiety disorders often occur along with other mental health problems - such as depression or substance abuse - which can make diagnosis more challenging. - Compare your symptoms to the criteria in the DSM-5. Many doctors use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose an anxiety disorder. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "What is Anxiety?: Fear and anxiety are part of life. You may feel anxious before you take a test or walk down a dark street. This kind of anxiety is useful - it can make you more alert or careful. It usually ends soon after you are out of the situation that caused it. But for millions of people in the United States, the anxiety does not go away, and gets worse over time. They may have chest pains or nightmares. They may even be afraid to leave home. These people have anxiety disorders. Types include - Panic disorder - Obsessive-compulsive disorder - Post-traumatic stress disorder - Phobias - Generalized anxiety disorder Treatment can involve medicines, therapy or both. NIH: National Institute of Mental Health. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you diagnose anxiety", "response": "Anxiety disorders (How are anxiety disorders diagnosed?): Your doctor or nurse will ask you questions about your symptoms and your medical history. Your doctor may also do a physical exam or other tests to rule out other health problems that could be causing your symptoms. Anxiety disorders are diagnosed when fear and dread of nonthreatening situations, events, places, or objects become excessive and are uncontrollable. Anxiety disorders are also diagnosed if the anxiety has lasted for at least six months and it interferes with social, work, family, or other aspects of daily life.2. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "Uterine prolapse (Complications): Uterine prolapse is often associated with prolapse of other pelvic organs. You might experience: - Anterior prolapse (cystocele). Weakness of connective tissue separating the bladder and vagina may cause the bladder to bulge into the vagina. Anterior prolapse is also called prolapsed bladder. - Posterior vaginal prolapse (rectocele). Weakness of connective tissue separating the rectum and vagina may cause the rectum to bulge into the vagina. You might have difficulty having bowel movements. Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude outside the body. Vaginal tissue that rubs against clothing can lead to vaginal sores (ulcers.) Rarely, the sores can become infected. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "What is Uterine prolapse?: Uterine prolapse occurs when the womb (uterus) drops down and presses into the vaginal area. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get a prolapse bladder", "response": "Anterior prolapse (cystocele) (Diagnosis): Diagnosis of anterior prolapse may involve: - A pelvic exam. You may be examined while lying down and while standing up. During the exam, your doctor looks for a tissue bulge into your vagina that indicates pelvic organ prolapse. You'll likely be asked to bear down as if during a bowel movement to see how much that affects the degree of prolapse. To check the strength of your pelvic floor muscles, you'll be asked to contract them, as if you're trying to stop the stream of urine. - Filling out a questionnaire. You may fill out a form that helps your doctor assess the degree of your prolapse and how much it affects your quality of life. Information gathered also helps guide treatment decisions. - Bladder and urine tests. If you have significant prolapse, you might be tested to see how well and completely your bladder empties. Your doctor might also run a test on a urine sample to look for signs of a bladder infection, if it seems that you're retaining more urine in your bladder than is normal after urinating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get neuromuscular disorders", "response": "Neuromuscular Disorders (Summary): Summary Neuromuscular disorders affect the nerves that control your voluntary muscles. Voluntary muscles are the ones you can control, like in your arms and legs. Your nerve cells, also called neurons, send the messages that control these muscles. When the neurons become unhealthy or die, communication between your nervous system and muscles breaks down. As a result, your muscles weaken and waste away. The weakness can lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include - Amyotrophic lateral sclerosis - Multiple sclerosis - Myasthenia gravis - Spinal muscular atrophy Many neuromuscular diseases are genetic, which means they run in families or there is a mutation in your genes. Sometimes, an immune system disorder can cause them. Most of them have no cure. The goal of treatment is to improve symptoms, increase mobility and lengthen life. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get neuromuscular disorders", "response": "Myasthenia gravis (Summary): Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get pulmonary hypertension", "response": "Pulmonary hypertension (Causes): The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: - Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis - Birth defects of the heart - Blood clots in the lung (pulmonary embolism) - Heart failure - Heart valve disease - HIV infection - Low oxygen levels in the blood for a long time (chronic) - Lung disease, such as COPD or pulmonary fibrosis - Medicines (for example, certain diet drugs) - Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you get pulmonary hypertension", "response": "Portal hypertension (Summary): Portal hypertension is abnormally high blood pressure in branches of the portal vein, the large vein that brings blood from the intestine to the liver. Portal hypertension itself does not cause symptoms, but complications from the condition can lead to an enlarged abdomen, abdominal discomfort, confusion, drowsiness and internal bleeding. It may be caused by a variety of conditions, but cirrhosis is the most common cause in Western countries. [1] [2] Treatment is generally directed toward the cause of the condition, although emergency treatment is sometimes needed for serious complications. [2]. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "High cholesterol (Diagnosis): A blood test to check cholesterol levels - called a lipid panel or lipid profile - typically reports: - Total cholesterol - LDL cholesterol - HDL cholesterol - Triglycerides - a type of fat in the blood For the most accurate measurements, don't eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken. Interpreting the numbers In the United States, cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In Canada and many European countries, cholesterol levels are measured in millimoles per liter (mmol/L). To interpret your test results, use these general guidelines. Children and cholesterol testing For most children, the National Heart, Lung, and Blood Institute recommends one cholesterol screening test between the ages of 9 and 11, and another cholesterol screening test between the ages of 17 and 21. Cholesterol testing is usually avoided between the ages of 12 and 16 because false-negative results are more likely within this age group. If your child has a family history of early-onset heart disease or a personal history of obesity or diabetes, your doctor may recommend earlier or more frequent cholesterol testing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "How to diagnose High blood cholesterol levels?: A cholesterol test is done to diagnose a lipid disorder. Some guidelines recommend having your first screening cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.) It is important to work with your health care provider to set your cholesterol goals. Newer guidelines steer doctors away from targeting specific levels of cholesterol. Instead, it recommends different medicines and doses depending on a person's history and risk factor profile. General targets are: - LDL: 70 to 130 mg/dL (lower numbers are better) - HDL: more than 50 mg/dL (high numbers are better) - Total cholesterol: less than 200 mg/dL (lower numbers are better) - Triglycerides: 10 to 150 mg/dL (lower numbers are better) If your cholesterol results are abnormal, you may also have other tests such as: - Blood sugar (glucose) test to look for diabetes - Kidney function tests - Thyroid function tests to look for an underactive thyroid gland. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how do you test for cholesterol level in your body", "response": "Cholesterol testing and results (When Should You Be Tested?): Everyone should have their first screening test by age 35 for men, and age 45 for women. Some guidelines recommend starting at age 20. You should have a cholesterol test done at an earlier age if you have: - Diabetes - Heart disease - Stroke - High blood pressure - A strong family history of heart disease Follow-up testing should be done: - Every 5 years if your results were normal - More often for people with diabetes, high blood pressure, heart disease, stroke, or blood flow problems to the legs or feet - Every year or so if you are taking medicines to control high cholesterol. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is a heart attack treated", "response": "What is Heart Attack?: A heart attack occurs when the supply of blood and oxygen to an area of the heart muscle is blocked, usually by a blood clot in a coronary artery. If the blockage is not treated within a few hours, the heart muscle will be permanently damaged and replaced by scar tissue. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "Asthma (Diagnosis): Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor also will figure out the severity of your asthma—that is, whether it's intermittent, mild, moderate, or severe. The level of severity will determine what treatment you'll start on. You may need to see an asthma specialist if: You need special tests to help diagnose asthma You've had a life-threatening asthma attack You need more than one kind of medicine or higher doses of medicine to control your asthma, or if you have overall problems getting your asthma well controlled You're thinking about getting allergy treatments Medical and Family Histories Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night. Your doctor also may want to know what factors seem to trigger your symptoms or worsen them. For more information about possible asthma triggers, go to \"What Are the Signs and Symptoms of Asthma?\" Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Physical Exam Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions (such as eczema). Keep in mind that you can still have asthma even if you don't have these signs on the day that your doctor examines you. Diagnostic Tests Lung Function Test Your doctor will use a test called spirometry (spi-ROM-eh-tre) to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicine and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma. Other Tests Your doctor may recommend other tests if he or she needs more information to make a diagnosis. Other tests may include: Allergy testing to find out which allergens affect you, if any. A test to measure how sensitive your airways are. This is called a bronchoprovocation (brong-KO-prav-eh-KA-shun) test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in. A test to show whether you have another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea. A chest x ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms. Diagnosing Asthma in Young Children Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it's hard to tell whether a child has asthma or another childhood condition. This is because the symptoms of asthma also occur with other conditions. Also, many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they're 6 years old. A child may wheeze because he or she has small airways that become even narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds. A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if: One or both parents have asthma The child has signs of allergies, including the allergic skin condition eczema The child has allergic reactions to pollens or other airborne allergens The child wheezes even when he or she doesn't have a cold or other infection The most certain way to diagnose asthma is with a lung function test, a medical history, and a physical exam. However, it's hard to do lung function tests in children younger than 5 years. Thus, doctors must rely on children's medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4–6 week trial of asthma medicines to see how well a child responds. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "What is Asthma?: Espaol Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7million of these people are children. Overview To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. The airways tend to react strongly to certain inhaled substances. When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways. This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed. Asthma Sometimes asthma symptoms are mild and go away on their own or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse. When symptoms get more intense and/or more symptoms occur, you're having an asthma attack. Asthma attacks also are called flareups or exacerbations (eg-zas-er-BA-shuns). Treating symptoms when you first notice them is important. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can be fatal. Outlook Asthma has no cure. Even when you feel fine, you still have the disease and it can flare up at any time. However, with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma. If you have asthma, you can take an active role in managing the disease. For successful, thorough, and ongoing treatment, build strong partnerships with your doctor and other health care providers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is asthma diagnosed", "response": "What is Asthma?: Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "Trisomy 18 (Exams and Tests): An exam during pregnancy may show an unusually large uterus and extra amniotic fluid. There may be an unusually small placenta when the baby is born. A physical exam of the infant may show unusual fingerprint patterns. X-rays may show a short breast bone. Chromosome studies will show trisomy 18. The chromosome abnormality may be present in every cell or present in only a certain percentage of the cells (called mosaicism). Studies may also show part of the chromosome in some cells. Rarely, part of the chromosome 18 becomes attached to another chromosome. This is called translocation. Other signs include: - Hole, split, or cleft in the iris of the eye (coloboma) - Separation between the left and right side of the abdominal muscle (diastasis recti) - Umbilical hernia or inguinal hernia There are often signs of congenital heart disease, such as: - Atrial septal defect (ASD) - Patent ductus arteriosus (PDA) - Ventricular septal defect (VSD) Tests may also show kidney problems, including: - Horseshoe kidney - Hydronephrosis - Polycystic kidney. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "What is Down syndrome?: Down syndrome is a chromosome disorder associated with intellectual disability, a characteristic facial appearance, and low muscle tone in infancy. The degree of intellectual disability varies from mild to moderate. People with Down syndrome may also be born with various health concerns such as heart defects or digestive abnormalities. They also have an increased risk to develop gastroesophageal reflux, celiac disease, hypothyroidism, hearing and vision problems, leukemia, and Alzheimer disease. Down syndrome is caused by having three copies of chromosome 21 (called trisomy 21) instead of the usual two copies and is typically not inherited. Treatment focuses on the specific symptoms in each person. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is edward's syndrome diagnosed", "response": "Trisomy 18 (Prevention): Tests can be done during pregnancy to find out if the child has this syndrome. Genetic testing is recommended for parents who have a child with this syndrome and who want to have more children. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "Generalized anxiety disorder (Diagnosis): To help diagnose generalized anxiety disorder, your doctor or mental health professional may: - Do a physical exam to look for signs that your anxiety might be linked to medications or an underlying medical condition - Order blood or urine tests or other tests, if a medical condition is suspected - Ask detailed questions about your symptoms and medical history - Use psychological questionnaires to help determine a diagnosis - Use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "What is Generalized anxiety disorder?: Generalized anxiety disorder (GAD) is a mental health condition in which a person is often worried or anxious about many things and finds it hard to control this anxiety. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is generalized anxiety disorder diagnosed", "response": "Generalized anxiety disorder (Risk factors): Women are diagnosed with generalized anxiety disorder somewhat more often than men are. The following factors may increase the risk of developing generalized anxiety disorder: - Personality. A person whose temperament is timid or negative or who avoids anything dangerous may be more prone to generalized anxiety disorder than others are. - Genetics. Generalized anxiety disorder may run in families. - Experiences. People with generalized anxiety disorder may have a history of significant life changes, traumatic or negative experiences during childhood, or a recent traumatic or negative event. Chronic medical illnesses or other mental health disorders may increase risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is gonorrhea diagnosed", "response": "Gonorrhea (Do I need to get tested for gonorrhea?): You also need to get tested if you have any symptoms of gonorrhea. Testing is very important, because women with untreated gonorrhea can develop serious health problems. If you are tested for gonorrhea, you also need to get tested for other STIs, including chlamydia, syphilis, and HIV. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is gonorrhea diagnosed", "response": "What is Gonorrhea?: Gonorrhea is a common sexually transmitted infection (STI). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is gonorrhea diagnosed", "response": "What is Gonorrhea?: Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is hemophilia treated", "response": "Hemophilia A (Treatment): People with inherited hemophilia A require life-long care, preferably through a specialized hemophilia treatment center. Although there is no cure for hemophilia A, current treatments usually work well. Treatment primarily consists of replacing the missing clotting factor VIII ( replacement therapy) and preventing complications that are associated with the disorder. The type and frequency of treatment often depends on the severity of the disorder in each person. People with mild or moderate hemophilia A may be treated with replacement therapy as needed (for example, when a specific bleeding episode occurs). This is called episodic therapy. Some people with mild hemophilia A may be treated with desmopressin (DDAVP). Desmopressin raises the levels of factor VIII in the blood and may be taken intravenously or through a nasal spray. Drugs known as antifibrinolytics, which slow the breakdown of clotting factors in the blood, can also be used to treat those with a mild form of the disorder. Some people with severe hemophilia A may receive periodic factor VIII infusions to prevent bleeding episodes and associated complications such as joint damage. This is referred to as prophylactic therapy. People can be trained to give infusions at home. This is especially important for people with severe disease because the infusion works the best within one hour of a bleeding episode. In general, rapid treatment is important because it reduces pain and damage to the joints, muscles or other affected tissues or organs . [5] Management Guidelines GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions. The National Hemophilia Foundation Web site posts the guidelines for management of pregnancy and delivery of women with bleeding disorders and carriers of hemophilia A and B. Click on the link to view the guidelines. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal National Library of Medicine Drug Information Portal Medline Plus Health Information National Library of Medicine Drug Information Portal Medline Plus Health Information. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is hemophilia treated", "response": "What are hemophilia?: Hemophilia is a bleeding disorder that slows the blood clotting process. People with this condition experience prolonged bleeding or oozing following an injury, surgery, or having a tooth pulled. In severe cases of hemophilia, continuous bleeding occurs after minor trauma or even in the absence of injury (spontaneous bleeding). Serious complications can result from bleeding into the joints, muscles, brain, or other internal organs. Milder forms of hemophilia do not necessarily involve spontaneous bleeding, and the condition may not become apparent until abnormal bleeding occurs following surgery or a serious injury. The major types of this condition are hemophilia A (also known as classic hemophilia or factor VIII deficiency) and hemophilia B (also known as Christmas disease or factor IX deficiency). Although the two types have very similar signs and symptoms, they are caused by mutations in different genes. People with an unusual form of hemophilia B, known as hemophilia B Leyden, experience episodes of excessive bleeding in childhood but have few bleeding problems after puberty. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is hemophilia treated", "response": "Hemophilia A (Treatment): Treatment includes replacing the missing clotting factor. You will receive factor VIII concentrates. How much you get depends on: - Severity of bleeding - Site of bleeding - Your weight and height Mild hemophilia may be treated with desmopressin (DDAVP). This medicine helps the body release factor VIII that is stored within the lining of blood vessels. To prevent a bleeding crisis, people with hemophilia and their families can be taught to give factor VIII concentrates at home at the first signs of bleeding. People with severe forms of the disease may need regular preventive treatment. DDAVP or factor VIII concentrate may also be needed before having dental extractions or surgery. You should get the hepatitis B vaccine. People with hemophilia are more likely to get hepatitis B because they may receive blood products. Some people with hemophilia A develop antibodies to factor VIII. These antibodies are called inhibitors. The inhibitors attack factor VIII so that it no longer works. In such cases, a man-made clotting factor called VIIa can be given. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is congenital heart disease passed down", "response": "What is Congenital heart disease?: Congenital heart diseaseis a problem with the heart's structure and function that is present at birth. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is congenital heart disease passed down", "response": "Facts About Color Blindness (How Genes are Inherited): Genes are bundled together on structures called chromosomes. One copy of each chromosome is passed by a parent at conception through egg and sperm cells. The X and Y chromosomes, known as sex chromosomes, determine whether a person is born female (XX) or male (XY) and also carry other traits not related to gender. In X-linked inheritance, the mother carries the mutated gene on one of her X chromosomes and will pass on the mutated gene to 50 percent of her children. Because females have two X chromosomes, the effect of a mutation on one X chromosome is offset by the normal gene on the other X chromosome. In this case the mother will not have the disease, but she can pass on the mutated gene and so is called a carrier. If a mother is a carrier of an X-linked disease (and the father is not affected), there is a: - 1 in 2 chance that a son will have the disease, - 1 in 2 chance that a daughter will be a carrier of the disease, - No chance that a daughter will have the disease. In autosomal recessive inheritance, it takes two copies of the mutant gene to give rise to the disease. An individual who has one copy of a recessive gene mutation is known as a carrier. When two carriers have a child, there is a: - 1 in 4 chance of having a child with the disease, - 1 in 2 chance of having a child who is a carrier, - 1 in 4 chance of having a child who neither has the disease nor is a carrier. In autosomal dominant inheritance, it takes just one copy of the mutant gene to bring about the disease. When an affected parent with one dominant gene mutation has a child, there is a 1 in 2 chance that a child will inherit the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "Epidural block - pregnancy (How is the Epidural Given?): The block or shot is given into an area over your lower back or spine. - You may be asked to lie on your side, or you may sit up. - Either way, you will be asked to pull your stomach inwards and hunch your back outwards. Your health care provider will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed: - The provider inserts a needle into your lower back. - The needle is placed into a small space outside your spinal cord. - A small soft tube (catheter) is placed into your back, next to your spine. - The needle is removed. The numbing medicine is given through the tube for as long as it is needed. In most cases, you will receive a low dose because it is safer for you and baby. Once the medicine takes effect (10 to 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions. You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "How to diagnose Epidural abscess?: The health care provider will perform a physical exam to look for a loss of functions, such as movement or sensation. Tests that may be done include: - Blood cultures - Complete blood count (CBC) - CT scan of head or spine - Draining of abscess and examination of the material - MRI of head or spine. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epidural harmful", "response": "Epidural abscess: An epidural abscess is a collection of pus (infected material) and germs between the outer covering of the brain and spinal cord and the bones of the skull or spine. The abscess causes swelling in the area. Epidural abscess is a rare disorder caused by infection in the area between the bones of the skull, or spine, and the membranes covering the brain and spinal cord (meninges). This infection is called an intracranial epidural abscess if it is inside the skull area. It is called a spinal epidural abscess if it is found in the spine area. Most are located in the spine. The spinal infection is usually caused by bacteria, but may be caused by a fungus. It can be due to other infections in the body (especially a urinary tract infection), or germs that spread through the blood. In some people, though, no other source of infection is found. An abscess inside the skull is called an intracranial epidural abscess. The cause may be any of the following: - Chronic ear infections - Chronic sinusitis - Head injury - Mastoiditis - Recent neurosurgery An abscess of the spine is called a spinal epidural abscess. It may be seen in people with any of the following: - Had back surgery or another invasive procedure involving the spine - Bloodstream infections - Boils, especially on the back or scalp - Bone infections of the spine (vertebral osteomyelitis) People who inject drugs are also at increased risk. Spinal epidural abscess may cause these symptoms: - Bowel or bladder incontinence - Difficulty urinating (urinary retention) - Fever and back pain Intracranial epidural abscess may cause these symptoms: - Fever - Headache - Lethargy - Nausea and vomiting - Pain at the site of recent surgery that gets worse (especially if fever is present) Nervous system symptoms depend on the location of the abscess and may include: - Decreased ability to move any part of the body - Loss of sensation in any area of the body, or abnormal changes in sensation - Weakness The health care provider will perform a physical exam to look for a loss of functions, such as movement or sensation. Tests that may be done include: - Blood cultures to check for bacteria in the blood - Complete blood count (CBC) - CT scan of head or spine - Draining of abscess and examination of the material - MRI of head or spine - Urine analysis and culture The goal of treatment is to cure the infection and reduce the risk of permanent damage. Treatment usually includes antibiotics and surgery. In some cases, antibiotics alone are used. Antibiotics are usually given through a vein (IV) for at least 4 to 6 weeks. Some people need to take them for a longer time, depending on the type of bacteria and how severe the disease is. Surgery may be needed to drain or remove the abscess. Surgery is also often needed to reduce pressure on the spinal cord or brain, if there is weakness or damage to the nerves. Early diagnosis and treatment greatly improves the chance of a good outcome. Once weakness, paralysis, or sensation changes occur, the chance of recovering lost function is greatly reduced. Permanent nervous system damage or death may occur. Complications may include: - Brain abscess - Brain damage - Bone infection (osteomyelitis) - Chronic back pain - Meningitis (infection of the membranes covering the brain and spinal cord) - Nerve damage - Return of infection - Spinal cord abscess An epidural abscess is a medical emergency. Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of spinal cord abscess. Treatment of certain infections, such as ear infections, sinusitis, and bloodstream infections, may decrease the risk of an epidural abscess. Early diagnosis and treatment are important to prevent complications. Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epilepsy diagnosed", "response": "Epilepsy (Diagnosis): To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures. Your evaluation may include: - A neurological exam. Your doctor may test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have. - Blood tests. Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures. Your doctor may also suggest tests to detect brain abnormalities, such as: - Electroencephalogram (EEG). This is the most common test used to diagnose epilepsy. In this test, doctors attach electrodes to your scalp with a paste-like substance. The electrodes record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions. Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test. - High-density EEG. In a variation of an EEG test, your doctor may recommend high-density EEG, which spaces electrodes more closely than conventional EEG - about a half a centimeter apart. High-density EEG may help your doctor more precisely determine which areas of your brain are affected by seizures. - Computerized tomography (CT) scan. A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts. - Magnetic resonance imaging (MRI). An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures. - Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors may use an fMRI before surgery to identify the exact locations of critical functions, such as speech and movement, so that surgeons can avoid injuring those places while operating. - Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. - Single-photon emission computerized tomography (SPECT). This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures. Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to MRI (SISCOM), which may provide even more-detailed results. - Neuropsychological tests. In these tests, doctors assess your thinking, memory and speech skills. The test results help doctors determine which areas of your brain are affected. Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start: - Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin. - Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring. - Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset. Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epilepsy diagnosed", "response": "What is Epilepsy?: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activityfrom illness to brain damage to abnormal brain developmentcan lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how is epilepsy diagnosed", "response": "Epilepsy - children (Exams and Tests): The provider will: - Ask about your child's medical and family history in detail - Ask about the seizure episode - Do a physical exam of your child, including a detailed look at the brain and nervous system The provider will order an EEG (electroencephalogram) to check the electrical activity in the brain. This test often shows any abnormal electrical activity in the brain. In some cases, the test shows the area in the brain where the seizures start. The brain may appear normal after a seizure or between seizures. To diagnose epilepsy or plan for epilepsy surgery, your child may need to: - Wear an EEG recorder for few days during day-to-day activities - Stay in the hospital where brain activity can be watched on video cameras (video EEG) The provider also may order other tests, including: - Blood chemistry - Blood sugar - Complete blood count (CBC) - Kidney function tests - Liver function tests - Lumbar puncture (spinal tap) - Tests for infectious diseases Head CT or MRI scan are often done to find the cause and location of the problem in the brain. Much less often, PET scan of the brain is needed to help plan surgery. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much ibuprofen is too much", "response": "How should Ibuprofen be used and what is the dosage?: Prescription ibuprofen comes as a tablet to take by mouth. It is usually taken three or four times a day for arthritis or every 4 to 6 hours as needed for pain. Nonprescription ibuprofen comes as a tablet, chewable tablet, suspension (liquid), and drops (concentrated liquid). Adults and children older than 12 years of age may usually take nonprescription ibuprofen every 4 to 6 hours as needed for pain or fever. Children and infants may usually be given nonprescription ibuprofen every 6 to 8 hours as needed for pain or fever, but should not be given more than 4 doses in 24 hours. Ibuprofen may be taken with food or milk to prevent stomach upset. If you are taking ibuprofen on a regular basis, you should take it at the same time(s) every day. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ibuprofen exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor. Ibuprofen comes alone and in combination with other medications. Some of these combination products are available by prescription only, and some of these combination products are available without a prescription and are used to treat cough and cold symptoms and other conditions. If your doctor has prescribed a medication that contains ibuprofen, you should be careful not to take any nonprescription medications that also contain ibuprofen. If you are selecting a product to treat cough or cold symptoms, ask your doctor or pharmacist for advice on which product is best for you. Check nonprescription product labels carefully before using two or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child. Nonprescription cough and cold combination products, including products that contain ibuprofen, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4 to 11 years of age, use caution and follow the package directions carefully. If you are giving ibuprofen or a combination product that contains ibuprofen to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give ibuprofen products that are made for adults to children. Before you give an ibuprofen product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child. Shake the suspension and drops well before each use to mix the medication evenly. Use the measuring cup provided to measure each dose of the suspension, and use the dosing device provided to measure each dose of the drops. The chewable tablets may cause a burning feeling in the mouth or throat. Take the chewable tablets with food or water. Stop taking nonprescription ibuprofen and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, the part of your body that was painful becomes red or swollen, your pain lasts for more than 10 days, or your fever lasts more than 3 days. Stop giving nonprescription ibuprofen to your child and call your child's doctor if your child does not start to feel better during the first 24 hours of treatment. Also stop giving nonprescription ibuprofen to your child and call your child's doctor if your child develops new symptoms, including redness or swelling on the painful part of his body, or if your child's pain or fever get worse or lasts longer than 3 days. Do not give nonprescription ibuprofen to a child who has a sore throat that is severe or does not go away, or that comes along with fever, headache, nausea, or vomiting. Call the child's doctor right away, because these symptoms may be signs of a more serious condition. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much ibuprofen is too much", "response": "Ibuprofen dosing for children (How Ibuprofen can Help Your Child): Ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID). It can help: - Reduce aches, pain, sore throat, or fever in children with a cold or the flu - Relieve headaches or toothaches - Reduce pain and swelling from an injury or broken bone. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much oxazepam could cause an overdose?", "response": "Oxazepam (How should this medicine be used?): Oxazepam comes as a capsule to take by mouth. It is usually taken three or four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take oxazepam exactly as directed. Oxazepam can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer time than prescribed by your doctor. Oxazepam may not work as well if it is taken for a long time. Oxazepam may help control your symptoms but will not cure your condition. Continue to take oxazepam even if you feel well. Do not skip doses even if you feel that you do not need them. Do not stop taking this medication without talking to your doctor. If you suddenly stop taking oxazepam, you may experience withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor will probably decrease your dose gradually. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how much oxazepam could cause an overdose?", "response": "What is Oxazepam overdose?: Oxazepam is a medicine used to treat anxiety and symptoms of alcohol withdrawal. It belongs to the class of medicines known as benzodiazepines. Oxazepam overdose occurs when someone accidentally or intentionally takes too much of this medicine. Benzodiazepines are the most common prescription drugs used in suicide attempts. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how nicotine effects the brain", "response": "What are the side effects or risks of Nicotine Oral Inhalation?: Nicotine oral inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: - irritation in the mouth and throat - cough - runny nose - taste changes - pain of the jaw, neck, or back - tooth problems - sinus pressure and pain - headache - pain, burning, or tingling in the hands or feet - gas Some side effects can be serious. If you experience the following symptom, call your doctor immediately: - rapid heart rate Nicotine inhalation may cause other side effects. Call your doctor if you have any unusual problems while using this medication. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "Pap test: The Pap test checks for cervical cancer. Cells scraped from the opening of the cervix are examined under a microscope. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. This test is sometimes called a Pap smear. You lie on a table and place your feet in stirrups. The health care provider gently places an instrument called a speculum into the vagina to open it slightly. This allows the provider to see inside the vagina and cervix. Cells are gently scraped from the cervix area. The sample of cells is sent to a lab for examination. Tell your provider about all the medicines you are taking. Some birth control pills that contain estrogen or progestin may affect test results. Also tell your provider if you: - Have had an abnormal Pap test - Might be pregnant DO NOT do the following for 24 hours before the test: - Douche (douching should never be done) - Have intercourse - Use tampons Avoid scheduling your Pap test while you have your period (are menstruating). Blood may make the Pap test results less accurate. If you are having unexpected bleeding, do not cancel your exam. Your provider will determine if the Pap test can still be done. Empty your bladder just before the test. A Pap test causes little to no discomfort for most women. It can cause some discomfort, similar to menstrual cramps. You may also feel some pressure during the exam. You may bleed a little bit after the test. The Pap test is a screening test for cervical cancer. Most cervical cancers can be detected early if a woman has routine Pap tests. Screening should start at age 21. After the first test: - You should have a Pap test every 3 years to check for cervical cancer. - If you are over age 30 and you also have HPV testing done, and both the Pap test and HPV test are normal, you can be tested every 5 years (HPV is the human papillomavirus, the virus that causes genital warts and cervical cancer). - Most women can stop having Pap tests after age 65 to 70 as long as they have had 3 negative tests within the past 10 years. You may not need to have a Pap test if you have had a total hysterectomy (uterus and cervix removed) and have not had an abnormal Pap test, cervical cancer, or other pelvic cancer. Discuss this with your provider. A normal result means there are no abnormal cells present. The Pap test is not 100% accurate. Cervical cancer may be missed in a small number of cases. Most of the time, cervical cancer develops very slowly, and follow-up Pap tests should find any changes in time for treatment. Abnormal results are grouped as follows: ASCUS or AGUS: - This result means there are atypical cells, but it is uncertain or unclear what these changes mean - The changes may be due to HPV - They may also mean there are changes that may lead to cancer LOW-GRADE DYSPLASIA (LSIL) OR HIGH-GRADE DYSPLASIA (HSIL): - This means changes that may lead to cancer are present - The risk of cervical cancer is greater with HSIL CARCINOMA IN SITU (CIS): - This result most often means the abnormal changes are likely to lead to cervical cancer if not treated ATYPICAL SQUAMOUS CELLS (ASC): - Abnormal changes have been found and may be HSIL ATYPICAL GLANDULAR CELLS (AGC): - Cell changes that may lead to cancer are seen in the upper part of the cervical canal or inside the uterus When a Pap test shows abnormal changes, further testing or follow-up is needed. The next step depends on the results of the Pap test, your previous history of Pap tests, and risk factors you may have for cervical cancer. For minor cell changes, doctors will recommend another Pap test in 6 to 12 months. Follow-up testing or treatment may include: - Colposcopy-directed biopsy - An HPV test to check for the presence of the HPV virus types most likely to cause cancer - Cervix cryosurgery - Cone biopsy Updated by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "Do you have information about CSF smear: Summary : A cerebrospinal fluid (CSF) smear is an exam of the fluid that moves in the space around the spinal cord and brain. CSF protects the brain and spinal cord from injury. How the Test is Performed : A sample of CSF fluid is needed. This is usually done with a lumbar puncture. This is called a spinal tap. The sample is sent to a laboratory, where a tiny amount is spread on a glass slide. A member of the laboratory team looks at the sample under a microscope. The smear shows the color of the fluid and the number and shape of cells present in the fluid. Other tests, such as a Gram stain or fungal wet prep, may be done to check for bacteria or fungi. How to Prepare for the Test : For information on how to prepare for the procedure to obtain the CSF sample, see spinal tap. How the Test Will Feel : The laboratory test is painless and does not involve you. For information on how it will feel to have a sample of CSF fluid removed, see spinal tap. Why the Test is Performed : The test is done to check for signs of infection in a sample of CSF. What Abnormal Results Mean : Bacteria or other germs in the sample may be a sign of: - Bacterial meningitis - Fungal infections - Tuberculosis Some bacteria or viruses can also be detected using special tests. Risks : A laboratory smear poses no risk. For risks from the procedure done to get a CSF sample, see spinal tap. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how often do you need a pap smear", "response": "HPV DNA test: The HPV DNA test is used to check for high-risk HPV infection in women. HPV infection around the genitals is common. It can be spread during sex. - Some types of HPV can cause cervical cancer and other cancers. These are called high-risk types. - Low-risk types of HPV may cause genital warts in the vagina, cervix, and on the skin. The virus that causes warts can be spread when you have sex. The HPV-DNA test is generally not recommended for detecting low-risk HPV infections. The HPV DNA test may be done during a Pap smear. You lie on a table and place your feet in stirrups. The health care provider places an instrument (called a speculum) into the vagina and opens it slightly to see inside. Cells are gently collected from the cervix area. The cervix is the lower part of the womb (uterus) that opens at the top of the vagina. The cells are sent to a laboratory for examination under a microscope. This examiner checks to see if the cells contain genetic material (called DNA) from types of HPV that cause cancer. More tests may be done to determine the exact type of HPV. Avoid the following for 24 hours before the test: - Douching - Having intercourse - Taking a bath - Using tampons Empty your bladder just before the test. The exam may cause some discomfort. Some women say it feels like menstrual cramps. You may also feel some pressure during the exam. You may bleed a bit after the test. High-risk types of HPV can lead to cervical cancer or anal cancer. The HPV-DNA test is done to determine if you are infected with one of these high-risk types. Your doctor may order an HPV-DNA test: - If you have a certain type of abnormal Pap test result - Along with a Pap smear to screen women age 30 and older for cervical cancer It's important to note that the HPV-DNA test does not replace a Pap smear. A Pap smear is the main screening test for cervical cancer. The HPV test results help your doctor decide if further testing or treatment is needed. A normal result means you do not have a high-risk type of HPV. An abnormal result means you have a high-risk type of HPV. High-risk types of HPV may cause cervical cancer and cancer of the throat, tongue, anus, or vagina. Most of the time, cervical cancer related to HPV is due to the following types: - HPV-16 (high risk type) - HPV-18 (high risk type) - HPV-31 - HPV-33 - HPV-35 - HPV-45 - HPV-52 - HPV-58 Other high-risk types of HPV are less common. Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the brain", "response": "Nicotine and tobacco (Treatment): It is hard to stop smoking or using smokeless tobacco, but anyone can do it. There are many ways to quit smoking. There are also resources to help you quit. Family members, friends, and co-workers may be supportive. Quitting tobacco is hard if you are trying to do it alone. To be successful, you must really want to quit. Most people who have quit smoking were unsuccessful at least once in the past. Try not to view past attempts as failures. See them as learning experiences. Most smokers find it hard to break all the habits they have created around smoking. A smoking cessation program may improve your chance for success. These programs are offered by hospitals, health departments, community centers, work sites, and national organizations. Nicotine replacement therapy may also be helpful. It involves the use of products that provide low doses of nicotine, but none of the toxins found in smoke. Nicotine replacement comes in the form of: - Gum - Inhalers - Throat lozenges - Nasal spray - Skin patches You can buy many types of nicotine replacement without a prescription. The goal is to relieve cravings for nicotine and ease your withdrawal symptoms. Health experts warn that e-cigarettes are not a replacement therapy for cigarette smoking. It is not known exactly how much nicotine is in e-cigarette cartridges, because information on labels is often wrong. Your health care provider can also prescribe other types of medicines to help you quit and prevent you from starting again. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the brain", "response": "What is Smoking?: There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "Nicotine and tobacco (Causes): Tobacco is a plant grown for its leaves, which are smoked, chewed, or sniffed. - Tobacco contains a chemical called nicotine. Nicotine is an addictive substance. - Millions of people in the United States have been able to quit smoking. Although the number of cigarette smokers in the United States has dropped in recent years, the number of smokeless tobacco users has steadily increased. Smokeless tobacco products are either placed in the mouth, cheek, or lip and sucked or chewed on, or placed in the nasal passage. The nicotine in these products is absorbed at the same rate as smoking tobacco, and addiction is still very strong. Both smoking and smokeless tobacco use carry many health risks. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "What is Smoking?: There's no way around it. Smoking is bad for your health. Smoking harms nearly every organ of the body. Cigarette smoking causes 87 percent of lung cancer deaths. It is also responsible for many other cancers and health problems. These include lung disease, heart and blood vessel disease, stroke and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome (SIDS). Your smoke is also bad for other people - they breathe in your smoke secondhand and can get many of the same problems as smokers do. E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Not much is known about the health risks of using them. Quitting smoking can reduce your risk of health problems. The earlier you quit, the greater the benefit. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how smoking tobacco affects the rest of the body", "response": "Benefits of quitting tobacco (Summary): If you smoke, you should quit. But quitting can be hard. Most people who have quit smoking have tried at least once, without success, in the past. View any past attempts to quit as a learning experience, not a failure. There are many reasons to quit using tobacco. Long-term use of tobacco can increase your risk of many serious health problems. THE BENEFITS OF QUITTING You may enjoy the following when you quit smoking. - Your breath, clothes, and hair will smell better. - Your sense of smell will return. Food will taste better. - Your fingers and fingernails will slowly appear less yellow. - Your stained teeth may slowly become whiter. - Your children will be healthier and will be less likely to start smoking. - It will be easier and cheaper to find an apartment or hotel room. - You may have an easier time getting a job. - Friends may be more willing to be in your car or home. - It may be easier to find a date. Many people do not smoke and do not like to be around people who smoke. - You will save money. If you smoke a pack a day, you spend about $2,000 a year on cigarettes. HEALTH BENEFITS Some health benefits begin almost immediately. Every week, month, and year without tobacco further improves your health. - Within 20 minutes of quitting: Your blood pressure and pulse rate drop to normal and the temperature of your hands and feet increases to normal. - Within 8 hours of quitting: Your blood carbon monoxide levels drop and your blood oxygen levels increase to normal levels. - Within 24 hours of quitting: Your risk of a sudden heart attack goes down. - Within 48 hours of quitting: Your nerve endings begin to regrow. Your senses of smell and taste begin to return to normal. - Within 2 weeks to 3 months of quitting: Your circulation improves. Walking becomes easier. Your lungs work better. Wounds heal more quickly. - Within 1 to 9 months of quitting: You have more energy. Smoking-related symptoms, such as coughing, nasal congestion, fatigue, and shortness of breath improve. You will have fewer illnesses, colds, and asthma attacks. You will gradually no longer be short of breath with everyday activities. - Within 1 year of quitting: Your risk of coronary heart disease is half that of someone still using tobacco. - Within 5 years of quitting: Your risk of mouth, throat, esophagus, and bladder cancers are reduced by half. - Within 10 years of quitting: Your risk of dying from lung cancer is about one half that of a person who still smokes. Other health benefits of quitting smoking include: - Lower chance of blood clots in the legs, which may travel to the lungs - Lower risk of erectile dysfunction - Fewer problems during pregnancy, such as babies born at low birth weight, premature labor, miscarriage, and cleft lip - Lower risk of infertility due to damaged sperm - Healthier teeth, gums, and skin Infants and children who you live with will have: - Asthma that is easier to control - Fewer visits to the emergency room - Fewer colds, ear infections, and pneumonia - Reduced risk of sudden infant death syndrome (SIDS) MAKING THE DECISION Like any addiction, quitting tobacco is difficult, especially if you do it alone. There are a lot of ways to quit smoking and many resources to help you. Talk to your health care provider about nicotine replacement therapy and smoking cessation medications. If you join smoking cessation programs, you have a much better chance of success. Such programs are offered by hospitals, health departments, community centers, and work sites. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "Generalized anxiety disorder - self-care (Therapy): Talk therapy takes place with a trained therapist and in a safe place. It helps you learn ways of managing and reducing your anxiety. Some forms of talk therapy can help you understand what causes your anxiety. This allows you to gain better control over it. Many types of talk therapy may be helpful for GAD. One common and effective talk therapy is cognitive-behavioral therapy (CBT). CBT can help you understand the relationship between your thoughts, your behaviors, and your symptoms. Often CBT involves a set number of visits. During CBT you can learn how to: - Understand and gain control of distorted views of stressors, such as other people's behavior or life events. - Recognize and replace panic-causing thoughts to help you feel more in control. - Manage stress and relax when symptoms occur. - Avoid thinking that minor problems will develop into terrible ones. Your provider can discuss talk therapy options with you. Then you can decide together if it is right for you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "What is Anxiety?: Fear and anxiety are part of life. You may feel anxious before you take a test or walk down a dark street. This kind of anxiety is useful - it can make you more alert or careful. It usually ends soon after you are out of the situation that caused it. But for millions of people in the United States, the anxiety does not go away, and gets worse over time. They may have chest pains or nightmares. They may even be afraid to leave home. These people have anxiety disorders. Types include - Panic disorder - Obsessive-compulsive disorder - Post-traumatic stress disorder - Phobias - Generalized anxiety disorder Treatment can involve medicines, therapy or both. NIH: National Institute of Mental Health. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to deal with anxiety", "response": "Social anxiety disorder (Treatment): The goal of treatment is to help you function effectively. The success of the treatment usually depends on the severity of your fears. Behavioral treatment is often tried first and may have long-lasting benefits: - Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts. - Systematic desensitization or exposure therapy may be used. You are asked to relax, then imagine the situations that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears. - Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation. Certain medicines, usually used to treat depression, may be very helpful for this disorder. They work by preventing your symptoms or making them less severe. You must take these medicines every day. DO NOT stop taking them without talking with your provider. Medicines called sedatives (or hypnotics) may also be prescribed. - These medicines should only be taken under a doctor's direction. - Your doctor will prescribe a limited amount of these drugs. They should not to be used everyday. - They may be used when symptoms become very severe or when you are about to be exposed to something that always brings on your symptoms. - If you are prescribed a sedative, do not drink alcohol while on this medicine. Lifestyle changes may help reduce how often the attacks occur. - Get regular exercise, enough sleep, and regularly scheduled meals. - Reduce or avoid the use of caffeine, some over-the-counter cold medicines, and other stimulants. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Overweight, obesity, and weight loss (What is the best way for me to lose weight?): The best way to lose weight is to use more calories than you take in. You can do this by following a healthy eating plan and being more active. Before you start a weight-loss program, talk to your doctor. Safe weight-loss programs that work well:. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Losing weight after pregnancy (Eat to Lose Weight): These healthy eating tips will help you lose weight safely. - DO NOT skip meals. With a new baby, many new moms forget to eat. If you do not eat, you will have less energy, and it will not help you lose weight. - Eat 5 to 6 small meals a day with healthy snacks in between (rather than 3 larger meals). - Eat breakfast. Even if you do not normally eat in the mornings, get into the habit of having breakfast. It will give you energy to start your day and stop you from feeling tired later. - Slow down. When you take your time eating, you will notice that it is easier to tell that you are full. It is tempting to multitask, but if you focus on your meal you will be less likely to overeat. - Choose nonfat or low-fat dairy products. - When you reach for a snack try to include foods with fiber and protein to help keep you full (such as raw bell pepper or carrot with bean dip, apple slices with peanut butter, or a slice of whole-wheat toast with hard-boiled egg). Drink at least 12 cups of fluid a day. - Keep a water bottle near the spot where you usually feed the baby, that way you'll remember to drink when they do. - Limit drinks like sodas, juices, and other fluids with added sugar and calories. They can add up and keep you from losing weight. - Choose broiled or baked rather than fried foods. - Limit sweets, sugar, saturated fat and trans fats. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to loose weight", "response": "Understanding Adult Overweight and Obesity (Who should lose weight?): Health care providers generally agree that people who are considered to be obese (have a BMI of 30 or greater) may improve their health by losing weight.If you are overweight (BMI between 25 and 29.9), experts recommend that you avoid gaining any extra weight. If you are overweight and have other risk factors (see below), losing weight may reduce these risks. Experts recommend you try to lose weight if you have two or more of the following:Family history of certain chronic diseases. If you have close relatives who have had diseases such as heart disease or diabetes, you may be more likely to develop these problems. Pre-existing medical problems. High blood pressure, high LDL (bad) cholesterol levels, low HDL (good) cholesterol levels, high triglycerides, and high blood sugar (prediabetes or diabetes) are all warning signs of some diseases linked to obesity. Large waist size. Men who have waist sizes greater than 40 inches and women who have waist sizes greater than 35 inches are at higher risk of diabetes, unhealthy blood fats (high cholesterol and triglycerides), high blood pressure, and heart disease.Fortunately, losing even a small amount of weight can help improve your health. This weight loss may lower your blood pressure and improve other risk factors.For example, research shows that people at high risk for type 2 diabetes who lose a modest amount of weight and increase their physical activity may prevent or delay type 2 diabetes. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to manage prostate cancer", "response": "Prostate cancer - treatment (Hormonal Therapy): Testosterone is the main male hormone. Prostate tumors need testosterone to grow. Hormonal therapy is treatment that decreases the effect of testosterone on prostate cancer. Hormone therapy is mainly used for cancer that has spread beyond the prostate. The treatment can help relieve symptoms and prevent further growth and spread of cancer. But it does not cure the cancer. The main type of hormone therapy is called a luteinizing hormone-releasing hormones (LH-RH) agonist: - The medicine blocks the testicles from making testosterone. The drugs must be given by injection, usually every 3 to 6 months. - Possible side effects include nausea and vomiting, hot flashes, anemia, fatigue, thinning bones (osteoporosis), reduced sexual desire, decreased muscle mass, weight gain, and impotence. The other type of hormone medicine is called an androgen-blocking drug: - It is often given along with LH-RH drugs to block the effect of testosterone produced by the adrenal glands, which make a small amount of testosterone. - Possible side effects include erection problems, reduced sexual desire, liver problems, diarrhea, and enlarged breasts. Much of the body's testosterone is made by the testes. As a result, surgery to remove the testes (called orchiectomy) can also be used as a hormonal treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to manage prostate cancer", "response": "What is prostate cancer?: Prostate cancer is a common disease that affects men, usually in middle age or later. In this disorder, certain cells in the prostate become abnormal and multiply without control or order to form a tumor. The prostate is a gland that surrounds the male urethra and helps produce semen, the fluid that carries sperm. Early prostate cancer usually does not cause pain, and most affected men exhibit no noticeable symptoms. Men are often diagnosed as the result of health screenings, such as a blood test for a substance called prostate specific antigen (PSA) or a medical procedure called a digital rectal exam. As the tumor grows larger, signs and symptoms can include difficulty starting or stopping the flow of urine, a feeling of not being able to empty the bladder completely, blood in the urine or semen, or pain with ejaculation. However, these changes can also occur with many other genitourinary conditions. Having one or more of these symptoms does not necessarily mean that a man has prostate cancer. The severity and outcome of prostate cancer varies widely. Early-stage prostate cancer can usually be treated successfully, and some older men have prostate tumors that grow so slowly that they may never cause health problems during their lifetime, even without treatment. In other men, however, the cancer is much more aggressive; in these cases, prostate cancer can be life-threatening. Some cancerous tumors can invade surrounding tissue and spread to other parts of the body. Tumors that begin at one site and then spread to other areas of the body are called metastatic cancers. The signs and symptoms of metastatic cancer depend on where the disease has spread. If prostate cancer spreads, cancerous cells most often appear in the lymph nodes, bones, lungs, liver, or brain. Bone metastases of prostate cancer most often cause pain in the lower back, pelvis, or hips. A small percentage of all prostate cancers cluster in families. These hereditary cancers are associated with inherited gene mutations. Hereditary prostate cancers tend to develop earlier in life than non-inherited (sporadic) cases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "Atherosclerosis (PREVENTION): Taking action to control your risk factors can help prevent or delay atherosclerosis and its related diseases. Your risk for atherosclerosis increases with the number of risk factors you have. One step you can take is to adopt a healthy lifestyle, which can include: Heart-Healthy Eating. Adopt heart-healthy eating habits, which include eating different fruits and vegetables (including beans and peas), whole grains, lean meats, poultry without skin, seafood, and fat-free or low-fat milk and dairy products. A heart-healthy diet is low in sodium, added sugar, solid fats, and refined grains. Following a heart-healthy diet is an important part of a healthy lifestyle. Physical Activity. Be as physically active as you can. Physical activity can improve your fitness level and your health. Ask your doctor what types and amounts of activity are safe for you. Read more about Physical Activity and Your Heart. Quit Smoking. If you smoke, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Read more about Smoking and Your Heart. Weight Control. If you’re overweight or obese, work with your doctor to create a reasonable weight-loss plan. Controlling your weight helps you control risk factors for atherosclerosis. Other steps that can prevent or delay atherosclerosis include knowing your family history of atherosclerosis. If you or someone in your family has an atherosclerosis-related disease, be sure to tell your doctor. If lifestyle changes aren’t enough, your doctor may prescribe medicines to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "What is Atherosclerosis?: Espaol Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Atherosclerosis Atherosclerosis-Related Diseases Atherosclerosis can affect any artery in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. As a result, different diseases may develop based on which arteries are affected. Coronary Heart Disease Coronary heart disease (CHD), also called coronary artery disease, occurs when plaque builds up in the coronary arteries. These arteries supply oxygen-rich blood to your heart. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. Plaque buildup also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. If blood flow to your heart muscle is reduced or blocked, you may have angina (chest pain or discomfort) or a heart attack. Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease (MVD). In coronary MVD, plaque doesn't cause blockages in the arteries as it does in CHD. Carotid Artery Disease Carotid (ka-ROT-id) artery disease occurs if plaque builds up in the arteries on each side of your neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you may have a stroke. Peripheral Artery Disease Peripheral artery disease (P.A.D.) occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis. If blood flow to these parts of your body is reduced or blocked, you may have numbness, pain, and, sometimes, dangerous infections. Chronic Kidney Disease Chronic kidney disease can occur if plaque builds up in the renal arteries. These arteries supply oxygen-rich blood to your kidneys. Over time, chronic kidney disease causes a slow loss of kidney function. The main function of the kidneys is to remove waste and extra water from the body. Overview The cause of atherosclerosis isn't known. However, certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. You can control some risk factors, such as lack of physical activity, smoking, and an unhealthy diet. Others you can't control, such as age and a family history of heart disease. Some people who have atherosclerosis have no signs or symptoms. They may not be diagnosed until after a heart attack or stroke. The main treatment for atherosclerosis is lifestyle changes. You also may need medicines and medical procedures. These treatments, along with ongoing medical care, can help you live a healthier life. Outlook Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. However, atherosclerosis remains a common health problem. You may be able to prevent or delay atherosclerosis and the diseases it can cause. Making lifestyle changes and getting ongoing care can help you avoid the problems of atherosclerosis and live a long, healthy life. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent atherosclerosis", "response": "Atherosclerosis (LIVING WITH): Improved treatments have reduced the number of deaths from atherosclerosis-related diseases. These treatments also have improved the quality of life for people who have these diseases. Adopting a healthy lifestyle may help you prevent or delay atherosclerosis and the problems it can cause. This, along with ongoing medical care, can help you avoid the problems of atherosclerosis and live a long, healthy life. Researchers continue to look for ways to improve the health of people who have atherosclerosis or may develop it. Ongoing Care If you have atherosclerosis, work closely with your doctor and other health care providers to avoid serious problems, such as heart attack and stroke. Follow your treatment plan and take all of your medicines as your doctor prescribes. Your doctor will let you know how often you should schedule office visits or blood tests. Be sure to let your doctor know if you have new or worsening symptoms. Emotional Issues and Support Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. Talk about how you feel with your doctor. Talking to a professional counselor also can help. If you're very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Community resources are available to help you learn more about atherosclerosis. Contact your local public health departments, hospitals, and local chapters of national health organizations to learn more about available resources in your area. Talk about your lifestyle changes with your family and friends—whoever can provide support or needs to understand why you're changing your habits. Family and friends may be able to help you make lifestyle changes. For example, they can help you plan healthier meals. Because atherosclerosis tends to run in families, your lifestyle changes may help many of your family members too. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "Neonatal conjunctivitis (Prevention): Pregnant women should get treatment for diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into all infants' eyes in the delivery room right after birth can help prevent many infections. (Most states have laws requiring this treatment.) When a mother has active herpes sores at the time of delivery, a Cesarean section (C-section) is recommended to prevent serious illness in the baby. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "How to prevent Vernal conjunctivitis?: Using air conditioning or moving to a cooler climate may help prevent the problem from getting worse in the future. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent conjunctivitis", "response": "Ligneous conjunctivitis (Summary): Ligneous conjunctivitis is a rare disorder characterized by the buildup of a protein called fibrin which causes inflammation of the conjunctiva (conjunctivitis) and leads to thick, woody (ligneous), inflamed growths that are yellow, white, or red. Ligneous conjunctivitis most often occurs on the inside of the eyelids, but may also affect the sclera, cornea and pupil, leading to vision loss. [1] A systemic form of the condition may occur, affecting the mucous membranes of the larynx, vocal chords, nose, trachea, bronchi, vagina, cervix, and gingiva. The cause of ligneous conjunctivitis is unknown. Autosomal recessive inheritance has been suggested in some cases. [2] Ligneous conjunctivitis is sometimes associated with a condition known as congenital plasminogen deficiency. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "How to Prevent Diabetes (Summary): Summary What is type 2 diabetes? If you have diabetes, your blood sugar levels are too high. With type 2 diabetes, this happens because your body does not make enough insulin, or it does not use insulin well (this is called insulin resistance). If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it. Who is at risk for type 2 diabetes? Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include - Having prediabetes, which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes - Being overweight or having obesity - Being age 45 or older - A family history of diabetes - Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander - Having high blood pressure - Having a low level of HDL (good) cholesterol or a high level of triglycerides - A history of diabetes in pregnancy - Having given birth to a baby weighing 9 pounds or more - An inactive lifestyle - A history of heart disease or stroke - Having depression - Having polycystic ovary syndrome (PCOS) - Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits - Smoking How can I prevent or delay getting type 2 diabetes? If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are - Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10 percent of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back. - Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats. - Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal. - Don't smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit. - Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "How to prevent Type 1 diabetes?: Type 1 diabetes cannot be prevented. There is no screening test for type 1 diabetes in people who have no symptoms. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent diabetes", "response": "Diabetes (Is there anything I can do to prevent type 2 diabetes?): Yes. Many studies, including the large Diabetes Prevention Program study, have proven that you can prevent diabetes by losing weight. Weight loss through healthy eating and more physical activity improves the way your body uses insulin and glucose. Learn how to eat healthier and get more physical activity. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung cancer - small cell (Prevention): If you smoke, now is the time to quit. If you are having trouble quitting, talk with your provider. There are many methods to help you quit, from support groups to prescription medicines. Also try to avoid secondhand smoke. If you smoke or used to smoke, talk with your provider about getting screened for lung cancer. To get screened, you need to have a CT scan of the chest. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung Cancer (Treatment Options by Stage): Limited-Stage Small Cell Lung Cancer Treatment of limited-stage small cell lung cancer may include the following: - Combination chemotherapy and radiation therapy to the chest. Radiation therapy to the brain may later be given to patients with complete responses. - Combination chemotherapy alone for patients who cannot be given radiation therapy. - Surgery followed by chemotherapy. - Surgery followed by chemotherapy and radiation therapy. - Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain. - Clinical trials of new chemotherapy, surgery, and radiation treatments. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. Extensive-Stage Small Cell Lung Cancer Treatment of extensive-stage small cell lung cancer may include the following: - Combination chemotherapy. - Radiation therapy to the brain, spine, bone, or other parts of the body where the cancer has spread, as palliative therapy to relieve symptoms and improve quality of life. - Radiation therapy to the chest may be given to patients who respond to chemotherapy. - Radiation therapy to the brain may be given to patients who have had a complete response, to prevent the spread of cancer to the brain. - Clinical trials of new chemotherapy treatments. Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent lung cancer", "response": "Lung cancer (Summary): Lung cancer is cancer that starts in the lungs. The lungs are located in the chest. When you breathe, air goes through your nose, down your windpipe (trachea), and into the lungs, where it flows through tubes called bronchi. Most lung cancer begins in the cells that line these tubes. There are 2 main types of lung cancer: - Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. - Small cell lung cancer (SCLC) makes up about 20% of all lung cancer cases. If the lung cancer is made up of both types, it is called mixed small cell/large cell cancer. If the cancer started somewhere else in the body and spreads to the lungs, it is called metastatic cancer to the lung. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent schizophrenia", "response": "Schizophrenia (Prevention): Schizophrenia cannot be prevented. Symptoms may be prevented by taking medicine exactly as the doctor instructed. Symptoms are likely to return if medicine is stopped. Changing or stopping medicines should only be done by the doctor who prescribed them. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to prevent schizophrenia", "response": "Schizophrenia (Treatment): During an episode of schizophrenia, the person may need to stay in the hospital for safety reasons. MEDICINES Antipsychotic drugs are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms. These drugs can cause side effects, but many side effects can be managed. Side effects should not prevent the person from getting treated for this serious condition. Common side effects from antipsychotics may include: - Dizziness - Feelings of restlessness or jitteriness - Sleepiness (sedation) - Slowed movements - Tremor - Weight gain Long-term use of antipsychotics may increase the risk of a movement disorder called tardive dyskinesia. This condition causes repeated movements that the person cannot control. Call the health care provider right away if you think you or your family member may have this condition due to the medicine. When schizophrenia does not improve with antipsychotics, other medicines may be tried. Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotics for life. SUPPORT PROGRAMS AND THERAPIES Support therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are also important. Family members and caregivers are very important during treatment. Therapy can teach important skills, such as: - Coping with symptoms that continue, even while taking medicines - Following a healthy lifestyle, including getting enough sleep and staying away from recreational drugs - Taking medicines correctly and managing side effects - Watching for the return of symptoms, and knowing what to do when they return - Getting the right support services. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "Heart attack (Treatment): Heart attack treatment at a hospital With each passing minute after a heart attack, more heart tissue loses oxygen and deteriorates or dies. The main way to prevent heart damage is to restore blood flow quickly. Medications Medications given to treat a heart attack include: - Aspirin. The 911 operator may instruct you to take aspirin, or emergency medical personnel may give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. - Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and with less heart damage. - Antiplatelet agents. Emergency room doctors may give you other drugs to help prevent new clots and keep existing clots from getting larger. These include medications, such as clopidogrel (Plavix) and others, called platelet aggregation inhibitors. - Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less \"sticky\" and less likely to form clots. Heparin is given intravenously or by an injection under your skin. - Pain relievers. You may receive a pain reliever, such as morphine, to ease your discomfort. - Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. - Beta blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta blockers can limit the amount of heart muscle damage and prevent future heart attacks. - ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Surgical and other procedures In addition to medications, you may undergo one of the following procedures to treat your heart attack: - Coronary angioplasty and stenting. Doctors insert a long, thin tube (catheter) that's passed through an artery, usually in your leg or groin, to a blocked artery in your heart. If you've had a heart attack, this procedure is often done immediately after a cardiac catheterization, a procedure used to locate blockages. This catheter is equipped with a special balloon that, once in position, is briefly inflated to open a blocked coronary artery. A metal mesh stent may be inserted into the artery to keep it open long term, restoring blood flow to the heart. Depending on your condition, your doctor may opt to place a stent coated with a slow-releasing medication to help keep your artery open. - Coronary artery bypass surgery. In some cases, doctors may perform emergency bypass surgery at the time of a heart attack. If possible, your doctor may suggest that you have bypass surgery after your heart has had time - about three to seven days - to recover from your heart attack. Bypass surgery involves sewing veins or arteries in place beyond a blocked or narrowed coronary artery, allowing blood flow to the heart to bypass the narrowed section. Once blood flow to your heart is restored and your condition is stable, you're likely to remain in the hospital for several days. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "Heart attack (Treatment): IMMEDIATE TREATMENT - You will be hooked up to a heart monitor, so the health care team can see how regularly your heart is beating. - You will receive oxygen so that your heart doesn't have to work as hard. - An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV. - You may get nitroglycerin and morphine to help reduce chest pain. - You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots. - Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks. EMERGENCY PROCEDURES Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart. - Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and usually no later than 12 hours after a heart attack. - A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is usually placed after or during angioplasty. It helps prevent the artery from closing up again. You may be given drugs to break up the clot. This is called thrombolytic therapy. It is best if these drugs are given soon after the onset of symptoms, usually no later than 12 hours after it and ideally within 30 minutes of arriving to the hospital. Some people may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called coronary artery bypass grafting and/or open heart surgery. TREATMENT AFTER A HEART ATTACK After several days, you will be discharged from the hospital. You will likely need to take medicines, some for the rest of your life. Always talk to your provider before stopping or changing how you take any medicines. Stopping certain medicines can be deadly. While under the care of your health care team, you will learn: - How to take medicines to treat your heart problem and prevent more heart attacks - How to eat a heart-healthy diet - How to be active and exercise safely - What to do when you have chest pain - How to stop smoking Strong emotions are common after a heart attack. - You may feel sad - You may feel anxious and worry about being careful about everything you do All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home. Most people who have had a heart attack take part in a cardiac rehabilitation program. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "how to treat a heart attack", "response": "What is Heart Attack?: A heart attack occurs when the supply of blood and oxygen to an area of the heart muscle is blocked, usually by a blood clot in a coronary artery. If the blockage is not treated within a few hours, the heart muscle will be permanently damaged and replaced by scar tissue. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are autoimmune blood disorders", "response": "Autoimmune disorders: An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders. The blood cells in the body's immune system help protect against harmful substances. Examples include bacteria, viruses, toxins, cancer cells, and blood and tissue from outside the body. These substances contain antigens. The immune system produces antibodies against these antigens that enable it to destroy these harmful substances. When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and antigens. As a result, the body sets off a reaction that destroys normal tissues. The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders. An autoimmune disorder may result in: - The destruction of body tissue - Abnormal growth of an organ - Changes in organ function An autoimmune disorder may affect one or more organ or tissue types. Areas often affected by autoimmune disorders include: - Blood vessels - Connective tissues - Endocrine glands such as the thyroid or pancreas - Joints - Muscles - Red blood cells - Skin A person may have more than one autoimmune disorder at the same time. Common autoimmune disorders include: - Addison disease - Celiac disease - sprue (gluten-sensitive enteropathy) - Dermatomyositis - Graves disease - Hashimoto thyroiditis - Multiple sclerosis - Myasthenia gravis - Pernicious anemia - Reactive arthritis - Rheumatoid arthritis - Sjögren syndrome - Systemic lupus erythematosus - Type I diabetes Symptoms will vary based on the type and location of the faulty immune response. Common symptoms include: - Fatigue - Fever - General ill-feeling (malaise) - Joint pain - Rash The health care provider will do a physical exam. Signs depend on the type of disease. Tests that may be done to diagnose an autoimmune disorder include: - Antinuclear antibody tests - Autoantibody tests - CBC - Comprehensive metabolic panel - C-reactive protein (CRP) - Erythrocyte sedimentation rate (ESR) - Urinalysis The goals of treatment are to: - Reduce symptoms - Control the autoimmune process - Maintain the body's ability to fight disease Treatments will depend on your disease and symptoms. Types of treatments include: - Supplements to replace a substance that the body lacks, such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disease - Blood transfusions if blood is affected - Physical therapy to help with movement if the bones, joints, or muscles are affected Many people take medicines to reduce the immune system's abnormal response. These are often called immunosuppressive medicines. Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus. Targeted drugs called tumor necrosis factor (TFN) blockers can be used for some diseases. The outcome depends on the disease. Most autoimmune diseases are chronic, but many can be controlled with treatment. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up. Complications depend on the disease. Medicines used to suppress the immune system can cause severe side effects, such as higher risk of infections. Call your health care provider if you develop symptoms of an autoimmune disorder. There is no known prevention for most autoimmune disorders. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are autoimmune blood disorders", "response": "Autoimmune disorders (Outlook (Prognosis)): The outcome depends on the disease. Most autoimmune diseases are chronic, but many can be controlled with treatment. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are known causes of bipolar disorder", "response": "Bipolar disorder (Risk factors): Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are known causes of bipolar disorder", "response": "How to diagnose Bipolar disorder?: To diagnose bipolar disorder, the health care provider may do some or all of the following: - Ask whether other family members have bipolar disorder - Ask about your recent mood swings and for how long you have had them - Perform a thorough exam and order lab tests to look for other illnesses that may be causing symptoms that resemble bipolar disorder - Talk to family members about your symptoms and overall health - Ask about any health problems you have and any medications you take - Watch your behavior and mood. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are pancreatic enzymes?", "response": "What are the treatments for Pancreatic abscess?: It may be possible to drain the abscess through the skin (percutaneous). Abscess drainage can be done through an endoscope using endoscopic ultrasound (EUS) in some cases. Surgery to drain the abscess and remove dead tissue is often needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are pancreatic enzymes?", "response": "Pancreatic cancer: Pancreatic cancer is cancer that starts in the pancreas. The pancreas is a large organ behind the stomach. It makes and releases enzymes into the intestines that help the body digest and absorb food, especially fats. The pancreas also makes and releases insulin and glucagon. These are hormones that help the body control blood sugar levels. There are different types of pancreatic cancers. The type depends on the cell the cancer develops in. Examples include: - Adenocarcinoma, the most common type of pancreatic cancer - Other more rare types include glucagonoma, insulinoma, islet cell tumor, VIPoma The exact cause of pancreatic cancer is unknown. It is more common in persons who: - Are obese - Have a diet high in fat and low in fruits and vegetables - Have diabetes - Have long-term exposure to certain chemicals - Have long-term inflammation of the pancreas (chronic pancreatitis) - Smoke Pancreatic cancer is slightly more common in women than in men. The risk increases with age. Family history of the disease also slightly increases the chance of developing this cancer. A tumor (cancer) in the pancreas may grow without any symptoms at first. This means the cancer is often advanced when it is first found. Symptoms of pancreatic cancer include: - Diarrhea - Dark urine and clay-colored stools - Fatigue and weakness - Sudden increase in blood sugar level (diabetes) - Jaundice (a yellow color in the skin, mucous membranes, or white part of the eyes) and itching of the skin - Loss of appetite and weight loss - Nausea and vomiting - Pain or discomfort in the upper part of the belly or abdomen The doctor will perform a physical exam and ask about your symptoms. During the exam, the doctor may feel a lump (mass) in your abdomen. Blood tests that may be ordered include: - Complete blood count (CBC) - Liver function tests - Serum bilirubin Imaging tests that may be ordered include: - CT scan of the abdomen - Endoscopic retrograde cholangiopancreatography (ERCP) - Endoscopic ultrasound - MRI of the abdomen Diagnosis of pancreatic cancer (and what type) is made by a pancreatic biopsy. If tests confirm you have pancreatic cancer, more tests will be done to see how far the cancer has spread within and outside the pancreas. This is called staging. Staging helps guide treatment and gives you an idea of what to expect. Treatment for adenocarcinoma depends on the stage of the tumor. Surgery may be done if the tumor has not spread or has spread very little. Along with surgery, chemotherapy or radiation therapy or both may be used before or after surgery. A small number of people can be cured with this treatment approach. When the tumor has not spread out of the pancreas but cannot be surgically removed, chemotherapy and radiation therapy together may be recommended. When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. With advanced cancer, the goal of treatment is to manage pain and other symptoms. For example, if the tube that carries bile is blocked by the pancreatic tumor, a procedure to place a tiny metal tube (stent) may be done to open the blockage. This can help relieve loss of appetite, jaundice, and itching of the skin. You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone. Some people with pancreatic cancer that can be surgically removed are cured. But in most people, the tumor has spread and cannot be completely removed at the time of diagnosis. Chemotherapy and radiation are often given after surgery to increase the cure rate (this is called adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery or cancer that has spread beyond the pancreas, a cure is not possible. In this case, chemotherapy is given to improve and extend one's life. Call for an appointment with your health care provider if you have: - Abdominal pain that does not go away - Back pain - Loss of appetite - Unexplained fatigue or weight loss - Other symptoms of this disorder Preventive measures include: - If you smoke, now is the time to quit. - Keep a diet high in fruits, vegetables, and whole grains. - Exercise regularly to stay at a healthy weight. Updated by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "Bulimia nervosa (What are the symptoms of bulimia?): Someone with bulimia may be thin, overweight, or have a normal weight. It can be difficult to tell based on a person's weight whether someone has bulimia. This is because binging and purging is most often done in private. However, family or friends may see empty food wrappers in unexpected places or vomit in the home. Over time, some symptoms of bulimia may include:5 Girls or women with bulimia may also have behavior changes such as: People with bulimia often have other mental health problems, including depression, anxiety, or substance abuse.6. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "What are the symptoms of Bulimia?: With bulimia, eating binges may occur as often as several times a day for many months. The person often eats large amounts of high-calorie foods, usually in secret. During these episodes, the person feels a lack of control over the eating. Binges lead to self-disgust, which causes purging to prevent weight gain. Purging may include: - Forcing oneself to vomit - Excessive exercise - Using laxatives, enemas, or diuretics (water pills) Purging often brings a sense of relief. People with bulimia are often at a normal weight, but they may see themselves as being overweight. Because the person's weight is often normal, other people may not notice this eating disorder. Symptoms that other people can see include: - Spending a lot of time exercising - Suddenly eating large amounts of food or buying large amounts of food that disappear right away - Regularly going to the bathroom right after meals - Throwing away packages of laxatives, diet pills, emetics (drugs that cause vomiting), or diuretics. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some common symptoms of bulimia", "response": "Bulimia nervosa (Symptoms): Bulimia signs and symptoms may include: - Being preoccupied with your body shape and weight - Living in fear of gaining weight - Feeling that you can't control your eating behavior - Eating until the point of discomfort or pain - Eating much more food in a binge episode than in a normal meal or snack - Forcing yourself to vomit or exercise too much to keep from gaining weight after bingeing - Misusing laxatives, diuretics or enemas after eating - Restricting calories or avoiding certain foods between binges - Using dietary supplements or herbal products excessively for weight loss If you have any bulimia symptoms, seek medical help as soon as possible. If left untreated, bulimia can severely impact your health. Talk to your primary care provider or a mental health provider about your bulimia symptoms and feelings. If you're reluctant to seek treatment, confide in someone about what you're going through, whether it's a friend or loved one, a teacher, a faith leader, or someone else you trust. He or she can help you take the first steps to get successful bulimia treatment. If you think a loved one may have symptoms of bulimia, have an open and honest discussion about your concerns. You can't force someone to seek professional care, but you can offer encouragement and support. You can also help find a qualified doctor or mental health provider, make an appointment, and even offer to go along. Because most people with bulimia are normal weight or slightly overweight, it may not be apparent to others that something is wrong. Red flags that family and friends may notice include: - Constantly worrying or complaining about being fat - Having a distorted, excessively negative body image - Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid - Not wanting to eat in public or in front of others - Going to the bathroom right after eating or during meals - Exercising too much - Having sores, scars or calluses on the knuckles or hands - Having damaged teeth and gums. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "Klinefelter syndrome (Treatment): If you or your son is diagnosed with Klinefelter syndrome, your health care team may include a doctor who specializes in diagnosing and treating disorders involving the body's glands and hormones (endocrinologist), a speech therapist, a pediatrician, a physical therapist, a genetic counselor, a reproductive medicine or infertility specialist, and a counselor or psychologist. Although there's no way to repair the sex chromosome changes due to Klinefelter syndrome, treatments can help minimize its effects. The earlier a diagnosis is made and treatment is started, the greater the benefits. But it's never too late to get help. Treatment for Klinefelter syndrome may include: - Testosterone replacement therapy. Starting at the time of the usual onset of puberty, testosterone replacement can be given to help stimulate changes that normally occur at puberty, such as developing a deeper voice, growing facial and body hair, and increasing muscle mass and penis size. Testosterone therapy can also improve bone density and reduce the risk of fractures. It will not result in testicle enlargement or improve infertility. - Breast tissue removal. In males who develop enlarged breasts, excess breast tissue can be removed by a plastic surgeon, leaving a more normal-looking chest. - Speech and physical therapy. These treatments can help boys with Klinefelter syndrome overcome problems with speech, language and muscle weakness. - Educational evaluation and support. Some boys with Klinefelter syndrome have trouble learning and socializing and can benefit from extra assistance. Talk to your child's teacher, school counselor or school nurse about what kind of support might help. - Fertility treatment. Most men with Klinefelter syndrome are unable to father children because few or no sperm are produced in the testicles. For some men with minimal sperm production, a procedure called intracytoplasmic sperm injection (ICSI) may help. During ICSI, sperm is removed from the testicle with a biopsy needle and injected directly into the egg. - Psychological counseling. Having Klinefelter syndrome can be a challenge, especially during puberty and young adulthood. For men with the condition, coping with infertility can be difficult. A family therapist, counselor or psychologist can help work through the emotional issues. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "What are the treatments for Klinefelter syndrome?: These resources address the diagnosis or management of Klinefelter syndrome: - Genetic Testing Registry: Klinefelter's syndrome, XXY - MedlinePlus Encyclopedia: Klinefelter Syndrome - MedlinePlus Encyclopedia: Testicular Failure These resources from MedlinePlus offer information about the diagnosis and management of various health conditions: - Diagnostic Tests - Drug Therapy - Surgery and Rehabilitation - Genetic Counseling - Palliative Care. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are some of the treatments available to males with klinefelter's", "response": "What are the treatments for Klinefelter syndrome?: Testosterone therapy may be prescribed. This can help: - Grow body hair - Improve appearance of muscles - Improve concentration - Improve mood and self esteem - Increase energy and sex drive - Increase strength Most men with this syndrome are not able to get a woman pregnant. But, an infertility specialist may be able to help. Seeing a doctor called an endocrinologist may also be helpful. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are symptoms of a nonfunctioning gallbladder", "response": "Gallbladder cancer (Symptoms): Gallbladder cancer signs and symptoms may include: - Abdominal pain, particularly in the upper right portion of the abdomen - Abdominal bloating - Fever - Losing weight without trying - Nausea - Yellowing of the skin and whites of the eyes (jaundice) Make an appointment with your doctor if you experience any signs or symptoms that worry you. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are symptoms of a nonfunctioning gallbladder", "response": "What is Gallbladder Cancer?: Your gallbladder is a pear-shaped organ under your liver. It stores bile, a fluid made by your liver to digest fat. As your stomach and intestines digest food, your gallbladder releases bile through a tube called the common bile duct. The duct connects your gallbladder and liver to your small intestine. Cancer of the gallbladder is rare. It is more common in women and Native Americans. Symptoms include - Jaundice (yellowing of the skin and whites of the eyes) - Pain above the stomach - Fever - Nausea and vomiting - Bloating - Lumps in the abdomen It is hard to diagnose gallbladder cancer in its early stages. Sometimes doctors find it when they remove the gallbladder for another reason. But people with gallstones rarely have gallbladder cancer. Because it is often found late, it can be hard to treat gallbladder cancer. Treatment options include surgery, chemotherapy, radiation, or a combination. NIH: National Cancer Institute. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "Childhood obesity (Overview): Childhood obesity is a serious medical condition that affects children and adolescents. Children who are obese are above the normal weight for their age and height. Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems - diabetes, high blood pressure and high cholesterol. Many obese children become obese adults, especially if one or both parents are obese. Childhood obesity can also lead to poor self-esteem and depression. One of the best strategies to reduce childhood obesity is to improve the eating and exercise habits of your entire family. Treating and preventing childhood obesity helps protect your child's health now and in the future. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "What causes Obesity?: Taking in more calories than your body burns can lead to obesity. This is because the body stores unused calories as fat. Obesity can be caused by: - Eating more food than your body can use - Drinking too much alcohol - Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Today, we know that biology is a big reason why some people cannot keep the weight off. Some people who live in the same place and eat the same foods become obese, while others do not. Our bodies have a complex system to keep our weight at a healthy level. In some people, this system does not work normally. The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We may feel that we are surrounded by things that make it easy to overeat and hard to stay active. - Many people feel they do not have time to plan and make healthy meals. - More people today work desk jobs compared to more active jobs in the past. - People with little free time may have less time to exercise. The term eating disorder means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: - Underactive thyroid (hypothyroidism) - Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: - Quitting smoking. Many people who quit smoking gain 4 to 10 pounds in the first 6 months after quitting. - Stress, anxiety, feeling sad, or not sleeping well - Menopause. Women may gain 12 to 15 pounds during menopause. - Pregnancy. Women may not lose the weight they gained during pregnancy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of childhood obesity", "response": "Childhood obesity (Causes): Lifestyle issues - too little activity and too many calories from food and drinks - are the main contributors to childhood obesity. But genetic and hormonal factors might play a role as well. For example, recent research has found that changes in digestive hormones can affect the signals that let you know you're full. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of pulmonary hypertension", "response": "Pulmonary hypertension (Causes): The right side of the heart pumps blood through the lungs, where it picks up oxygen. Blood returns to the left side of the heart, where it is pumped to the rest of the body. When the small arteries (blood vessels) of the lungs become narrowed, they cannot carry as much blood. When this happens, pressure builds up. This is called pulmonary hypertension. The heart needs to work harder to force the blood through the vessels against this pressure. Over time, this causes the right side of the heart to become larger. This condition is called right-sided heart failure, or cor pulmonale. Pulmonary hypertension may be caused by: - Autoimmune diseases that damage the lungs, such as scleroderma and rheumatoid arthritis - Birth defects of the heart - Blood clots in the lung (pulmonary embolism) - Heart failure - Heart valve disease - HIV infection - Low oxygen levels in the blood for a long time (chronic) - Lung disease, such as COPD or pulmonary fibrosis - Medicines (for example, certain diet drugs) - Obstructive sleep apnea In rare cases, the cause of pulmonary hypertension is unknown. In this case, the condition is called idiopathic pulmonary arterial hypertension (IPAH). Idiopathic means the cause of a disease is not known. IPAH affects more women than men. If pulmonary hypertension is caused by a known medicine or medical condition, it is called secondary pulmonary hypertension. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of pulmonary hypertension", "response": "Pulmonary hypertension (Treatment): There is no cure for pulmonary hypertension. The goal of treatment is to control symptoms and prevent more lung damage. It is important to treat medical disorders that cause pulmonary hypertension, such as obstructive sleep apnea, lung conditions, and heart valve problems. Many treatment options for pulmonary arterial hypertension are available. If you are prescribed medicines, they may be taken by mouth (oral), received through the vein (intravenous, or IV), or breathed in (inhaled). Your provider will decide which medicine is best for you. You will be closely monitored during treatment to watch for side effects and to see how well you are responding to the medicine. DO NOT stop taking your medicines without talking to your provider. Other treatments may include: - Blood thinners to reduce the risk of blood clots, especially if you have IPAH - Oxygen therapy at home - Heart-lung transplant, if medicines do not work Other important tips to follow: - Avoid pregnancy - Avoid heavy physical activities and lifting - Avoid traveling to high altitudes - Get a yearly flu vaccine, as well as other vaccines such as the pneumonia vaccine - Stop smoking. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Tooth abscess: A tooth abscess is a buildup of infected material (pus) in the center of a tooth. It is an infection caused by bacteria. A tooth abscess may form if there is tooth decay. It may also occur when a tooth is broken, chipped, or injured in other ways. Openings in the tooth enamel allow bacteria to infect the center of the tooth (the pulp). Infection may spread from the root of the tooth to the bones supporting the tooth. Infection results in a buildup of pus and tissue swelling within the tooth. This causes a toothache. The toothache may stop if pressure is relieved. But the infection can remain active and continue to spread. This can cause more pain and can destroy tissue. The main symptom is a severe toothache. The pain is continuous. It does not stop. It can be described as gnawing, sharp, shooting, or throbbing. Other symptoms may include: - Bitter taste in the mouth - Breath odor - General discomfort, uneasiness, or ill feeling - Fever - Pain when chewing - Sensitivity of the teeth to hot or cold - Swelling of the gum over the infected tooth, which may look like a pimple - Swollen glands of the neck - Swollen area of the upper or lower jaw, which is a very serious symptom Your dentist will closely look at your teeth, mouth, and gums. It may hurt when the dentist taps the tooth. Biting or closing your mouth tightly also increases the pain. Your gums may be swollen and red, and may drain thick material. Dental x-rays and other tests can help your dentist determine which tooth or teeth are causing the problem. The goals of treatment are to cure the infection, save the tooth, and prevent complications. Your dentist might prescribe antibiotics to fight the infection. Warm saltwater rinses may help ease the pain. Over-the-counter pain relievers may relieve your toothache and fever. Do NOT place aspirin directly on your tooth or gums. This increases irritation of the tissues and can result in mouth ulcers. A root canal may be recommended in an attempt to save the tooth. If you have a severe infection, your tooth may be removed, or you may need surgery to drain the abscess. Some people may need to be admitted to the hospital. Untreated abscesses may get worse and can lead to life-threatening complications. Prompt treatment cures the infection in most cases. The tooth can often be saved. These complications can occur: - Loss of the tooth - Blood infection - Spread of infection to soft tissue - Spread of infection to the jaw bone - Spread of infection to other areas of the body, which can cause brain abscess, inflammation in the heart, pneumonia, or other complications Call your dentist if you have a throbbing toothache that does not go away, or if you notice a bubble (or “pimple”) on your gums. Prompt treatment of dental decay reduces the risk of tooth abscess. Have your dentist examine any broken or chipped teeth right away. Updated by: Michael Kapner, DDS, general and aesthetic dentistry, Norwalk Medical Center, Norwalk, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Impacted tooth (Causes): Teeth start to pass through the gums (emerge) during infancy. This happens again when permanent teeth replace the primary (baby) teeth. If a tooth does not come in, or emerges only partially, it is considered to be impacted. This most commonly happens with the wisdom teeth (the third set of molars). They are the last teeth to emerge. They usually come in between the ages of 17 and 21. An impacted tooth remains stuck in gum tissue or bone for various reasons. The area may be overcrowded, leaving no room for the teeth to emerge. For example, the jaw may be too small to fit the wisdom teeth. Teeth may also become twisted, tilted, or displaced as they try to emerge. This results in impacted teeth. Impacted wisdom teeth are very common. They are often painless and do not cause problems. However, some professionals believe an impacted tooth pushes on the next tooth, which pushes the next tooth. Eventually, this can cause a misaligned bite. A partially emerged tooth can trap food, plaque, and other debris in the soft tissue around it, which can lead to inflammation and tenderness of the gums and unpleasant mouth odor. This is called pericoronitis. The retained debris may also lead to the decay on the wisdom tooth or the neighboring tooth. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the main causes tooth loss?", "response": "Cavities/tooth decay (Complications): Cavities and tooth decay are so common that you may not take them seriously. And you may think that it doesn't matter if children get cavities in their baby teeth. However, cavities and tooth decay can have serious and lasting complications, even for children who don't have their permanent teeth yet. Complications of cavities may include: - Pain - Tooth abscess - Swelling or pus around a tooth - Damage or broken teeth - Chewing problems - Positioning shifts of teeth after tooth loss When cavities and decay become severe, you may have: - Pain that interferes with daily living - Weight loss or nutrition problems from painful or difficult eating or chewing - Tooth loss, which may affect your appearance, as well as your confidence and self-esteem - In rare cases, a tooth abscess - a pocket of pus that's caused by bacterial infection - which can lead to more serious or even life-threatening infections. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the risk factors of type ii diabetes", "response": "Risk Factors for Type 2 Diabetes: You can take steps to help prevent or delay type 2 diabetes by losing weight if you are overweight, eating fewer calories, and being more physically active. Talk with your health care professional about any of the health conditions listed above that may require medical treatment. Managing these health problems may help reduce your chances of developing type 2 diabetes. Also, ask your health care professional about any medicines you take that might increase your risk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the risk factors of type ii diabetes", "response": "Who is at risk for Diabetes??: Diabetes is a serious, life-long disease. It can lead to problems such as heart disease, stroke, vision loss, kidney disease, and nerve damage. More than 8 million people in the United States have type 2 diabetes and dont know it. Many people dont find out they have diabetes until they are faced with problems such as blurry vision or heart trouble. Certain factors can increase your risk for diabetes, and its important to know what they are. Type 1 Diabetes Type 1 diabetes is an autoimmune disease. In an autoimmune reaction, antibodies, or immune cells, attach to the bodys own healthy tissues by mistake, signaling the body to attack them. At present, scientists do not know exactly what causes the body's immune system to attack the cells, but many believe that both genetic factors and environmental factors, such as viruses, are involved. Studies are now underway to identify these factors and prevent type 1 diabetes in people at risk. Learn more about the causes of type 1 diabetes. Type 2 Diabetes Type 2 diabetes -- the most common form -- is linked closely to overweight and obesity, high blood pressure, and abnormal cholesterol levels. Many people with type 2 diabetes are overweight. Being overweight can keep your body from using insulin properly. Genes also play an important role in a person's risk for type 2 diabetes. Having certain genes or combinations of genes may increase or decrease a persons risk for developing the disease. Here are the risk factors for type 2 diabetes. - being over 45 years of age - being overweight or obese - having a first-degree relative -- a parent, brother, or sister -- with diabetes - being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) being over 45 years of age being overweight or obese having a first-degree relative -- a parent, brother, or sister -- with diabetes being African American, American Indian or Alaska Native, Asian American or Pacific Islander, or Hispanic American/Latino. (Watch the video to learn more about native Americans and diabetes risk. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) - having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds - having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. - having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher - being inactive or exercising fewer than three times a week. - having polycystic ovary syndrome, also called PCOS (women only) - on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) - history of cardiovascular disease (disease affecting the heart and blood vessels). having gestational diabetes, or giving birth to at least one baby weighing more than 9 pounds having blood pressure of 140/90 or higher, or having been told that you have high blood pressure. having abnormal cholesterol levels -- an HDL cholesterol level of 35 or lower, or a triglyceride level of 250 or higher being inactive or exercising fewer than three times a week. having polycystic ovary syndrome, also called PCOS (women only) on previous testing, having prediabetes (an A1C level of 5.7 to 6.4 percent), impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) history of cardiovascular disease (disease affecting the heart and blood vessels). Learn more about the causes of type 2 diabetes. Prediabetes and Type 2 Diabetes Before people develop type 2 diabetes, they usually have prediabetes -- a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. People with prediabetes are more likely to develop diabetes within 10 years and also are more likely to have a heart attack or stroke. Prediabetes is increasingly common in the U.S. adult population. In 2012, about 86 million people in the U.S. had pre-diabetes, and 51% of those 65 or older had prediabetes. Learn more about prediabetes. Gestational Diabetes Some women develop diabetes during the late stages of pregnancy. This is called gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it has a lifelong risk for developing diabetes, mostly type 2. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for cystic fibrosis", "response": "Cystic fibrosis (Symptoms): Screening of newborns for cystic fibrosis is now performed in every state in the United States. As a result, the condition can be diagnosed within the first month of life, before symptoms develop. For people born before newborn screening was performed, it's important to be aware of the signs and symptoms of cystic fibrosis. Cystic fibrosis signs and symptoms vary, depending on the severity of the disease. Even in the same person, symptoms may worsen or improve as time passes. Some people may not experience symptoms until adolescence or adulthood. People with cystic fibrosis have a higher than normal level of salt in their sweat. Parents often can taste the salt when they kiss their children. Most of the other signs and symptoms of cystic fibrosis affect the respiratory system and digestive system. However, adults diagnosed with cystic fibrosis are more likely to have atypical symptoms, such as recurring bouts of inflamed pancreas (pancreatitis), infertility and recurring pneumonia. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: - A persistent cough that produces thick mucus (sputum) - Wheezing - Breathlessness - Exercise intolerance - Repeated lung infections - Inflamed nasal passages or a stuffy nose The thick mucus can also block tubes that carry digestive enzymes from your pancreas to your small intestine. Without these digestive enzymes, your intestines aren't able to completely absorb the nutrients in the food you eat. The result is often: - Foul-smelling, greasy stools - Poor weight gain and growth - Intestinal blockage, particularly in newborns (meconium ileus) - Severe constipation Frequent straining while passing stool can cause part of the rectum - the end of the large intestine - to protrude outside the anus (rectal prolapse). When this occurs in children, it may be a sign of cystic fibrosis. Parents should consult a physician knowledgeable about cystic fibrosis. Rectal prolapse in children may sometimes require surgery. Rectal prolapse in children with cystic fibrosis is less common than it was in the past, which may be due to earlier testing, diagnosis and treatment of cystic fibrosis. If you or your child has symptoms of cystic fibrosis - or if someone in your family has cystic fibrosis - talk with your doctor about testing for the disease. Seek immediate medical care if you or your child has difficulty breathing. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for cystic fibrosis", "response": "Cystic fibrosis (Symptoms): Symptoms in newborns may include: - Delayed growth - Failure to gain weight normally during childhood - No bowel movements in first 24 to 48 hours of life - Salty-tasting skin Symptoms related to bowel function may include: - Belly pain from severe constipation - Increased gas, bloating, or a belly that appears swollen (distended) - Nausea and loss of appetite - Stools that are pale or clay-colored, foul smelling, have mucus, or that float - Weight loss Symptoms related to the lungs and sinuses may include: - Coughing or increased mucus in the sinuses or lungs - Fatigue - Nasal congestion caused by nasal polyps - Repeated episodes of pneumonia (symptoms of pneumonia in someone with cystic fibrosis include fever, increased coughing and shortness of breath, increased mucus, and loss of appetite) - Sinus pain or pressure caused by infection or polyps Symptoms that may be noticed later in life: - Infertility (in men) - Repeated inflammation of the pancreas (pancreatitis) - Respiratory symptoms - Clubbed fingers. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for cystic fibrosis", "response": "Cystic fibrosis (Complications): - Damaged airways (bronchiectasis). Cystic fibrosis is one of the leading causes of bronchiectasis, a condition that damages the airways. This makes it harder to move air in and out of the lungs and clear mucus from the airways (bronchial tubes). - Chronic infections. Thick mucus in the lungs and sinuses provides an ideal breeding ground for bacteria and fungi. People with cystic fibrosis may often have sinus infections, bronchitis or pneumonia. - Growths in the nose (nasal polyps). Because the lining inside the nose is inflamed and swollen, it can develop soft, fleshy growths (polyps). - Coughing up blood (hemoptysis). Over time, cystic fibrosis can cause thinning of the airway walls. As a result, teenagers and adults with cystic fibrosis may cough up blood. - Pneumothorax. This condition, in which air collects in the space that separates the lungs from the chest wall, also is more common in older people with cystic fibrosis. Pneumothorax can cause chest pain and breathlessness. - Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. - Acute exacerbations. People with cystic fibrosis may experience worsening of their respiratory symptoms, such as coughing and shortness of breath, for several days to weeks. This is called an acute exacerbation and requires treatment in the hospital. - Nutritional deficiencies. Thick mucus can block the tubes that carry digestive enzymes from your pancreas to your intestines. Without these enzymes, your body can't absorb protein, fats or fat-soluble vitamins. - Diabetes. The pancreas produces insulin, which your body needs to use sugar. Cystic fibrosis increases the risk of diabetes. Around 30 percent of people with cystic fibrosis develop diabetes by age 30. - Blocked bile duct. The tube that carries bile from your liver and gallbladder to your small intestine may become blocked and inflamed, leading to liver problems and sometimes gallstones. - Intestinal obstruction. Intestinal obstruction can happen to people with cystic fibrosis at all ages. Children and adults with cystic fibrosis are more likely than are infants to develop intussusception, a condition in which a section of the intestines folds in on itself like an accordion. - Distal intestinal obstruction syndrome (DIOS). DIOS is partial or complete obstruction where the small intestine meets the large intestine. Almost all men with cystic fibrosis are infertile because the tube that connects the testes and prostate gland (vas deferens) is either blocked with mucus or missing entirely. Certain fertility treatments and surgical procedures sometimes make it possible for men with cystic fibrosis to become biological fathers. Although women with cystic fibrosis may be less fertile than other women, it's possible for them to conceive and to have successful pregnancies. Still, pregnancy can worsen the signs and symptoms of cystic fibrosis, so be sure to discuss the possible risks with your doctor. - Thinning of the bones (osteoporosis). People with cystic fibrosis are at higher risk of developing a dangerous thinning of bones. - Electrolyte imbalances and dehydration. Because people with cystic fibrosis have saltier sweat, the balance of minerals in their blood may be upset. Signs and symptoms include increased heart rate, fatigue, weakness and low blood pressure. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "What are the symptoms of Prostate Cancer?: Symptoms Most cancers in their early, most treatable stages don't cause any symptoms. Early prostate cancer usually does not cause symptoms. However, if prostate cancer develops and is not treated, it can cause these symptoms: - a need to urinate frequently, especially at night - difficulty starting urination or holding back urine - inability to urinate - weak or interrupted flow of urine - painful or burning urination - difficulty in having an erection - painful ejaculation - blood in urine or semen - pain or stiffness in the lower back, hips, or upper thighs. a need to urinate frequently, especially at night difficulty starting urination or holding back urine inability to urinate weak or interrupted flow of urine painful or burning urination difficulty in having an erection painful ejaculation blood in urine or semen pain or stiffness in the lower back, hips, or upper thighs. Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If You Have Symptoms If you have any of these symptoms, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. The doctor will ask questions about your medical history and perform an exam to try to find the cause of the prostate problems. The PSA Test The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present. PSA screening for prostate cancer is not perfect. (Screening tests check for disease in a person who shows no symptoms.) Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers. Other Tests The doctor may order other exams, including ultrasound, MRI, or CT scans, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope. If Cancer is Present If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope. One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "Familial prostate cancer: Familial prostate cancer is a cluster of prostate cancer within a family. Most cases of prostate cancer occur sporadically in people with no family history of the condition. However, approximately 5% to 10% of prostate cancer cases are believed to be primarily caused by a genetic predisposition to the condition. [1] In many families, the underlying genetic cause is unknown; however, some of these cases are caused by changes ( mutations ) in the BRCA1 , BRCA2, HOXB13, or several other genes . Other cases are likely due to a combination of gene(s) and other shared factors such as environment and lifestyle. [2] High-risk cancer screening at an earlier age is typically recommended in men who have an increased risk for prostate cancer based on personal and/or family histories. The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below. Signs and Symptoms Approximate number of patients (when available) Autosomal dominant inheritance - Neoplasm - Prostate cancer - Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional. Testing Resources The Genetic Testing Registry (GTR) provides information about the genetic tests for this condition. The intended audience for the GTR is health care providers and researchers. Patients and consumers with specific questions about a genetic test should contact a health care provider or a genetics professional. FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Learn more orphan products. National Library of Medicine Drug Information Portal. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the symptoms for prostate cancer", "response": "What are the symptoms of Prostate Cancer?: Yes. Any of the symptoms caused by prostate cancer may also be due to enlargement of the prostate, which is not cancer. If you have any of the symptoms mentioned in question #10, see your doctor or a urologist to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of headaches", "response": "Rebound headaches (Overview): Rebound headaches (medication-overuse headaches) are caused by regular, long-term use of medication to treat headaches, such as migraine. Pain relievers offer relief for occasional headaches. But if you take them more than a couple of days a week, they may trigger rebound headaches. It appears that any medication taken for pain relief can cause rebound headaches, but only if you already have a headache disorder. Pain relievers taken regularly for another condition, such as arthritis, have not been shown to cause rebound headaches in people who never had a headache disorder. Rebound headaches usually stop when you stop taking the pain medication. It's tough in the short term, but your doctor can help you beat rebound headaches for long-term relief. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of headaches", "response": "What causes Headaches - danger signs?: Problems with blood vessels and bleeding in the brain cancause as a headache. These include: - Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM. - Blood flow to part of the brain stops. This is called a stroke. - Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm. - Bleeding in the area between the brain and the thin tissue that covers the brain. This iscalled a subarachnoid hemorrhage Other causes of headaches that should be checked by a doctor right awayinclude: - Blood pressure that is very high - Brain tumor - Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus) - Buildup of pressure inside the skull that appears to be, but is not a tumor (pseudomotor cerebri) - Carbon monoxide poisoning - Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess - Swollen, inflamed arterythat supplies blood to part of the head, temple, and neck area (temporal arteritis). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what are the causes of headaches", "response": "Sex headaches (Causes): Any type of sexual activity that leads to orgasm can trigger sex headaches. Abrupt-onset and slow-to-build sex headaches can be primary headache disorders not associated with any underlying condition. Sex headaches that come on suddenly are more likely to be associated with: - A widening or bubble in the wall of an artery inside your head (intracranial aneurysm) - An abnormal connection between arteries and veins in the brain (arteriovenous malformation) that bleeds into the spinal fluid-filled space in and around the brain - Bleeding into the wall of an artery leading to the brain (dissection) - Stroke - Coronary artery disease - Use of some medications, such as birth control pills - Inflammation from certain infections Sex headaches associated with loss of consciousness, vomiting, stiff neck, other neurological symptoms and severe pain lasting more than 24 hours are more likely to be due to an underlying cause. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what blood tests confirm celiac disease", "response": "Celiac Disease (What tests do doctors use to diagnose celiac disease?): A health care professional may take a blood sample from you and send the sample to a lab to test for antibodies common in celiac disease. If blood test results are negative and your doctor still suspects celiac disease, he or she may order more blood tests.If a biopsy and other blood tests do not clearly confirm celiac disease, your doctor may order genetic blood tests to check for certain gene changes, or variants.4 You are very unlikely to have celiac disease if these gene variants are not present. Having these variants alone is not enough to diagnose celiac disease because they also are common in people without the disease. In fact, most people with these genes will never get celiac disease.If blood tests suggest you have celiac disease, your doctor will perform a biopsy to be sure. During a biopsy, the doctor takes a small piece of tissue from your small intestine during a procedure called an upper GI endoscopy.If a doctor suspects you have dermatitis herpetiformis, he or she will perform a skin biopsy. For a skin biopsy, the doctor removes tiny pieces of skin tissue to examine with a microscope.A doctor examines the skin tissue and checks the tissue for antibodies common in celiac disease. If the skin tissue has the antibodies, a doctor will perform blood tests to confirm celiac disease. If the skin biopsy and blood tests both suggest celiac disease, you may not need an intestinal biopsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what blood tests confirm celiac disease", "response": "Celiac disease - sprue (Exams and Tests): The following tests may be performed: - Bone density - Cholesterol (may be low) - Complete blood count (CBC - test for anemia) - Comprehensive metabolic panel - Folate level (serum) - Iron level (serum) - Prothrombin time - Vitamin B12 level (serum) - Vitamin D level Blood tests can detect antibodies, called antitissue transglutaminase antibodies (tTGA) or anti-endomysial antibodies (EMA) which may help detect the condition. The health care provider will order these antibody tests if celiac disease is suspected. If the tests are positive, upper endoscopy is often performed to sample a piece of tissue (biopsy) from the first part of the small intestine (duodenum). The biopsy may show a flattening of the villi in the parts of the intestine below the duodenum. Genetic testing of the blood can also be done to help determine who may be at risk for celiac disease. A follow-up biopsy or blood test may be ordered several months after the diagnosis and treatment. These tests assess how well treatment is working. Normal results mean that you have responded to treatment. This confirms the diagnosis. However, this does not mean that the disease has been cured. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "Hypoglycemia (Complications): If you ignore the symptoms of hypoglycemia too long, you may lose consciousness. That's because your brain needs glucose to function properly. Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to: - Seizure - Loss of consciousness - Death Hypoglcemia can also contribute to: - Falls - Injuries - Motor vehicle accidents Hypoglycemia unawareness Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. The body and brain no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats. When this happens, the risk of severe, life-threatening hypoglycemia is increased. Undertreated diabetes If you have diabetes, episodes of low blood sugar are uncomfortable and can be frightening. Repeated episodes of hypoglycemia may cause you to take less insulin to ensure that your blood sugar level doesn't go too low. But long-term high blood sugar levels can be dangerous too, possibly causing damage to your nerves, blood vessels and various organs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "What to do for Hypoglycemia?: Diabetes-related Hypoglycemia - When people with diabetes think their blood glucose level is low, they should check it and treat the problem right away. - To treat hypoglycemia, people should have a serving of a quick-fix food, wait 15 minutes, and check their blood glucose again. They should repeat the treatment until their blood glucose is 70 mg/dL or above. - People at risk for hypoglycemia should keep quick-fix foods in the car, at workanywhere they spend time. - People at risk for hypoglycemia should be careful when driving. They should check their blood glucose frequently and snack as needed to keep their level 70 mg/dL or above. Hypoglycemia Unrelated to Diabetes - In reactive hypoglycemia, symptoms occur within 4 hours of eating. People with reactive hypoglycemia are usually advised to follow a healthy eating plan recommended by a registered dietitian. - Fasting hypoglycemia can be caused by certain medications, critical illnesses, hereditary enzyme or hormonal deficiencies, and some kinds of tumors. Treatment targets the underlying problem. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what can cause hypoglycemia", "response": "Hypoglycemia (Symptoms): If blood sugar levels become too low, signs and symptoms may include: - An irregular heart rhythm - Fatigue - Pale skin - Shakiness - Anxiety - Sweating - Hunger - Irritability - Tingling sensation around the mouth - Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: - Confusion, abnormal behavior or both, such as the inability to complete routine tasks - Visual disturbances, such as blurred vision - Seizures - Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. When to see a doctor Seek a doctor's help immediately if: - You have what may be symptoms of hypoglycemia and you don't have diabetes. - You have diabetes and hypoglycemia isn't responding to treatment. Initial treatment of hypoglycemia is drinking juice or regular soft drinks, eating candy or taking glucose tablets. If this treatment doesn't raise your blood sugar and improve your symptoms, contact your doctor right away. Seek emergency help if: - Someone with diabetes or a history of recurring hypoglycemia has symptoms of severe hypoglycemia or loses consciousness. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes bipolar disorder", "response": "Bipolar disorder (Risk factors): Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include: - Having a first-degree relative, such as a parent or sibling, with bipolar disorder - Periods of high stress, such as the death of a loved one or other traumatic event - Drug or alcohol abuse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes bipolar disorder", "response": "How to diagnose Bipolar disorder?: To diagnose bipolar disorder, the health care provider may do some or all of the following: - Ask whether other family members have bipolar disorder - Ask about your recent mood swings and for how long you have had them - Perform a thorough exam and order lab tests to look for other illnesses that may be causing symptoms that resemble bipolar disorder - Talk to family members about your symptoms and overall health - Ask about any health problems you have and any medications you take - Watch your behavior and mood. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes fungal pneumonia", "response": "Pneumonia (Causes): Bacteria, viruses, and fungi infections can cause pneumonia. These infections cause inflammation in the air sacs, or alveoli, of the lungs. This inflammation causes the air sacs to fill with fluid and pus. Bacteria Bacteria are the most common cause of pneumonia in adults. Many types of bacteria can cause bacterial pneumonia. Streptococcus pneumoniae or pneumococcus bacteria are the most common cause of bacterial pneumonia in the United States. If your pneumonia is caused by one of the following types of bacteria, it is called atypical pneumonia. Legionella pneumophila. This type of pneumonia sometimes is called Legionnaire's disease, and it has caused serious outbreaks. Outbreaks have been linked to exposure to cooling towers, whirlpool spas, and decorative fountains. Mycoplasma pneumoniae. This is a common type of pneumonia that usually affects people younger than 40 years old. People who live or work in crowded places like schools, homeless shelters, and prisons are at higher risk for this type of pneumonia. It's usually mild and responds well to treatment with antibiotics. However, Mycoplasma pneumoniae can be very serious. It may be associated with a skin rash and hemolysis. This type of bacteria is a common cause of “walking pneumonia”. Chlamydia pneumoniae. This type of pneumonia can occur all year and often is mild. The infection is most common in people 65 to 79 years old. Bacterial pneumonia can occur on its own or develop after you've had a viral cold or the flu. Bacterial pneumonia often affects just one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. Read more Most of the time, the body filters bacteria out of the air that we breathe to protect the lungs from infection. Your immune system, the shape of your nose and throat, your ability to cough, and fine, hair-like structures called cilia help stop the germs from reaching your lungs. Read How the Lungs Work for more information. Sometimes bacteria manage to enter the lungs and cause infections. This is more likely to occur if: Your immune system is weak A germ is very strong Your body fails to filter out the bacteria from the air that you breathe. For example, if you can't cough because you've had a stroke or are sedated, bacteria may remain in your airways. When bacteria reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the bacteria. These cells cause inflammation in alveoli (air sacs) and can cause these spaces to fill up with fluid and pus. This causes the symptoms of pneumonia. Viruses Viruses that infect the respiratory tract may cause pneumonia. The influenza or flu virus is the most common cause of viral pneumonia in adults. Respiratory syncytial virus (RSV) is the most common cause of viral pneumonia in children younger than one year old. Other viruses can cause pneumonia such as the common cold virus known as rhinovirus, human parainfluenza virus (HPIV), and human metapneumovirus (HMPV). Most cases of viral pneumonia are mild. They get better in about one to three weeks without treatment. Some cases are more serious and may require treatment in a hospital. If you have viral pneumonia, you run the risk of getting bacterial pneumonia. Fungi Pneumocystis pneumonia is a serious fungal infection caused by Pneumocystis jirovecii. It occurs in people who have weak immune systems due to HIV/AIDS or the long-term use of medicines that suppress their immune systems, such as those used to treat cancer or as part of organ or blood and marrow stem cell transplant procedures. Other fungal infections also can lead to pneumonia. The following are three fungi that occur in the soil in some parts of the United States and can cause some people to get pneumonia. Coccidioidomycosis. This fungus is found in Southern California and the desert Southwest. It is the cause of valley fever. Histoplasmosis. This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus. This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what causes fungal pneumonia", "response": "What causes Pneumonia?: Many germs can cause pneumonia. Examples include different kinds of bacteria, viruses, and, less often, fungi. Most of the time, the body filters germs out of the air that we breathe to protect the lungs from infection. Your immune system, the shape of your nose and throat, your ability to cough, and fine, hair-like structures called cilia (SIL-e-ah) help stop the germs from reaching your lungs. (For more information, go to the Diseases and Conditions Index How the Lungs Work article.) Sometimes, though, germs manage to enter the lungs and cause infections. This is more likely to occur if: Your immune system is weak A germ is very strong Your body fails to filter germs out of the air that you breathe For example, if you can't cough because you've had a stroke or are sedated, germs may remain in your airways. (\"Sedated\" means you're given medicine to make you sleepy.) When germs reach your lungs, your immune system goes into action. It sends many kinds of cells to attack the germs. These cells cause the alveoli (air sacs) to become red and inflamed and to fill up with fluid and pus. This causes the symptoms of pneumonia. Germs That Can Cause Pneumonia Bacteria Bacteria are the most common cause of pneumonia in adults. Some people, especially the elderly and those who are disabled, may get bacterial pneumonia after having the flu or even a common cold. Many types of bacteria can cause pneumonia. Bacterial pneumonia can occur on its own or develop after you've had a cold or the flu. This type of pneumonia often affects one lobe, or area, of a lung. When this happens, the condition is called lobar pneumonia. The most common cause of pneumonia in the United States is the bacterium Streptococcus (strep-to-KOK-us) pneumoniae, or pneumococcus (nu-mo-KOK-us). Lobar Pneumonia Another type of bacterial pneumonia is called atypical pneumonia. Atypical pneumonia includes: Legionella pneumophila. This type of pneumonia sometimes is called Legionnaire's disease, and it has caused serious outbreaks. Outbreaks have been linked to exposure to cooling towers, whirlpool spas, and decorative fountains. Mycoplasma pneumonia. This is a common type of pneumonia that usually affects people younger than 40 years old. People who live or work in crowded places like schools, homeless shelters, and prisons are at higher risk for this type of pneumonia. It's usually mild and responds well to treatment with antibiotics. However, mycoplasma pneumonia can be very serious. It may be associated with a skin rash and hemolysis (the breakdown of red blood cells). Chlamydophila pneumoniae. This type of pneumonia can occur all year and often is mild. The infection is most common in people 65 to 79 years old. Viruses Respiratory viruses cause up to one-third of the pneumonia cases in the United States each year. These viruses are the most common cause of pneumonia in children younger than 5 years old. Most cases of viral pneumonia are mild. They get better in about 1 to 3 weeks without treatment. Some cases are more serious and may require treatment in a hospital. If you have viral pneumonia, you run the risk of getting bacterial pneumonia as well. The flu virus is the most common cause of viral pneumonia in adults. Other viruses that cause pneumonia include respiratory syncytial virus, rhinovirus, herpes simplex virus, severe acute respiratory syndrome (SARS), and more. Fungi Three types of fungi in the soil in some parts of the United States can cause pneumonia. These fungi are: Coccidioidomycosis (kok-sid-e-OY-do-mi-KO-sis). This fungus is found in Southern California and the desert Southwest. Histoplasmosis (HIS-to-plaz-MO-sis). This fungus is found in the Ohio and Mississippi River Valleys. Cryptococcus (krip-to-KOK-us). This fungus is found throughout the United States in bird droppings and soil contaminated with bird droppings. Most people exposed to these fungi don't get sick, but some do and require treatment. Serious fungal infections are most common in people who have weak immune systems due to the long-term use of medicines to suppress their immune systems or having HIV/AIDS. Pneumocystis jiroveci (nu-mo-SIS-tis ye-RO-VECH-e), formerly Pneumocystis carinii, sometimes is considered a fungal pneumonia. However, it's not treated with the usual antifungal medicines. This type of infection is most common in people who: Have HIV/AIDS or cancer Have had an organ transplant and/or blood and marrow stem cell transplant Take medicines that affect their immune systems Other kinds of fungal infections also can lead to pneumonia. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what does kidney disease look like", "response": "Kidney disease - resources: The following organizations are good resources for information on kidney disease: - National Institute of Diabetes and Digestive and Kidney Disease -- www.niddk.nih.gov/health-information/kidney-disease - National Kidney Foundation -- www.kidney.org - American Kidney Fund -- www.kidneyfund.org - American Geriatrics Society's Health in Aging Foundation -- www.healthinaging.org/aging-and-health-a-to-z/topic:kidney-problems/ Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what does kidney disease look like", "response": "Who is at risk for Kidney Disease??: Diabetes and high blood pressure are the two leading risk factors for kidney disease. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease -- without you feeling it. There are several other risk factors for kidney disease. Cardiovascular (heart) disease is a risk factor. So is family history: if you have a mother, father, sister, or brother who has had kidney disease, then you are at increased risk. African Americans, Hispanics, and Native Americans tend to have a greater risk for kidney failure. This is mostly due to higher rates of diabetes and high blood pressure in these communities, although there may be other reasons. (Watch the video to learn more about the connection between heart disease and kidney disease. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what does kidney disease look like", "response": "Diabetic Kidney Disease (What is diabetic kidney disease?): Diabetic kidney disease is a type of kidney disease caused by diabetes.Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with diabetes has kidney disease.1The main job of the kidneys is to filter wastes and extra water out of your blood to make urine. Your kidneys also help control blood pressure and make hormones that your body needs to stay healthy.Your kidneys are located in the middle of your back, just below your rib cage.When your kidneys are damaged, they can’t filter blood like they should, which can cause wastes to build up in your body. Kidney damage can also cause other health problems.Kidney damage caused by diabetes usually occurs slowly, over many years. You can take steps to protect your kidneys and to prevent or delay kidney damage.Watch a video about Diabetes and Kidney Disease.What are other names for diabetic kidney disease?Diabetic kidney disease is also called DKD, chronic kidney disease, CKD, kidney disease of diabetes, or diabetic nephropathy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is acute diverticulitis", "response": "Diverticulitis (Symptoms): People with diverticulosis often have no symptoms, but they may have bloating and cramping in the lower part of the belly. Rarely, they may notice blood in their stool or on toilet paper. Symptoms of diverticulitis are more severe and often start suddenly, but they may become worse over a few days. They include: - Tenderness, usually in the left lower side of the abdomen - Bloating or gas - Fever and chills - Nausea and vomiting - Not feeling hungry and not eating. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is acute diverticulitis", "response": "What is Diverticulitis?: Diverticulitis occurs when small, bulging sacs or pouches that form on the inner wall of the intestine (diverticula) become inflamed or infected. Most often, these pouches are in the large intestine (colon). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is acute diverticulitis", "response": "Diverticulitis (Diagnosis): Diverticulitis is usually diagnosed during an acute attack. Because abdominal pain can indicate a number of problems, your doctor will need to rule out other causes for your symptoms. Your doctor will likely start with a physical examination, including checking your abdomen for tenderness. Women, in addition, generally have a pelvic examination to rule out pelvic disease. After that, your doctor will likely recommend: - Blood and urine tests, to check for signs of infection. - Pregnancy test for women of childbearing age, to rule out pregnancy as a cause of abdominal pain. - Liver function tests, to rule out other causes of abdominal pain. - Stool test, to rule out infection in people who have diarrhea. - CT scan, which can indicate inflamed or infected pouches and confirm a diagnosis of diverticulitis. CT can also indicate the severity of diverticulitis and guide treatment. Diagnosis at Mayo Clinic Diverticulitis can be difficult to diagnose because abdominal pain is a symptom of many digestive disorders. Mayo Clinic has radiologists who specialize in digestive disorders and have experience distinguishing diverticulitis from other conditions. Mayo's digestive disease specialists (gastroenterologists) have experience diagnosing the severity of diverticulitis. Precise diagnosis is important for appropriate treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is binge eating disorder", "response": "How to diagnose Binge eating disorder?: The health care provider will perform a physical exam and ask about your eating patterns and symptoms. Blood tests may be done. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is binge eating disorder", "response": "Binge eating disorder (How does binge eating disorder affect pregnancy?): Binge eating disorder can cause problems getting pregnant and during pregnancy. Pregnancy can also trigger binge eating disorder. Obesity raises the level of the hormone estrogen in your body. Higher levels of estrogen can stop you from ovulating, or releasing an egg from the ovary. This can make it more difficult to get pregnant. However, if you do not want to have children right now and have sex, you should use birth control. Overweight or obesity may also cause problems during pregnancy. Overweight and obesity raises your risk for: Pregnancy can raise the risk for binge eating disorder in women who are at higher risk for eating disorders. In one study, almost half of the women with binge eating disorder got the condition during pregnancy. The research suggests that binge eating during pregnancy may be caused by:16 After pregnancy, postpartum depression and weight from pregnancy can trigger binge eating disorder in women with a history of binge eating. Women with binge eating disorder before pregnancy often gain more weight during pregnancy than women without an eating disorder. Researchers think that weight gain during pregnancy may cause some women who had binge eating disorder before pregnancy to binge eat during pregnancy.17. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "COPD: Español Also known as chronic obstructive pulmonary disease; chronic bronchitis; or emphysema. COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time. COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin (AAT) deficiency can also cause the disease. Overview To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial tubes or airways. Within the lungs, your bronchial tubes branch many times into thousands of smaller, thinner tubes called bronchioles. These tubes end in bunches of tiny round air sacs called alveoli. Small blood vessels called capillaries run along the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, a waste product, called carbon dioxide (CO2) gas, moves from the capillaries into the air sacs. This process, called gas exchange, brings in oxygen for the body to use for vital functions and removes the CO2. The airways and air sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate and the air goes out. In COPD, less air flows in and out of the airways because of one or more of the following: The airways and air sacs lose their elastic quality. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed. The airways make more mucus than usual and can become clogged. Normal Lungs and Lungs With COPD In the United States, the term COPD includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe. Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate. Outlook COPD is a major cause of disability, and it is the third leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it. COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself. Most of the time, COPD is diagnosed in middle-aged or older adults. The disease is not contagious, meaning it cannot be passed from person to person. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it hard to breathe. You may also have heard COPD called other names, like emphysema or chronic bronchitis. In people who have COPD, the airways that carry air in and out of the lungs are partially blocked, making it difficult to get air in and out. COPD is a major cause of death and illness throughout the world. It kills more than 120,000 Americans each year. That's one death every 4 minutes. How COPD Affects Airways The \"airways\" are the tubes that carry air in and out of the lungs through the nose and mouth. The airways of the lungs branch out like an upside-down tree. At the end of each branch are many small, balloon-like air sacs. In healthy people, the airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air, like a small balloon, and when you breathe out, the balloon deflates and the air goes out. In people with COPD, the airways and air sacs lose their shape and become floppy. Less air gets in and less air goes out of the airways because - The airways and air sacs lose their elasticity like an old rubber band. - The walls between many of the air sacs are destroyed. - The walls of the airways become thick and inflamed or swollen. - Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. The airways and air sacs lose their elasticity like an old rubber band. The walls between many of the air sacs are destroyed. The walls of the airways become thick and inflamed or swollen. Cells in the airways make more mucus or sputum than usual, which tends to clog the airways. COPD Develops Slowly, Has No Cure When COPD is severe, shortness of breath and other symptoms of COPD can get in the way of even the most basic tasks, such as doing light housework, taking a walk, even washing and dressing. COPD develops slowly, and it may be many years before you notice symptoms like feeling short of breath. Most of the time, COPD is diagnosed in middle-aged or older people. There is no cure for COPD. The damage to your airways and lungs cannot be reversed, but there are things you can do to control the disabling effects of the disease. COPD is not contagious. You cannot catch it from someone else. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is copd", "response": "What is COPD?: Chronic obstructive pulmonary disease, or COPD, is a progressive lung disease in which the airways of the lungs become damaged, making it harder to breathe. With COPD, airways become blocked, making it harder to get air in and out. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is epilepsy", "response": "Epilepsy: The epilepsies are a spectrum of brain disorders ranging from severe, life-threatening and disabling, to ones that are much more benign. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. The epilepsies have many possible causes and there are several types of seizures. Anything that disturbs the normal pattern of neuron activity—from illness to brain damage to abnormal brain development—can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, changes in important features of brain cells called channels, or some combination of these and other factors. Having a single seizure as the result of a high fever (called febrile seizure) or head injury does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. A measurement of electrical activity in the brain and brain scans such as magnetic resonance imaging or computed tomography are common diagnostic tests for epilepsy. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 70 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some drugs are more effective for specific types of seizures. An individual with seizures, particularly those that are not easily controlled, may want to see a neurologist specifically trained to treat epilepsy. In some children, special diets may help to control seizures when medications are either not effective or cause serious side effects. While epilepsy cannot be cured, for some people the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures may cause brain damage. It is not uncommon for people with epilepsy, especially children, to develop behavioral and emotional problems in conjunction with seizures. Issues may also arise as a result of the stigma attached to having epilepsy, which can led to embarrassment and frustration or bullying, teasing, or avoidance in school and other social settings. For many people with epilepsy, the risk of seizures restricts their independence (some states refuse drivers licenses to people with epilepsy) and recreational activities. Epilepsy can be a life-threatening condition. Some people with epilepsy are at special risk for abnormally prolonged seizures or sudden unexplained death in epilepsy. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is epilepsy", "response": "What is Epilepsy?: Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is epilepsy", "response": "Epilepsy - resources: The following organizations are good resources for information on epilepsy: - Epilepsy Foundation -- www.epilepsy.com - National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm - US Centers for Disease Control and Prevention -- www.cdc.gov/epilepsy Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of congenital heart defects", "response": "Congenital Heart Defects (CAUSES): If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur. Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect. Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects. Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects. Researchers continue to search for the causes of congenital heart defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of congenital heart defects", "response": "How to diagnose Congenital Heart Defects?: Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older. Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason. Specialists Involved Pediatric cardiologists are doctors who specialize in the care of babies and children who have heart problems. Cardiac surgeons are specialists who repair heart defects using surgery. Physical Exam During a physical exam, the doctor will: Listen to your child's heart and lungs with a stethoscope Look for signs of a heart defect, such as cyanosis (a bluish tint to the skin, lips, or fingernails), shortness of breath, rapid breathing, delayed growth, or signs of heart failure Diagnostic Tests Echocardiography Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen. Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working. Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed. During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb. Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born. EKG (Electrocardiogram) An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart. An EKG can detect if one of the heart's chambers is enlarged, which can help diagnose a heart problem. Chest X Ray A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged. It also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure. Pulse Oximetry For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of how much oxygen is in the blood. Cardiac Catheterization During cardiac catheterization (KATH-e-ter-ih-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart. Special dye is injected through the catheter into a blood vessel or one of the hearts chambers. The dye allows the doctor to see blood flowing through the heart and blood vessels on an x-ray image. The doctor also can use cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart. Cardiac catheterization also is used to repair some heart defects. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-compulsive disorder (OCD) (Overview): Obsessive-compulsive disorder (OCD) features a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress. You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior - the vicious cycle of OCD. OCD often centers around certain themes - for example, a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped. If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-compulsive disorder (OCD) (Causes): The cause of obsessive-compulsive disorder isn't fully understood. Main theories include: - Biology. OCD may be a result of changes in your body's own natural chemistry or brain functions. - Genetics. OCD may have a genetic component, but specific genes have yet to be identified. - Environment. Some environmental factors such as infections are suggested as a trigger for OCD, but more research is needed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of ocd", "response": "Obsessive-compulsive disorder (OCD) (Risk factors): Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include: - Family history. Having parents or other family members with the disorder can increase your risk of developing OCD. - Stressful life events. If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD. - Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "Coffin Lowry Syndrome (Prognosis): The prognosis for individuals with Coffin-Lowry syndrome varies depending on the severity of symptoms. Early intervention may improve the outlook for patients. Life span is reduced in some individuals with Coffin-Lowry syndrome. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "What is Coffin Lowry Syndrome?: Coffin-Lowry syndrome is a rare genetic disorder characterized by craniofacial (head and facial) and skeletal abnormalities, delayed intellectual development, short stature, and hypotonia. Characteristic facial features may include an underdeveloped upper jaw bone (maxillary hypoplasia), a broad nose, protruding nostrils (nares), an abnormally prominent brow, down-slanting eyelid folds (palpebral fissures), widely spaced eyes (hypertelorism), large low-set ears, and unusually thick eyebrows. Skeletal abnormalities may include abnormal front-to-back and side-to-side curvature of the spine (kyphoscoliosis), unusual prominence of the breastbone (pigeon chest, or pectus carinatum), dental abnormalities, and short, hyperextensible, tapered fingers. Other features may include feeding and respiratory problems, developmental delay, hearing impairment, awkward gait, stimulus-induced drop episodes, and heart and kidney involvement. The disorder affects males and females in equal numbers, but symptoms are usually more severe in males. The disorder is caused by a defective gene, RSK2, which is found in 1996 on the X chromosome (Xp22.2-p22.1). Thus, the syndrome is typically more severe in males because males have only one X chromosome, while females have two. It is unclear how changes (mutations) in the DNA structure of the gene lead to the clinical findings. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the cause of the coffin lowry syndrome?", "response": "Coffin Lowry Syndrome (Treatment): There is no cure and no standard course of treatment for Coffin-Lowry syndrome. Treatment is symptomatic and supportive, and may include physical and speech therapy and educational services. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "Achondroplasia: Achondroplasia is a disorder of bone growth that causes the most common type of dwarfism. Achondroplasia is one of a group of disorders called chondrodystrophies, or osteochondrodysplasias. Achondroplasia may be inherited as an autosomal dominant trait, which means that if a child gets the defective gene from 1 parent, the child will have the disorder. If 1 parent has achondroplasia, the infant has a 50% chance of inheriting the disorder. If both parents have the condition, the infant's chances of being affected increase to 75%. However, most cases appear as spontaneous mutations. This means that 2 parents without achondroplasia may give birth to a baby with the condition. The typical appearance of achondroplastic dwarfism can be seen at birth. Symptoms may include: - Abnormal hand appearance with persistent space between the long and ring fingers - Bowed legs - Decreased muscle tone - Disproportionately large head-to-body size difference - Prominent forehead (frontal bossing) - Shortened arms and legs (especially the upper arm and thigh) - Short stature (significantly below the average height for a person of the same age and sex) - Narrowing of the spinal column spinal stenosis - Spine curvatures called kyphosis and lordosis During pregnancy, a prenatal ultrasound may show excessive amniotic fluid surrounding the unborn infant. Examination of the infant after birth shows increased front-to-back head size. There may be signs of hydrocephalus (\"water on the brain\"). X-rays of the long bones can reveal achondroplasia in the newborn. There is no specific treatment for achondroplasia. Related abnormalities, including spinal stenosis and spinal cord compression, should be treated when they cause problems. People with achondroplasia seldom reach 5 feet (1.5 meters) in height. Intelligence is in the normal range. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Health problems that may develop include: - Breathing problems from a small upper airway and from pressure on the area of the brain that controls breathing - Lung problems from a small ribcage If there is a family history of achondroplasia and you plan to have children, you may find it helpful to speak to your health care provider. Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "What is Achondroplasia?: Achondroplasia is a disorder of bone growth that prevents the changing of cartilage (particularly in the long bones of the arms and legs) to bone. It is characterized by dwarfism, limited range of motion at the elbows, large head size, small fingers, and normal intelligence. Achondroplasia can cause health complications such as apnea, obesity, recurrent ear infections, and lordosis of the spine. Achondroplasia is caused by mutations in the FGFR3 gene. It is inherited in an autosomal dominant fashion. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the disorder achondroplasia", "response": "Achondroplasia (Prevention): Genetic counseling may be helpful for prospective parents when 1 or both have achondroplasia. However, because achondroplasia most often develops spontaneously, prevention is not always possible. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "Lymphoma (Treatment): Which lymphoma treatments are right for you depends on the type and stage of your disease, your overall health, and your preferences. The goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. Lymphoma treatments include: - Active surveillance. Some forms of lymphoma are very slow growing. You and your doctor may decide to wait to treat your lymphoma when it causes signs and symptoms that interfere with your daily activities. Until then, you may undergo periodic tests to monitor your condition. - Chemotherapy. Chemotherapy uses drugs to destroy fast-growing cells, such as cancer cells. The drugs are usually administered through a vein, but can also be taken as a pill, depending on the specific drugs you receive. - Other drug therapy. Other drugs used to treat lymphoma include targeted drugs that focus on specific abnormalities in your cancer cells. Immunotherapy drugs use your immune system to kill cancer cells. - Radiation therapy. Radiation therapy uses high-powered beams of energy, such as X-rays and protons, to kill cancer cells. - Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, involves using high doses of chemotherapy and radiation to suppress your bone marrow. Then healthy bone marrow stem cells from your body or from a donor are infused into your blood where they travel to your bones and rebuild your bone marrow. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "What are the treatments for Primary lymphoma of the brain?: Primary lymphoma of the brain is usually first treated with corticosteroids to control swelling and improve symptoms. The main treatment is with chemotherapy. Younger patients may receive high-dose chemotherapy, followed by an autologous stem cell transplant. Radiation therapy of the whole brain may be done after chemotherapy. Boosting the immune system, such as in those with HIV, may also be tried. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what is the treatment for lymphoma", "response": "Hodgkin lymphoma (Treatment): Treatment depends on the following: - The type of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma) - The stage (where the disease has spread) - Whether the tumor is more than 4 inches (10 cm) wide - Your age and other medical issues - Other factors, including weight loss, night sweats, and fever You may receive chemotherapy, radiation therapy, or both. Your doctor can tell you more about your specific treatment. High-dose chemotherapy may be given when Hodgkin lymphoma returns after treatment or does not respond to the first treatment. This is followed by a stem cell transplant that uses your own stem cells. You and your health care provider may need to manage other concerns during your leukemia treatment, including: - Having chemotherapy at home - Managing your pets during chemotherapy - Bleeding problems - Dry mouth - Eating enough calories - Safe eating during cancer treatment. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "Brucellosis (Overview): Brucellosis is a bacterial infection that spreads from animals to people - most often via unpasteurized milk, cheese and other dairy products. More rarely, the bacteria that cause brucellosis can spread through the air or through direct contact with infected animals. Brucellosis symptoms may include fever, joint pain and fatigue. The infection can usually be treated successfully with antibiotics. Treatment takes several weeks to months, however, and relapses are common. While brucellosis is uncommon in the United States, the disease affects hundreds of thousands of people and animals worldwide. Avoiding unpasteurized dairy products and taking precautions when working with animals or in a laboratory can help prevent brucellosis. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "What is Brucellosis?: Brucellosis is an infectious disease that occurs from contact with animals carrying brucella bacteria. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what medications are prescribed for brucellosis", "response": "Brucellosis (Complications): Brucellosis can affect almost any part of your body, including your reproductive system, liver, heart and central nervous system. Chronic brucellosis may cause complications in just one organ or throughout your body. Possible complications include: - Infection of the heart's inner lining (endocarditis). This is one of the most serious complications of brucellosis. Untreated endocarditis can damage or destroy the heart valves and is the leading cause of brucellosis-related deaths. - Arthritis. Joint infection is marked by pain, stiffness and swelling in your joints, especially the knees, hips, ankles, wrists and spine. Spondylitis - inflammation of the joints between the bones (vertebrae) of your spine or between your spine and pelvis - can be particularly hard to treat and may cause lasting damage. - Inflammation and infection of the testicles (epididymo-orchitis). The bacteria that cause brucellosis can infect the epididymis, the coiled tube that connects the vas deferens and the testicle. From there, the infection may spread to the testicle itself, causing swelling and pain, which may be severe. - Inflammation and infection of the spleen and liver. Brucellosis can also affect the spleen and liver, causing them to enlarge beyond their normal size. - Central nervous system infections. These include potentially life-threatening illnesses such as meningitis, an inflammation of the membranes surrounding the brain and spinal cord, and encephalitis, inflammation of the brain itself. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what test do you do for rheumatoid \"arthritis?\"", "response": "Rheumatoid Arthritis (Is there a test?): Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. Rheumatoid arthritis can be hard to diagnose because: - There is no single test for the disease. - The symptoms can be the same as in other kinds of joint disease. - The full symptoms can take time to develop. To diagnose rheumatoid arthritis, doctors use medical history, a physical exam, x-rays and other imaging tests, and lab tests. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what test do you do for rheumatoid \"arthritis?\"", "response": "How to diagnose Rheumatoid Arthritis?: Rheumatoid arthritis can be difficult to diagnose in its early stages because the full range of symptoms develops over time, and only a few symptoms may be present in the early stages. As part of the diagnosis, your doctor will look for symptoms such as swelling, warmth, pain, and limitations in joint motion throughout your body. Your doctor may ask you questions about the intensity of your pain symptoms, how often they occur, and what makes the pain better or worse. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what test do you do for rheumatoid \"arthritis?\"", "response": "Rheumatoid arthritis (Diagnosis): Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. During the physical exam, your doctor will check your joints for swelling, redness and warmth. He or she may also check your reflexes and muscle strength. Blood tests People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Imaging tests Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what the treatment for bronchitis", "response": "Bronchitis (Treatment): Most cases of acute bronchitis get better without treatment, usually within a couple of weeks. Medications Because most cases of bronchitis are caused by viral infections, antibiotics aren't effective. However, if your doctor suspects that you have a bacterial infection, he or she may prescribe an antibiotic. In some circumstances, your doctor may recommend other medications, including: - Cough medicine. If your cough keeps you from sleeping, you might try cough suppressants at bedtime. - Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs. Therapies If you have chronic bronchitis, you may benefit from pulmonary rehabilitation - a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what the treatment for bronchitis", "response": "What are the treatments for Bronchitis - acute?: Most people DO NOT need antibiotics for acute bronchitis. The infection will almost always go away on its own within 1 week. Doing these things may help you feel better: - Drink plenty of fluids. - If you have asthma or another chronic lung condition, use your inhaler. - Get plenty of rest. - Take aspirin or acetaminophen (Tylenol and other brands) if you have a fever. Do not give aspirin to children. - Use a humidifier or steam in the bathroom. Certain medicines that you can buy without a prescription can help break up or loosen mucus. Look for the word \"guaifenesin\" on the label. Ask the pharmacist if you need help finding it. If your symptoms do not improve or if you are wheezing, your doctor may prescribe an inhaler to open your airways. If your doctor thinks you also have bacteria in your airways, he or she may prescribe antibiotics. This medicine will only get rid of bacteria, not viruses. A bacterial infection is more common if you also have a chronic lung disease like COPD. Sometimes, bacteria may infect the airways along with the virus. If your doctor thinks this has happened, you may be prescribed antibiotics. Sometimes, corticosteroid medicine is also needed to reduce inflammation in the lungs. Other tips include: - Do not smoke. - Avoid secondhand smoke and air pollution. - Wash your hands (and your children's hands) often to avoid spreading viruses and other germs. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what the treatment for bronchitis", "response": "Industrial bronchitis (Treatment): The goal of treatment is to reduce the irritation. Getting more air into the workplace or wearing masks to filter out the offending dust particles may help. Some people may need to be taken out of the workplace. Some cases of industrial bronchitis go away without treatment. Other times, a person may need inhaled anti-inflammatory medicines. If you are at risk or have experienced this problem and you smoke, stop smoking. Helpful measures include: - Breathing humidified air - Increasing fluid intake - Resting. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what treatment do you use to cure chickenpox", "response": "Chickenpox (Treatment): In otherwise healthy children, chickenpox typically requires no medical treatment. Your doctor may prescribe an antihistamine to relieve itching. But for the most part, the disease is allowed to run its course. If you're at high risk of complications For people who have a high risk of complications from chickenpox, doctors sometimes prescribe medications to shorten the duration of the infection and to help reduce the risk of complications. If you or your child falls into a high-risk group, your doctor may suggest an antiviral drug such as acyclovir (Zovirax) or another drug called immune globulin intravenous (Privigen). These medications may lessen the severity of the disease when given within 24 hours after the rash first appears. Other antiviral drugs, such as valacyclovir (Valtrex) and famciclovir (Famvir), also may lessen the severity of the disease, but may not be approved or appropriate for all cases. In some instances, your doctor may recommend getting the chickenpox vaccine after exposure to the virus. This can prevent the disease or lessen its severity. Don't give anyone with chickenpox - child or adult - any medicine containing aspirin because this combination has been associated with a condition called Reye's syndrome. Treating complications If complications do develop, your doctor will determine the appropriate treatment. Treatment for skin infections and pneumonia may be with antibiotics. Treatment for encephalitis is usually with antiviral drugs. Hospitalization may be necessary. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "what treatment do you use to cure chickenpox", "response": "What are the treatments for Chickenpox?: Treatment involves keeping the person as comfortable as possible. Here are things to try: - Avoid scratching or rubbing the itchy areas. Keep fingernails short to avoid damaging the skin from scratching. - Wear cool, light, loose bedclothes. Avoid wearing rough clothing, particularly wool, over an itchy area. - Take lukewarm baths using little soap and rinse thoroughly. Try a skin-soothing oatmeal or cornstarch bath. - Apply a soothing moisturizer after bathing to soften and cool the skin. - Avoid prolonged exposure to excessive heat and humidity. - Try over-the-counter oral antihistamines such as diphenhydramine (Benadryl), but be aware of possible side effects, such as drowsiness. - Try over-the-counter hydrocortisone cream on itchy areas. Medicines that fight the chickenpox virus are available, but not given to everyone. To work well, the medicine should be started within the first 24 hours of the rash. - Antiviral drugs are not very often prescribed to otherwise healthy children who do not have severe symptoms. Adults and teens, who are at risk for more severe symptoms, may benefit from antiviral medicine if it is given early. - Antiviral medicine may be very important forthose who have skin conditions (such as eczema or recent sunburn), lung conditions (such as asthma), or who have recently taken steroids. - Some providers also give antiviral medicines to people in the same household who also develop chickenpox, because they will most often develop more severe symptoms. Do NOT give aspirin or ibuprofen to someone who may have chickenpox. Use of aspirin has been associated with a serious condition called Reyes syndrome. Ibuprofen has been associated with more severe secondary infections. Acetaminophen (Tylenol) may be used. A child with chickenpox should not return to school or play with other children until all chickenpox sores have crusted over or dried out. Adults should follow this same rule while considering when to return to work or be around others. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "Calcium carbonate overdose: Calcium carbonate is commonly found in antacids (for heartburn) and some dietary supplements. Calcium carbonate overdose occurs when someone takes more than the normal or recommended amount of a product containing this substance. This can be by accident or on purpose. This is for information only and not for use in the treatment or management of an actual overdose. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. Calcium carbonate can be dangerous in large amounts. Some products that contain calcium carbonate are certain: - Antacids (Tums, Chooz) - Mineral supplements - Hand lotions - Vitamin and mineral supplements Other products may also contain calcium carbonate. Symptoms of a calcium carbonate overdose include: - Abdominal pain - Bone pain - Coma - Confusion - Constipation - Depression - Diarrhea - Headache - Irregular heartbeat - Muscle twitching - Nausea - Vomiting Seek medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to. Have this information ready: - Person's age, weight, and condition - The name of the product (ingredients and strength, if known) - When it was swallowed - The amount swallowed Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions. This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week. Take the container with you to the hospital, if possible. The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood tests may be done. Symptoms will be treated. The person may receive: - Activated charcoal - Blood and urine tests - Breathing support - Chest x-ray - EKG (electrocardiogram, or heart tracing) - Intravenous fluids (through a vein) - Laxative - Medicine to treat symptoms - Tube through the mouth into the stomach to empty the stomach (gastric lavage) Calcium carbonate is not very poisonous. Recovery is quite likely. But, long-term overuse is more serious than a single overdose, because it can cause kidney damage. Few people die from an antacid overdose. Keep all medicines in child-proof bottles and out of the reach of children. Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "What is Overdose?: An overdose is when you take more than the normal or recommended amount of something, usually a drug. An overdose may result in serious, harmful symptoms or death. If you take too much of something on purpose, it is called an intentional or deliberate overdose. If the overdose happens by mistake, it is called an accidental overdose. For example, a young child may accidentally take an adult's heart medicine. Your doctor may refer to an overdose as an ingestion. Ingestion means you swallowed something. An overdose is not the same as a poisoning, although the effects can be the same. Poisoning occurs when someone or something (such as the environment) exposes you to dangerous chemicals, plants, or other harmful substances without your knowledge. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at higher risk for calcium overdose?", "response": "Calcium - ionized: Ionized calcium is calcium in your blood that is not attached to proteins. It is also called free calcium. All cells need calcium in order to work. Calcium helps build strong bones and teeth. It is important for heart function. It also helps with muscle contraction, nerve signaling, and blood clotting. This article discusses the test used to measure the amount of ionized calcium in blood. A blood sample is needed. Most of the time blood is drawn from a vein located on the inside of the elbow or the back of the hand. You should not eat or drink for at least 6 hours before the test. Many medicines can interfere with blood test results. - Your health care provider will tell you if you need to stop taking any medicines before you have this test. - DO NOT stop or change your medicines without talking to your provider first. Your provider may order this test if you have signs of kidney or parathyroid disease. The test may also be done to monitor progress and treatment of these diseases. Most of the time, blood tests measure your total calcium level. This looks at both ionized calcium and calcium attached to proteins. You may need to have a separate ionized calcium test if you have factors that increase or decrease total calcium levels. These may include abnormal blood levels of albumin or immunoglobulins. - Children: 4.8 to 5.3 milligrams per deciliter (mg/dL) or 1.20 to 1.32 millimoles per liter (millimol/L) - Adults: 4.8 to 5.6 mg/dL or 1.20 to 1.40 millimol/L Normal value ranges may vary slightly among different laboratories. Talk to your health care provider about the meaning of your specific test results. The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens. Higher-than-normal levels of ionized calcium may be due to: - Decreased levels of calcium in the urine from an unknown cause - Hyperparathyroidism - Hyperthyroidism - Milk-alkali syndrome - Multiple myeloma - Paget disease - Sarcoidosis - Thiazide diuretics - Thrombocytosis (high platelet count) - Tumors - Vitamin A excess - Vitamin D excess Lower-than-normal levels may be due to: - Hypoparathyroidism - Malabsorption - Osteomalacia - Pancreatitis - Renal failure - Rickets - Vitamin D deficiency Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "Dengue (Summary): Summary Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found - Wear insect repellent with DEET - Wear clothes that cover your arms, legs and feet - Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "How to prevent Dengue fever?: Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever and other infections. Limit outdoor activity during mosquito season, especially when they are most active, at dawn and dusk. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "who is at risk for contracting dengue fever? is there a certain age group or race that contracts dengue fever?", "response": "Dengue fever (Causes): Dengue fever is caused by any one of four types of dengue viruses spread by mosquitoes that thrive in and near human lodgings. When a mosquito bites a person infected with a dengue virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person's bloodstream. After you've recovered from dengue fever, you have immunity to the type of virus that infected you - but not to the other three dengue fever virus types. The risk of developing severe dengue fever, also known as dengue hemorrhagic fever, actually increases if you're infected a second, third or fourth time. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "why can you not take grapefruit with felodipine", "response": "What is Grapefruit?: Grapefruit is a citrus fruit. People use the fruit, oil from the peel, and extracts from the seed as medicine. Grapefruit seed extract is processed from grapefruit seeds and pulp obtained as a byproduct from grapefruit juice production. Vegetable glycerin is added to the final product to reduce acidity and bitterness. Grapefruit juice is used for high cholesterol, hardening of the arteries (atherosclerosis), cancer, a skin disease called psoriasis, and for weight loss and obesity. Grapefruit seed extract is taken by mouth for bacterial, viral, and fungal infections including yeast infections. Grapefruit oil is applied to the skin for muscle fatigue, hair growth, toning the skin, and for acne and oily skin. It is also used for the common cold and flu (influenza). Grapefruit seed extract is applied to the skin as a facial cleanser, first-aid treatment, remedy for mild skin irritations, and as a vaginal douche for vaginal yeast infections (candidiasis). It is also used as an ear or nasal rinse for preventing and treating infections; as a gargle for sore throats; and a dental rinse for preventing gingivitis and promoting healthy gums; and as a breath freshener. Some people inhale grapefruit vapors to help the body retain water, for headache, stress, and depression. Grapefruit seed extract vapor has also been inhaled for the treatment of lung infections. In food and beverages, grapefruit is consumed as a fruit, juice, and is used as a flavoring component. In manufacturing, grapefruit oil and seed extract are used as a fragrance component in soaps and cosmetics; and as a household cleaner for fruits, vegetables, meats, kitchen surfaces, dishes, and so on In agriculture, grapefruit seed extract is used to kill bacteria and fungus, fight mold growth, kill parasites in animal feeds, preserve food and disinfect water. Its important to remember that drug interactions with grapefruit juice are well documented. The chemistry of the grapefruit varies by the species, the growing conditions, and the process used to extract the juice. Before adding grapefruit to your diet or your list of natural medicines, check with your healthcare provider if you take medications. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "why can you not take grapefruit with felodipine", "response": "Felodipine (What special dietary instructions should I follow?): Talk to your doctor about drinking grapefruit juice or eating grapefruit while taking felodipine. Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can i take keflex to cure staph?", "response": "Staph infections (Treatment): Treatment of a staph infection may include: - Antibiotics. Your doctor may perform tests to identify of the staph bacteria behind your infection, and to help choose the antibiotic that will work best. Antibiotics commonly prescribed to treat staph infections include certain cephalosporins, nafcillin or related antibiotics, sulfa drugs, or vancomycin. Vancomycin increasingly is required to treat serious staph infections because so many strains of staph bacteria have become resistant to other traditional medicines. But vancomycin and some other antibiotics have to be given intravenously. If you're given an oral antibiotic, be sure to take it as directed, and to finish all of the medication prescribed by your doctor. Ask your doctor what signs and symptoms you should watch for that might indicate your infection is worsening. - Wound drainage. If you have a skin infection, your doctor will likely make an incision into the sore to drain fluid that has collected there. - Device removal. If your infection involves a device or prosthetic, prompt removal of the device is needed. For some devices, removal might require surgery. Antibiotic resistance Staph bacteria are very adaptable, and many varieties have become resistant to one or more antibiotics. For example, only about 10 percent of today's staph infections can be cured with penicillin. The emergence of antibiotic-resistant strains of staph bacteria - often described as methicillin-resistant Staphylococcus aureus (MRSA) strains - has led to the use of IV antibiotics, such as vancomycin, with the potential for more side effects, such as vancomycin. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can i take keflex to cure staph?", "response": "What are the treatments for Staph infections - self-care at home?: If test results show you have a staph infection, treatment may include: - Taking antibiotics - Cleaning and draining the wound - Surgery to remove an infected device. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "can i take keflex to cure staph?", "response": "Carbuncle (Treatment): Carbuncles usually must drain before they will heal. This most often occurs on its own in less than 2 weeks. Placing a warm moist cloth on the carbuncle helps it to drain, which speeds healing. Apply a clean, warm moist cloth several times each day. Never squeeze a boil or try to cut it open at home, because this can spread the infection and make it worse. You need to seek treatment if the carbuncle: - Lasts longer than 2 weeks - Returns frequently - Is located on the spine or the middle of the face - Occurs with a fever or other systemic symptoms Treatment helps reduce complications related to an infection.Your provider may prescribe: - Antibacterial soaps - Antibiotics applied to the skin or taken by mouth Deep or large lesions may need to be drained by your provider. Proper hygiene is very important to prevent the spread of infection. - Wash your hands thoroughly with soap and warm water after touching a carbuncle. - Do not re-use or share washcloths or towels. This can cause the infection to spread. - Clothing, washcloths, towels, and sheets or other items that contact infected areas should be washed in very hot (preferably boiling) water. - Bandages should be changed often and thrown away in a bag that can be tightly closed. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "could tetanus be a cause of death?", "response": "Tetanus (Summary): Summary Tetanus is a serious illness caused by Clostridium bacteria. The bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn. The infection causes painful tightening of the muscles, usually all over the body. It can lead to \"locking\" of the jaw. This makes it impossible to open your mouth or swallow. Tetanus is a medical emergency. You need to get treatment in a hospital. A vaccine can prevent tetanus. It is given as a part of routine childhood immunization. Adults should get a tetanus shot, or booster, every 10 years. If you get a bad cut or burn, see your doctor - you may need a booster. Immediate and proper wound care can prevent tetanus infection. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "could tetanus be a cause of death?", "response": "What is Tetanus?: Tetanus is aninfection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C. tetani). If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}
{"instruction": "could tetanus be a cause of death?", "response": "Tetanus (Complications): Once tetanus toxin has bonded to your nerve endings it is impossible to remove. Complete recovery from a tetanus infection requires new nerve endings to grow, which can take up to several months. Complications of tetanus infection may include: - Broken bones. The severity of spasms may cause the spine and other bones to break. - Blockage of a lung artery (pulmonary embolism). A blood clot that has traveled from elsewhere in your body can block the main artery of the lung or one of its branches. - Death. Severe tetanus-induced (tetanic) muscle spasms can interfere with or stop your breathing. Respiratory failure is the most common cause of death. Lack of oxygen may also induce cardiac arrest and death. Pneumonia is another cause of death. If your symptoms worsen or feel concerning, seek help from a healthcare professional.", "source": "mediqa_qa", "safety_level": "safe"}