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


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Pancreatic cysts are collections (pools) of fluid that can form within the head, body, and tail of the pancreas. Some pancreatic cysts are true cysts (non-inflammatory cysts), that is, they are lined by a special layer of cells that are responsible for secreting fluid into the cysts. Other cysts are pseudocysts (inflammatory cysts) and do not contain specialized lining cells. Often these pseudocysts contain pancreatic digestive juices because they are connected to the pancreatic ducts. Pancreatic cysts can range in size from several millimeters to several centimeters. Many pancreatic cysts are small and benign and produce no symptoms, but some cysts become large and cause symptoms, and others are cancerous or precancerous. (Precancerous cysts are benign cysts that have the potential to become cancerous.)Different types of cysts contain different types of fluids. For example, pseudocysts that form after an attack of acute pancreatitis contain digestive enzymes such as amylase in high concentrations. Mucinous cysts contain mucus (a proteinaceous liquid) produced by the mucinous cells that form the inside lining of the cyst.


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A paraganglioma is a rare tumor that begins in certain nerve cells that are dispersed throughout the body. This tumor can affect people of any age but most often shows up between the ages of 30 and 50. The tumor is often slow growing and noncancerous (benign). But it can invade nearby parts of the body, become cancerous (malignant) and spread distantly (metastasize).With about half of paraganglioma tumors, the abnormal cells produce hormones known as catecholamines or adrenaline, which is the fight-or-flight hormone. This may induce high blood pressure, a rapid heartbeat, flushed skin, sweating, headache and tremors.Surgery to remove the tumor is usually the first treatment choice for a paraganglioma, if feasible. If left untreated, a paraganglioma can result in severe or life-threatening damage and progress to the point where surgical treatment isn't an option. In people with cancerous and distantly spread (metastatic) paraganglioma, medicine and other treatments can help control the disease and symptoms and even extend survival.


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Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.

In the early stages of Parkinson's disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

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

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

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Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump.Patellar tendinitis, also known as jumper's knee, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, even people who don't participate in jumping sports can get patellar tendinitis.For most people, treatment of patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee

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

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


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

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

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

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

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Penicillin allergy is an abnormal reaction of your immune system to the antibiotic drug penicillin. Penicillin is prescribed for treating various bacterial infections.


Common signs and symptoms of penicillin allergy include hives, rash and itching. Severe reactions include anaphylaxis, a life-threatening condition that affects multiple body systems.


Research has shown that penicillin allergies may be over-reported — a problem that can result in the use of less appropriate and more expensive antibiotic treatments. Therefore, an accurate diagnosis is needed when penicillin allergy is suspected to ensure the best treatment options in the future.


Other antibiotics, particularly those with chemical properties similar to penicillin, can also result in allergic reactions.

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

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

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Pericarditis is swelling and irritation of the pericardium, the thin saclike membrane surrounding your heart. Pericarditis often causes chest pain and sometimes other symptoms. The sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other.Pericarditis usually begins suddenly but doesn't last long (acute). When symptoms develop more gradually or persist, pericarditis is considered chronic.Most cases are mild and usually improve on their own. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help to reduce the risk of long-term complications from pericarditis.

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

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

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Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.When you develop peripheral artery disease (PAD), your extremities — usually your legs — don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (claudication).Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This condition may be reducing blood flow to your heart and brain, as well as your legs.You often can successfully treat peripheral artery disease by quitting tobacco, exercising and eating a healthy diet

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


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

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

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

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


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Peritonitis is inflammation of the peritoneum, the thin layer of tissue covering the inside of your abdomen and most of its organs. The inflammation is usually the result of a fungal or bacterial infection. This can be caused by an abdominal injury, an underlying medical condition, or a treatment device, such as a dialysis catheter or feeding tube.

Peritonitis is a serious condition that needs immediate medical attention. Prompt intravenous (IV) antibiotics are needed to treat the infection. Surgery is sometimes necessary to remove infected tissue. The infection can spread and become life-threatening if it isn’t treated promptly

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Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.1There are 10 specific types of personality disorders (such as borderline personality disorder). Common to all personality disorders is a long-term pattern of behavior and inner experience that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood, and causes distress or problems in functioning. Without treatment, the behavior and experience is inflexible and usually long-lasting. The pattern is seen in at least two of these areas:

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If your nose runs and your eyes water or you start sneezing and wheezing after petting or playing with a cat, you likely have a cat allergy. A cat allergy can contribute to constant allergy symptoms, as exposure can occur at work, school, day care or in other indoor environments, even if a cat is not present.

Cats produce multiple allergens (proteins that can cause allergy). These allergens are found on the fur and skin and in saliva. All cats produce allergens; studies have not shown that cats can be hypoallergenic (meaning that they don’t cause allergy). Homes with more than one cat have higher levels of cat allergens. Characteristics such as the length of a cat’s hair, its sex and the amount of time a cat spends indoors are not associated with cat allergen levels.Dust and pollen in a cat’s coat can also cause allergy symptoms. In those cases, the allergy is to the dust or pollen, not to the cat.

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Peyronie's Disease is an inflammatory, benign condition that may cause a curvature, deformity or shortening of the erect penis. This process is produced by scar formation in the fibrous covering of the erectile bodies of the penis. Men may or may not feel tenderness, a lump, or an area of scarring {plaque) in the shaft of the penis. Occasionally, this condition is also associated with pain, and, in some cases, erections and stress on the penis can exacerbate the pain. Many patients with Peyronie's disease suffer psychological trauma, may experience difficulty with sexual intercourse, and may also suffer from erectile dysfunction. Those who suffer from erectile dysfunction, however, may not notice these symptoms. Peyronie's disease occurs more often in men between the ages of 50 and 70, although younger men are not immune. Its' accurate incidence is unknown, but it is not rare. Studies show that about three percent of men over the age of 40 have scar tissue in their penis labeled as Peyronie's disease. However, only a minority of these men have significant enough scarring, curvature, erectile dysfunction, or penile shortening to require medical attention.


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Phantom limb pain (PLP) refers to ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, but the pain is real.


The onset of this pain most often occurs soon after surgery. It can feel like a variety of things, such as burning, twisting, itching or pressure. It is often felt in fingers or toes. It is believed that nearly 80 percent of the amputee population worldwide has experienced this kind of pain.


The length of time this pain lasts differs from person to person. It can last from seconds to minutes, to hours, to days. For most people, PLP diminishes in both frequency and duration during the first six months, but many continue to experience some level of these sensations for years.


People are often reluctant to tell anyone that they are experiencing PLP or phantom limb sensations, for fear that they will be considered “crazy.” However, it is important to report these pains as soon as you begin to experience them so treatment can be started.

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


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


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Pheochromocytoma (PCC) is the term used for a rare tumor that has grown in the adrenal glands. These tumors are usually benign, meaning they are not cancerous. Most cases involve only one adrenal gland, but it is possible for both to be involved.In rare cases, PCC can be cancerous. These malignant tumors will spread like other cancers and can cause serious complications.The condition causes the adrenal glands to pump out too much adrenaline and noradrenaline. These two hormones help keep the heart rate, blood pressure, and stress response in balance. They are also responsible for the body's "fight or flight" response.When the body contains too much of these compounds at one time, it goes into a reactive state as if it were in a constant state of high stress.PCC will always form on the inside of the adrenal glands. They are often grouped together with similar tumors called paragangliomas, which are tumors that grow on the outside of the glands. The tumors are different, but both alter the production of the adrenal glands


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A pilonidal (pie-low-NIE-dul) cyst is an abnormal pocket in the skin that usually contains hair and skin debris. A pilonidal cyst is almost always located near the tailbone at the top of the cleft of the buttocks.Pilonidal cysts usually occur when hair punctures the skin and then becomes embedded. If a pilonidal cyst becomes infected, the resulting abscess is often extremely painful. The cyst can be drained through a small incision or removed surgically.Pilonidal cysts most commonly occur in young men, and the problem has a tendency to recur. People who sit for prolonged periods of time, such as truck drivers, are at higher risk of developing a pilonidal cyst.

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

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Pineoblastoma is one of several different types of tumors that arise in the area of the pineal gland, requiring different therapies. The exact diagnosis is critical for choosing the correct therapy. Pineal tumors typically present with hydrocephalus, a buildup of fluid pressure within the brain

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

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

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A pinworm infection is one of the most common types of human intestinal worm infections. Pinworms are tiny, narrow worms. They’re white in color and less than half an inch long. A pinworm infection, also known as enterobiasis or oxyuriasis, is the most common type of worm infection in humans in the United States, according to the Centers for Disease Control and Prevention (CDC).

Pinworm infections can spread easily. They’re most common in children between the ages of 5 and 10, people who live in institutions, and those who have regular, close contact with individuals in these groups. An effective treatment for pinworm infections is medication, though reinfection is possible. Serious complications and long-term health effects are rare.


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



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Pityriasis rosea is a rash that usually begins as a large circular or oval spot on your chest, abdomen or back. Called a herald patch, this spot can be up to 4 inches (10 centimeters) across.The herald patch is typically followed by smaller spots that sweep out from the middle of your body in a shape that resembles drooping pine-tree branches.Pityriasis (pit-ih-RIE-uh-sis) rosea can affect any age group. It most commonly occurs between the ages of 10 and 35. It usually goes away on its own within 10 weeks. Pityriasis rosea can cause itching. Treatment may help relieve the symptoms.


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Placentaaccreta happens when the placenta attaches too firmly to the uterine wall. Normally the placenta attaches to the uterine wall during pregnancy but detaches easily during childbirth. When accreta occurs, the blood vessels andother tissue from the placenta grow more deeply into the tissue of the uterus,which can cause bleeding during the third trimester and possibly dangerous hemorrhaging (blood loss) during delivery. If the placenta penetrates even further into the uterine wall, reaching the muscle, it is called placenta increta. If it grows all the way through the uterine wall, it is called placenta percreta.


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


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


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


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


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


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

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POEMS syndrome is associated with a group of disorders known as monoclonal gammopathies or plasma cell dyscrasias. These disorders are characterized the uncontrolled growth of a single clone (monoclonal) of plasma cells, which results in the abnormal accumulation of M-proteins (also known as immunoglobulins) in the blood. Immunoglobulins in health fight infection. However, the specific role M-proteins play and the exact cause of POEMS syndrome is unknown. Research would suggest that a chemical called VEGF (vascular endothelial growth factor) plays an important role in this disease.

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


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


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

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Polio is a contagious viral illness that in its most severe form causes nerve injury leading to paralysis, difficulty breathing and sometimes death.


In the U.S., the last case of naturally occurring polio was in 1979. Today, despite a worldwide effort to wipe out polio, poliovirus continues to affect children and adults in parts of Asia and Africa.


The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect yourself from polio if you're traveling anywhere there's a risk of polio.


Adults who have been vaccinated who plan to travel to an area where polio is occurring should receive a booster dose of inactivated poliovirus vaccine (IPV). Immunity after a booster lasts a lifetime.

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


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


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

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Polyhydramnios is where there is too much amniotic fluid around the baby during pregnancy. Amniotic fluid is the fluid that surrounds your baby in the womb.


Too much amniotic fluid is normally spotted during a check-up in the later stages of pregnancy.


It isn't usually a sign of anything serious, but you'll probably have some extra check-ups and will be advised to give birth in hospital.

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


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

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Polymyositis is a disease of muscle featuring inflammation of the muscle fibers. The cause of the disease is not known. It begins when white blood cells, the immune cells of inflammation, spontaneously invade muscles. The muscles affected are typically those closest to the trunk or torso. This results in weakness that can be severe. Polymyositis is a chronic illness featuring progressive muscle weakness with periods of increased symptoms, called flares or relapses, and minimal or no symptoms, known as remissions.


Polymyositis is slightly more common in females. It affects all age groups, although its onset is most common in middle childhood and in the 20s. Polymyositis occurs throughout the world. Polymyositis can be associated with a characteristic skin rash and is then referred to as "dermatomyositis." Dermatomyositis in children is referred to as juvenile dermatomyositis. "Amyopathic dermatomyositis" is the term used to describe people who have skin changes compatible with dermatomyositis but do not have diseased muscle involvement.


Polymyositis can also affect other areas of the body and is, therefore, referred to as a systemic illness. Occasionally, it is associated with cancer or with other diseases of connective tissue (such as systemic lupus erythematosus, scleroderma, and rheumatoid arthritis). Depending on which other diseases it is associated with, it may be referred to as an "overlap syndrome" or "mixed connective tissue disease."

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


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


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


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Porphyria is a group of disorders that can cause nerve or skin problems.


A porphyria that affects the skin is called cutaneous porphyria. A porphyria that affects the nervous system is called acute porphyria.


The most common type of porphyria is porphyria cutanea tarda (PCT), which affects the skin. PCT is also the most treatable.


No known cure exists for any type of porphyria.

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


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


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

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The literature lacks consensus regarding the nomenclature applicable to the development of new health problems in persons who previously had acute paralytic poliomyelitis, with frequently used terms including "late effects of polio" (LEoP), "postpolio syndrome" (PPS) and "postpolio muscular atrophy." PPS is typically characterized as a sub-category of LEoP. [1]


PPS is a neurologic disorder characterized by new and progressive muscular weakness, pain, and fatigue many years after the acute paralytic polio. Halstead introduced the term "post-polio syndrome" in 1986, and he published revised criteria for diagnosing PPS in 1991, in which new muscle weakness was introduced as an obligatory criterion.

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


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


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

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People with Prader-Willi syndrome typically have mild to moderate intellectual impairment and learning disabilities. Behavioral problems are common, including temper outbursts, stubbornness, and compulsive behavior such as picking at the skin. Sleep abnormalities can also occur. Additional features of this condition include distinctive facial features such as a narrow forehead, almond-shaped eyes, and a triangular mouth; short stature; and small hands and feet. Some people with Prader-Willi syndrome have unusually fair skin and light-colored hair. Both affected males and affected females have underdeveloped genitals. Puberty is delayed or incomplete, and most affected individuals are unable to have children (infertile).

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


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


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

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Slightly elevated blood pressure is known as prehypertension. Prehypertension will likely turn into high blood pressure (hypertension) unless you make lifestyle changes, such as getting more exercise and eating healthier foods. Both prehypertension and high blood pressure increase your risk of heart attack, stroke and heart failure.


A blood pressure reading has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure). Prehypertension is a systolic pressure from 120 to 139 millimeters of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg.


Weight loss, exercise and other healthy lifestyle changes can often control prehypertension, and set the stage for a lifetime of better health.

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


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


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

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


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


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


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

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Presbyopia is when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging. In fact, the word “presbyopia” means “old eye” in Greek. You may start to notice presbyopia shortly after age 40. You will probably find that you hold reading materials farther away in order to see them clearly.

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


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

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Premature labor is also called preterm labor. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date.

Premature labor can lead to an early birth. But the good news is that doctors can do a lot to delay an early delivery. The longer your baby gets to grow inside you -- right up to your due date -- the less likely he or she is to have problems after birth.


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Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or isn't caused by sexual stimulation. Priapism is usually painful.

Although priapism is an uncommon condition overall, it occurs commonly in certain groups, such as people who have sickle cell anemia. Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction).

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

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

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

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

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

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Proctitis is an inflammation of the lining of the rectum. The rectum is a muscular tube that's connected to the end of your colon. Stool passes through the rectum on its way out of the body.

Proctitis can cause rectal pain and the continuous sensation that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.

Proctitis is common in people who have inflammatory bowel diseases. Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers.

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A prolactinoma is a benign tumor (called an adenoma) of the pituitary gland. A prolactinoma produces an excessive amount of the hormone prolactin. Prolactin is a natural hormone which supports a woman's normal lactation, which is the secretion of milk by the mammary glands of the breast. Prolactinomas are the most common type of pituitary tumor. Symptoms of prolactinoma are caused by pressure of the tumor on surrounding tissues or by excessive release of prolactin from the tumor into the blood (causing a condition known as hyperprolactinemia).

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

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

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

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

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

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

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

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

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

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

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


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

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


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

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


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


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

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


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

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Pyloric stenosis is an uncommon condition in infants that blocks food from entering the small intestine.Normally, a muscular valve (pylorus) between the stomach and small intestine holds food in the stomach until it is ready for the next stage in the digestive process. In pyloric stenosis, the pylorus muscles thicken and become abnormally large, blocking food from reaching the small intestine.Pyloric stenosis can lead to forceful vomiting, dehydration and weight loss. Babies with pyloric stenosis may seem to be hungry all the time.


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


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Pilates aims to strengthen the body in an even way, with particular emphasis on core strength to improve general fitness and wellbeing. Pilates exercises are done on a mat or using special equipment, such as the Reformer, the Cadillac and Wunda Chair. With its system of pulleys and springs, handles and straps, the apparatus can provide either resistance or support, depending on your needs.Pilates was developed by German-born Joseph Pilates, who believed mental and physical health were closely connected. His method was influenced by western forms of exercise, including gymnastics, boxing and Greco-Roman wrestling. Pilates immigrated to the US in the 1920s and opened a studio in New York, where he taught his method – which he called contrology – for several decades.


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


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There are two types of pregnancy tests; one uses a urine sample, the other a sample of blood. Both tests detect the presence of a hormone called human chorionic gonadotropin (hCG). This hormone is produced by the placenta shortly after the embryo attaches to the uterine lining and builds up rapidly in your body in the first few days of pregnancy. It is this rapid shift in hormones that triggers most of your pregnancy symptoms.

URINE TEST  :-Urine tests can be performed in two different ways and these can be performed at home or in a clinic. One way involves collecting your urine in a cup and dipping a stick into the urine or putting urine into a special container with an eyedropper. Another option involves placing a stick into your urine stream and catching your urine in midstream.

Tests vary in how long you have to wait to get a result. You will be looking for a change in color, a line, or a symbol (like a plus or minus). The newer digital pregnancy test offered by Clearblue Easy makes reading your results simple: the window will either show the words “not pregnant” or “pregnant”.


BLOOD TEST:- There are two types of blood tests. A quantitative blood test measures the exact amount of hCG in the blood, and a qualitative hCG blood test gives a simple yes or no answer to whether you are pregnant or not.


Advantages of having a blood test done:

1.Can detect a pregnancy earlier than a urine test at about 7-12 days from possible conception (but if a negative result is received, a test should be repeated if a period is missed.)

2.Can measure the concentration of hCG hormone in your blood (this is useful information for your healthcare provider in tracking certain problems in pregnancy)


Disadvantages to having a blood test done:

1.More expensive than a urine test (price depends on cost of doctor’s visit and lab fees)

2.Takes longer to get result

3.Must be done in a doctor’s office.


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n addition to a complete blood cell count, the principal studies used to establish the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) are flow cytometry of peripheral blood and bone marrow analysis. Flow cytometry measures the percentage of cells that are deficient in the glycosyl phosphatidylinositol–anchored proteins (GPI-APs) and identifies discrete populations with different degrees of deficiency. Because of the missing GPI-APs, red blood cells (RBCs) and other cells in patients with PNH lack DAF (CD55) and MIRL (CD59), which regulate complement. Hemosiderin is nearly always present in the urine sediment and can accumulate in the kidneys; this is visible on magnetic resonance images (MRI) or computed tomography (CT) scans. An elevated reticulocyte count and serum lactate dehydrogenase (LDH) level with a low serum haptoglobin level in the absence of hepatosplenomegaly are the hallmarks of intravascular hemolysis.Bone marrow examination will differentiate classic PNH from PNH that develops in the setting of other bone marrow disorders. In addition, bone marrow examination will identify an erythroid and hyperplastic bone marrow during the hemolytic phase or a hypoplastic bone marrow in the aplastic phase.


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

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A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women.
A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina.
Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.
The Pap smear is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer in some women.
Doctors generally recommend repeating Pap testing every 3 years for women ages 21-65.
Women age 30 and older can consider Pap testing every 5 years if the procedure is combined with testing for HPV.
If you have certain risk factors, your doctor may recommend more-frequent Pap smears, regardless of your age. These risk factors include:

1.A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
2.Exposure to diethylstilbestrol (DES) before birth
3.HIV infection
4.Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use

You and your doctor can discuss the benefits and risks of Pap smears and decide what's best for you based on your risk factors.

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Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a feedback loop that includes calcium, PTH, vitamin D, and, to some extent, phosphorus (phosphate) and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcemia or hypocalcemia. This test measures the amount of PTH in the blood.
PTH is produced by four button-sized parathyroid glands that are located in the neck behind the thyroid gland. Normally, these glands secrete PTH into the bloodstream in response to low blood calcium levels. The hormone works in three ways to help raise blood calcium levels back to normal:

1.PTH promotes the release of calcium from bones into the bloodstream.
2.It stimulates the kidneys to convert vitamin D from the inactive to the active form, which in turn increases the absorption of calcium from food in the intestines.
3.It acts on the kidneys to suppress the excretion of calcium in the urine while encouraging excretion of phosphorus.
4.As calcium levels begin to increase in the blood, PTH normally decreases.

Parathyroid hormone itself is composed of 84 amino acids (sometimes called PTH (1-84)). Intact and fragmented hormone is present in and secreted by the parathyroid gland. The intact hormone represents a smaller fraction, but its portion is increased when calcium levels are low and decreased when calcium levels are high.
Once released into the blood stream, PTH has a very short life span; levels fall by half in less than 5 minutes due to uptake and cleavage in the liver and kidneys. The fragments are referred to as C-terminal fragments and are variably sized, missing anywhere from 6 amino acids to more than half the N-terminal portion of the molecule. C-terminal fragments have a longer half-life, exist in much higher concentrations, and are eventually cleared by the kidneys. Although it was originally thought that the C-terminal fragments were inactive, it now appears that certain fragments may have biologic activities that are able to oppose those of intact PTH.

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Parietal cell antibodies are autoantibodies, proteins produced by the immune system that mistakenly target a type of specialized cells that line the stomach wall. This test detects these antibodies in the blood to help diagnose pernicious anemia.
Pernicious anemia is an autoimmune condition that can occur when the body's immune system targets its own tissues and develops antibodies directed against the parietal cells and/or intrinsic factor.

1.Parietal cells are specialized cells in the stomach that make acid to help in food digestion and also make intrinsic factor.
2.Intrinsic factor is required for the absorption of vitamin B12 from food.

During digestion, stomach acids produced by parietal cells release vitamin B12 from food, which binds to intrinsic factor to form a complex. The formation of this complex allows vitamin B12 to be absorbed in the small intestine. Among having functional roles in the brain and nervous system, vitamin B12 is important in the production of red blood cells (RBCs).
When the body’s immune system mistakenly targets its own tissues and develops antibodies directed against parietal cells and/or intrinsic factor, it can cause inflammation and progressively damage the parietal cells. This autoimmune condition, called autoimmune atrophic gastritis, can disrupt the production or function of intrinsic factor.
Without sufficient intrinsic factor, vitamin B12 goes largely unabsorbed, leading to vitamin B12 deficiency. Deficiency in vitamin B12 can result in megaloblastic anemia, characterized by the production of fewer but larger red blood cells (macrocytes). Vitamin B12 deficiency can also result in nerve-related signs and symptoms (neuropathy), such as numbness and tingling that start first in the hands and feet, muscle weakness, slow reflexes, loss of balance and unsteady walking. Other disorders can cause vitamin B12 deficiency and result in megaloblastic anemia. When it is due to a lack of intrinsic factor, it is called pernicious anemia. Besides anemia, a decrease in the numbers of neutrophils and platelets (neutropenia, thrombocytopenia) may also occur.
The tests for parietal cell and/or intrinsic factor antibodies may be used along with several other tests, such as complete blood count (CBC) and blood smear, to help diagnose pernicious anemia.

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The pericardium is a two-layered, sac-like membrane that surrounds the heart. Pericardial membranes produce pericardial fluid, a liquid that sits between the pericardium's membranes. The fluid acts as a lubricant for the movement of the heart, reducing friction as the heart pumps blood.

A variety of conditions and diseases can cause inflammation of the pericardium (pericarditis) and/or excessive accumulation of pericardial fluid (pericardial effusion). Pericardial fluid analysis is a group of tests that evaluate this liquid to help diagnose the cause of the increased fluid.

The two main reasons for fluid accumulation in the pericardial space are:

1.An imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. Transudates are most often caused by congestive heart failure or cirrhosis.

2.An injury or inflammation of the pericardium, in which case the fluid that accumulates is called an exudate. Conditions such as infections, malignancies (metastatic cancer, lymphoma, mesothelioma), or autoimmune disease may cause the accumulation of exudate.

Determining if the increased fluid is transudate or exudate is important because it helps narrow down the possible causes of pericardial fluid buildup. Healthcare practitioners and laboratorians use an initial set of tests, including cell count, protein or albumin level, and appearance of the fluid, to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pericarditis and/or pericardial effusion.

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A Peripheral smear is a drop of blood spread thinly onto a glass slide that is then treated with a special stain and examined under a microscope by a trained laboratorian. It is a snapshot of the cells that are present in the fluid portion of the blood (plasma) at the time the sample is obtained. The Peripheral smear allows for the evaluation of these cells:
White blood cells (WBCs, leukocytes) — help fight infections
Red blood cells (RBCs, erythrocytes) — carry oxygen to tissues
Platelets (thrombocytes) — small cell fragments that are vital to proper blood clot formation
These cell populations are produced and mainly mature in the bone marrow and are eventually released into the bloodstream as needed. The number and type of each cell present in the blood is dynamic but is generally maintained by the body within specific ranges.
The drop of blood on the slide used for a Peripheral smear contains millions of RBCs, thousands of WBCs, and hundreds of thousands of platelets. Under the microscope, the stained WBCs can be easily seen and the number and type of cells present can be estimated. The laboratorian can compare their size, shape, and general appearance to the established appearance of "normal" cells. It is also possible to distinguish between the five different types of WBCs and to determine their relative percentages (manual differential). During this examination, the laboratorian can also evaluate the size, shape, and color (indicators of hemoglobin content) of the RBCs (RBC morphology) and also estimate the number of platelets present.
A variety of diseases and conditions can affect the number and appearance of blood cells. Examination of the Peripheral smear can be used to support findings from other tests and examinations. For example, RBCs that appear larger and paler than normal may support other results that indicate a type of anemia. Similarly, the presence of WBCs that are not fully mature may add to information from other tests to help make a diagnosis of infection, malignancy, or other conditions.

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Phosphorus is a mineral that combines with other substances to form organic and inorganic phosphate compounds. The terms phosphorus and phosphate are often used interchangeably when talking about testing, but it is the amount of inorganic phosphate in the blood that is measured with a serum phosphorus/phosphate test.
Phosphates are vital for energy production, muscle and nerve function, and bone growth. They also play an important role as a buffer, helping to maintain the body's acid-base balance.
Phosphorus comes into the body through the diet. It is found in many foods and is readily absorbed by the intestines. About 70-80% of the body's phosphates combine with calcium to help form bones and teeth, another 10% are found in muscle, and about 1% is in nerve tissue. The rest is found within cells throughout the body, where they are mainly used to store energy.
Normally, only about 1% of total body phosphates are present in the blood. A wide variety of foods, such as beans, peas and nuts, cereals, dairy products, eggs, beef, chicken, and fish, contain significant amounts of phosphorus. The body maintains phosphorus/phosphate levels in the blood by regulating how much it absorbs from the intestines and how much it excretes via the kidneys. Phosphate levels are also affected by the interaction of parathyroid hormone (PTH), calcium, and vitamin D.
Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, malabsorption, acid-base imbalances, hypercalcemia, and with disorders that affect kidney function. Phosphorus excesses (hyperphosphatemia) may be seen with increased intake of the mineral, hypocalcemia, and with kidney dysfunction.
Someone with a mild to moderate phosphorus deficiency often does not have any symptoms. With a severe phosphorus deficiency, symptoms may include muscle weakness and confusion. An extreme excess of phosphorus may cause symptoms that are similar to those seen with low calcium, including muscle cramps, confusion, and even seizures.

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Platelet antibodies may be allo- or autoantibodies and may be directed to a wide range of antigenic "targets" carried on platelet cytoplasmic membranes. Serum platelet antibody test is optimized to identify the presence of platelet allo-antibodies in the patient.
Platelet alloantibodies are involved in several clinical situations such as:

-Immune mediated refractoriness to platelet transfusions usually due to antibodies to HLA class I and sometimes to antibodies specific to platelet antigens.

-Neonatal alloimmune thrombocytopenia (NAIT)

-Posttransfusion purpura (PTP), which are usually associated with platelet-specific antibodies

This test is not recommended for the diagnosis of immune thrombocytopenia (ITP) or autoimmune thrombocytopenia. Tests that are optimized to detect antibodies bound to the platelets will be useful in these situations; cell-bound platelet antibody (Direct) test is strongly recommended instead (CBPAN / Cell Bound Platelet Auto-Antibody Screen, Blood).

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Platelets, also called thrombocytes, are tiny fragments of cells that are essential for normal blood clotting. They are formed from very large cells called megakaryocytes in the bone marrow and are released into the blood to circulate. The platelet count is a test that determines the number of platelets in a person's sample of blood.
When there is an injury to a blood vessel or tissue and bleeding begins, platelets help stop bleeding in three ways. They:

1.Adhere to the injury site
2.Clump together (aggregate) with other platelets
3.Release chemical compounds that stimulate further aggregation of other platelets

These steps result in the formation of a loose platelet plug at the site of the injury in a process called primary hemostasis. At the same time, activated platelets support the coagulation cascade, a series of steps that involves the sequential activation of proteins called clotting factors. This secondary hemostasis process results in the formation of strands of fibrin that weave through the loose platelet plug, form a fibrin net, and compress to form a stable clot that remains in place until the injury has healed. When the clot is no longer needed, other factors break the clot down and remove it.
Each component of primary and secondary hemostasis must be present, activated at the right time, and functioning properly for adequate clotting. If there are insufficient platelets, or if platelets are not functioning normally, a stable clot may not form and a person may be at an increased risk of excessive bleeding.
Platelets survive in the circulation about 8 to 10 days, and the bone marrow must continually produce new platelets to replace those that degrade, are used up, and/or are lost through bleeding. Determining the number of platelets in blood with a platelet count can help diagnose a range of disorders having to do with too few or too many platelets.

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When a doctor requires a platelet count, then a complete blood count may be ordered. The CBC blood test will include a measurement of platelet distribution width, which is how the PLATELET DISTRIBUTION WIDTH blood test results will be measured. The PLATELET DISTRIBUTION WIDTH is a reflection of how uniform in size a patient’s platelets happen to be. This can help to determine how effectively a person’s bone marrow is functioning and if follow-up tests may be required.
For platelet width, the general rule is that larger platelets are generally younger, while smaller platelets have been around for a few days. Having a high number of large platelets when someone has typically has a low platelet count indicates the bone marrow has stepped up production levels.
Because the PLATELET DISTRIBUTION WIDTH (PDW) is part of a complete blood count, it may be ordered for a wide variety of reasons. The most common issues that doctors will examine are unexplained bruising, bleeding that continues on from small cuts or wounds, numerous nosebleeds, or internal bleeding in the digestive tract. The presence of a continuous rash or purplish spots on the skin may also cause this test to be ordered.
For women, when there is continuous and heavy menstrual bleeding, the PLATELET DISTRIBUTION WIDTH (PDW) blood test may be ordered as well.
If the PDW blood test has abnormal results and if there isn’t a known cause for them, then a doctor may choose to perform additional follow-up tests in an attempt to confirm a diagnosis. This may include testing to find inflammatory conditions, the presence of infectious diseases, kidney failure, or bleeding disorders. Liver disease and iron studies may also be ordered, as will vitamin levels.
In severe instances of abnormality when there is not a definitive cause that can be determined, then a bone marrow biopsy may be ordered.
For patients who live in high altitude area, PDW test results may be affected by an individual’s living habits. Be sure to speak with a doctor about this issue if you have recently spent a at least 30 days in a high altitude climate.
The PDW blood test is generally used as a screening tool to see if a patient is experiencing good health. It is typically ordered as part of a routine health screening. If bone marrow disorders are suspected, however, it may also be ordered. Consider these results, compare them to your own results, and then be sure to speak with your doctor about what this may indicate for you and your unique health history.

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Pleural fluid is found in the pleural cavity and serves as a lubricant for the movement of the lungs during inhalation and exhalation. It is derived from a plasma filtrate from blood capillaries and is found in small quantities between the layers of the pleurae - membranes that cover the chest cavity and the outside of each lung.

A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis comprises a group of tests used to determine the cause. There are two main reasons fluid may collect in the pleural space:


1.Fluid may accumulate in the pleural space because of an imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid usually involves both lungs and is often a result of either cirrhosis or congestive heart failure.

2.Fluid accumulation may be caused by injury or inflammation of the pleurae, in which case the fluid is called an exudate. It usually involves one lung and may be seen in infections (pneumonia, tuberculosis, sarcoidosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), rheumatoid disease, or systemic lupus erythematosus.

Differentiation between the types of fluid is important because it helps diagnose the specific disease or condition. Doctors and laboratory scientists use an initial set of tests (cell count, albumin and appearance of the fluid) to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion.




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Pleural fluid is a liquid derived from the blood in the tiny blood vessels (capillaries) in the lungs. It is found in small quantities between the layers of the pleurae – membranes that cover the chest cavity and the outside of each lung. It serves as a lubricant for the movement of the lungs during breathing.
A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis is a group of tests that evaluate this liquid to determine the cause of the increased fluid.

The two main reasons for fluid accumulation in the pleural space are:

1.An imbalance between the pressure of the liquid within blood vessels, which drives fluid out of blood vessels, and the amount of protein in blood, which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid more commonly involves both sides of the chest and is most frequently a result of either congestive heart failure or cirrhosis.
2.An injury to or inflammation of the pleurae, in which case the fluid that accumulates is called an exudate. It more commonly involves one side of the chest and may be seen in infections (pneumonia, tuberculosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), or other causes of inflammation (sarcoidosis, autoimmune diseases).
 
Determining the type of fluid present is important because it helps to shorten the list of possible causes of pleural effusion. Healthcare practitioners and laboratorians use an initial set of tests (cell count, protein, albumin, and lactate dehydrogenase (LD) level, and appearance of the fluid) to distinguish between transudates and exudates. If the fluid is an exudate, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion. See the "The Test" tab for more on this.


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Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low concentrations in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Heme is an iron-containing pigment that is a component of hemoglobin and a number of other proteins. It consists of an organic portion (protoporphyrin) bound to an iron atom. The synthesis of heme is a step-by-step process that requires the sequential action of eight different enzymes. If there is a deficiency in one of these enzymes, the process is impeded and intermediate porphyrins such as uroporphyrin, coproporphyrin, and protoporphyrin build up in the body's fluids and tissues. The precursors that accumulate depend on which enzyme is deficient, and they can exert toxic effects.
Porphyrin tests are used to help diagnose and monitor a group of disorders called porphyrias. There are seven types of porphyria, and each one is associated with a different enzyme deficiency. Most porphyrias are inherited, the result of a gene mutation. They may be classified according to the signs and symptoms of the disease as neurological, cutaneous, or both.
The porphyrias that cause neurological symptoms present with acute attacks lasting days or weeks. Signs and symptoms during the attack include abdominal pain, constipation, confusion, hallucinations, and/or seizures. There are four neurologic porphyrias: acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and the very rare ALA dehydratase deficiency porphyria (ADP). Some cases of VP and HCP may also have skin-related symptoms.
The cutaneous porphyrias are associated with photosensitivity that causes redness, swelling, a burning sensation, blistering, skin thickening, hyperpigmentation, and/or scarring. There are three cutaneous porphyrias: porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP), and congenital erythropoietic porphyria (CEP). For more information about each disease, see the article on Porphyria.

To diagnose porphyrias, clinical laboratories measure porphyrins and their precursors in urine, blood, and/or stool. Testing may include measurement of one or more of the following:

1.Porphobilinogen (PBG), a porphyrin precursor, in urine
2.Delta-aminolevulinic acid (ALA), another porphyrin precursor, in urine
3.Porphyrins (uroporphyrin, coproporphyrin, and protoporphyrin) in urine, blood, or stool

Specialized laboratories may offer testing for one or more of the affected enzymes. The most commonly measured enzyme is porphobilinogen deaminase (PBG-D) in red blood cells, which tests for acute intermittent porphyria. A few laboratories offer genetic testing for specific gene mutations that cause one of the porphyrias, but this type of testing is not widely available.
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The postcoital test (PCT) (also known as Sims test, Huhner test or Sims-Huhner test) is a test in the evaluation of infertility. The test examines interaction between sperm and mucus of the cervix.
The PCT is scheduled close to ovulation when mucus is abundant, and the infertile couple is asked to have sexual intercourse, preferably in early hours of morning. Several hours later (usually 2), the woman is examined by the physician. The mucus is aspirated from cervical canal and spread on a glass slide. Smear from posterior fornix is used as control. 10-50 motile sperms per high power field are considered normal. Rotatory or shaky motion of sperms indicates presence of antispermal antibody. Cervical mucus is examined for quality, viscosity and fern test.

A poor PCT may indicate sperm or mucus problems, including perhaps presence of immune factors that inactivate sperm. Also ovulatory problems and poor coital technique may affect the PCT. The test is useless in presence of cervical infection.

With the application of principles of evidence-based medicine the role of the PCT has been questioned and its use has become controversial.
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Potassium is an electrolyte that is vital to cell metabolism. It helps transport nutrients into cells and removes waste products out of cells. It is also important in muscle function, helping to transmit messages between nerves and muscles. This test measures the amount of potassium in the blood and/or urine.
Potassium, along with other electrolytes such as sodium, chloride, and bicarbonate (total CO2), helps regulate the amount of fluid in the body and maintains a stable acid-base balance. Potassium is present in all body fluids, but most potassium is found within the cells. Only a small amount is present in fluids outside the cells and in the liquid part of the blood (called serum or plasma).
We get most of the potassium we need from the foods that we eat and most people have an adequate intake of potassium. The body uses what it requires and the kidneys eliminate the rest in the urine. The body tries to keep the blood potassium level within a very narrow range. Levels are mainly controlled by aldosterone, a hormone produced by the adrenal glands in the kidneys.
Because the blood concentration of potassium is so small, minor changes can have significant consequences. If potassium levels are too low or too high, there can be serious health consequences; a person may be at risk for developing shock, respiratory failure, or heart rhythm disturbances. An abnormal potassium level can alter the function of the nerves and muscles; for example, the heart muscle may lose its ability to contract.


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Painful urination (dysuria) is discomfort or burning with urination, usually felt in the tube that carries urine out of your bladder (urethra) or the area surrounding your genitals (perineum).

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Palpitations are the perceived abnormality of the heartbeat characterized by awareness of cardiac muscle contractions in the chest: hard, fast and/or irregular beats. It is both a symptom reported by the patient and a medical diagnosis. Palpitation can be associated with anxiety and does not necessarily indicate a structural or functional abnormality of the heart, but it can be a symptom arising from an objectively rapid or irregular heartbeat. Palpitation can be intermittent and of variable frequency and duration, or continuous. Associated symptoms include dizziness, shortness of breath, sweating, headaches, and chest pain.

Palpitation may be associated with coronary heart disease, hyperthyroidism, diseases affecting cardiac muscle such as hypertrophic cardiomyopathy, diseases causing low blood oxygen such as asthma and emphysema; previous chest surgery; kidney disease; low levels of brain serotonin; blood loss, and pain; drugs such as antidepressants, statins, alcohol, nicotine, caffeine, cocaine, and amphetamines; electrolyte imbalances of magnesium, potassium and calcium; and deficiencies of nutrients such as taurine, arginine, and iron.
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A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who usually has diabetes. Because the pancreas is a vital organ, performing functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas is attached in a different location. In the event of rejection of the new pancreas, which would quickly cause life-threatening diabetes, there would be a significant chance the recipient would not survive very well for long without the native pancreas, however dysfunctional, still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes, who can develop severe complications. Patients with the most common, and deadliest, form of pancreatic cancer (pancreatic adenomas, which are usually malignant, with a poor prognosis and high risk for metastasis, as opposed to more treatable pancreatic neuroendocrine tumors or pancreatic insulinomas) are usually not eligible for valuable pancreatic transplantations, since the condition usually has a very high mortality rate and the disease, which is usually highly malignant and detected too late to treat, could and probably would soon return.
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Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells have the ability to invade other parts of the body. There are a number of types of pancreatic cancer. The most common, pancreatic adenocarcinoma, accounts for about 85% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type. These adenocarcinomas start within the part of the pancreas which makes digestive enzymes. Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells. One to two percent of cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma.

Signs and symptoms of the most common form of pancreatic cancer may include yellow skin, abdominal or back pain, unexplained weight loss, light-colored stools, dark urine and loss of appetite. There are usually no symptoms in the disease's early stages, and symptoms that are specific enough to suggest pancreatic cancer typically do not develop until the disease has reached an advanced stage. By the time of diagnosis, pancreatic cancer has often spread to other parts of the body.
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Pancreatitis is inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types, acute pancreatitis and chronic pancreatitis. Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting. The pain often goes into the back and is usually severe. In acute pancreatitis a fever may occur and symptoms typically resolve in a few days. In chronic pancreatitis weight loss, fatty stool, and diarrhea may occur. Complications may include infection, bleeding, diabetes mellitus, or problems with other organs.

The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Other causes include direct trauma, certain medications, infections such as mumps, and tumors among others. Chronic pancreatitis may develop as a result of acute pancreatitis. It is most commonly due to many years of heavy alcohol use. Other causes include high levels of blood fats, high blood calcium, some medications, and certain genetic disorders such as cystic fibrosis among others. Smoking increases the risk of both acute and chronic pancreatitis. Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase. In chronic pancreatitis these tests may be normal. Medical imaging such as ultrasound and CT scan may also be useful.
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Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen. The maximum degree of symptoms occurs within minutes. Typically they last for about 30 minutes but the duration can vary from seconds to hours. There may be a fear of losing control or chest pain. Panic attacks themselves are not dangerous physically.

Panic attacks can occur due to number of disorders including panic disorder, social anxiety disorder, post traumatic stress disorder, drug use disorder, depression, and medical problems. They can either be triggered or occur unexpectedly. Risk factors include smoking and psychological stress. Diagnosis should involve ruling out other conditions that can produce similar symptoms including hyperthyroidism, hyperparathyroidism, heart disease, lung disease, and drug use.

Treatment of panic attacks should be directed at the underlying cause. In those with frequent attacks, counselling or medications may be used. Breathing training and muscle relaxation techniques may also help. Those affected are at a higher risk of suicide.
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Panic disorder is an anxiety disorder characterized by recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something really bad is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past.

The cause of panic disorder is unknown. Panic disorder often runs in families. Risk factors include smoking, psychological stress, and a history of child abuse. Diagnosis involves ruling out other potential causes of anxiety including other mental disorders, medical conditions such as heart disease or hyperthyroidism, and drug use. Screening for the condition may be done using a questionnaire.

Panic disorder is usually treated with counselling and medications. The type of counselling used is typically cognitive behavioral therapy (CBT) which is effective in more than half of people. Medications used include antidepressants and occasionally benzodiazepines or beta blockers. Following stopping treatment up to 30% of people have a recurrence.
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Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

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Parkinson’s disease affects the nerve cells in the brain that produce dopamine. Parkinson’s disease symptoms include muscle rigidity, tremors, and changes in speech and gait. After diagnosis, treatments can help relieve symptoms, but there is no c

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Skin peeling on fingertips is a very common problem. Skin around fingertips is sensitive and if you don't take proper care then there are many factors which can cause the skin to peel off. In the cold climate the skin looses moisture, becomes dry and begin to flak, so don't let your skin become dry. Skin conditions such as eczema and psoriasis, sunburn and skin infections can  also cause peeling of skin around fingertips. Allergies, diabetes and vitamin B deficiency, use of harsh chemical and even frequent wasting of hands can cause peeling of fingertips skin. There are a number of natural home remedies that can repair your peeling of fingertip skin. 

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Peeling skin syndrome (also known as "Acral peeling skin syndrome," "Continual peeling skin syndrome," "Familial continual skin peeling," "Idiopathic deciduous skin," and "Keratolysis exfoliativa congenita") is an autosomal recessive disorder characterized by lifelong peeling of the stratum corneum, and may be associated with pruritus, short stature, and easily removed anagen hair.
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Periodontitis, also known as gum disease and pyorrhea, is a set of inflammatory diseases affecting the tissues surrounding the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth.

Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an over-aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe (i.e., a clinical examination) and by evaluating the patient's X-ray films (i.e., a radiographic examination), to determine the amount of bone loss around the teeth. Specialists in the treatment of periodontitis are periodontists; their field is known as "periodontology" or "periodontics".
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Personality change refers to a shift in the way you think, act or feel. It may be noticeable only to you, or it may be evident to people close to you.


Gradual personality changes can be normal as you age. It is also normal for you to have changing behaviors or feelings based on your mood, but these changes are temporary and can usually be attributed to a specific event. A sudden, undesired or uncontrollable change in your personality may be the sign of a serious condition.

Several mental illnesses can lead to personality changes. These include anxiety disorders, borderline personality disorder, dementia, and schizophrenia. In the case of mental illness, personality changes may be the result of an interplay of factors, including heredity, environment and stress. These types of changes typically emerge before adolescence. Most mental illnesses are thought to result from imbalances in brain chemicals (neurotransmitters) and are treated with medication and psychotherapy.

Sudden changes in personality can also result from brain damage or infection. Possible causes of brain damage include injury, stroke, infection and inflammation, among others.

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Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, a hoarse voice. Symptoms usually last three to five days. Complications can include sinusitis and acute otitis media. Pharyngitis is typically a type of respiratory tract infection.

Most cases are caused by a viral infection. Strep throat is the cause in about 25% of children and 10% of adults. Uncommon causes include other bacteria such as gonorrhea, fungus, irritants such as smoke, allergies, and gastroesophageal reflux disease. Specific testing is not recommended in people who have clear symptoms of a viral infection such as a cold. Otherwise a rapid antigen detection test (RAPD) or throat swab is recommended. Other conditions that can produce similar symptoms include epiglottitis, thyroiditis, retropharyngeal abscess, and occasionally heart disease.
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Phlegm is a liquid secreted by the mucous membranes of mammals. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing (sputum). Phlegm is in essence a water-based gel consisting of glycoproteins, immunoglobulins, lipids and other substances. Its composition varies depending on climate, genetics, and state of the immune system. Its color can vary from transparent to pale or dark yellow and green, from light to dark brown, and even to dark grey depending on the constituents.
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An unreasonable sort of fear that can cause avoidance and panic. Phobias are a relatively common type of anxiety disorder. Phobias can be treated with cognitive behavioral therapy, using exposure and fear-reduction techniques. In many cases, antianxiety or antidepressant medication proves helpful, especially during the early stages of therapy.

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A pimple, zit or spot is a kind of comedo and one of the many results of excess oil getting trapped in the pores. Some of the varieties are pustules or papules. Pimples can be treated by various acne medications prescribed by a physician, or purchased at a pharmacy with a wide variety of treatments.
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Also called conjunctivitis. Redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants and toxic agents. Viral and bacterial forms of conjunctivitis are common in childhood.

The leading cause of a red eye is virus infection. Viral pink eye is usually associated with more of a watery discharge, not green or yellow in color, and is frequently associated with viral cold-like symptoms. The eyelids may be swollen. Sometimes looking at bright lights is painful. While viral pink eye, may not require an antibiotic, the doctor should see the child, as occasionally this form of pink eye can be associated with infection of the cornea, (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious.

The bacteria that most commonly cause pink eye are staphylococcus, pneumococcus, and streptococcus. Symptoms include eye pain, swelling, redness, and a moderate to large amount of discharge, usually yellow or greenish in color. The discharge commonly accumulates after sleep. The eyelids may be stuck together requiring a warm wash cloth applied to the eyes to remove the discharge. This bacterial pink eye responds to repeated warm wash cloths applied to the eyes and antibiotic eye drops or ointment.

Chlamydia is a form a bacterial that is an uncommon form of pink eye in the U.S., but is very common in Africa and the Middle Eastern countries. It can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with tetracycline (except in children less than eight years old, because of possible teeth discoloration) or erythromycin.


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Plantar fasciitis is a disorder that results in pain in the heel and bottom of the foot. The pain is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin and may be worsened by a tight Achilles tendon. The condition typically comes on slowly. In about a third of people both legs are affected.

The causes of plantar fasciitis are not entirely clear. Risk factors include overuse such as from long periods of standing, an increase in exercise, and obesity. It is also associated with inward rolling of the foot and a lifestyle that involves little exercise. While heel spurs are frequently found it is unclear if they have a role in causing the condition. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring. As inflammation plays a lesser role, many feel the condition should be renamed plantar fasciosis. The diagnosis is typically based on signs and symptoms with ultrasound sometimes used to help. Other conditions with similar symptoms include osteoarthritis, ankylosing spondylitis, heel pad syndrome, and reactive arthritis.
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Primary lateral sclerosis is a type of motor neuron disease that causes muscle nerve cells to slowly break down, causing weakness. Primary lateral sclerosis (PLS) causes weakness in your voluntary muscles, such as those you use to control your legs, arms and tongue.

Primary lateral sclerosis can happen at any age, but it usually occurs between ages 40 and 60. A subtype of primary lateral sclerosis, known as juvenile primary lateral sclerosis, begins in early childhood and is caused by an abnormal gene passed from parents to children.

Primary lateral sclerosis is often mistaken for another, more common motor neuron disease called amyotrophic lateral sclerosis (ALS). However, primary lateral sclerosis progresses more slowly than ALS, and in most cases isn't fatal.

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Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.

Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include other lung diseases such as cystic fibrosis, COPD, and asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, or a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
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eastern poison ivy/Toxicodendron rydbergii -- western poison ivy) typically grows as a vine or shrub, and it can be found throughout much of North America (except in the desert, Alaska, and Hawaii). It grows in open fields, wooded areas, on the roadside, and along riverbanks. It can also be found in urban areas, such as parks or backyards. Poison ivy plants typically have leaf arrangements that are clustered in groups of three leaflets (trifoiate), though this can vary. The color and shape of the leaves may also vary depending upon the exact species, the local environment, and the time of year. The plant may have yellow or green flowers, and white to green-yellow berries, depending on the season. Eastern poison ivy typically grows as a hairy ropelike vine, whereas western poison ivy tends to grow as a low shrub.

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Polycystic kidney disease (PKD or PCKD, also known as polycystic kidney syndrome) is a genetic disorder in which the renal tubules become structurally abnormal, resulting in the development and growth of multiple cysts within the kidney. These cysts may begin to develop before birth or in infancy, in childhood, or in adulthood. Cysts are non-functioning tubules filled with fluid pumped into them, which range in size from microscopic to enormous, crushing adjacent normal tubules and eventually rendering them non-functional also.

PKD is caused by abnormal genes which produce a specific abnormal protein which has an adverse affect on tubule development. PKD is a general term for two types, each having their own pathology and genetic cause: autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD). The abnormal gene exists in all cells in the body: as a result, cysts may occur in the liver, seminal vesicles, and pancreas. This genetic defect can also cause aortic root aneurysms, and aneurysms in the circle of Willis cerebral arteries, which if they rupture, can cause a subarachnoid hemorrhage.
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Polycystic liver disease (PLD or PCLD) is a rare condition that causes cysts -- fluid-filled sacs -- to grow throughout the liver. A normal liver has a smooth, uniform appearance. A polycystic liver can look like a cluster of very large grapes. Cysts also can grow independently in different parts of the liver. The cysts, if they get too numerous or large, may cause discomfort and health complications. But most people with polycystic liver disease do not have symptoms and live a normal life.

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

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

PCOS is due to a combination of genetic and environmental factors. Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts. Cysts may be detectable by ultrasound. Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and hyperprolactinemia.
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Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. Onset is typically between one week and one month following childbirth. PPD can also negatively affect the person's child.

While the exact cause of PPD is unclear, the cause is believed to be a combination of physical and emotional factors. These may include factors such as hormonal changes and sleep deprivation. Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder. Diagnosis is based on a person's symptoms. While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.
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The premature graying problem is largely genetic. Hair follicles contain pigment cells that produce melanin, which gives your tresses their color. When your body stops generating melanin, hair presents itself as gray, white, or silver

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Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Often symptoms are present for around six days. A woman's pattern of symptoms may change over time. Symptoms do not occur during pregnancy or following menopause.

Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life. Emotional symptoms must not be present during the initial part of the menstrual cycle. A daily list of symptoms over a few months may help in diagnosis. Other disorders that cause similar symptoms need to be excluded before a diagnosis is made.

The cause of PMS is unknown. Some symptoms may be worsened by a high-salt diet, alcohol, or caffeine. The underlying mechanism is believed to involve changes in hormone levels. Reducing salt, caffeine, and stress along with increasing exercise is typically all that is recommended in those with mild symptoms. Calcium and vitamin D supplementation may be useful in some. Anti-inflammatory drugs such as naproxen may help with physical symptoms. In those with more significant symptoms birth control pills or the diuretic spironolactone may be useful.

Up to 80% women report having some symptoms prior to menstruation. These symptoms qualify as PMS in 20 to 30% of pre-menopausal women. Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that has greater psychological symptoms. PMDD affects three to eight percent of pre-menopausal women. Antidepressant medication of the selective serotonin reuptake inhibitors class may be used in addition to usual measures for in PMDD.
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Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.

Still, you don't have to let these problems control your life. Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome

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Prickly heat is the common name for the medical term "miliaria rubia." It is also known as heat rash. The rash creates an area of red skin with many tiny raised bumps. This area may also blister.

The face, neck, shoulders, and chest are the most common places for prickly heat to occur, although it may show up anywhere. While it can affect anyone, children are more likely to get prickly heat than adults.

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Probiotics are the latest health obsession thanks to their seemingly endless list of health benefits. But the hype may be warranted; these friendly bacteria are the real deal. Various probiotic strains have been shown to support the gastrointestinal (GI) tract, prevent inflammation, boost immunity and alleviate conditions ranging from allergies to diarrhea, although more research needs to be done to sort out specific strains, outcomes and dosages. “Conventionally, when people hear about probiotics, they typically think of yogurt or supplements,” says Dr. B.J. Hardick, founder of the Centre for Maximized Living in London, Ontario. “Most people are unfortunately unaware of several other incredible -- and typically better -- sources of healthy gut bacteria.” Among those sources is a wide array of cultured and fermented foods. On the next slides, we’ll describe the benefits of 13 probiotic foods – some may surprise you

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Prostate cancer is the development of cancer in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other parts of the body, particularly the bones and lymph nodes. It may initially cause no symptoms. In later stages it can lead to difficulty urinating, blood in the urine, or pain in the pelvis, back or when urinating. A disease known as benign prostatic hyperplasia may produce similar symptoms. Other late symptoms may include feeling tired due to low levels of red blood cells.

Factors that increase the risk of prostate cancer include: older age, a family history of the disease, and race. About 99% of cases occur in those over the age of 50. Having a first-degree relative with the disease increases the risk two to threefold. In the United States, it is more common in the African American population than the white American population. Other factors that may be involved include a diet high in processed meat, red meat, or milk products or low in certain vegetables. An association with gonorrhea has been found, but a reason for this relationship has not been identified. Prostate cancer is diagnosed by biopsy. Medical imaging may then be done to determine if the cancer has spread to other parts of the body.
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Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. These skin patches are typically red, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.

There are five main types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. Plaque psoriasis, also known as psoriasis vulgaris, makes up about 90 percent of cases. It typically presents as red patches with white scales on top. Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp. Guttate psoriasis has drop-shaped lesions. Pustular psoriasis presents as small non-infectious pus-filled blisters. Inverse psoriasis forms red patches in skin folds. Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types Fingernails and toenails are affected in most people with psoriasis at some point in time. This may include pits in the nails or changes in nail color.
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Progressive supranuclear palsy, or PSP, is a rare neurodegenerative disease that is often misdiagnosed as Parkinson's disease because its symptoms are similar. Because of its rarity, PSP is mostly unknown by the general public.

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Posttraumatic stress disorder (PTSD) is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person's life. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress but instead may express their memories through play. A person with PTSD is at a higher risk for suicide and intentional self-harm.

Most people who have experienced a traumatic event will not develop PTSD. People who experience interpersonal trauma (for example rape or child abuse) are more likely to develop PTSD, as compared to people who experience non-assault based trauma such as accidents and natural disasters. About half of people develop PTSD following rape. Children are less likely than adults to develop PTSD after trauma, especially if they are under ten years of age. Diagnosis is based on the presence of specific symptoms following a traumatic event.
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Periorbital puffiness, also known as "puffy eyes", or swelling around the eyes, is the appearance of swelling in the tissues around the eyes, called the orbits. It is almost exclusively caused by fluid buildup around the eyes, or periorbital edema. Minor puffiness usually detectable below the eyes only (although at times they could be present all around) is often called eye bags. Such transient puffiness is distinct from the age related and gradual increase in the size of the fat pad lying below the lower eyelids (suborbicularis oculi fat – "SOOF") which can also be colloquially referred to as eye bags.
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Pulmonary fibrosis (literally "scarring of the lungs") is a respiratory disease in which scars are formed in the lung tissues, leading to serious breathing problems. Scar formation, the accumulation of excess fibrous connective tissue (the process called fibrosis), leads to thickening of the walls, and causes reduced oxygen supply in the blood. As a consequence patients suffer from perpetual shortness of breath.

In some patients the specific cause of the disease can be diagnosed, but in others the probable cause cannot be determined, a condition called idiopathic pulmonary fibrosis. There is no known cure for the scars and damage in the lung due to pulmonary fibrosis.
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Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure within the arteries of the lungs. Symptoms include shortness of breath, syncope, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition may make it difficult to exercise. Onset is typically gradual.

The cause is often unknown. Risk factors include a family history, prior blood clots in the lungs, HIV/AIDS, sickle cell disease, cocaine use, COPD, sleep apnea, living at high altitudes, and problems with the mitral valve. The underlying mechanism typically involves inflammation of the arteries in the lungs. Diagnosis involves first ruling out other potential causes.

There is no cure. Treatment depends on the type of disease. A number of supportive measures such as oxygen therapy, diuretics, and medications to inhibit clotting may be used. Medications specifically for the condition include epoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, and sildenafil. A lung transplant may be an option in certain cases.

While the exact frequency of the condition is unknown, it is estimated that about 1,000 new cases occur a year in the United States. Females are more often affected than males. Onset is typically between 20 and 60 years of age. It was first identified by Ernst von Romberg in 1891.
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Prediabetes is the precursor stage before diabetes mellitus in which not all of the symptoms required to diagnose diabetes are present, but blood sugar is abnormally high. This stage is often referred to as the "grey area." It is not a disease; the American Diabetes Association says, "Prediabetes should not be viewed as a clinical entity in its own right but rather as an increased risk for diabetes and cardiovascular disease (CVD). Prediabetes is associated with obesity (especially abdominal or visceral obesity), dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension." It is thus a metabolic diathesis or syndrome, and it usually involves no symptoms and only high blood sugar as the sole sign.

Impaired fasting blood sugar and impaired glucose tolerance are two forms of prediabetes that are similar in clinical definition (glucose levels too high for their context) but are physiologically distinct. Insulin resistance, the insulin resistance syndrome (metabolic syndrome or syndrome X), and prediabetes are closely related to one another and have overlapping aspects.
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Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception (probably several months before) as well as throughout pregnancy and breast feeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.

An inadequate or excessive amount of some nutrients may cause malformations or medical problems in the fetus, and neurological disorders and handicaps are a risk that is run by mothers who are malnourished. 23.8% of babies worldwide are estimated to be born with lower than optimal weights at birth due to lack of proper nutrition. Personal habits such as smoking, alcohol, caffeine, using certain medications and street drugs can negatively and irreversibly affect the development of the baby, which happens in the early stages of pregnancy.

Caffeine is sometimes assumed to cause harm to the unborn baby but there is not enough evidence so say if this is true. A recent review showed that more research is needed to show whether caffeine intake effects birth weight, preterm births, gestational diabetes and other outcomes.
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Healthy eating plays a very important role in a healthy pregnancy. You need to eat foods from a variety of sources to make sure you get all the vitamins, minerals and nutrients you and your developing baby need. Eating well will also help you feel better, give you more energy and help you gain a healthy amount of weight. It will also contribute to your baby's healthy growth and development.


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Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Often symptoms are present for around six days. A woman's pattern of symptoms may change over time. Symptoms do not occur during pregnancy or following menopause.

Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life. Emotional symptoms must not be present during the initial part of the menstrual cycle. A daily list of symptoms over a few months may help in diagnosis. Other disorders that cause similar symptoms need to be excluded before a diagnosis is made.
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Polynesia  is a subregion of Oceania, made up of more than 1,000 islands scattered over the central and southern Pacific Ocean. The indigenous people who inhabit the islands of Polynesia are termed Polynesians, who share many similar traits including language family, culture, and beliefs.[1] Historically, they had a strong tradition of sailing, using stars to navigate at night.

The term Polynesia was first used in 1756 by French writer Charles de Brosses, and originally applied to all the islands of the Pacific. In 1831, Jules Dumont d'Urville proposed a restriction on its use during a lecture to the Geographical Society of Paris. Historically, the islands of the South Seas have been known as South Sea Islands[2], and their inhabitants as South Sea Islanders, even though the Hawaiian Islands are located in the North Pacific. Another term, the Polynesian Triangle, explicitly includes the Hawaiian Islands, as they form its northern vertex.


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A Pap smear is a test for women that can help find or prevent cervical cancer. During the procedure, cells are collected from the cervix, which is the lower, narrow end of the uterus that opens into the vagina. The cells are checked for cancer or for signs that they may become cancer. These are called precancerous cells. Finding and treating precancerous cells can help prevent cervical cancer. The Pap smear is a reliable way to find cancer early, when it's most treatable.

Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

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potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte. Electrolytes are electrically charged minerals in your body that help control muscle and nerve activity, maintain fluid levels, and perform other important functions. Your body needs potassium to help your heart and muscles work properly. Potassium levels that are too high or too low may indicate a medical problem.

Other names: potassium serum, serum potassium, serum electrolytes, k


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A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.

Other names: urine protein, 24-hour urine protein; urine total protein; ratio; reagent strip urinalysis.

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The pancreas is the organ responsible for the production of insulin, a crucial hormone that helps our bodies turn sugar into fuel. Additionally, the pancreas also creates enzymes that break down fat, protein and carbohydrates during digestion.

An individual without a properly functioning pancreas does not have the necessary amount of insulin being produced in their bodies, and thus, there is a surplus sugar in their blood. This can cause major problems in the body, such as kidney failure, heart disease, strokes or even death. The most common cause of pancreas disease is Type I Diabetes, formerly known as juvenile diabetes.Experimental transplant of islet cells have started to be performed as a way to treat diabetes. In these instances, the insulin-producing islet cells are isolated from the donor's pancreas and injected into the patient's liver, where they begin to produce insulin for the recipient.

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Physical medicine and rehabilitation (PM&R), also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. A physician having completed training in this field is referred to as a physiatrist. Unlike other medical specialties that focus on a medical “cure,” the goals of the physiatrist are to maximize patients’ independence in activities of daily living and improve quality of life.

Physiatrists are experts in designing comprehensive, patient-centered treatment plans, and are integral members of the care team. They utilize cutting-edge as well as time-tested treatments to maximize function and quality of life for their patients, who can range in age from infants to octogenarians.

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By definition, physical therapy is a unique science and art that utilizes a wide variety of procedures to restore function to the body, reduce pain and help prevent future injury. When daily life is altered due to an injury, accident, chronic medical condition or re-injury, we realize we are responsible for helping to put our patients' lives back on course and help each individual get back to life.Physical therapy utilizes a variety of evidence-based treatments, physical exercises and hands-on modalities to begin the rehabilitation process at the onset of injury or pain.


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Psychosocial rehabilitation (also termed psychiatric rehabilitation or PSR) promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental illness or mental health concern.  Psychosocial rehabilitation services and supports are collaborative, person directed, and individualized, and an essential element of the human services spectrum.  They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning and social environments of their choice and include a wide continuum of services and supports.  (PSR/RPS Canada, 2013)

PSR approaches are evidence-based best and promising practices in the key life domains of Employment, Education, Leisure, Wellness and Basic Living Skills as well as Family Involvement and Peer Support and Peer Delivered services. Because of their demonstrated effectiveness and recovery orientation, these approaches should be widely available to people living with long term mental illness and/or substance use problems.

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The chain of nerve cells that runs from the brain through the spinal cord out to the muscle is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscle cause periodic paralysis, in which the weakness comes and goes.

The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralyzed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralyzed muscle. Paralysis almost always causes a change in muscle tone. Paralyzed muscle may be flaccid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved.

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Some people might hear “psoriasis” and think of the skin disease that causes itchy, scaly rashes and crumbling nails. It's true, psoriasis is an autoimmune disease that primarily affects the skin. But about 30 percent of people with psoriasis also develop a form of inflammatory arthritis called psoriatic arthritis (PsA). Like psoriasis, PsA is an autoimmune disease, meaning it occurs when the body’s immune system mistakenly attacks healthy tissue, in this case the joints and skin. The faulty immune response causes inflammation that triggers joint pain, stiffness and swelling. The inflammation can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively.Most people with psoriatic arthritis have skin symptoms before joint symptoms. However, sometimes the joint pain and stiffness strikes first. In some cases, people get psoriatic arthritis without any skin changes.The disease may lay dormant in the body until triggered by some outside influence, such as a common throat infection. Another theory suggesting that bacteria on the skin triggers the immune response that leads to joint inflammation has yet to be proven.


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Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function

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Primary biliary cirrhosis, sometimes called PBC, is a disease in which the bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins.When bile ducts are damaged, as in primary biliary cirrhosis, harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

Primary biliary cirrhosis is considered an autoimmune disease, in which the body turns against its own cells.Researchers think it is triggered by a combination of genetic and environmental factors. Primary biliary cirrhosis usually develops slowly and medication can slow its progression, especially if treatment begins early.


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PSC is a disease that damages and blocks bile ducts inside and outside the liver. Bile is a liquid made in the liver. Bile ducts are tubes that carry bile out of the liver to the gallbladder and small intestine. In the intestine, bile helps break down fat in food.

In PSC, inflammation of the bile ducts leads to scar formation and narrowing of the ducts over time. As scarring increases, the ducts become blocked. As a result, bile builds up in the liver and damages liver cells. Eventually, scar tissue can spread throughout the liver, causing cirrhosis and liver failure.


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Prostatitis is inflammation of the prostate gland. The inflammation can be due to an infection as well as other various causes. Prostatitis accounts for nearly 2 million visits per year to outpatient urology practices in the United States.

The prostate gland is part of the male reproductive system, and it is a walnut-sized gland found in men that is located below the bladder and in front of the rectum. It surrounds the urethra, the tube through which urine and semen exit the body. Its main function is to produce seminal fluid in order to transport sperm through the urethra.

The NIH consensus definition and classification of prostatitis:

Acute bacterial prostatitis:
Caused by a bacterial infection and it typically starts suddenly and may include flu-like symptoms. It is the least common of the four types of prostatitis.
Chronic bacterial prostatitis:
Characterized by recurrent bacterial infections of the prostate gland. Between attacks the symptoms might be minor or the patient may even be symptom free, however it can be difficult to successfully treat.
Chronic prostatitis/chronic pelvic pain syndrome:
Most cases of prostatitis fall into this category, however it is the least understood. It can be further characterized as inflammatory or noninflammatory, depending upon the presence or absence of infection-fighting cells in the urine, semen, and prostatic fluid. Often no specific cause can be identified. The symptoms can come and go or remain chronically.
Asymptomatic inflammatory prostatitis:
This condition is often diagnosed incidentally during the work-up for infertility or prostate cancer. Individuals with this form of prostatitis will not complain of symptoms or discomfort, but they will have the presence of infection-fighting cells present in semen/prostatic fluid.

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Premenstrual syndrome (PMS) refers to the range of physical and emotional symptoms many women experience in the lead up to a period. Premenstrual dysphoric disorder (PMDD) is a more serious form of PMS. Here you will find information on PMS, PMDD symptoms, causes and treatments.


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