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<s>[INST] When to seek urgent medical care when I have Bedwetting ? [/INST] Be sure to mention bedwetting to your child's health care provider.
Children should have a physical exam and a urine test to rule out urinary tract infection or other causes.
If your child is having pain with urination, fever, or blood in the urine, contact your child's doctor right away. </s> |
<s>[INST] What to expect if I have Bedwetting (Outlook/Prognosis)? [/INST] The condition poses no threat to the health of the child if there is no physical cause of bedwetting. The child may feel embarrassment or have a loss of self-esteem because of the problem. It is important to reassure the child. Most children respond to some type of treatment. </s> |
<s>[INST] What are the symptoms of Bowlegs? [/INST] Knees do not touch when standing with feet together (ankles touching) Bowing of legs is same on both side of the body (symmetrical) Bowed legs continue beyond age 3 </s> |
<s>[INST] What causes Bowlegs? [/INST] Infants are born bowlegged because of their folded position in the uterus. The infant's bowed legs begin to straighten once the child starts to walk and the legs begin to bear weight (about 12 to 18 months old).
By around age 3, the child can usually stand with the ankles apart and the knees just touching. If the bowed legs are still present, the child is called bowlegged.
Bowlegs may be caused by illnesses such as:
Blount's disease Bone dysplasias (abnormal development) Fractures that do not heal correctly Lead or fluoride poisoning Rickets, which is caused by a vitamin D deficiency </s> |
<s>[INST] When to seek urgent medical care when I have Bowlegs ? [/INST] Call your health care provider if your child shows persistent or worsening bowed legs after age 3. </s> |
<s>[INST] What to expect if I have Bowlegs (Outlook/Prognosis)? [/INST] In many cases the outcome is good, and there is usually no problem walking. </s> |
<s>[INST] What are the symptoms of Child physical abuse? [/INST] An adult may bring an injured child to an emergency room with a strange explanation of the cause of the injury. The child's injury may not be recent.
Symptoms include:
Black eyes Broken bones that are unusual and unexplained Bruise marks shaped like hands, fingers, or objects (such as a belt) Bruises in areas where normal childhood activities would not usually result in bruising Bulging fontanelle (soft spot) or separated sutures in an infant's skull Burn (scalding) marks, usually seen on the child's hands, arms, or buttocks Choke marks around the neck Cigarette burns on exposed areas or on the genitals Circular marks around the wrists or ankles (signs of twisting or tying up)' Human bite marks Lash marks Unexplained unconsciousness in an infant </s> |
<s>[INST] What causes Child physical abuse? [/INST] Physical abuse tends to occur at moments of great stress. Many people who commit physical abuse were abused themselves as children. As a result, they often do not realize that abuse is not appropriate discipline.
Often people who commit physical abuse also have poor impulse control. This prevents them from thinking about what happens as a result of their actions.
The rate of child abuse is fairly high. The most common form is neglect. </s> |
<s>[INST] When to seek urgent medical care when I have Child physical abuse ? [/INST] All states require that you report any known or suspected child abuse.
Call your health care provider, Child Protective Services, or local police if you suspect or know that someone is being abused. </s> |
<s>[INST] What to expect if I have Child physical abuse (Outlook/Prognosis)? [/INST] The child's physical recovery depends on the severity of the injuries. Psychological recovery depends on the results of therapy, and whether the child can develop trusting relationships with adult caregivers.
The authorities will determine whether the abuser gets psychiatric help, such as parenting training and impulse/anger management training.
Child protection agencies generally make every effort to reunite families when possible. </s> |
<s>[INST] What are the symptoms of Child neglect and psychological abuse? [/INST] Symptoms of psychological abuse may include:
Difficulties in school Eating disorders, leading to weight loss or poor weight gain Emotional issues such as low self-esteem, depression, and anxiety Rebellious behavior
8Sleep disorders
Vague physical complaints </s> |
<s>[INST] What causes Child neglect and psychological abuse? [/INST] The rate at which children are physically and emotionally neglected is difficult to define.
Abused children are at risk of becoming abusers themselves as adults. </s> |
<s>[INST] When to seek urgent medical care when I have Child psychological abuse and neglect ? [/INST] Call your health care provider if a child has:
Physical changes, such as unexplained injuries, weight loss, or severe tiredness Unexplained behavior changes
Suspected child abuse of any form must be reported to the authorities. </s> |
<s>[INST] What to expect if I have Child psychological abuse and neglect (Outlook/Prognosis)? [/INST] With treatment, many children and parents can be reunited as a family.
The long-term outcome depends on:
How severe the abuse was For how long the child was abused The success of therapy and parenting classes </s> |
<s>[INST] What are the symptoms of Child sexual abuse? [/INST] Symptoms of sexual abuse in chlildren are similar to those of depression or severe anxiety and nervousness.
They can include:
Bowel disorders, such as soiling oneself (encopresis) Eating disorders, such as anorexia nervosa Genital or rectal symptoms, such as pain during a bowel movement or urination, or vaginal itch or discharge Repeated headaches Sleep problems Stomach aches (vague complaints)
Children who are abused may:
Display disruptive behaviors such as using alcohol and street drugs or engaging in high-risk sexual behaviors Do poorly in school Have excessive fears Withdraw from normal activities </s> |
<s>[INST] What causes Child sexual abuse? [/INST] Society was reluctant to deal with child sexual abuse a few decades ago. Today, it is considered a serious issue.
It is difficult to determine how often child sexual abuse occurs, because it is more secret than physical abuse. Children are often scared to tell anyone about the abuse. Many cases of abuse are not reported.
Abusers are usually men. They tend to know the person they are abusing. The abuser violates the trust of the younger person, which makes the sexual abuse even more devastating.
Child sexual abuse occurs in all social and economic classes of people. It has the same type of risk factors as physical child abuse, including:
Alcohol and drug abuse Family troubles Poverty
Abusers often have a history of physical or sexual abuse themselves.
A small group of repeated abusers have the psychiatric disorder, pedophilia. Their preferred sexual contact is with children. </s> |
<s>[INST] When to seek urgent medical care when I have Child sexual abuse ? [/INST] If you suspect child abuse in any form, immediately call your health care provider, Child Protective Services, or police. </s> |
<s>[INST] What to expect if I have Child sexual abuse (Outlook/Prognosis)? [/INST] The biggest issue is the child's mental health.
The outcome depends on:
Family and social support The child's personality The length of time the child was abused and the type of abuse Therapy </s> |
<s>[INST] What are the symptoms of Cryptorchidism? [/INST] There are usually no symptoms, except that the testicle cannot be found in the scrotum (this may be described as an empty scrotum). </s> |
<s>[INST] What causes Cryptorchidism? [/INST] Most of the time, children's testicles descend by the time they are 9 months old. Undescended testicles are fairly common in infants who are born early (premature infants). It occurs in about 3 - 4% of full-term infants.
Once a testicle has been found in the scrotum, it is considered descended, even if it is temporarily pulled back (retracted) during a later examination.
Some babies have a condition called retractile testes, in which the health care provider sometimes cannot find the testicles. This is due to the muscle reflex that retracts the testicles and the small testicle size before puberty. The testicles will descend at puberty. Surgery is not needed.
Testicles that do not descend by the time the child is 1 year old should be evaluated. Studies suggest that surgery should be done by this age. Surgery can reduce the chances of permanent damage to the testicles, which can lead to fertility problems later in life.
Testicles that do not naturally descend into the scrotum are considered abnormal. An undescended testicle is more likely to develop cancer, even if it is brought down into the scrotum. The other testicle is also more likely to develop cancer, even if it descended properly.
Bringing the testicle into the scrotum can improve sperm production and increases the odds of good fertility. It also allows the health care provider to examine the testicle to detect cancer early.
In other cases, no testicle may be found, even during surgery. This may be due to a problem that occurred while the baby was still developing in the mother (congenital). </s> |
<s>[INST] When to seek urgent medical care when I have Cryptorchidism ? [/INST] Call your child's health care provider if he appears to have an undescended testicle. </s> |
<s>[INST] What to expect if I have Cryptorchidism (Outlook/Prognosis)? [/INST] Most cases get better on their own, without any treatment. Medicine or surgery to correct the condition is usually successful. In about 5% of patients with undescended testicles, the testicles cannot be found at the time of surgery. This is called a vanished or absent testis. </s> |
<s>[INST] What are the symptoms of Ellis-van Creveld syndrome? [/INST] Cleft lip or palate Epispadias or undescended testicle (cryptorchidism) Extra fingers (polydactyly) Limited range of motion Nail problems, including missing or deformed nails Short arms and legs, especially forearm and lower leg Short height (between 3 1/2 and 5 feet tall) Sparse, absent, or fine textured hair Tooth abnormalities: Peg teeth Widely spaced teeth Teeth present at birth (natal teeth) Delayed or missing teeth </s> |
<s>[INST] What causes Ellis-van Creveld syndrome? [/INST] Ellis-van Creveld is passed down through families (inherited). It is caused by defects in one of two Ellis van Creveld syndrome genes (EVC and EVC2) that are next to each other.
The severity of the disease varies from person to person. The highest rate of the condition is seen among the Old Order Amish population of Lancaster County, Pennsylvania. It is fairly rare in the general population. </s> |
<s>[INST] Who is at highest risk for Ellis-van Creveld syndrome ? [/INST] Ellis-van Creveld is passed down through families (inherited). </s> |
<s>[INST] When to seek urgent medical care when I have Ellis-van Creveld syndrome ? [/INST] Call your health care provider if your child has symptoms of this syndrome. If you have a family history of Ellis-van Creveld syndrome and your child has any symptoms, visit your health care provider.
Genetic counseling can help families understand the condition and how to care for the patient. </s> |
<s>[INST] What to expect if I have Ellis-van Creveld syndrome (Outlook/Prognosis)? [/INST] Many babies with this condition die in early infancy, usually due to a small chest or heart defect. Stillbirth is common.
The outcome depends on which body system is involved and to what extent that body system is involved. Like most genetic conditions involving bones or the physical structure, intelligence is normal. </s> |
<s>[INST] What are the symptoms of Juvenile idiopathic arthritis? [/INST] Arthritis symptoms:
Joint stiffness when you wake up in the morning Joint pain Limited range of motion Joints may be warm or swollen and sometimes red A child may stop using an affected limb or may limp Back pain
Body-wide JRA symptoms:
Fever, usually high fevers every day Rash (trunk and extremities) that comes and goes with the fever Swollen lymph nodes (glands) JRA can also cause eye inflammation called uveitis. This problem can occur without any eye symptoms, or someone may have: Red eyes Eye pain Increased pain when looking at light (photophobia) Vision changes
Many other medical problems can cause symptoms similar to those of juvenile rheumatoid arthritis, including:
Lyme disease rheumatic fever bone infections (osteomyelitis) Sarcoidosis psoriatic arthritis vasculitis Inflammatory bowel disease </s> |
<s>[INST] What causes Juvenile idiopathic arthritis? [/INST] The cause of JRA is not known. It is thought to be an autoimmune illness. In this type of condition, the body's immune system mistakenly attacks and destroys healthy body tissue.
It is divided into several categories:
Systemic JRA involves joint swelling or pain, fevers, and rash. It is the least common category. Polyarticular JRA involves many joints. This form of JRA may turn into rheumatoid arthritis. It may involve large and small joints of the legs and arms, as well as the TMJ and cervical spine. Pauciarticular JRA involves only a few joints, usually the hips, knees, or ankles. </s> |
<s>[INST] Who is at highest risk for Juvenile idiopathic arthritis ? [/INST] JRA usually occurs before age 16. </s> |
<s>[INST] When to seek urgent medical care when I have Juvenile idiopathic arthritis ? [/INST] Call for an appointment with your health care provider if:
You notice symptoms of juvenile rheumatoid arthritis Symptoms get worse or do not improve with treatment New symptoms develop </s> |
<s>[INST] What to expect if I have Juvenile idiopathic arthritis (Outlook/Prognosis)? [/INST] JRA is seldom life threatening.
Children who have many joints involved, or who have a positive rheumatoid factor are more likely to have chronic pain and poor school attendance, and to be disabled.
Long periods with no symptoms are more common in those who have only a small number of joints involved. Many patients with JRA eventually go into remission with very little loss of function and deformity. </s> |
<s>[INST] What are the symptoms of Stress in childhood? [/INST] Children may not recognize that they are stressed. Parents may suspect that the child is excessively stressed if the child has experienced a potentially stressful situation and begins to have symptoms such as:
Physical symptoms:
Decreased appetite, other changes in eating habits Headache New or recurrent bedwetting Nightmares Sleep disturbances Stuttering Upset stomach or vague stomach pain Other physical symptoms with no physical illness
Emotional or behavioral symptoms:
Anxiety Worries Inability to relax New or recurring fears (fear of the dark, fear of being alone, fear of strangers) Clinging, unwilling to let you out of sight Questioning (may or may not ask questions) Anger Crying Whining Inability to control emotions Aggressive behavior Stubborn behavior Regression to behaviors that are typical of an earlier developmental stage Unwillingness to participate in family or school activities </s> |
<s>[INST] What causes Stress in childhood? [/INST] Stress is a response to any situation or factor that creates a negative emotional or physical change or both. People of all ages can experience stress. In small quantities, stress is good, it can motivate you and help you be more productive. However, excessive stress can interfere with life, activities, and health. Stress can affect the way people think, act, and feel.
Children learn how to respond to stress by what they have seen and experienced in the past. Most stresses experienced by children may seem insignificant to adults, but because children have few previous experiences from which to learn, even situations that require small changes can have enormous impacts on a child's feelings of safety and security.
Pain, injury, and illness are major stressors for children. Medical treatments produce even greater stress. Recognition of parental stress (such as that seen in divorce or financial crisis) is a severe stressor for children, as is death or loss of a loved one. </s> |
<s>[INST] When to seek urgent medical care when I have Stress in childhood ? [/INST] Seek professional help or advice when signs of stress do not decrease or disappear. </s> |
<s>[INST] How can parents help? [/INST] Parents can help children respond to stress in healthy ways. Following are some tips:
Provide a safe, secure, familiar, consistent, and dependable home. Be selective in the television programs that young children watch (including news broadcasts), which can produce fears and anxiety. Spend calm, relaxed time with your children. Encourage your child to ask questions. Encourage expression of concerns, worries, or fears. Listen to your child without being critical. Build your child's feelings of self-worth. Use encouragement and affection. Try to involve your child in situations where he or she can succeed. Try to use positive encouragement and reward instead of punishment. Allow the child opportunities to make choices and have some control in his or her life. This is particularly important, because research shows that the more people feel they have control over a situation, the better their response to stress will be. Encourage physical activity. Develop awareness of situations and events that are stressful for children. These include new experiences, fear of unpredictable outcomes, unpleasant sensations, unmet needs or desires, and loss. Recognize signs of unresolved stress in your child. Keep your child informed of necessary and anticipated changes such as changes in jobs or moving </s> |
<s>[INST] What are the symptoms of Alcohol withdrawal? [/INST] Alcohol withdrawal symptoms usually occur within 5 - 10 hours after the last drink, but can occur days later. Symptoms get worse in 48 - 72 hours, and may persist for weeks.
Common symptoms include:
Anxiety or nervousness Depression Not thinking clearly Fatigue Irritability Jumpiness or shakiness Mood swings Nightmares
Other symptoms may include:
Clammy skin Enlarged (dilated) pupils Headache Insomnia (sleeping difficulty) Loss of appetite Nausea and vomiting Pallor Rapid heart rate Sweating Tremor of the hands or other body parts
A severe form of alcohol withdrawal called delirium tremens can cause:
Agitation Severe confusion Seeing or feeling things that aren't there (hallucinations) Fever Seizures </s> |
<s>[INST] What causes Alcohol withdrawal? [/INST] Alcohol withdrawal occurs most often in adults, but it may occur in teenagers or children.
The more you drink every day, the more likely you are to develop alcohol withdrawal symptoms when you stop drinking.
You may have more severe withdrawal symptoms if you have certain other medical problems. </s> |
<s>[INST] When to seek urgent medical care when I have Alcohol withdrawal ? [/INST] Alcohol withdrawal is a serious condition that may rapidly become life threatening.
Call your health care provider or go the emergency room if you think you might be in alcohol withdrawal, especially if you were using alcohol often and recently stopped.
Call for an appointment with your health care provider if symptoms persist after treatment.
Go to the emergency room or call the local emergency number (such as 911) if seizures, fever, severe confusion, hallucinations, or irregular heartbeats occur. </s> |
<s>[INST] What to expect if I have Alcohol withdrawal (Outlook/Prognosis)? [/INST] How well a person does depends on the amount of organ damage and whether the person can stop drinking completely.
Alcohol withdrawal may range from a mild and uncomfortable disorder to a serious, life-threatening condition.
Symptoms such as sleep changes, rapid changes in mood, and fatigue may last for months. People who continue to drink a lot may develop health problems such as liver and heart disease.
Most people who go through alcohol withdrawal make a full recovery. However, death is possible, especially if delirium tremens occurs. </s> |
<s>[INST] What are the symptoms of Anxiety and Stress? [/INST] Stress is a normal feeling. In small doses, stress can help you get things done. Stress does not affect everyone the same way.
Many people feel stress symptoms in their body. You may be having pain i n your abdomen, headaches, and muscle tightness or pain.
When you are very stressed, you may notice:
A faster heart rate Skipped heartbeats Rapid breathing Sweating Trembling Dizziness Other symptoms include: Loose stools Frequent need to pee Dry mouth Problems swallowing You may have a harder time focusing, feel tired most of the time, or lose your temper more often. Stress may also cause sexual problems. It can also cause problems with falling or staying asleep and nightmares </s> |
<s>[INST] What causes Anxiety and Stress? [/INST] Many people have stress when they need to adapt or change.
Examples are:
Starting a new job or school Moving to a new home Getting married Having a child Breaking up with someone An injury or illness to you, a friend, or a loved one is a common cause of stress. Feelings of stress and anxiety are common in people who feel depressed and sad.
Some drugs may cause or worsen symptoms of stress.
These can include:
Some inhaler medicines used to treat asthma Thyroid drugs Some diet pills Some cold remedies Caffeine, cocaine, alcohol, and tobacco products may also cause or make symptoms of stress or anxiety worse. </s> |
<s>[INST] When to seek urgent medical care when I have Anxiety and Stress? [/INST] Call a suicide hotline if you have thoughts of suicide.
Reasons you may want to seek more help are:
You have feelings of panic, such as dizziness, rapid breathing, or a racing heartbeat. You are unable to work or function at home or at your job. You have fears that you cannot control. You are having memories of a traumatic event. Do not stop taking any prescribed medicines without talking to your doctor. </s> |
<s>[INST] What are the symptoms of Cocaine withdrawal? [/INST] Primary symptoms may include:
Agitation and restless behavior Depressed mood Fatigue Generalized malaise 8Increased appetite Vivid and unpleasant dreams Slowing of activity
The craving and depression can last for months following cessation of long-term heavy use (particularly daily).
Withdrawal symptoms may also be associated with suicidal thoughts in some people.
During withdrawal, there can be powerful, intense cravings for cocaine. However, the "high" associated with ongoing use becomes less and less pleasant, and can produce fear and extreme suspicion rather than joy (euphoria). Just the same, the cravings may remain powerful. </s> |
<s>[INST] What causes Cocaine withdrawal? [/INST] Cocaine produces a sense of extreme joy by causing the brain to release higher than normal amounts of some biochemicals. However, cocaine's effects on other parts of the body can be very serious or even deadly.
When cocaine use is stopped or when a binge ends, a crash follows almost immediately. This crash is accompanied by a strong craving for more cocaine. Additional symptoms include:
fatigue, lack of pleasure, anxiety, irritability, sleepiness, sometimes agitation or extreme suspicion.
Cocaine withdrawal often has no visible physical symptoms like the vomiting and shaking that accompanies the withdrawal from heroin or alcohol.
In the past, people underestimated the how addictive cocaine can be. However, cocaine is addictive when addiction is defined as a desire for more of the drug, despite negative consequences.
The level of craving, irritability, delayed depression, and other symptoms produced by cocaine withdrawal rivals or exceeds that felt with other withdrawal syndromes. </s> |
<s>[INST] When to seek urgent medical care when I have Cocaine withdrawal ? [/INST] Call your health care provider if you use cocaine and need help to stop using it. </s> |
<s>[INST] What to expect if I have Cocaine withdrawal (Outlook/Prognosis)? [/INST] Cocaine addiction is difficult to treat, and relapse can occur. However, the rates of achieving stabilization are as good as those for other chronic illnesses like diabetes and asthma.
Treatment should start with the least restrictive option and move up if necessary. Outpatient care is as effective as inpatient care for most people addicted to cocaine, according to the research.
Presently there are no effective medications for reducing craving, although some are being tested. Some studies have reported that medications such as amantadine and bromocriptine may help to reduce patient's craving, increase energy, and normalize sleep, particularly among those with the most seriously addicted. </s> |
<s>[INST] Culture-bound Syndrome? [/INST] Some doctors believe dhat syndrome to be either a culture-bound presentation of clinical depression as a somatized set of symptoms or a result of Western doctors' misinterpretation of patients' descriptions of their condition. It is very common in Pakistani culture as well. Most of them come with the complaints of "drops".. and become extremely anxious about it and see it as loss of "male power". it is often related with obsessive ruminations and somatoform symptoms. Others see it as a distinct clinical entity which is less culture-bound than these critics assert, and describe it as one form of a syndrome of "semen-loss anxiety" which also occurs in other Eastern cultures as jiryan and shen-k'uei, as well as in Western cultures. </s> |
<s>[INST] What are the symptoms of Drug dependence? [/INST] Some of the symptoms and behaviors of drug dependence include:
Confusion Continuing to use drugs even when health, work, or family are being harmed Episodes of violence Hostility when confronted about drug dependence Lack of control over drug abuse - being unable to stop or reduce alcohol intake Making excuses to use drugs Missing work or school, or a decrease in performance Need for daily or regular drug use to function Neglecting to eat Not caring for physical appearance No longer taking part in activities because of drug abuse Secretive behavior to hide drug use Using drugs even when alone </s> |
<s>[INST] What causes Drug dependence? [/INST] Drug abuse can lead to drug dependence or addiction. People who use drugs for pain relief may become dependent, although this is rare in those who don't have a history of addiction.
The exact cause of drug abuse and dependence is not known. However, a person's genes, the action of the drug, peer pressure, emotional distress, anxiety, depression, and environmental stress all can be factors.
Peer pressure can lead to drug use or abuse, but at least half of those who become addicted have depression, attention deficit disorder, post-traumatic stress disorder, or another mental health problem.
Children who grow up in an environment of illicit drug use may first see their parents using drugs. This may put them at a higher risk for developing an addiction later in life for both environmental and genetic reasons.
People who are more likely to abuse or become dependent on drugs include those who:
Have depression, bipolar disorder, anxiety disorders, and schizophrenia Have easy access to drugs Have low self-esteem, or problems with relationships Live a stressful lifestyle, economic or emotional Live in a culture where there is a high social acceptance of drug use
Commonly abused substances include:
Opiates and narcotics are powerful painkillers that cause drowsiness (sedation) and sometimes feelings of euphoria. These include heroin, opium, codeine, meperidine (Demerol), hydromorphone (Dilaudid), and oxycodone (Oxycontin).
Central nervous system (CNS) stimulants include amphetamines, cocaine, dextroamphetamine, methamphetamine, and methylphenidate (Ritalin). These drugs have a stimulating effect, and people can start needing higher amounts of these drugs to feel the same effect (tolerance).
Central nervous system depressants include alcohol, barbiturates (amobarbital, pentobarbital, secobarbital), benzodiazepines (Valium, Ativan, Xanax), chloral hydrate, and paraldehyde. These substances produce a sedative and anxiety -reducing effect, which can lead to dependence.
Hallucinogens include LSD, mescaline, psilocybin ("mushrooms"), and phencyclidine (PCP or "angel dust"). They can cause people to see things that aren't there (hallucinations) and can lead to psychological dependence. Tetrahydrocannabinol (THC) is the active ingredient found in marijuana (cannabis) and hashish.
There are several stages of drug use that may lead to dependence. Young people seem to move more quickly through the stages than do adults.
Experimental use: typically involves peers, done for recreational use; the user may enjoy defying parents or other authority figures.
Regular use: the user misses more and more school or work; worries about losing drug source; uses drugs to "fix" negative feelings; begins to stay away from friends and family; may change friends to those who are regular users; shows increased tolerance and ability to "handle" the drug.
Daily preoccupation: the user loses any motivation; does not care about school and work; has obvious behavior changes; thinking about drug use is more important than all other interests, including relationships; the user becomes secretive; may begin dealing drugs to help support habit; use of other, harder drugs may increase; legal problems may increase.
Dependence: cannot face daily life without drugs; denies problem; physical condition gets worse; loss of "control" over use; may become suicidal; financial and legal problems get worse; may have broken ties with family members or friends. </s> |
<s>[INST] When to seek urgent medical care when I have Drug dependence ? [/INST] Call for an appointment with your health care provider if you are addicted to drugs and would like to get off of them, or if you have been cut off from your drug supply and are at risk of withdrawal.
Most employers also offer referral services for their employees with substance abuse problems. </s> |
<s>[INST] What to expect if I have Drug dependence (Outlook/Prognosis)? [/INST] Drug abuse and dependence may lead to a fatal drug overdose. Some people start taking the drugs again after they have stopped. Relapses can lead to continued dependence. </s> |
<s>[INST] How to do Exposure Therapy? [/INST] Some of the rules for constructing a good program of Exposure Therapy are:
The subject should have a final goal which should represent non-phobic behavior. This might be (for example) to hold a large snake and rub it against their cheek for several minutes. They should also have in mind a series of intermediate steps such that once they have partially habituated to one step the next is close enough to it that they can readily move on. Such a sequence is called a hierarchy. It may be explicit, in the form of a list of increasingly challenging tasks, or implicit, in the form of a set of principles for escalating the exposure. The therapist will decide which of these will be more useful for the subject. (A useful way of constructing such a hierarchy is the Method of Factors. At every stage the subjects self-exposure should be completely voluntary - a criterion that may be derived from the theory of cognitive dissonance. One important corollary of this principle is that, at every moment, the subject must have an easy way of terminating the exposure. By choosing not to escape - and therefore practising a competing response - the subject thereby weakens the arousal-escape connection. The arousal experienced at any point should be the maximum that the subject is prepared to accept (this is the main difference between Exposure Therapy and Systematic desensitization). It's useful if at each stage the subject asks themselves "is there anything more I could do?" By considering which factors they can manipulate they should be able to keep moving smoothly up their hierarchy. Research by Marks and Rachmann citation needed demonstrated that optimum results are obtained with daily practice lasting at least an hour; and that the daily session should be ended by allowing the level of arousal to fall off to around half its peak value. For this reason it's useful for the subject to keep a note of their arousal level on a 0-8 scale (where 0=no arousal and 8=intolerable arousal). Before this fall-off phase the level of arousal should be maintained at an uncomfortable but tolerable level. </s> |
<s>[INST] What are the symptoms of Fibromyalgia? [/INST] Pain in the main symptom of fibromyalgia. It may be mild to severe.
Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas. The pain may feel like a deep ache, or a shooting, burning pain. The joints are not affected, although the pain may feel like it is coming from the joints.
People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.
Pain may get worse with activity, cold or damp weather, anxiety, and stress.
Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.
Other symptoms of fibromyalgia may include:
Irritable bowel syndrome (IBS) Memory and concentration problems Numbness and tingling in hands and feet Palpitations Reduced ability to exercise Tension or migraine headaches </s> |
<s>[INST] What causes Fibromyalgia? [/INST] The cause is unknown. Possible causes or triggers of fibromyalgia include:
Physical or emotional trauma Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients Sleep disturbances Infection, such as a virus, although none has been identified </s> |
<s>[INST] Who is at highest risk for Fibromyalgia ? [/INST] Fibromyalgia is most common among women aged 20 to 50.
The following conditions may be seen with fibromyalgia or mimic its symptoms:
Chronic neck or back pain Chronic fatigue syndrome Depression Hypothyroidism (underactive thyroid) Lyme disease Sleep disorders </s> |
<s>[INST] When to seek urgent medical care when I have Fibromyalgia ? [/INST] Call your health-care provider if you have symptoms of fibromyalgia. </s> |
<s>[INST] What to expect if I have Fibromyalgia (Outlook/Prognosis)? [/INST] Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years. </s> |
<s>[INST] What are the symptoms of Grief? [/INST] There can be five stages of grief. These reactions might not occur in a specific order, and can (at times) occur together. Not everyone experiences all of these emotions:
Denial, disbelief, numbness Anger, blaming others Bargaining (for instance "If I am cured of this cancer, I will never smoke again.") Depressed mood, sadness, and crying Acceptance, coming to terms
People who are grieving may have crying spells, some trouble sleeping, and lack of productivity at work. </s> |
<s>[INST] What causes Grief? [/INST] Grief may be triggered by the death of a loved one. People also can experience grief if they have an illness for which there is no cure, or a chronic condition that affects their quality of life. The end of a significant relationship may also cause a grieving process.
Everyone feels grief in their own way. However, there are common stages to the process of mourning. It starts with recognizing a loss and continues until a person eventually accepts that loss. People's responses to grief will be different, depending on the circumstances of the death.
For example, if the person who died had a chronic illness, the death may have been expected. The end of the person's suffering might even have come as a relief. If the death was accidental or violent, coming to a stage of acceptance might take longer. </s> |
<s>[INST] When to seek urgent medical care when I have Grief ? [/INST] Call your health care provider if:
You can't deal with grief You are using excessive amounts of drugs or alcohol You become very depressed You have prolonged depression that interferes with your daily life </s> |
<s>[INST] What to expect if I have Grief (Outlook/Prognosis)? [/INST] It may take a year or longer to overcome strong feelings of grief, and to accept the loss. </s> |
<s>[INST] What are the symptoms of Hyperventilation syndrome? [/INST] Patients with hyperventilation syndrome, might not be aware that they are breathing fast. However, they will be aware of having many of the other symptoms, including:
Belching Bloating Chest pain Confusion Dizziness Dry mouth Lightheadedness Muscle spasms in hands and feet Numbness and tingling in the arms or around the mouth Palpitations Shortness of breath Sleep disturbances Weakness </s> |
<s>[INST] What causes Hyperventilation syndrome? [/INST] Anxiety and nervousness Bleeding Cardiac disease, such as congestive heart failure or heart attack Drugs (such as an aspirin overdose) Infection such as pneumonia or sepsis Ketoacidosis and similar medical conditions Lung disease such as asthma, chronic obstructive pulmonary disease (COPD), or pulmonary embolism Panic attack Pregnancy Severe pain Situations where there is a psychological advantage in having a sudden, dramatic illness (for example, somatization disorder) Stimulant use Stress </s> |
<s>[INST] Who is at highest risk for Hyperventilation syndrome ? [/INST] Hyperventilation syndrome can be triggered by emotions of stress, anxiety, depression, or anger. Occasional hyperventilation from panic is generally related to a specific fear or phobia, such as a fear of heights, dying, or closed-in spaces (claustrophobia). </s> |
<s>[INST] When to seek urgent medical care when I have Hyperventilation syndrome ? [/INST] Rapid breathing for the first time. (This is a medical emergency and you should be taken to the emergency room right away.) Severe pain, having a fever, or noticed any bleeding. Worsening of symptoms. </s> |
<s>[INST] What are the symptoms of Marijuana intoxication? [/INST] The intoxicating effects of marijuana include relaxation, sleepiness, and mild euphoria (getting high).
Smoking marijuana leads to fast and predictable signs and symptoms. Eating marijuana can cause slower, and sometimes less predictable effects.
Marijuana can cause undesirable side effects, which increase with higher doses. These side effects include:
Decreased short-term memory Dry mouth Impaired perception and motor skills Red eyes
More serious side effects include panic, paranoia, or acute psychosis, which may be more common with new users or in those who already have a psychiatric disease.
The amount and effect of these side effects varies from person to person, as well as with the amount of marijuana used.
Marijuana is often cut with hallucinogens and other, more dangerous drugs that have more serious side effects than marijuana. These side effects may include:
Acute high blood pressure with headache Chest pain and heart rhythm disturbances Extreme hyperactivity and physical violence Heart attack Seizures Stroke Sudden collapse (cardiac arrest) </s> |
<s>[INST] When to seek urgent medical care when I have Marijuana intoxication ? [/INST] If someone who has been using marijuana develops any of the symptoms of intoxication, has trouble breathing, or cannot be awakened, call 911 or your local emergency number.
If the person has stopped breathing or has no pulse, begin CPR and continue it until help arrives. </s> |
<s>[INST] What to expect if I have Marijuana intoxication (Outlook/Prognosis)? [/INST] People who have seizures, cardiac arrest, or a heart attack may not survive. However, these reactions are rare. </s> |
<s>[INST] What are the symptoms of Night terror? [/INST] Night terrors are most common during the first third of the night, often between midnight and 2 a.m.
Children often scream and are very frightened and confused. They thrash around violently and are often not aware of their surroundings. You may be unable to talk to, comfort, or fully wake up a child who is having a night terror. The child may be sweating, breathing very fast (hyperventilating), have a fast heart rate (palpitations), and widened (dilated) pupils. The spell may last 10 - 20 minutes, then the child goes back to sleep.
Most children are unable to explain what happened the next morning. They often have no memory of the event when they wake up the next day.
Children with night terrors may also sleep walk.
In contrast, nightmares are more common in the early morning. They may occur after someone watches frightening movies or TV shows, or has an emotional experience. A person may remember the details of a dream when he or she wakes up, and will not be disoriented after the episode. </s> |
<s>[INST] What causes Night terror? [/INST] The cause is unknown, but night terrors may be triggered by:
Fever Lack of sleep Periods of emotional tension, stress, or conflict
Night terrors are most common in boys ages 5 - 7, although they also can occur in girls. They are fairly common in children ages 3 - 7, and much less common after that.
Night terrors may run in families. They can occur in adults, especially when there is emotional tension or the use of alcohol. </s> |
<s>[INST] When to seek urgent medical care when I have Night terror ? [/INST] Call for an appointment with your health care provider if:
The night terrors occur often They disrupt sleep on a regular basis Other symptoms occur with the night terror The night terror causes, or almost causes, injuries </s> |
<s>[INST] What to expect if I have Night terror (Outlook/Prognosis)? [/INST] Most children outgrow night terrors in a short period of time. The number of episodes usually decreases after age 10. Rarely, children will have problems falling asleep or staying asleep. </s> |
<s>[INST] What causes Nightmare? [/INST] Anxiety and stress are the most common causes of nightmares.
A major life event occurs before the nightmare in some cases.
Other causes of nightmares include:
Abrupt alcohol withdrawal Breathing disorder in sleep (sleep apnea) Death of a loved one (bereavement) Excessive alcohol consumption Illness with a fever Recent withdrawal from a drug, such as sleeping pills Side effect of a drug Sleep disorder (for example, narcolepsy or sleep terror disorder) Eating just before going to bed, which raises the body's metabolism and brain activity </s> |
<s>[INST] When to seek urgent medical care when I have Nightmare ? [/INST] Contact your health care provider if:
You have nightmares more than once a week Nightmares stop you from getting a good night's rest, or from keeping up with your daily activities for a long period of time </s> |
<s>[INST] What are the symptoms of Opiate withdrawal? [/INST] Early symptoms of withdrawal include:
Agitation Anxiety Muscle aches Increased tearing Insomnia Runny nose Sweating Yawning
Late symptoms of withdrawal include:
Abdominal cramping Diarrhea Dilated pupils Goose bumps Nausea Vomiting
Opioid withdrawal reactions are very uncomfortable but are not life threatening.
Symptoms usually start within 12 hours of last heroin usage and within 30 hours of last methadone exposure. </s> |
<s>[INST] What causes Opiate withdrawal? [/INST] About 9% of the population is believed to misuse opiates over the course of their lifetime, including illegal drugs like heroin and prescribed pain medications such as Oxycontin.
These drugs can cause physical dependence. This means that a person relies on the drug to prevent symptoms of withdrawal. Over time, greater amounts of the drug become necessary to produce the same effect.
The time it takes to become physically dependent varies with each individual.
When the drugs are stopped, the body needs time to recover, and withdrawal symptoms result. Withdrawal from opiates can occur whenever any chronic use is discontinued or reduced.
Some people even withdraw from opiates after being given such drugs for pain while in the hospital without realizing what is happening to them. They think they have the flu, and because they don't know that opiates would fix the problem, they don't crave the drugs. </s> |
<s>[INST] When to seek urgent medical care when I have Opiate withdrawal ? [/INST] Call your doctor if you are using or withdrawing from opiates. </s> |
<s>[INST] What to expect if I have Opiate withdrawal (Outlook/Prognosis)? [/INST] Withdrawal from opiates is painful, but not life threatening. </s> |
<s>[INST] What are the symptoms of Personality disorder? [/INST] Symptoms vary widely depending on the type of personality disorder.
In general, personality disorders involve feelings, thoughts, and behaviors that do not adapt to a wide range of settings.
These patterns usually begin in adolescence and may lead to problems in social and work situations.
The severity of these conditions ranges from mild to severe. </s> |
<s>[INST] What causes Personality disorder? [/INST] The causes of personality disorders are unknown. However, many genetic and environmental factors are thought to play a role.
Mental health professionals categorize these disorders into the following types:
Antisocial personality disorder Avoidant personality disorder Borderline personality disorder Dependent personality disorder Histrionic personality disorder Narcissistic personality disorder Obsessive compulsive personality disorder Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder </s> |
<s>[INST] When to seek urgent medical care when I have Personality disorder ? [/INST] Call for an appointment with your health care provider or mental health professional if you or someone close to you has symptoms of a personality disorder. </s> |
<s>[INST] What to expect if I have Personality disorder (Outlook/Prognosis)? [/INST] The outlook varies. Some personality disorders go away during middle age without any treatment, while others only improve slowly throughout life, even with treatment. </s> |
<s>[INST] What are the symptoms of Sleep walking? [/INST] When people sleepwalk, they may sit up and look as though they are awake when they are actually asleep. They may get up and walk around, or do complex activities such as moving furniture, going to the bathroom, and dressing or undressing. Some people even drive a car while they are asleep.
The episode can be very brief (a few seconds or minutes) or it can last for 30 minutes or longer, but most episodes last for less than 10 minutes. If they are not disturbed, sleepwalkers will go back to sleep. However, they may fall asleep in a different or even unusual place.
Symptoms of sleepwalking include:
Acting confused or disoriented when they wake up Having blank look on face Opening eyes during sleep Not remembering the sleep walking episode when they wake up Performing detailed activity of any type during sleep Rarely, showing aggressive behavior when they are woken up by someone else Sitting up and appearing awake during sleep Taking in sleep and saying things that do not make sense Walking during sleep Taking in sleep and saying things that do not make sense </s> |
<s>[INST] What causes Sleep walking? [/INST] The normal sleep cycle has distinct stages, from light drowsiness to deep sleep. During rapid eye movement (REM) sleep, the eyes move quickly and vivid dreaming is most common.
Each night people go through several cycles of non-REM and REM sleep. S leepwalking (somnambulism) most often occurs during deep, non-REM sleep (stage 3 or stage 4 sleep) early in the night. If it occurs during REM sleep, it is part of REM behavior disorder and tends to happen near morning.
The cause of sleepwalking in children is usually unknown. Fatigue, lack of sleep, and anxiety are all associated with sleepwalking.
In adults, sleepwalking may occur with:
Alcohol, sedatives, or other medication Medical conditions, such as partial complex seizures Mental disorders
In the elderly, sleepwalking may be a symptom of an organic brain syndrome or REM behavior disorders.
Sleepwalking can occur at any age, but it happens most often in children ages 5 - 12. It appears to run in families. </s> |
<s>[INST] When to seek urgent medical care when I have Sleepwalking ? [/INST] You probably won't need to visit your health care provider if you are sleepwalking. However, discuss the condition with your doctor if:
You also have other symptoms Sleepwalking is frequent or persistent You perform potentially dangerous activities (such as driving) while sleepwalking </s> |
<s>[INST] What to expect if I have Sleepwalking (Outlook/Prognosis)? [/INST] Sleepwalking usually decreases as children get older.
It usually does not indicate a serious disorder, although it can be a symptom of other disorders.
It is unusual for sleepwalkers to perform activities that are dangerous. However, you may need to take care to prevent injuries such as falling down stairs or climbing out of a window. </s> |
<s>[INST] Could SCT be an instance of childhood-onset dysexecutive syndrome? [/INST] The Executive system of the human brain coordinates actions and strategies for everyday tasks. Dysexecutive syndrome is defined as "cluster of impairments generally associated with damage to the frontal lobes of the brain" which includes "difficulties with high-level tasks such as planning, organising, initiating, monitoring and adapting behaviour."
Adele Diamond has recently postulated that the core cognitive deficit of those with ADHD-PI (ADD), is working memory, or, as she coined in her recent paper on the subject, "childhood-onset dysexecutive syndrome". She states:
"Instructional methods that place heavy demands on working memory will disproportionately disadvantage individuals with ADD". "language problems often co-occur with ADD, and it is suggested that part of the reason might be that linguistic tasks, especially verbal ones, tax working memory so heavily. Spatial and artistic skills, however, are often preserved or superior in individuals with ADD." "The working memory deficit in many children with ADD is accompanied by markedly slowed reaction times, a characteristic that covaries with poorer working memory in general". "Individuals with ADD have difficulty maintaining a sufficiently high level of motivation to complete a task...They go looking for something else to do or think about because they are bored...to remedy a general lower arousal level.." </s> |
<s>[INST] What are the symptoms of Stress? [/INST] Stress is a normal feeling. In small doses, stress can help you get things done. Stress does not affect everyone the same way.
Many people feel stress symptoms in their body. You may be having pain in your abdomen, headaches, and muscle tightness or pain.
When you are very stressed, you may notice:
A faster heart rate (palpitations) Skipped heartbeats Rapid breathing Sweating Trembling Dizziness
Other symptoms include:
Loose stools Frequent need to pee Dry mouth Problems swallowing
You may have a harder time focusing, feel tired most of the time, or lose your temper more often. Stress may also cause sexual problems. It can also cause problems with falling or staying asleep and nightmares </s> |
<s>[INST] What causes Stress? [/INST] Many people have stress when they need to adapt or change. Examples are:
Starting a new job or school Moving to a new home Getting married Having a child Breaking up with someone
An injury or illness to you, a friend, or a loved one is a common cause of stress. Feelings of stress and anxiety are common in people who feel depressed and sad.
Some drugs may cause or worsen symptoms of stress. These can include:
Some inhaler medicines used to treat asthma Thyroid drugs Some diet pills Some cold remedies Caffeine, cocaine, alcohol, and tobacco products may also cause or make symptoms of stress or anxiety worse.
When these feelings happen often, a person may have an anxiety disorder. Other problems where stress may be present are:
Obsessive-compulsive disorder Panic disorder Post-traumatic stress disorder (PTSD) </s> |
<s>[INST] When to seek urgent medical care when I have Stress ? [/INST] Call a suicide hotline if you have thoughts of suicide.
Reasons you may want to seek more help are:
You have feelings of panic, such as dizziness, rapid breathing, or a racing heartbeat. You are unable to work or function at home or at your job. You have fears that you cannot control. You are having memories of a traumatic event.
Do not stop taking any prescribed medicines without talking to your doctor. </s> |
<s>[INST] When to seek urgent medical care when I have Substance abuse ? [/INST] If you are concerned about the possibility of getting addicted to any prescribed medications If you are concerned about possible drug abuse by yourself or a family member If you are interested in getting more information on drug abuse If you are seeking treatment of drug abuse for yourself or a family member </s> |
<s>[INST] What are the symptoms of Suicide? [/INST] Often, but not always, a person may show certain symptoms or behaviors before a suicide attempt, including:
Having trouble concentrating or thinking clearly Giving away belongings Talking about going away or the need to get my affairs in order Suddenly changing behavior, especially calmness after a period of anxiety Losing interest in activities that they used to enjoy Performing self-destructive behaviors, such as heavily drinking alcohol, using illegal drugs, or cutting their body Pulling away from friends or not wanting to go out Suddenly having trouble in school or work Talking about death or suicide, or even saying that they want to hurt themselves Talking about feeling hopeless or guilty Changing sleep or eating habits </s> |
<s>[INST] What causes Suicide? [/INST] Suicide and suicidal behaviors usually occur in people with:
Bipolar disorder Borderline personality disorder Depression Drug or alcohol dependence Schizophrenia
People who try to commit suicide are often trying to get away from a life situation that seems impossible to deal with. Many who make a suicide attempt are seeking relief from:
Feeling ashamed, guilty, or like a burden to others Feeling like a victim Feelings of rejection, loss, or loneliness
Suicidal behaviors may be caused by a situation or event that the person views as overwhelming, such as:
Aging (the elderly have the highest rate of suicide) Death of a loved one Dependence on drugs or alcohol Emotional trauma Serious physical illness Unemployment or money problems
Most suicide attempts do not result in death. Many of these attempts are done in a way that makes rescue possible. These attempts are often a cry for help.
Some people attempt suicide in a way that is somewhat non-violent, such as poisoning or overdose. Males, especially elderly men, are more likely to choose violent methods, such as shooting themselves. As a result, suicide attempts by males are more likely to be completed.
Relatives of people who attempt or commit suicide often blame themselves or become very angry. They may see the suicide attempt as selfish. However, people who try to commit suicide often mistakenly believe that they are doing their friends and relatives a favor by taking themselves out of the world. </s> |
<s>[INST] Who is at highest risk for Suicide ? [/INST] Risk factors for suicide in teenagers include:
Access to guns Family member who committed suicide History of hurting themselves on purpose History of being neglected or abused Living in communities where there have been recent outbreaks of suicide in young people Romantic breakup </s> |
<s>[INST] When to seek urgent medical care when I have Suicide ? [/INST] Call a health care provider right away if you or someone you know is having thoughts of suicide. </s> |
<s>[INST] What to expect if I have Suicide (Outlook/Prognosis)? [/INST] Always take suicide attempts and threats seriously.
About one-third of people who try to commit suicide will try again within 1 year.
About 10% of people who threaten or try to commit suicide will eventually kill themselves.
The person needs mental health care right away. Do not dismiss the person as just trying to get attention. </s> |
<s>[INST] How is a toxicology screen performed? [/INST] Toxicology screening is most often done using a blood or urine sample. However, it may be done soon after swallowing the medication, using stomach contents that are obtained through gastric lavage or after vomiting. </s> |
<s>[INST] How to prepare for a toxicology screen? [/INST] No special preparation is needed.
If able, tell your health care provider what drugs (including over-the-counter medications) you have taken, including when and how much.
This test is sometimes part of an investigation for drug use or abuse. Special consents, handling and labeling of specimens, or other special procedures may be required. </s> |
<s>[INST] How will a toxicology screen feel? [/INST] Blood test: When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Urine test: A urine test involves normal urination. There is no discomfort. </s> |
Subsets and Splits