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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Histomorphologically, VUE is characterized by a lymphocytic infiltrate of the chorionic villi without a demonstrable cause. Plasma cells should be absent; the presence of plasma cells suggests an infective etiology, e.g. CMV infection.
Villitis of unknown etiology, abbreviated VUE, is an inflammatory process that involves the chorionic villi (villitis) whose cause (etiology) is not known. VUE is associated with recurrent miscarriage and intrauterine growth restriction, and recurs in subsequent pregnancies.
The cause of juvenile cellulitis is unknown. Cytologic examination of aspirates of affected lymph nodes, pustules, abscesses, and joint fluid rarely reveal bacteria, and culture results of intact lesion are always negative for bacterial growth, suggesting a nonbacterial etiology. As signs resolve following treatment with glucocorticoids, the cause is likely to be an immune disorder.
Large doses of glucocorticoids are the treatment of choice, and are administered until the signs have resolved. In uncomplicated cases, this can take up to a month. If dogs are not treated promptly and with high doses of steroids, severe scarring may occur. If there is evidence of secondary bacterial infection, treatment with antibiotics is required.
Reactive gastropathy, also chemical gastropathy, is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation.
Reactive gastropathy has a large number of causes, including:
- Alcohol abuse.
- Bile reflux, such as may be seen post-Billroth II.
- NSAIDs.
The second most common cause of SJS and TEN is infection, particularly in children. This includes upper respiratory infections, otitis media, pharyngitis, and Epstein-Barr virus, Mycoplasma pneumoniae and cytomegalovirus infections. The routine use of medicines such as antibiotics, antipyretics and analgesics to manage infections can make it difficult to identify if cases were caused by the infection or medicines taken.
Viral diseases reported to cause SJS include: herpes simplex virus (debated), AIDS, coxsackievirus, influenza, hepatitis, and mumps.
In pediatric cases, Epstein-Barr virus and enteroviruses have been associated with SJS.
Recent upper respiratory tract infections have been reported by more than half of patients with SJS.
Bacterial infections linked to SJS include group A beta-hemolytic streptococci, diphtheria, brucellosis, lymphogranuloma venereum, mycobacteria, "Mycoplasma pneumoniae", rickettsial infections, tularemia, and typhoid.
Fungal infections with coccidioidomycosis, dermatophytosis, and histoplasmosis are also considered possible causes. Malaria and trichomoniasis, protozoal infections, have also been reported as causes.
The etiology of the condition is unknown. Possible but unproven infectious causes are "Klebsiella", polyomaviridae, Epstein–Barr virus, parvovirus B19, and human herpesvirus 6. Jilin University researchers suggested in 2017 that monocytes recruited to inflammatory lesions could produce macrophage colony-stimulating factor, which leads to a complex signal transduction, which leads to the histiocytosis characteristic of Rosai–Dorfman disease.
In 2016 the Histiocyte Society proposed a classification of histiocytoses into five groups designated by letters: "C," "H," "L," "M," and "R." Group "R" included Rosai–Dorfman disease and "miscellaneous noncutaneous, non-Langerhans cell histiocytoses." Rosai–Dorfman disease itself was classified into "Familial," "Classical (nodal)," "Extranodal," "Neoplasia-associated," and "Immune disease-associated" subtypes.
Etiology uncertain. Wissler suggested an allergic reaction to bacteraemia as the pathogenic factor.
Wissler's syndrome (or Wissler's disease or Wissler-Fanconi syndrome) is a rheumatic disease that has a similar presentation to sepsis. It is sometimes considered closely related to Still's disease. It is named for Guido Fanconi and Hans Wissler It was first described by Wissler in 1944 and Fanconi in 1946. Single observations by E. Uhse in 1943 («Febris maculosa intermittens»), Fykow in 1929 and Nowak in 1942.
Specific characteristics regarding the white dots and predicted etiology are presented of selected diseases.
Prurigo gestationis (also called "Besnier prurigo", "Early-onset prurigo of pregnancy," "Linear IgM dermatosis of pregnancy," "Papular dermatitis of pregnancy," "Prurigo of pregnancy", and "Spangler's papular dermatitis of pregnancy") is an eruption consisting of pruritic, excoriated papules of the proximal limbs and upper trunk, most often occurring between the 20th and 34th week of gestation.
The exact etiology is unknown, but it is considered likely to be a flareup of atopic dermatitis during pregnancy.
It is sometimes considered to be a term encompassing Besnier prurigo and other conditions.
It is sometimes considered a diagnosis of exclusion.
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) primarily occurs in adults (with a mean age of 27). Symptoms include blurred vision in both eyes, but the onset may occur at a different time in each eye. There are yellow-white placoid lesions in the posterior pole at the level of the RPE. Some suggest a genetic predisposition to the disease, while others postulate an abnormal immune response to a virus.
Sclerosing lymphangitis is a skin condition characterized by a cordlike structure encircling the coronal sulcus of the penis, or running the length of the shaft, that has been attributed to trauma during vigorous sexual play.
Nonvenereal sclerosing lymphangitis is a rare penile lesion consisting of a minimally tender, indurated cord involving the coronal sulcus and occasionally adjacent distal penile skin. This disorder most often occurs after vigorous sexual activity and resolves spontaneously.
Etiology of Sclerosing lymphangitis is unknown but has been postulated to be secondary to thrombosis of lymphatic vessels. Spontaneous recovery can occur anywhere within a couple weeks to several months.
Although it is commonly recommended the patient abstain from any sexual activitiy during the recovery, there is no evidence that this expedites recovery nor that not abstaining worsens the condition.
Although SJS can be caused by viral infections and malignancies, the main cause is medications. A leading cause appears to be the use of antibiotics, particularly sulfa drugs. Between 100 and 200 different drugs may be associated with SJS. No reliable test exists to establish a link between a particular drug and SJS for an individual case. Determining what drug is the cause is based on the time interval between first use of the drug and the beginning of the skin reaction. Drugs discontinued more than 1 month prior to onset of mucocutaneous physical findings are highly unlikely to cause SJS and TEN. SJS and TEN most often begin between 4 and 28 days after culprit drug administration. A published algorithm (ALDEN) to assess drug causality gives structured assistance in identifying the responsible medication.
SJS may be caused by adverse effects of the drugs vancomycin, allopurinol, valproate, levofloxacin, diclofenac, etravirine, isotretinoin, fluconazole, valdecoxib, sitagliptin, oseltamivir, penicillins, barbiturates, sulfonamides, phenytoin, azithromycin, oxcarbazepine, zonisamide, modafinil, lamotrigine, nevirapine, pyrimethamine, ibuprofen, ethosuximide, carbamazepine, bupropion, telaprevir, and nystatin.
Medications that have traditionally been known to lead to SJS, erythema multiforme, and toxic epidermal necrolysis include sulfonamide antibiotics, penicillin antibiotics, cefixime (antibiotic), barbiturates (sedatives), lamotrigine, phenytoin (e.g., Dilantin) (anticonvulsants) and trimethoprim. Combining lamotrigine with sodium valproate increases the risk of SJS.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a rare cause of SJS in adults; the risk is higher for older patients, women, and those initiating treatment. Typically, the symptoms of drug-induced SJS arise within a week of starting the medication. Similar to NSAIDs, paracetamol (acetaminophen) has also caused rare cases of SJS. People with systemic lupus erythematosus or HIV infections are more susceptible to drug-induced SJS.
There has long been said to be a link between "rheumatic" pain and the weather. There appears to be no firm evidence in favour or against; a 1995 questionnaire given to 557 people by A. Naser and others at the Brigham and Women's Hospital's Pain Management Center concludes that "changes in barometric pressure are the main link between weather and pain. Low pressure is generally associated with cold, wet weather and an increase in pain. Clear, dry conditions signal high pressure and a decrease in pain."
Many rheumatic disorders of chronic, intermittent joint pain have historically been caused by infectious diseases. Their etiology was unknown until the 20th century and not treatable, like Lyme disease (in the Northern and Northeastern US), coccidiomycosis or Valley fever (in the Western US), and Chikungunya in India and a myriad of causes for postinfectious arthritis also known as reactive arthritis like, for example, the once very common rheumatic fever after Group A Streptococcus infection up to the rare Whipple's disease.
Major rheumatic disorders currently recognized include
- Back pain
- Bursitis/Tendinitis of the shoulder, wrist, biceps, leg, knee cap (patella), ankle, hip, and Achilles tendon
- Capsulitis
- Neck pain
- Osteoarthritis
- Palindromic rheumatism has been theorized to be a form of rheumatoid arthritis.
Although these disorders probably have little in common in terms of their epidemiology, they do share three characteristics: they cause chronic, often intermittent pain, they are difficult to treat and are collectively very common.
Rheumatic diseases caused by autoimmunity include:
- Ankylosing spondylitis
- relapsing polychondritis
- systemic lupus erythematosus
- rheumatoid arthritis
- gout, inflammatory arthritis, pseudogout
- juvenile arthritis
- Sjögren syndrome
- scleroderma
- Polymyositis
- Dermatomyositis
- Behçet's disease
- Psoriatic arthritis
Pyaemia (or pyemia) is a type of septicaemia that leads to widespread abscesses of a metastatic nature. It is usually caused by the staphylococcus bacteria by pus-forming organisms in the blood. Apart from the distinctive abscesses, pyaemia exhibits the same symptoms as other forms of septicaemia. It was almost universally fatal before the introduction of antibiotics.
Sir William Osler included a three-page discussion of pyaemia in his textbook "The Principles and Practice of Medicine", published in 1892. He defined pyaemia as follows:
Earlier still, Ignaz Semmelweis – who would later die of the disease – included a section titled "Childbed fever is a variety of pyaemia" in his treatise, "The Etiology of Childbed Fever" (1861). Jane Grey Swisshelm, in her autobiography titled "Half a Century", describes the treatment of pyaemia in 1862 during the American Civil War.
Healthcare-associated pneumonia can be defined as pneumonia in a patient with at least one of the following risk factors:
- hospitalization in an acute care hospital for two or more days in the last 90 days;
- residence in a nursing home or long-term care facility in the last 30 days
- receiving outpatient intravenous therapy (like antibiotics or chemotherapy) within the past 30 days
- receiving home wound care within the past 30 days
- attending a hospital clinic or dialysis center in the last 30 days
- having a family member with known multi-drug resistant pathogens
HCAP is a condition in patients who can come from the community, but have frequent contact with the healthcare environment. Historically, the etiology and prognosis of nursing home pneumonia appeared to differ from other types of community acquired pneumonia, with studies reporting a worse prognosis and higher incidence of multi drug resistant organisms as etiology agents. The definition criteria which has been used is the same as the one which has been previously used to identify bloodstream healthcare associated infections.
HCAP is no longer recognized as a clinically independent entity. This is due to increasing evidence from a growing number of studies that many patients defined as having HCAP are not at high risk for MDR pathogens. As a result, 2016 IDSA guidelines removed consideration of HCAP as a separate clinical entity.
Antibiotics are effective. Prophylactic treatment consists in prevention of suppuration.
Multifocal choroiditis and panuveitis (MCP) is an idiopathic inflammatory disorder of unknown etiology affecting the choroid, retina, and vitreous of the eye that presents asymmetrically, most often in young myopic women with photopsias, enlargement of the physiologic blind spot and decreased vision.
The first description of the disease was written in 1973.
In contrast to cutaneous LP, which is self limited, lichen planus lesions in the mouth may persist for many years, and tend to be difficult to treat, with relapses being common. Atrophic/erosive lichen planus is associated with a small risk of cancerous transformation, and so people with OLP tend to be monitored closely over time to detect any potential change early. Sometimes OLP can become secondarily infected with Candida organisms.
Heterogeneous medical condition in medicine are those medical conditions which have several etiologies, like hepatitis or diabetes. Medical conditions are normally defined pathologically (liver inflammation) or clinically (excessive urination) and not etiologically, and therefore it is normal to have more than one cause for them. The word is used as an opposition to homogeneous, meaning that given a group of patients, the disease is the same for all of them.
When a condition is heterogeneous, it is normally divided in endotypes.