Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors that are unhealthy and inflexible. The behaviors cause serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and problems. They often have stormy relationships with other people. The cause of personality disorders is unknown. However, genes and childhood experiences may play a role. The symptoms of each personality disorder are different. They can mild or severe. People with personality disorders may have trouble realizing that they have a problem. To them, their thoughts are normal, and they often blame others for their problems. They may try to get help because of their problems with relationships and work. Treatment usually includes talk therapy and sometimes medicine.

Polymyalgia rheumatica is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders. Symptoms of polymyalgia rheumatica (pol-e-my-AL-juh rue-MAT-ih-kuh) usually begin quickly and are worse in the morning. Most people who develop polymyalgia rheumatica are older than 65. It rarely affects people under 50. You may receive symptom relief by taking anti-inflammatory drugs called corticosteroids. But relapses are common, and you'll need to visit your doctor regularly to watch for serious side effects of these drugs. Polymyalgia rheumatica is related to another inflammatory disorder called giant cell arteritis, which can cause headaches, vision difficulties, jaw pain and scalp tenderness. It's possible to have both of these conditions together.

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Tobacco use is the most common preventable cause of death. About half of the people who don't quit smoking will die of smoking-related problems. Quitting smoking is important for your health. Soon after you quit, your circulation begins to improve, and your blood pressure starts to return to normal. Your sense of smell and taste return, and it's easier for you to breathe. In the long term, giving up tobacco can help you live longer. Your risk of getting cancer decreases with each year you stay smoke-free. Quitting is not easy. You may have short-term affects such as weight gain, irritability, and anxiety. Some people try several times before they succeed. There are many ways to quit smoking. Some people stop "cold turkey." Others benefit from step-by-step manuals, counseling, or medicines or products that help reduce nicotine addiction. Some people think that switching to e-cigarettes can help you quit smoking, but that has not been proven. Your health care provider can help you find the best way for you to quit.

The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.

A lumbar puncture (also called a spinal tap) is a procedure to collect and look at the fluid (cerebrospinal fluid, or CSF) surrounding the brain and spinal cord. During a lumbar puncture, a needle is carefully inserted into the spinal canal low in the back (lumbar area). Samples of CSF are collected.

Paracentesis is a procedure to take out fluid that has collected in the belly (peritoneal fluid). This fluid buildup is called ascites . Ascites may be caused by infection, inflammation, an injury, or other conditions, such as cirrhosis or cancer. The fluid is taken out using a long, thin needle put through the belly.

Sciatica is often characterized by one or more of the following symptoms: Constant pain in only one side of the buttock or leg (rarely in both legs) Pain that is worse when sitting Leg pain that is often described as burning, tingling, or searing (versus a dull ache) Weakness, numbness, or difficulty moving the leg, foot, and/or toes A sharp pain that may make it difficult to stand up or walk Pain that radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot) Sciatica Causes and Treatments Video Watch: Sciatica Causes and Treatments Video Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms are usually based on the location of the pinched nerve. While symptoms can be painful and potentially debilitating, it is rare that permanent sciatic nerve damage (tissue damage) will result, and spinal cord involvement is possible but rare.

Carotid artery stenosis can be caused by cholesterol build-up in the blood vessels (atherosclerosis). Blood clots can form in this area and travel up to the brain. This condition may be present for a long time before symptoms appear. When symptoms do occur, stroke or brief stroke-like attacks are common. If this condition is discovered as a result of a stroke or stroke-like attack, cholesterol lowering medications and blood thinners may be used to improve blood flow to the brain. If the degree of narrowing is severe, surgery may be needed to open the blood vessel.

New flu vaccines are released every year to keep up with rapidly adapting flu viruses. Because flu viruses evolve so quickly, last year's vaccine may not protect you from this year's viruses. After vaccination, your immune system produces antibodies that will protect you from the vaccine viruses.

A simple test of fingernail clippings could replace a blood draw as a way to diagnose and monitor type 2 diabetes mellitus (T2DM), with huge implications for tracking the disease in the developing world. Research on this method by a team of Belgian researchers was reported July 28, 2015, at the 2015 American Association for Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo in Atlanta. The team, led by Joris R. Delanghe, MD, PhD, of the Department of Global Chemistry, Microbiology and Immunology at Ghent University, collected nail clippings from 25 people with T2DM and 25 without the disease. The clippings were ground into a powder and tested with an inexpensive FT-IR photometer to measure how much the protein in the nails had bonded with sugar molecules, a process known as glycation. “We found a striking difference in the measurements between the control group and the patients with diabetes,” Delanghe said. In an interview with Evidence-Based Diabetes Management, he said replacing the standard blood test to measure glycated hemoglobin is a huge advantage. In many cultures, he said, “Taking blood is something that cannot be tolerated.” - See more at: http://www.ajmc.com/journals/evidence-based-diabetes-management/2015/september-2015/fingernail-tests-may-offer-cheap-simple-way-to-diagnose-diabetes#sthash.XQxnBcNO.dpuf

The examination of the groin, hernial orifices and male external genitalia are clinical examinations which undergraduate medical students are commonly less confident about performing competently, due to the lack of clinical exposure.

Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a small gland located at the base of your neck, just above your breastbone. The great majority of thyroid nodules aren't serious and don't cause symptoms. Thyroid cancer accounts for only a small percentage of thyroid nodules. You often won't know you have a thyroid nodule until your doctor discovers it during a routine medical exam. Some thyroid nodules, however, may become large enough to be visible or make it difficult to swallow or breathe.

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Your thyroid lies below your Adam’s apple, along the front of the windpipe. The thyroid has two side lobes, connected by a bridge (isthmus) in the middle. When the thyroid is its normal size, you can’t feel it.

Colonoscopy is a test that allows your doctor to look at the inner lining of your large intestine (rectum and colon). He or she uses a thin, flexible tube called a colonoscope to look at the colon. A colonoscopy helps find ulcers, colon polyps, tumors, and areas of inflammation or bleeding.

Your body's immune system protects you from disease and infection. But if you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake. Autoimmune diseases can affect many parts of the body. No one is sure what causes autoimmune diseases. They do tend to run in families. Women - particularly African-American, Hispanic-American, and Native-American women - have a higher risk for some autoimmune diseases. There are more than 80 types of autoimmune diseases, and some have similar symptoms. This makes it hard for your health care provider to know if you really have one of these diseases, and if so, which one. Getting a diagnosis can be frustrating and stressful. Often, the first symptoms are fatigue, muscle aches and a low fever. The classic sign of an autoimmune disease is inflammation, which can cause redness, heat, pain and swelling. The diseases may also have flare-ups, when they get worse, and remissions, when symptoms get better or disappear. Treatment depends on the disease, but in most cases one important goal is to reduce inflammation. Sometimes doctors prescribe corticosteroids or other drugs that reduce your immune response.

Stomach acid is natural, a valuable chemical contributor to orderly digestion. But in excess or in the wrong place, it's a menace, inflaming and irritating the esophagus, typically causing heartburn and sometimes contributing to the development of ulcers in the stomach and the duodenum, the first part of the small intestine.

Management of postpartum hemorrhage at vaginal delivery. The approach to treatment of postpartum hemorrhage (PPH) differs somewhat depending on the cause and whether hemorrhage occurs after a vaginal birth or after a cesarean delivery.

The ACL is one of the four main ligaments within the knee that connect the femur to the tibia. The knee is essentially a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) ligaments.

A man set to become the world’s first head transplant patient has scheduled the procedure for December 2017. Valery Spiridonov, 30, was diagnosed with a genetic muscle-wasting condition called Werdnig-Hoffmann disease, and volunteered for the procedure despite the risks involved, Central European News (CEN) reported. “When I realized that I could participate in something really big and important, I had no doubt left in my mind and started to work in this direction,” Spiridonov, a Russian computer scientist, told CEN. “The only thing I feel is the sense of pleasant impatience, like I have been preparing for something important all my life and it is starting to happen.”