Portal:Medicine

The Medicine Portal

The color fresco Care of The Sick by Domenico di Bartolo, 1441–1442, depicting the Santa Maria della Scala hospital in Siena, Italy

Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism. In recent centuries, since the advent of modern science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.

Prescientific forms of medicine, now known as traditional medicine or folk medicine, remain commonly used in the absence of scientific medicine and are thus called alternative medicine. Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery. (Full article...)

Featured articles -

Featured articles are displayed here, which represent some of the best content on English Wikipedia.

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  A large flap lesion in the femur head typical of late stage Osteochondritis dissecans. In this case, the lesion was caused by avascular necrosis of the bone just under the cartilage.

  
  Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. OCD usually causes pain during and after sports. In later stages of the disorder there will be swelling of the affected joint that catches and locks during movement. Physical examination in the early stages does only show pain as symptom, in later stages there could be an effusion, tenderness, and a crackling sound with joint movement.
  
  
  OCD is caused by blood deprivation of the secondary physes around the bone core of the femoral condyle. This happens to the epiphyseal vessels under the influence of repetitive overloading of the joint during running and jumping sports. During growth such chondronecrotic areas grow into the subchondral bone. There it will show as bone defect area under articular cartilage. The bone will then possibly heal to the surrounding condylar bone in 50% of the cases. Or it will develop into a pseudarthrosis between condylar bone core and osteochondritis flake leaving the articular cartilage it supports prone to damage. The damage is executed by ongoing sport overload. The result is fragmentation (dissection) of both cartilage and bone, and the free movement of these bone and cartilage fragments within the joint space, causing pain, blockage and further damage. OCD has a typical anamnesis with pain during and after sports without any history of trauma. Some symptoms of late stages of osteochondritis dissecans are found with other diseases like rheumatoid disease of children and meniscal ruptures. The disease can be confirmed by X-rays, computed tomography (CT) or magnetic resonance imaging (MRI) scans. (Full article...)
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  A CT scan showing a pulmonary contusion (red arrow) accompanied by a rib fracture (purple arrow)

  
  A pulmonary contusion, also known as lung contusion, is a bruise of the lung, caused by chest trauma. As a result of damage to capillaries, blood and other fluids accumulate in the lung tissue. The excess fluid interferes with gas exchange, potentially leading to inadequate oxygen levels (hypoxia). Unlike pulmonary laceration, another type of lung injury, pulmonary contusion does not involve a cut or tear of the lung tissue.
  
  
  A pulmonary contusion is usually caused directly by blunt trauma but can also result from explosion injuries or a shock wave associated with penetrating trauma. With the use of explosives during World Wars I and II, pulmonary contusion resulting from blasts gained recognition. In the 1960s its occurrence in civilians began to receive wider recognition, in which cases it is usually caused by traffic accidents. The use of seat belts and airbags reduces the risk to vehicle occupants. (Full article...)
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  Portrait by Julian Smith, 1930s

  
  Howard Walter Florey, Baron Florey, OM FRS FRCP (/ˈflɔːri/; 24 September 1898 – 21 February 1968) was an Australian pharmacologist and pathologist who shared the Nobel Prize in Physiology or Medicine in 1945 with Ernst Chain and Sir Alexander Fleming for his role in the development of penicillin.
  
  Although Fleming received most of the credit for the discovery of penicillin, it was Florey and his team at the University of Oxford who made it into a useful and effective drug, ten years after Fleming had abandoned its development. They developed techniques for growing, purifying and manufacturing the drug, tested it for toxicity and efficacy on animals, and carried out the first clinical trials. In 1941, they used it to treat a police constable from Oxford. He started to recover, but subsequently died because Florey was unable, at that time, to make enough penicillin. Later trials in Britain, the United States and North Africa were highly successful. (Full article...)
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  Genetics is the study of genes, genetic variation, and heredity in organisms. It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar working in the 19th century in Brno, was the first to study genetics scientifically. Mendel studied "trait inheritance", patterns in the way traits are handed down from parents to offspring over time. He observed that organisms (pea plants) inherit traits by way of discrete "units of inheritance". This term, still used today, is a somewhat ambiguous definition of what is referred to as a gene.
  
  Trait inheritance and molecular inheritance mechanisms of genes are still primary principles of genetics in the 21st century, but modern genetics has expanded to study the function and behavior of genes. Gene structure and function, variation, and distribution are studied within the context of the cell, the organism (e.g. dominance), and within the context of a population. Genetics has given rise to a number of subfields, including molecular genetics, epigenetics, and population genetics. Organisms studied within the broad field span the domains of life (archaea, bacteria, and eukarya). (Full article...)
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  CT scan of the brain showing subarachnoid hemorrhage as a white area in the center (marked by the arrow) and stretching into the sulci to either side

  
  Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consciousness, fever, weakness, numbness, and sometimes seizures. Neck stiffness or neck pain are also relatively common. In about a quarter of people a small bleed with resolving symptoms occurs within a month of a larger bleed.
  
  
  SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm. Risk factors for spontaneous cases include high blood pressure, smoking, family history, alcoholism, and cocaine use. Generally, the diagnosis can be determined by a CT scan of the head if done within six hours of symptom onset. Occasionally, a lumbar puncture is also required. After confirmation further tests are usually performed to determine the underlying cause. (Full article...)
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  Computer–aided reconstruction of a rotavirus based on several electron micrographs

  
  Rotaviruses are the most common cause of diarrhoeal disease among infants and young children. Nearly every child in the world is infected with a rotavirus at least once by the age of five. Immunity develops with each infection, so subsequent infections are less severe. Adults are rarely affected. Rotavirus is a genus of double-stranded RNA viruses in the family Reoviridae. There are nine species of the genus, referred to as A, B, C, D, F, G, H, I and J. Rotavirus A is the most common species, and these rotaviruses cause more than 90% of rotavirus infections in humans.
  
  The virus is transmitted by the faecal–oral route. It infects and damages the cells that line the small intestine and causes gastroenteritis (which is often called "stomach flu" despite having no relation to influenza). Although rotavirus was discovered in 1973 by Ruth Bishop and her colleagues by electron micrograph images and accounts for approximately one third of hospitalisations for severe diarrhoea in infants and children, its importance has historically been underestimated within the public health community, particularly in developing countries. In addition to its impact on human health, rotavirus also infects other animals, and is a pathogen of livestock. (Full article...)
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  The location and development of endometrial cancer

  
  Endometrial cancer is a cancer that arises from the endometrium (the lining of the uterus or womb). It is the result of the abnormal growth of cells that have the ability to invade or spread to other parts of the body. The first sign is most often vaginal bleeding not associated with a menstrual period. Other symptoms include pain with urination, pain during sexual intercourse, or pelvic pain. Endometrial cancer occurs most commonly after menopause.
  
  
  Approximately 40% of cases are related to obesity. Endometrial cancer is also associated with excessive estrogen exposure, high blood pressure and diabetes. Whereas taking estrogen alone increases the risk of endometrial cancer, taking both estrogen and a progestogen in combination, as in most birth control pills, decreases the risk. Between two and five percent of cases are related to genes inherited from the parents. Endometrial cancer is sometimes called "uterine cancer", although it is distinct from other forms of cancer of the uterus such as cervical cancer, uterine sarcoma, and trophoblastic disease. The most frequent type of endometrial cancer is endometrioid carcinoma, which accounts for more than 80% of cases. Endometrial cancer is commonly diagnosed by endometrial biopsy or by taking samples during a procedure known as dilation and curettage. A pap smear is not typically sufficient to show endometrial cancer. Regular screening in those at normal risk is not called for. (Full article...)
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  Buruli ulcer lesions. Top-left, an early ulcer. Top-right, a larger ulcer across the lower arm and wrist. Bottom, a large ulcer on the thigh.

  
  Buruli ulcer (/bəˈruːli/) is an infectious disease characterized by the development of painless open wounds. The disease is limited to certain areas of the world, most cases occurring in Sub-Saharan Africa and Australia. The first sign of infection is a small painless nodule or area of swelling, typically on the arms or legs. The nodule grows larger over days to weeks, eventually forming an open ulcer. Deep ulcers can cause scarring of muscles and tendons, resulting in permanent disability.
  
  Buruli ulcer is caused by skin infection with bacteria called Mycobacterium ulcerans. The mechanism by which M. ulcerans is transmitted from the environment to humans is not known, but may involve the bite of an aquatic insect or the infection of open wounds. Once in the skin, M. ulcerans grows and releases the toxin mycolactone, which blocks the normal function of cells, resulting in tissue death and immune suppression at the site of the ulcer. (Full article...)
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  Amphetamine (contracted from alpha-methylphenethylamine) is a central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity; it is also used to treat binge eating disorder in the form of its inactive prodrug lisdexamfetamine. Amphetamine was discovered as a chemical in 1887 by Lazăr Edeleanu, and then as a drug in the late 1920s. It exists as two enantiomers: levoamphetamine and dextroamphetamine. Amphetamine properly refers to a specific chemical, the racemic free base, which is equal parts of the two enantiomers in their pure amine forms. The term is frequently used informally to refer to any combination of the enantiomers, or to either of them alone. Historically, it has been used to treat nasal congestion and depression. Amphetamine is also used as an athletic performance enhancer and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant. It is a prescription drug in many countries, and unauthorized possession and distribution of amphetamine are often tightly controlled due to the significant health risks associated with recreational use.
  
  The first amphetamine pharmaceutical was Benzedrine, a brand which was used to treat a variety of conditions. Pharmaceutical amphetamine is prescribed as racemic amphetamine, Adderall, dextroamphetamine, or the inactive prodrug lisdexamfetamine. Amphetamine increases monoamine and excitatory neurotransmission in the brain, with its most pronounced effects targeting the norepinephrine and dopamine neurotransmitter systems. (Full article...)
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  Meninges of the central nervous system: dura mater, arachnoid mater, and pia mater.

  
  Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasionally photophobia. Other symptoms include confusion or altered consciousness, nausea, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash (a rash that does not fade when a glass is rolled over it) may also be present.
  
  The inflammation may be caused by infection with viruses, bacteria, fungi or parasites. Non-infectious causes include malignancy (cancer), subarachnoid hemorrhage, chronic inflammatory disease (sarcoidosis) and certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. A lumbar puncture, in which a needle is inserted into the spinal canal to collect a sample of cerebrospinal fluid (CSF), can diagnose or exclude meningitis. (Full article...)
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  McGill in her laboratory, 1942

  
  Frances Gertrude McGill (November 18, 1882 – January 21, 1959) was a Canadian forensic pathologist, criminologist, bacteriologist, allergologist and allergist. Nicknamed "the Sherlock Holmes of Saskatchewan" for her deductive skills and public fame, McGill influenced the development of forensic pathology in Canadian police work and was internationally noted for her expertise in the subject.
  
  After completing her medical degree at the University of Manitoba in 1915, McGill moved to Saskatchewan, where she was hired first as the provincial bacteriologist and then as the provincial pathologist. She worked extensively with the Royal Canadian Mounted Police (RCMP) and local police forces for more than thirty years, and was instrumental in establishing the first RCMP forensic laboratory. She directed the RCMP laboratory for three years, and trained new RCMP recruits in forensic detection methods. After retiring in 1946, McGill was appointed Honorary Surgeon for the RCMP by the Canadian Minister of Justice, becoming one of the first official female members of the force, and she continued to act as a consultant to the RCMP until her death in 1959. (Full article...)
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  Microscopic image of a Lewy body (adjacent to arrowhead) in a neuron of the substantia nigra; scale bar=20 microns (0.02 mm)

  
  Dementia with Lewy bodies (DLB) is a type of dementia characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic bodily functions. Memory loss is not always an early symptom. The disease worsens over time and is usually diagnosed when cognitive impairment interferes with normal daily functioning. Together with Parkinson's disease dementia, DLB is one of the two Lewy body dementias. It is a common form of dementia, but the prevalence is not known accurately and many diagnoses are missed. The disease was first described on autopsy by Kenji Kosaka in 1976, and he named the condition several years later.
  
  REM sleep behavior disorder (RBD)—in which people lose the muscle paralysis (atonia) that normally occurs during REM sleep and act out their dreams—is a core feature. RBD may appear years or decades before other symptoms. Other core features are visual hallucinations, marked fluctuations in attention or alertness, and parkinsonism (slowness of movement, trouble walking, or rigidity). A presumptive diagnosis can be made if several disease features or biomarkers are present; the diagnostic workup may include blood tests, neuropsychological tests, imaging, and sleep studies. A definitive diagnosis usually requires an autopsy. (Full article...)
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  Linezolid is an antibiotic used for the treatment of infections caused by Gram-positive bacteria that are resistant to other antibiotics. Linezolid is active against most Gram-positive bacteria that cause disease, including streptococci, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA). The main uses are infections of the skin and pneumonia although it may be used for a variety of other infections including drug-resistant tuberculosis. It is used either by injection into a vein or by mouth.
  
  
  When given for short periods, linezolid is a relatively safe antibiotic. It can be used in people of all ages and in people with liver disease or poor kidney function. Common side effects with short-term use include headache, diarrhea, rash, and nausea. Serious side effects may include serotonin syndrome, bone marrow suppression, and high blood lactate levels, particularly when used for more than two weeks. If used for longer periods it may cause nerve damage, including optic nerve damage, which may be irreversible. (Full article...)
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  Xenon is a chemical element; it has symbol Xe and atomic number 54. It is a dense, colorless, odorless noble gas found in Earth's atmosphere in trace amounts. Although generally unreactive, it can undergo a few chemical reactions such as the formation of xenon hexafluoroplatinate, the first noble gas compound to be synthesized.
  
  Xenon is used in flash lamps and arc lamps, and as a general anesthetic. The first excimer laser design used a xenon dimer molecule (Xe₂) as the lasing medium, and the earliest laser designs used xenon flash lamps as pumps. Xenon is also used to search for hypothetical weakly interacting massive particles and as a propellant for ion thrusters in spacecraft. (Full article...)
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  A serpin (white) with its 'reactive centre loop' (blue) bound to a protease (grey). Once the protease attempts catalysis it will be irreversibly inhibited. (PDB: 1K9O​)

  
  Serpins are a superfamily of proteins with similar structures that were first identified for their protease inhibition activity and are found in all kingdoms of life. The acronym serpin was originally coined because the first serpins to be identified act on chymotrypsin-like serine proteases (serine protease inhibitors). They are notable for their unusual mechanism of action, in which they irreversibly inhibit their target protease by undergoing a large conformational change to disrupt the target's active site. This contrasts with the more common competitive mechanism for protease inhibitors that bind to and block access to the protease active site.
  
  Protease inhibition by serpins controls an array of biological processes, including coagulation and inflammation, and consequently these proteins are the target of medical research. Their unique conformational change also makes them of interest to the structural biology and protein folding research communities. The conformational-change mechanism confers certain advantages, but it also has drawbacks: serpins are vulnerable to mutations that can result in serpinopathies such as protein misfolding and the formation of inactive long-chain polymers. Serpin polymerisation not only reduces the amount of active inhibitor, but also leads to accumulation of the polymers, causing cell death and organ failure. (Full article...)

Selected image –

Lateral radiograph of the knee of a child demonstrating fragmentation of the tuberosity of the tibia (see inset) with overlying soft tissue swelling, indicative of Osgood-Schlatter disease.

Photo credit: Kristin M Houghton; Radiograph courtesy of BC Children's Hospital. (cc-by-2.0)

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  Fig. 1. Pulvermacher's chain. The handles pointing away from the holder are insulated so that the physician can safely place the device in contact with any part of the patient's body.

  
  
  The Pulvermacher chain, or in full as it was sold the Pulvermacher hydro-electric chain, was a type of voltaic battery sold in the second half of the 19th century for medical applications. Its chief market was amongst the numerous quack practitioners who were taking advantage of the popularity of the relatively new treatment of electrotherapy, or "electrification" as it was then known. Its unique selling point was its construction of numerous linked cells, rendering it mechanically flexible. A variant intended to be worn wrapped on parts of the body for long periods was known as Pulvermacher's galvanic chain or electric belt.
  
  The Pulvermacher Company attracted a great deal of antagonism from the medical community due to their use of the names of well-known physicians in their advertising without permission. The nature of their business; in selling to charlatans and promoting quack practices also made them unpopular with the medical community. Despite this, the Pulvermacher chain was widely reported as a useful source of electricity for medical and scientific purposes, even amongst the most vocal critics of the Pulvermacher Company. (Full article...)
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  Scanning electron micrograph of HIV-1 (in green) budding from cultured lymphocyte. Multiple round bumps on cell surface represent sites of assembly and budding of virions.

  
  The human immunodeficiency viruses (HIV) are two species of Lentivirus (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment, the average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype.
  
  In most cases, HIV is a sexually transmitted infection and occurs by contact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids. Non-sexual transmission can occur from an infected mother to her infant during pregnancy, during childbirth by exposure to her blood or vaginal fluid, and through breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells.
  Research has shown (for both same-sex and opposite-sex couples) that HIV is not contagious during sexual intercourse without a condom if the HIV-positive partner has a consistently undetectable viral load. (Full article...)
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  U.S. Army Huey helicopter spraying Agent Orange over agricultural land during the Vietnam War in its herbicidal warfare campaign

  
  Agent Orange is a chemical herbicide and defoliant, one of the tactical use Rainbow Herbicides. It was used by the U.S. military as part of its herbicidal warfare program, Operation Ranch Hand, during the Vietnam War from 1961 to 1971. The U.S. was strongly influenced by the British who used Agent Orange during the Malayan Emergency. It is a mixture of equal parts of two herbicides, 2,4,5-T and 2,4-D. In addition to its damaging environmental effects, traces of dioxin (mainly TCDD, the most toxic of its type) found in the mixture have caused major health problems and deformities for many individuals who were exposed and for their children.
  
  Agent Orange was produced in the United States beginning in the late 1940s and was used in industrial agriculture, and was also sprayed along railroads and power lines to control undergrowth in forests. During the Vietnam War, the U.S. military procured over 20,000,000 U.S. gal (76,000,000 L; 17,000,000 imp gal), consisting of a fifty-fifty mixture of 2,4-D and dioxin-contaminated 2,4,5-T. Nine chemical companies produced it: Dow Chemical Company, Monsanto Company, Diamond Shamrock Corporation, Hercules Inc., Thompson Hayward Chemical Co., United States Rubber Company (Uniroyal), Thompson Chemical Co., Hoffman-Taff Chemicals, Inc., and Agriselect. (Full article...)
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  Vitamin B₆ is one of the B vitamins, and is an essential nutrient for humans. The term essential nutrient refers to a group of six chemically similar compounds, i.e., "vitamers", which can be interconverted in biological systems. Its active form, pyridoxal 5′-phosphate, serves as a coenzyme in more than 140 enzyme reactions in amino acid, glucose, and lipid metabolism.
  
  Plants synthesize pyridoxine as a means of protection from the UV-B radiation found in sunlight and for the role it plays in the synthesis of chlorophyll. Animals cannot synthesize any of the various forms of the vitamin, and hence must obtain it via diet, either of plants, or of other animals. There is some absorption of the vitamin produced by intestinal bacteria, but this is not sufficient to meet dietary needs. For adult humans, recommendations from various countries' food regulatory agencies are in the range of 1.0 to 2.0 milligrams (mg) per day. These same agencies also recognize ill effects from intakes that are too high, and so set safe upper limits, ranging from as low as 25 mg/day to as high as 100 mg/day depending on the country. Beef, pork, fowl and fish are generally good sources; dairy, eggs, mollusks and crustaceans also contain vitamin B₆, but at lower levels. There is enough in a wide variety of plant foods so that a vegetarian or vegan diet does not put consumers at risk for deficiency. (Full article...)
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  Arrow points to brachytherapy beads used to treat prostate cancer.

  
  Brachytherapy is a form of radiation therapy where a sealed radiation source is placed inside or next to the area requiring treatment. The word "brachytherapy" comes from the Greek word βραχύς, brachys, meaning "short-distance" or "short". Brachytherapy is commonly used as an effective treatment for cervical, prostate, breast, esophageal and skin cancer and can also be used to treat tumours in many other body sites. Treatment results have demonstrated that the cancer-cure rates of brachytherapy are either comparable to surgery and external beam radiotherapy (EBRT) or are improved when used in combination with these techniques. Brachytherapy can be used alone or in combination with other therapies such as surgery, EBRT and chemotherapy.
  
  Brachytherapy contrasts with unsealed source radiotherapy, in which a therapeutic radionuclide (radioisotope) is injected into the body to chemically localize to the tissue requiring destruction. It also contrasts to External Beam Radiation Therapy (EBRT), in which high-energy x-rays (or occasionally gamma-rays from a radioisotope like cobalt-60) are directed at the tumour from outside the body. Brachytherapy instead involves the precise placement of short-range radiation-sources (radioisotopes, iodine-125 or caesium-131 for instance) directly at the site of the cancerous tumour. These are enclosed in a protective capsule or wire, which allows the ionizing radiation to escape to treat and kill surrounding tissue but prevents the charge of radioisotope from moving or dissolving in body fluids. The capsule may be removed later, or (with some radioisotopes) it may be allowed to remain in place. (Full article...)
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  The ovulatory shift hypothesis holds that women experience evolutionarily adaptive changes in subconscious thoughts and behaviors related to mating during different parts of the ovulatory cycle. It suggests that what women want, in terms of men, changes throughout the menstrual cycle. Two meta-analyses published in 2014 reached opposing conclusions on whether the existing evidence was robust enough to support the prediction that women's mate preferences change across the cycle. A newer 2018 review does not show women changing the type of men they desire at different times in their fertility cycle. (Full article...)
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  Two United States Navy sailors demonstrate treatment for decompression sickness inside a decompression chamber

  
  Decompression sickness (DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompression. DCS most commonly occurs during or soon after a decompression ascent from underwater diving, but can also result from other causes of depressurisation, such as emerging from a caisson, decompression from saturation, flying in an unpressurised aircraft at high altitude, and extravehicular activity from spacecraft. DCS and arterial gas embolism are collectively referred to as decompression illness.
  
  Since bubbles can form in or migrate to any part of the body, DCS can produce many symptoms, and its effects may vary from joint pain and rashes to paralysis and death. DCS often causes air bubbles to settle in major joints like knees or elbows, causing individuals to bend over in excruciating pain, hence its common name, the bends. Individual susceptibility can vary from day to day, and different individuals under the same conditions may be affected differently or not at all. The classification of types of DCS according to symptoms has evolved since its original description in the 19th century. The severity of symptoms varies from barely noticeable to rapidly fatal. (Full article...)
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  Divers breathe a mixture of oxygen, helium and nitrogen for deep dives to avoid the effects of narcosis. A cylinder label shows the maximum operating depth and mixture (oxygen/helium).

  
  Narcosis while diving (also known as nitrogen narcosis, inert gas narcosis, raptures of the deep, Martini effect) is a reversible alteration in consciousness that occurs while diving at depth. It is caused by the anesthetic effect of certain gases at high partial pressure. The Greek word νάρκωσις (narkōsis), "the act of making numb", is derived from νάρκη (narkē), "numbness, torpor", a term used by Homer and Hippocrates. Narcosis produces a state similar to drunkenness (alcohol intoxication), or nitrous oxide inhalation. It can occur during shallow dives, but does not usually become noticeable at depths less than 30 metres (98 ft).
  
  Except for helium and probably neon, all gases that can be breathed have a narcotic effect, although widely varying in degree. The effect is consistently greater for gases with a higher lipid solubility, and although the mechanism of this phenomenon is still not fully clear, there is good evidence that the two properties are mechanistically related. As depth increases, the mental impairment may become hazardous. Divers can learn to cope with some of the effects of narcosis, but it is impossible to develop a tolerance. Narcosis can affect all ambient pressure divers, although susceptibility varies widely among individuals and from dive to dive. The main modes of underwater diving that deal with its prevention and management are scuba diving and surface-supplied diving at depths greater than 30 metres (98 ft). (Full article...)
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  Nasodigitoacoustic syndrome, also called Keipert syndrome, is a rare congenital syndrome first described by J.A. Keipert and colleagues in 1973. The syndrome is characterized by a misshaped nose, broad thumbs and halluces (the big toes), brachydactyly, sensorineural hearing loss, facial features such as hypertelorism (unusually wide-set eyes), and developmental delay.
  
  It is believed to be inherited in an X-linked recessive manner, which means a genetic mutation causing the disorder is located on the X chromosome, and while two copies of the mutated gene must be inherited for a female to be born with the disorder, just one copy is sufficient to cause a male to be born with the disorder. Nasodigitoacoustic syndrome is likely caused by a mutated gene located on the X chromosome between positions Xq22.2–q28. (Full article...)
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  Sir Victor Ewings Negus, MS, FRCS (6 February 1887 – 15 July 1974) was a British surgeon who specialised in laryngology and also made fundamental contributions to comparative anatomy with his work on the structure and evolution of the larynx. He was born and educated in London, studying at King's College School, then King's College London, followed by King's College Hospital. The final years of his medical training were interrupted by the First World War, during which he served with the Royal Army Medical Corps. After the war, he qualified as a surgeon and studied with laryngologists in France and the USA before resuming his career at King's College Hospital where he became a junior surgeon in 1924.
  
  In the 1920s, Negus worked on aspects of both throat surgery and the anatomy of the larynx, the latter work contributing to his degree of Master of Surgery (1924). His surgical innovations included designs for laryngoscopes, bronchoscopes, oesophagoscopes, an operating table, and tracheotomy equipment. His major publications were The Mechanism of the Larynx (1929) and his work on the clinical text Diseases of the Nose and Throat, starting with the fourth edition of 1937. Negus was also awarded several lectureships and published many medical papers and other works on comparative anatomy and laryngology. He became a senior surgeon at King's College Hospital in 1940 and a consulting surgeon in 1946. (Full article...)
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  Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people who have a psychotic disorder, specifically schizophrenia.
  
  Thought broadcasting is considered a severe delusion and it induces multiple complications, from lack of insight to social isolation. The delusion normally occurs along with other symptoms. Thought broadcasting is considered rare. In one study, for instance, it had a prevalence of 6% among individuals with schizophrenia. (Full article...)
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  Osteitis fibrosa cystica of the tibia. Arrows point to the brown tumors which are typically present in bones of people with OFC.

  
  Osteitis fibrosa cystica (/ˌɒstiˈaɪtɪs faɪˈbroʊsə ˈsɪstɪkə/ OSS-tee-EYE-tis fy-BROH-sə SIS-tik-ə) is a skeletal disorder resulting in a loss of bone mass, a weakening of the bones as their calcified supporting structures are replaced with fibrous tissue (peritrabecular fibrosis), and the formation of cyst-like brown tumors in and around the bone. Osteitis fibrosis cystica (OFC), also known as osteitis fibrosa, osteodystrophia fibrosa, and von Recklinghausen's disease of bone (not to be confused with von Recklinghausen's disease, neurofibromatosis type I), is caused by hyperparathyroidism, which is a surplus of parathyroid hormone from over-active parathyroid glands. This surplus stimulates the activity of osteoclasts, cells that break down bone, in a process known as osteoclastic bone resorption. The hyperparathyroidism can be triggered by a parathyroid adenoma, hereditary factors, parathyroid carcinoma, or renal osteodystrophy. Osteoclastic bone resorption releases minerals, including calcium, from the bone into the bloodstream, causing both elevated blood calcium levels, and the structural changes which weaken the bone. The symptoms of the disease are the consequences of both the general softening of the bones and the excess calcium in the blood, and include bone fractures, kidney stones, nausea, moth-eaten appearance in the bones, appetite loss, and weight loss.
  
  First described in the nineteenth century, OFC is currently detected through a combination of blood testing, X-rays, and tissue sampling. Before 1950, around half of those diagnosed with hyperparathyroidism in the United States saw it progress to OFC, but with early identification techniques and improved treatment methods, instances of OFC in developed countries are increasingly rare. Where treatment is required, it normally involves addressing the underlying hyperparathyroidism before commencing long-term treatment for OFC—depending on its cause and severity, this can range from hydration and exercise to surgical intervention. (Full article...)
• 
  Mayo Foundation v. United States, 562 U.S. 44 (2011), is a United States Supreme Court case in which the Court upheld a Treasury Department regulation on the grounds that the courts should defer to government agencies in tax cases in absence of an unreasonable decision on the part of the agency.
  
  Under the Federal Insurance Contributions Act (FICA), students and their educational employers are exempted from paying Social Security taxes. The Treasury Department issued a regulation in 2004, declaring those who worked more than 40 hours a week were ineligible for such an exemption. The Mayo Foundation filed suit to challenge the regulation and for a refund of the taxes it had paid on its medical residents—recently graduated physicians, who work more than full-time providing patient care but who are still considered trainees by the medical profession. The District Court ruled for the Mayo Foundation and struck the regulation, but was reversed by the Court of Appeals. (Full article...)
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  For the diagnosis, brain scans (such as MRI) should be done to rule out other potential causes.

  
  Idiopathic intracranial hypertension (IIH), previously known as pseudotumor cerebri and benign intracranial hypertension, is a condition characterized by increased intracranial pressure (pressure around the brain) without a detectable cause. The main symptoms are headache, vision problems, ringing in the ears, and shoulder pain. Complications may include vision loss.
  
  
  This condition is idiopathic, meaning there is no known cause. Risk factors include being overweight or a recent increase in weight. Tetracycline may also trigger the condition. The diagnosis is based on symptoms and a high opening pressure found during a lumbar puncture with no specific cause found on a brain scan. (Full article...)
• 
  Steroid 21-hydroxylase is a protein that in humans is encoded by the CYP21A2 gene. The protein is an enzyme that hydroxylates steroids at the C21 position on the molecule. Naming conventions for enzymes are based on the substrate acted upon and the chemical process performed. Biochemically, this enzyme is involved in the biosynthesis of the adrenal gland hormones aldosterone and cortisol, which are important in blood pressure regulation, sodium homeostasis and blood sugar control. The enzyme converts progesterone and 17α-hydroxyprogesterone into 11-deoxycorticosterone and 11-deoxycortisol, respectively, within metabolic pathways which in humans ultimately lead to aldosterone and cortisol creation—deficiency in the enzyme may cause congenital adrenal hyperplasia.
  
  Steroid 21-hydroxylase is a member of the cytochrome P450 family of monooxygenase enzymes that use an iron-containing heme cofactor to oxidize substrates. (Full article...)

Did you know –

• ... that the most common cause of acute coronary syndrome is disruption of atherosclerotic plaque in a coronary artery?

• ... that the polymeal is a diet-based approach to combating heart disease, proposed in December 2004 by Oscar Franco?
• ... that a mammotome is a device that uses a computer-guided probe to perform breast biopsies, and that it can be conducted on an outpatient basis under local anaesthetic?

General images –

The following are images from various Medicine-related articles on Wikipedia.

• 
  Depiction of smallpox in Franciscan Bernardino de Sahagún's history of the conquest of Mexico, Book XII of the Florentine Codex, from the defeated Aztecs' point of view (from History of medicine)
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  Hippocrates (c. 460–370 BCE). Known as the "father of medicine". (from History of medicine)
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  Botánicas such as this one in Jamaica Plain, Boston, cater to the Latino community and sell folk medicine alongside statues of saints, candles decorated with prayers, lucky bamboo, and other items. (from Traditional medicine)
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  Ethical prayer for medical wisdom by Dr Edmond Fernandes (from Medical ethics)
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  The numbers of Americans lacking health insurance and the uninsured rate from 1987 to 2008 (from Health insurance)
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  The Edwin Smith Surgical Papyrus, written in the 17th century BCE, contains the earliest recorded reference to the brain. New York Academy of Medicine. (from History of medicine)
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  Sketch of Muslim physician Muhammad ibn Zakariya al-Razi (from History of medicine)
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  A doctor checks a patient's pulse in Meiji-era Japan. (from History of medicine)
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  COVID-19 swab testing in Rwanda (2021) (from History of medicine)
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  A Ukrainian monument to the HIV pandemic (from History of medicine)
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  Galen (129–216 CE), known for his wide insights into anatomy (from History of medicine)
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  Taoist symbol of Yin and Yang (from Medical ethics)
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  Health spending by country. Percent of GDP (Gross domestic product). For example: 11.2% for Canada in 2022. 16.6% for the United States in 2022. (from Health care)
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  Replica of Antonie van Leeuwenhoek's microscope of the 1670s (from History of medicine)
• 
  A 12th-century Byzantine manuscript of the Hippocratic Oath (from Medical ethics)
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  The Quaker-run York Retreat, founded in 1796, gained international prominence as a centre for moral treatment and a model of asylum reform following the publication of Samuel Tuke's Description of the Retreat (1813). (from History of medicine)
• 
  Smallpox vaccination in Niger, 1969. A decade later, this was the first infectious disease to be eradicated. (from History of medicine)
• 
  National Hospital for Neurology and Neurosurgery in London, United Kingdom is a specialist neurological hospital. (from Health care)
• 
  Yarrow, a medicinal plant found in human-occupied caves in the Upper Palaeolithic period (from History of medicine)
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  The plinthios brochos as described by Greek physician Heraklas, a sling for binding a fractured jaw. These writings were preserved in one of Oribasius' collections. (from History of medicine)
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  American combat surgery during the Pacific War, 1943 (from History of medicine)
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  Mexico City epidemic of 1737, with elites calling on the Virgin of Guadalupe (from History of medicine)
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  Total healthcare cost per person. Public and private spending. US dollars PPP. For example: $6,319 for Canada in 2022. $12,555 for the US in 2022. (from Health care)
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  Charite in Berlin (from History of medicine)
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  American Civil War hospital at Gettysburg, 1863 (from History of medicine)
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  Life Expectancy of the total population at birth among several OECD member nations. Data source: OECD's iLibrary (from Health insurance)
• 
  Statue of Robert Koch, father of medical bacteriology, at Robert-Koch-Platz (Robert Koch square) in Berlin (from History of medicine)
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  Louis Pasteur experimenting on bacteria, c. 1870 (from History of medicine)
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  AMA Code of Medical Ethics (from Medical ethics)
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  The emergency room is often a frontline venue for the delivery of primary medical care. (from Health care)
• 
  Hospital train "Therapist Matvei Mudrov" in Khabarovsk, Russia (from Health care)
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  Health Expenditure per capita (in PPP-adjusted US$) among several OECD member nations. Data source: OECD's iLibrary (from Health insurance)
• 
  An American billing clerk preparing a detailed invoice. (1992) (from Medical billing)
• 
  "More Doctors Smoke Camels than Any Other Cigarette" advertisement for Camel cigarettes in the 1940s (from Medical ethics)
• 
  Traditional medicine in a market in Antananarivo, Madagascar (from Traditional medicine)
• 
  Zhang Zhongjing – a Chinese pharmacologist, physician, inventor, and writer of the Eastern Han dynasty (from History of medicine)
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  Patient, Surrey County Lunatic Asylum, c. 1850–58. The asylum population in England and Wales rose from 1,027 in 1827 to 74,004 in 1900. (from History of medicine)
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  A 12th-century manuscript of the Hippocratic Oath in Greek, one of the most famous aspects of classical medicine that carried into later eras (from History of medicine)
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  Mandrake (written 'ΜΑΝΔΡΑΓΟΡΑ' in Greek capitals). Naples Dioscurides, 7th century (from History of medicine)
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  Guy's Hospital in 1820 (from History of medicine)
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  Most countries have seen a tremendous increase in life expectancy since 1945. However, in southern Africa, the HIV epidemic beginning around 1990 has eroded national health. (from History of medicine)
• 
  Medical personnel place sterilized covers on the arms of the daVinci Xi surgical system, a minimally-invasive robotic surgery system, at the William Beaumont Army Medical Center. (from History of medicine)
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  healthcare expenditure in Japan by age group (from Health insurance)
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  Curandera performing a limpieza in Cuenca, Ecuador (from Traditional medicine)
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  Primary care may be provided in community health centers. (from Health care)
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  18th-century medical remedies collected by a British Gentry family (from History of medicine)
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  Medicine during the First World War - medical transport (from History of medicine)
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  Sometimes traditional medicines include parts of endangered species, such as the slow loris in Southeast Asia. (from Traditional medicine)
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  Seven named physicians and botanists of the Classical world from Vienna Dioscurides. Clockwise from top center: Galen, Dioscorides, Nicander, Rufus of Ephesus, Andreas of Carystus, Apollonius Mus or of Pergamon, Crateuas (from History of medicine)
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  Emil Kraepelin (1856–1926), the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics (from History of medicine)
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  A cochlear implant is a common kind of neural prosthesis, a device replacing part of the human nervous system. (from History of medicine)
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  Global concentrations of health care resources, as depicted by the number of physicians per 10,000 individuals, by country. Data is sourced from a World Health Statistics 2010, a WHO report. (from Health care)
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  "Diagram of the causes of mortality in the army in the East" by Florence Nightingale (from History of medicine)
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  Infographic showing how healthcare data flows within the billing process (from Medical billing)
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  A cuneiform terracotta tablet describing a medicinal recipe for poisoning (c. 18th century BCE). Discovered in Nippur, Iraq.
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  Magical stela or cippus of Horus inscribed with healing encantations (c. 332 to 280 BCE) (from History of medicine)
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  Health expenditure funding types (from Health insurance)
• 
  Life expectancy vs healthcare spending of rich OECD countries. US average of $10,447 in 2018. (from Health care)
• 
  A Neo-Assyrian cuneiform tablet fragment describing medical text (c. 9th to 7th century BCE) (from History of medicine)
• 
  Jackson Memorial Hospital in Miami, the primary teaching hospital of the University of Miami's Miller School of Medicine and the largest hospital in the United States with 1,547 beds (from Health care)

More Did you know (auto generated)

• ... that Tang Zonghai was one of the first advocates for the integration of Chinese and Western medicine?
• ... that Margaret C. Roberts was encouraged to study medicine by LDS Church leader Brigham Young to reduce mortality rates during childbirth?
• ... that Constance Fozzard was told during her surgical training that women with children could not become consultants?
• ... that Mary Robertson was the first woman to receive a Doctor of Science degree in medicine from the University of Cape Town?
• ... that a lack of screening for pregnant women with syphilis in sub-Saharan Africa is associated with increased infant mortality?
• ... that fourteenth-century Buddhist monk Tuệ Tĩnh is referred to as a founding father of traditional Vietnamese medicine?

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