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| === '''For patient information, click [[Pica (patient information)|here]]''' ===
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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
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| Image = |
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| Caption = |
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| DiseasesDB = 29704 |
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| ICD10 = {{ICD10|F|50|8|f|50}}, {{ICD10|F|98|3|f|90}} |
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| ICD9 = {{ICD9|307.52}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D010842 |
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| }}
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| {{SI}}
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| {{CMG}}; {{AE}} {{KS}} {{Fs}}
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| {{SK}} Pica syndrome
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| ==Overview==
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| ==Historical Perspective==
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| *Pica is derived from a Latin word 'pica pica' which means magpie, a bird known for its behavior of gathering and eating almost everything.
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| *It was first documented in the 13th century in Latin work of Bartholomeus de Glanville, although the actual term was not used.<ref name="pmid1562860">{{cite journal |vauthors=Parry-Jones B, Parry-Jones WL |title=Pica: symptom or eating disorder? A historical assessment |journal=Br J Psychiatry |volume=160 |issue= |pages=341–54 |date=March 1992 |pmid=1562860 |doi=10.1192/bjp.160.3.341 |url=}}</ref>
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| *The first time term ‘Pica’ was mentioned in a medical context was in 1563 in a surgical work, ‘''An Excellent Treatise of Wounds made with Gonne Shot’, by Thomas Gale'', where pica was addressed in pregnant women and children.<ref name="pmid1562860">{{cite journal |vauthors=Parry-Jones B, Parry-Jones WL |title=Pica: symptom or eating disorder? A historical assessment |journal=Br J Psychiatry |volume=160 |issue= |pages=341–54 |date=March 1992 |pmid=1562860 |doi=10.1192/bjp.160.3.341 |url=}}</ref>
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| *Historically, clay ingestion had been used for medical purposes probably due to its effect on gastrointestinal (GI) system. It was particularly suggested as a treatment of intestinal infection and spasm.<ref name="pmid11001006">{{cite journal |vauthors=Rose EA, Porcerelli JH, Neale AV |title=Pica: common but commonly missed |journal=J Am Board Fam Pract |volume=13 |issue=5 |pages=353–8 |date=2000 |pmid=11001006 |doi= |url=}}</ref>
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| ==Classification==
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| Pica may be classified according to the name of the eaten substance; the most common types by far are geophagia and amylophagia:
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| *Acuphagia (sharp objects)
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| *Amylophagia (purified starch)
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| *Cautopyreiophagia (burnt matches)
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| *Coniophagia (dust, dirt)
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| *Coprophagia (feces)
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| *Emetophagia (vomit)
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| *Geomelophagia (raw potatoes)
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| *Geophagia (earth, soil, clay, chalk)
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| *Hyalophagia (glass)
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| *Lithophagia (stones)
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| *Metallophagia (metal)
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| *Mucophagia (mucus)
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| *Pagophagia (ice)
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| *Plumbophagia (lead, paint chips)
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| *Trichophagia (hair, wool, fibers)
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| *Urophagia (urine)
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| *Hematophagia (blood)
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| *Xylophagia (wood, paper)
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| *Hyalophagia (glass)
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| *Ryzophagia (raw rice)
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| *Sapophagia (soap)
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| ==Pathophysiology==
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| The exact pathogenesis of Pica is not fully understood. However there are different theories on developing Pica:
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| ===Nutritional Theory===
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| *Children with anemia and low plasma zinc levels may develop Pica and crave for substances rich in the insufficient nutrients.<ref name="pmid25156147">{{cite journal |vauthors=Miao D, Young SL, Golden CD |title=A meta-analysis of pica and micronutrient status |journal=Am J Hum Biol |volume=27 |issue=1 |pages=84–93 |date=2015 |pmid=25156147 |pmc=4270917 |doi=10.1002/ajhb.22598 |url=}}</ref>
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| *Kaolinite, a clay mineral, which has negative surface charge commonly ingested in Pica and can absorb the ions with positive surface charge, such as iron and causes iron-deficiency anemia.<ref name="Ali2009">{{cite journal|last1=Ali|first1=Zainab|title=Pica in people with intellectual disability: a literature review of aetiology, epidemiology and complications|journal=Journal of Intellectual & Developmental Disability|volume=26|issue=3|year=2009|pages=205–215|issn=1366-8250|doi=10.1080/13668250020054486}}</ref> <ref name="pmid18838005">{{cite journal |vauthors=von Garnier C, Stünitz H, Decker M, Battegay E, Zeller A |title=Pica and refractory iron deficiency anaemia: a case report |journal=J Med Case Rep |volume=2 |issue= |pages=324 |date=October 2008 |pmid=18838005 |pmc=2567333 |doi=10.1186/1752-1947-2-324 |url=}}</ref>
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| *There is not enough evidence to determine whether Pica is the cause of nutritional deficiency or nutritional deficiency leads to Pica development.<ref name="Ali2009">{{cite journal|last1=Ali|first1=Zainab|title=Pica in people with intellectual disability: a literature review of aetiology, epidemiology and complications|journal=Journal of Intellectual & Developmental Disability|volume=26|issue=3|year=2009|pages=205–215|issn=1366-8250|doi=10.1080/13668250020054486}}</ref> <ref name="pmid30868957">{{cite journal |vauthors=Leung AKC, Hon KL |title=Pica: A Common Condition that is Commonly Missed - An Update Review |journal=Curr Pediatr Rev |volume=15 |issue=3 |pages=164–169 |date=2019 |pmid=30868957 |doi=10.2174/1573396315666190313163530 |url=}}</ref>
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| ===Gastrointestinal Distress===
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| Geophagia causes increase in gastrointestinal PH. This effect can sooth gastric pain and gastroesophageal reflux. <ref name="pmid15694906">{{cite journal |vauthors=Kettaneh A, Eclache V, Fain O, Sontag C, Uzan M, Carbillon L, Stirnemann J, Thomas M |title=Pica and food craving in patients with iron-deficiency anemia: a case-control study in France |journal=Am J Med |volume=118 |issue=2 |pages=185–8 |date=February 2005 |pmid=15694906 |doi=10.1016/j.amjmed.2004.07.050 |url=}}</ref>
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| ==Causes==
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| Disease name] may be caused by [cause1], [cause2], or [cause3].
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| Common causes of [disease] include [cause1], [cause2], and [cause3].
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| The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
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| OR
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| The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click [[Pericarditis causes#Overview|here]].
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| ==Differentiating ((Page name)) from other Diseases==
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| [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
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| [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
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| ==Epidemiology and Demographics==
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| The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
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| In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
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| In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
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| Patients of all age groups may develop [disease name].
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| The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
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| [Disease name] commonly affects individuals younger than/older than [number of years] years of age.
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| [Chronic disease name] is usually first diagnosed among [age group].
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| [Acute disease name] commonly affects [age group].
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| There is no racial predilection to [disease name].
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| [Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
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| [Disease name] affects men and women equally.
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| [Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
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| The majority of [disease name] cases are reported in [geographical region].
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| [Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
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| ==Risk Factors==
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| There are no established risk factors for [disease name].
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| The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
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| Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
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| Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.
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| ==Screening==
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| There is insufficient evidence to recommend routine screening for [disease/malignancy].
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| According to the [guideline name], screening for [disease name] is not recommended.
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| According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
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| ==Natural History, Complications, and Prognosis==
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| If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
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| Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
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| Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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| ==Diagnosis==
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| ===Diagnostic Study of Choice===
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| The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
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| The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
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| The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
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| There are no established criteria for the diagnosis of [disease name].
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| ===History and Symptoms===
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| The majority of patients with [disease name] are asymptomatic.
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| The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
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| ===Physical Examination===
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| Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
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| Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
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| The presence of [finding(s)] on physical examination is diagnostic of [disease name].
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| The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
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| ===Laboratory Findings===
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| An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
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| Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
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| [Test] is usually normal among patients with [disease name].
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| Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
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| There are no diagnostic laboratory findings associated with [disease name].
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| ===Electrocardiogram===
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| There are no ECG findings associated with [disease name].
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| An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| ===X-ray===
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| There are no x-ray findings associated with [disease name].
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| An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===Echocardiography or Ultrasound===
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| There are no echocardiography/ultrasound findings associated with [disease name].
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| Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===CT scan===
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| There are no CT scan findings associated with [disease name].
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| [Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===MRI===
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| There are no MRI findings associated with [disease name].
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| [Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
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| ===Other Imaging Findings===
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| There are no other imaging findings associated with [disease name].
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| [Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| ===Other Diagnostic Studies===
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| There are no other diagnostic studies associated with [disease name].
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| [Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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| Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
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| ==Treatment==
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| ===Medical Therapy===
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| There is no treatment for [disease name]; the mainstay of therapy is supportive care.
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| Supportive therapy for [disease name] includes [therapy 1], [therapy 2], and [therapy 3].
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| The majority of cases of [disease name] are self-limited and require only supportive care.
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| [Disease name] is a medical emergency and requires prompt treatment.
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| The mainstay of treatment for [disease name] is [therapy].
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| The optimal therapy for [malignancy name] depends on the stage at diagnosis.
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| [Therapy] is recommended among all patients who develop [disease name].
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| Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
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| Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].
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| Empiric therapy for [disease name] depends on [disease factor 1] and [disease factor 2].
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| Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
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| ===Surgery===
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| Surgical intervention is not recommended for the management of [disease name].
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| Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
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| The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
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| The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
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| Surgery is the mainstay of treatment for [disease or malignancy].
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| ===Primary Prevention===
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| There are no established measures for the primary prevention of [disease name].
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| There are no available vaccines against [disease name].
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| Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
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| [Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
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| ===Secondary Prevention===
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| There are no established measures for the secondary prevention of [disease name].
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| Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
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| ==References==
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| {{reflist|2}}
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| {{SIB}}
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| [[Category:Signs and symptoms]]
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| [[Category:Psychiatry]]
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| [[Category:Overview complete]]
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| {{WH}}
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| {{WS}}
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