Persius/hicric huggingface dataset:
Tobramycin microbiology

# Microbiology
Tobramycin is an aminoglycoside antibiotic produced by Streptomyces tenebrarius. It acts primarily by disrupting protein synthesis, leading to altered cell membrane permeability, progressive disruption of the cell envelope, and eventual cell death.
Tobramycin has in-vitro activity against a wide range of gram-negative organisms including Pseudomonas aeruginosa. It is bactericidal at concentrations equal to or slightly greater than inhibitory concentrations.

### Susceptibility Testing
A single sputum sample from a cystic fibrosis patient may contain multiple morphotypes of Pseudomonas aeruginosa and each morphotype may have a different level of in-vitro susceptibility to tobramycin. Treatment for 6 months with TOBI in two clinical studies did not affect the susceptibility of the majority of P. aeruginosa isolates tested; however, increased minimum inhibitory concentrations (MICs) were noted in some patients. The clinical significance of this information has not been clearly established in the treatment of P. aeruginosa in cystic fibrosis patients. For additional information regarding the effects of TOBI on P. aeruginosa MIC values and bacterial sputum density, please refer to the CLINICAL STUDIES section.
The in-vitro antimicrobial susceptibility test methods used for parenteral tobramycin therapy can be used to monitor the susceptibility of P. aeruginosa isolated from cystic fibrosis patients. If decreased susceptibility is noted, the results should be reported to the clinician.
Susceptibility breakpoints established for parenteral administration of tobramycin do not apply to aerosolized administration of TOBI. The relationship between in-vitro susceptibility test results and clinical outcome with TOBI therapy is not clear.
Topoisomerase inhibitor

# Overview
Topoisomerase inhibitors are chemotherapy agents designed to interfere with the action of topoisomerase enzymes (topoisomerase I and II), which are enzymes that control the changes in DNA structure by catalyzing the breaking and rejoining of the phosphodiester backbone of DNA strands during the normal cell cycle.
In recent years, topoisomerase inhibitors have become popular targets for cancer chemotherapy treatments. It is thought that topoisomerase inhibitors block the ligation step of the cell cycle, and that topoisomerase I and II inhibitors interfere with the transcription and replication of DNA by upsetting proper DNA supercoiling.
A commonly prescribed class of topoisomerase inhibitors are fluoroquinolones.
- Topoisomerase I inhibitors:  irinotecan, topotecan, camptothecin and lamellarin D
- Topoisomerase II inhibitors:  amsacrine, etoposide, etoposide phosphate, teniposide and doxorubicin
Toxicodendron rydbergii
Toxicodendron rydbergii (syn. Rhus rydbergii; Western Poison-ivy) is a species of Toxicodendron native to most of the United States except the Pacific States, where it can be found growing in forests, and other wooded areas, usually near streams and rivers.
It is a shrub that can grow to 1 m (3 ft) tall, rarely up to 3 m (10 ft). The leaves are trifoliate and alternate.  The leaflets are variable in size and shape, and are usually 15 cm (6 in) long, turning yellow or orange in autumn. The fruits are small, round, and yellowish.

# Caution
All parts of this plant contain Urushiol, which can cause severe dermatitis in some individuals.
Trapezius muscles (cat)
The Trapezius muscles are a set of muscles found in mammals. In the cat they are three thin flat muscles that cover the back, and to a lesser extent, the neck. They pull the scapula toward the mid dorsal line, anteriorly, and posteriorly.

# Clavotrapezius
The most anterior of the trapezius muscles, it is also the largest. Its fibers run obliquely to the ventral surface. Origin, superior nuchal line and median dorsal line, Insertion, clavicle, Action, draws the clavicle dorsal and towards the head.

# Acromiotrapezius
Acromiotrapezius is the middle trapezius muscle. It covers the dorsal and lateral surfaces of the scapula. Origin, neural spines of the cervical vertebrae, Insertion, In the metacromion process and fascia of clavotrapezius, Action, draws the scapula to the dorsal, and holds the two scapula together

# Spinotrapezius
Spinotrapezius, also called thoracic trapezius, is the most posterior of the three. It is triangular shaped. Posterior to the acromiotrapezius and overlaps latissimus dorsi on the front. Origin, neural spines of the thoracic vertebra, Insertion, scapular fascia, Action, draws the scapula to the dorsal and caudal regions.
Trichomycosis axillaris

# Overview
Trichomycosis axillaris is a superficial bacterial colonization of the hair shafts in sweat glandbearing areas, such as the armpits and the pubic area. It is a trivial disease of worldwide occurrence that is believed to be caused by the genus Corynebacteria (mostly Corynebacterium tenuis).

# Presentation
It is characterised by yellow, black or red granular nodules or concretions that stick to the hair shaft. Usually the condition is symptomless and all that is noticed are sweaty, smelly armpits.

# Diagnosis

## Physical Examination

### Skin
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.
- Trichomycosis axillaris. Adapted from Dermatology Atlas.

# Treatment
Daily cleansing with soap and water and application of benzoyl peroxide generally cures the infection.  Regular use of antiperspirants aids in prevention. Topical erythromycin is occasionally required to eliminate the infection.
Trimethoprim overdosage

# Overdosage

## Acute
Signs of acute overdosage with trimethoprim may appear following ingestion of 1 gram or more of the drug and include nausea, vomiting, dizziness, headaches, mental depression, confusion and bone marrow depression (see OVERDOSAGE-Chronic).
Treatment consists of gastric lavage and general supportive measures. Acidification of the urine will increase renal elimination of trimethoprim. Peritoneal dialysis is not effective and hemodialysis only moderately effective in eliminating the drug.

## Chronic
Use of trimethoprim at high doses and/or for extended periods of time may cause bone marrow depression manifested as thrombocytopenia, leukopenia and/or megaloblastic anemia. If signs of bone marrow depression occur, trimethoprim should be discontinued and the patient should be given leucovorin, 3 to 6 mg intramuscularly daily for three days, or as required to restore normal hematopoiesis.
Tripeptidyl peptidase I
Tripeptidyl-peptidase 1, also known as Lysosomal pepstatin-insensitive protease, is an enzyme that in humans is encoded by the TPP1 gene.  TPP1 should not be confused with the TPP1 shelterin protein which protects telomeres and is encoded by the ACD gene.  Mutations in the TPP1 gene leads to late infantile neuronal ceroid lipofuscinosis.

# Structure

## Gene
The human gene TPP1 encodes a member of the sedolisin family of serine proteases. The human gene has 13 exons and locates at the chromosome band 11p15.

## Protein
The human TPP1 is 61kDa in size and composed of 563 amino acids. An isoform of 34.5kDa and 320 amino acids is generated by alternative splicing and a peptide fragment of 1-243 amino acid is missing. TPP1 contains a globular structure with a subtilisin-like fold, a Ser475-Glu272-Asp360 catalytic triad. It also contains an octahedrally coordinated Ca2+-binding site that are characteristic features of the S53 sedolisin family of peptidases. Unlike other S53 peptidases, it has steric constraints on the P4 substrate pocket, which might contribute to its preferential cleavage of tripeptides from the unsubstituted N-terminus of proteins. Two alternative conformations of the catalytic Asp276 are associated with the activation status of TPP1.

# Function
High expression of TPP1 is found in bone marrow, placenta, lung, pineal and lymphocytes. The protease functions in the lysosome to cleave N-terminal tripeptides from substrates and has weaker endopeptidase activity. It is synthesized as a catalytically inactive enzyme which is activated and autoproteolyzed upon acidification.

# Clinical significance
The neuronal ceroid lipofuscinoses (NCLs) are a group of inherited neurodegenerative disorders with pathological phenotypes that auto fluorescent lipopigments present in neurons and other cell types. Over the past two decades, accumulating evidences indicates that NCLs are caused by mutations in eight different genes, including genes encoding several soluble proteins (cathepsin D, PPT1, and TPP1). Mutations of gene TPP1 result in late-infantile neuronal ceroid lipofuscinosis which is associated with the failure to degrade specific neuropeptides and a subunit of ATP synthase in the lysosome. Mutations in the TPP1 gene lead to late infantile neuronal ceroid lipofuscinosis, a fatal neurodegenerative disease of childhood. It has been demonstrated that a single injection of intravitreal implantation of autologous bone marrow derived stem cells transduced with a TPP1 expression construct at an early stage in the disease progression could substantially inhibit the development of disease-related retinal function deficits and structural changes. This result implies that ex vivo gene therapy using autologous stem cells may be an effective means of achieving sustained delivery of therapeutic compounds to tissues such as the retina for which systemic administration would be ineffective.
Ultrafiltration (renal)
In biological terms, Ultrafiltration occurs at the barrier between the blood and the filtrate in the renal corpuscle or Bowman's capsule in the kidneys. The Bowman's capsule contains a dense capillary network called the glomerulus. Blood flows into these capillaries through a wide afferent arteriole and leaves through a narrower efferent arteriole. The blood pressure inside these capillaries is high because:
- The renal artery contains blood at very high pressure which enters the glomerulus via the short afferent arteriole.
- The efferent arteriole has a smaller diameter than the afferent arteriole.
The high pressure forces small molecules such as water, glucose, amino acids, sodium chloride and urea through the filter, from the blood in the glomerular capsule across the basement membrane of the Bowman's capsule and into the nephron. This type of high pressure filtration is ultrafiltration. The fluid formed in this way is called glomerular filtrate. Molecules such as plasma proteins and blood cells do not pass through the filter because they are too big.
Glomerular pressure is about 75 millimeters of mercury (10 kPa). It is opposed by osmotic pressure(30 mmHg, 4.0 kPa) and hydrostatic pressure (20 mmHg, 2.7 kPa) of solutes present in capsular space. This difference in pressure is called effective pressure(25 mmHg)(3.3 kPa).
It is also used in hemodialysis to clean whole blood while keeping its composition intact.

# Slow Continuous Ultrafiltration
Slow Continuous Ultrafiltration (SCUF) is an artificial method which approximately mimics the ultrafiltration function of the kidneys.  SCUF is a continuous renal replacement therapy (CRRT) generally used to remove fluid from fluid overloaded patients suffering acute renal failure.  During SCUF blood is removed from the body and is passed through an extracorporeal circuit through a hemofilter and a predetermined percentage of plasma water is removed based upon a prescription.  Typically, no more than 2 liters an hour of fluid is removed.  The remaining blood is returned to the patient. Unlike hemodialysis, hemofiltration and hemodiafiltration, no dialysate or replacement fluids are used in SCUF.
University of Worcester
The University of Worcester is a university in Worcester in the United Kingdom.  It was given university status by the Privy Council in September 2005, having previously been known as University College Worcester, and before that as Worcester College of Higher Education.  It is the only university in Herefordshire or Worcestershire.

# History
The establishment opened in 1947 as part of the University of Birmingham Department of Education, operating as an Emergency Teacher Training College.  In the 1970s the Council for National Academic Awards (CNAA) validated the degrees for the Worcester College of Higher Education.  The Herefordshire and Worcestershire College of Nursing and Midwifery was absorbed into the group in 1995.
In 1997 the Privy Council gave the institution degree-awarding powers and it subsequently became known as the University College Worcester (UCW).  In 2005 it became a fully-fledged university.

# Ongoing development
In 2005, the institution announced plans for a "superlibrary" in the heart of Worcester, creating a combined university and public library  the first of its kind in the UK.  A second campus is also under construction on the site of the old Worcester Royal Infirmary in Castle Street.  This is due to begin in early 2007.  The university is home to resident applied theatre company, C&T.

# Students Union
Worcester Students' Union is the on-site union for all students registered at the University of Worcester. It has a shop, offices, a bar (The Dive), a sandwich shop, a lounge area, a computer facility, a Student Advice Bureau, and a Student Development and Welfare Office.
Unproven cancer therapy

# Overview
Unproven cancer therapy is a broad term describing conventional, alternative, and complementary treatments for cancer which have not been approved by a governing body (for instance, the United States Food and Drug Administration) as being effective.
Such therapies can be categorized broadly into three groups:
- New cancer treatments proposed or in clinical trials by establishment oncologists or scientists but not yet proven effective, or not proven effective in a particular situation. As a result of such trials, these therapies are ultimately proven effective or ineffective.
- Unproven cancer treatments that are offered by unorthodox practitioners as an alternative to mainstream cancer treatment. Practitioners of such therapies often operate outside the regulatory sphere of the FDA and do not seek its approval.
- Unorthodox treatments offered as a complement to scientifically based treatment rather than as a substitute, often primarily for comfort or palliation of symptoms.

# Background
Medical science has made major advances in the treatment of cancer, from the development of chemotherapy in the 1940s through the recognition of the importance of adjuvant therapy and the development of newer targeted therapies. Nonetheless, cancer remains a common and all too often incurable disease, and the side effects of chemotherapy and other cancer treatments can range from unpleasant to potentially fatal.
Therefore, the field of cancer treatment is fertile ground for the use of unproven therapies. Unproven pharmaceutical treatments for cancer are aggressively investigated in clinical trials, and a large number of unregulated alternative therapies have developed.

# Examples of unproven therapies
Cancer therapies such as these are generally considered to be unproven or disproven for their effect on the cancer itself.  Some of these may offer substantial emotional or comfort care benefits to receptive patients.
- Cancer guided imagery
- Coley's Toxins
- Gerson therapy
- Homeopathy
- Hoxsey method
- Therapeutic touch
Urinary bladder disease
Urinary bladder disease can be congenital or acquired.

# Types
- Cystitis cystica is a chronic cystitis glandularis accompanied by the formation of cysts. This disease can cause chronic urinary tract infections.
- Interstitial cystitis is a bladder disease of unknown etiology characterized by a bladder wall infiltrated by inflammatory cells resulting in ulcerated mucosa and scarring, spasm of the detrusor muscle, hematuria, urgency, increased frequency, and pain on urination.
- The bladder may rupture if overfilled and not emptied. This can occur in the case of binge drinkers who have consumed large quantities, but are not conscious due to stupor of the need to urinate. This condition is very rare in women, but does occur. Symptoms include localized pain and uraemia (poisoning due to reabsorbed waste).
Urogential tuberculosis

# Overview
Urogenital tuberculosis is a form of tuberculosis that affects the urogenital system.

# Epidemiology
It usually strikes young adults with tuberculosis in other places of the body as well. It is common in Asia, but less common in sub-Saharan Africa.

# Symptoms
- Persistent cystitis, unresponsive to antibiotics.
- Urinary frequency
- Dysuria
- Loin discomfort
- Malaise and general symptoms of tuberculosis
- Ulcer
However, the infection arises insidiously, being  potentially asymptomatic for a long period of time.

## Other signs
- Pus cells and red cells in the urine, but no bacterial growth on routine bacterial culture
- Painless intermittent microscopic haematuria
- A painless, non-tender, irregular, and sometimes fluctuating mass on one side of the scrotum.

# Pathogenesis
The infection may affect the kidneys, ureter and bladder and may cause significant damage to each.

# Complications
Urogenital tuberculosis may cause strictures of the ureter, which, however, may heal when infection is treated.
Vestibulo-ocular reflex
The vestibulo-ocular reflex (VOR) or oculovestibular reflex is a reflex eye movement that stabilizes images on the retina during head movement by producing an eye movement in the direction opposite to head movement, thus preserving the image on the center of the visual field. For example, when the head moves to the right, the eyes move to the left, and vice versa. Since slight head movements are present all the time, the VOR is very important for stabilizing vision: patients whose VOR is impaired find it difficult to read using print, because they cannot stabilize the eyes during small head tremors. The VOR reflex does not depend on visual input and works even in total darkness or when the eyes are closed.

# Gain
The "gain" of the VOR is defined as the change in the eye angle divided by the change in the head angle during the head turn. If the gain of the VOR is wrong (different than 1)for example, if eye muscles are weak, or if a person puts on a new pair of eyeglassesthen head movements result in image motion on the retina, resulting in blurred vision. Under such conditions, motor learning adjusts the gain of the VOR to produce more accurate eye motion. This is what is referred to as VOR adaptation.
Ethanol consumption can disrupt the VOR, reducing dynamic visual acuity.

# Circuit
The main neural circuit for the horizontal VOR is fairly simple. Vestibular nuclei in the brainstem receive signals related to head movement from the Scarpa's ganglion located on CN VIII, or the vestibular nerve. From this Vestibular nuclei excitatory fibers cross to the contralateral CN VI nerve nucleus. There they synapse with 2 additional pathways. One projects directly to the lateral rectus of eye.  Another nerve tract projects from the CN VI nucleus by the abducens internuclear interneurons or abducens interneurons to the oculomotor nuclei, which contain motorneurons that drive eye muscle activity, specifically activating the medial rectus muscles of the eye. Another pathway directly projects from the vestibular nucleus through the ascending tract of Dieters to the ipsilateral medial rectus motoneurons. In addition there are inhibitory vestibular pathways to the ipsilateral CN VI nucleus.  However no direct vestibular neuron medial rectus motoneuron pathway exists.  

# Role of cerebellum
The cerebellum is essential for motor learning to correct the VOR in order to ensure accurate eye movements. Motor learning in the VOR is in many ways analogous to classical eyeblink conditioning, since the circuits are homologous and the molecular mechanisms are similar.
Vaginal cancer overview

# Overview
Vaginal cancer is a type of cancer that forms in the tissues of the vagina. The vagina leads from the cervix (the opening of the uterus) to the outside of the body.
Carcinomas of the vagina are uncommon tumors comprising 1% to 2% of gynecologic malignancies. They can be effectively treated, and when found in early stages, are often curable. The histologic distinction between squamous cell carcinoma and adenocarcinoma is important because the two types represent distinct diseases, each with a different pathogenesis and natural history. Squamous cell vaginal cancer (approximately 85% of cases) initially spreads superficially within the vaginal wall and later invades the paravaginal tissues and the parametria. Distant metastases occur most commonly in the lungs and liver.
Adenocarcinoma (approximately 15% of cases) has a peak incidence between 17 and 21 years of age and differs from squamous cell carcinoma by an increase in pulmonary metastases and supraclavicular and pelvic node involvement. Rarely, melanoma and sarcoma are described as primary vaginal cancers. Adenosquamous carcinoma is a rare and aggressive mixed epithelial tumor comprising approximately 1% to 2% of cases.

# Classification
Vaginal cancer may be classified according to histopathology into squamous cell carcinoma, adenocarcinoma, and vaginal sarcoma.

# Pathophysiology
On gross pathology, an ulcerating or fungating mass , or an annular constricting lesion is characteristic finding of vaginal cancer.

# Differential diagnosis
Vaginal cancer must be differentiated from cervical carcinoma, rectal carcinoma, uterine carcinoma, vaginal lymphoma, vaginal cyst, vaginal node of endometriosis, and uterine fibroids.

# Epidemiology and Demographics
In 2015, the incidence of vaginal cancer is approximately 2-3 per 100,000 individuals with a death number of 910.

# Risk factors
The risk factors of vaginal cancer may include vaginal adenosis, cervical cancer, diethylstilbestrol, human papillomavirus infection, HIV infection, unhealthy lifestyle, and age.

# Prognosis
Depending on the extent of the tumor at the time of diagnosis, the prognosis of vaginal cancer may vary. However, the prognosis is generally regarded as good.

# History and Symptoms
Common symptoms of vaginal cancer include vaginal bleeding, abnormal vaginal discharge, mass, and pain during intercourse.

# Staging
Vaginal cancer may be classified into 4 subtypes based on FIGO or AJCC staging system.

# Pelvic MRI
Pelvic MRI may be helpful in the diagnosis of vaginal cancer.

# Other Diagnostic Studies
Cystoscopy, ureteroscopy, proctoscopy, lymphangiogram, and cone biopsy may be helpful to detect the spread of vaginal cancer.

# Medical therapy
Medical therapies of vaginal cancer include surgery, radiation, and chemotherapy. The optimal therapy depends on the stage at diagnosis.
Vancomycin how supplied
Vancomycin Injection, USP is supplied as a frozen, iso-osmotic, premixed solution in a 100 mL, 150 mL underfilled /200 mL, or 200 mL single dose GALAXY plastic container (PL 2040) in the following vancomycin-equivalent dose:
STORAGE AND HANDLING
Store at or below -20C (-4F).
See DIRECTIONS FOR USE OF Vancomycin Injection, USP in GALAXY plastic container (PL 2040).
Handle frozen product containers with care. Product containers may be fragile in the frozen state.