Persius/hicric huggingface dataset:
Inferior vena cava syndrome
Inferior vena cava syndrome (IVCS) is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.

# Frequency
Epidemiological data is elusive owing to the wide variety of clinical presentation. In the U.S., incidence is estimated to be at 510 cases per 100'000 per year.

# Causes

## Common Causes
- Abdominal aortic aneurysm
- Acute pancreatitis
- Adrenal cortical carcinoma
- Budd-chiari syndrome
- Deep vein thrombosis
- Gastric adenocarcinoma
- Hepatic abscess
- Hepatic hemangioma
- Hepatic venous thrombosis
- Infective phlebitis
- Pancreatic pseudocysts
- Renal vein thrombosis
- Seminoma
- Teratoma
- Tumors
- Uterus pressure
- Vascular catheterization
- Vena caval filters

## Causes by Organ System

## Causes in Alphabetical Order
- Abdominal aortic aneurysm
- Acute pancreatitis
- Adrenal cortical carcinoma
- Budd-chiari syndrome
- Deep vein thrombosis
- Dialysis
- Gastric adenocarcinoma
- Hepatic abscess
- Hepatic hemangioma
- Hepatic venous thrombosis
- Infective phlebitis
- Liver transplants
- Nephrotic syndrome
- Oral contraceptives
- Pacemaker wires
- Pancreatic pseudocysts
- Physical trauma
- Polycystitis
- Psoa hematoma
- Renal angiomyolipoma
- Renal cell carcinoma
- Renal vein thrombosis
- Retroperitoneal fibrosis
- Retroperitoneal leiomyosarcoma
- Seminoma
- Teratoma
- Tumors
- Uterus pressure
- Vascular catheterization
- Vena caval filters

# Symptoms
IVCS presents with a wide variety of signs and symptoms, making it difficult to diagnose clinically.
- Edema of the lower extremities
- Tachycardia
- In pregnant women, signs of fetal hypoxia and distress may be seen in the CTG
Interferon gamma receptor 1
Interferon gamma receptor 1 (IFNGR1) also known as CD119 (Cluster of Differentiation 119), is a protein that in humans is encoded by the IFNGR1 gene.

# Function
The gene IFNGR1 encodes IFN-R1, which is the ligand-binding chain (alpha) of the heterodimeric gamma interferon receptor, which is found on macrophages. IFNGR2, encodes IFN-R2, the non-ligand-binding partner of the heterodimeric receptor.

# Interactions
Interferon gamma receptor 1 has been shown to interact with Interferon-gamma.

# Mutations
Mutations in the IFNGR1 gene can lead to extreme susceptibility to Mycobacterial infections. All known mutations and common variations in the IFNGR1 are present in the IFNGR1 mutation database.
Interferon gamma receptor 2
Interferon gamma receptor 2 also known as IFN-R2 is a protein which in humans is encoded by the IFNGR2 gene.

# Function
This gene (IFNGR2) encodes the non-ligand-binding beta chain of the gamma interferon receptor. Human interferon-gamma receptor is a multimer of two IFN-R1 chains (encoded by IFNGR1) and two IFN-R2 chains.

# Clinical significance
Defects in IFNGR2 are a cause of autosomal recessive mendelian susceptibility to mycobacterial disease (MSMD), also known as familial disseminated atypical mycobacterial infection.
All known mutations in IFNGR2 are collected in the IFNGR2 mutation database .
Vas-occlusive contraception

# Overview
Vas-occlusive contraception is an experimental male contraceptive method that is not yet approved for general use. Proposed methods of vas-occlusive contraception attempt to prevent sperm from traveling down the vasa deferentia. Potential methods include clips, plugs, valves, and other devices.
The intra vas device, analogous to the intrauterine device (IUD) for women, is meant to be a reversible alternative to a vasectomy.  The device consists of a set of flexible, hollow silicone plugs, each about a millimeter in diameter and 2.5 cm long.  The IVDs are inserted into the vas deferens and block the flow of sperm from the testes to the seminal glands.

# Progress
As of 2005, human clinical trials are being performed to evaluate its effectiveness as a contraceptive.  One version is currently in research and development at the Shepherd Medical Company in Vancouver. Another version currently being researched in China is an elastomer plug device, using medical-grade polyurethane (MPU) and silicone rubber (MSR) injected as a liquid.

# Related Chapters
- Male contraceptive
Intraventricular hemorrhage

# Overview
Intraventricular hemorrhage (or "IVH") is a bleeding of the ventricles, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space.

# In infants
This type of hemorrhage is particularly common in infants, especially premature infants or those of very low birth weight.  The cause of IVH in premature infants, unlike that in older infants, children or adults, is rarely due to trauma.  Instead it is thought to result from changes in perfusion of the delicate cellular structures that are present in the growing brain.  The lack of blood flow results in cell death and subsequent breakdown of the blood vessel walls, leading to bleeding.  While this bleeding can result in further injury, it is itself a marker for injury that has already occurred.  Most intraventricular hemorrhages occur in the first 72 hours after birth.

# In adults
Intraventricular hemorrhage is rare in adults and requires a great deal of force to cause.  Thus the hemorrhage usually does not occur without extensive associated damage, and so the outcome is rarely good.

# Associated conditions
Brain contusions and subarachnoid hemorrhages are commonly associated with IVH.  The bleeding can involve the middle communicating artery or the posterior communicating artery.
In both adults and infants, IVH can cause dangerous increases in intracranial pressure, damage to the brain tissue, and hydrocephalus.
Isoniazid adverse reactions

# Adverse Reactions
The most frequent reactions are those affecting the nervous system and the liver.

## Nervous System Reactions
Peripheral neuropathy is the most common toxic effect. It is dose-related, occurs most often in the malnourished and in those predisposed to neuritis (e.g., alcoholics and diabetics), and is usually preceded by paresthesias of the feet and hands. The incidence is higher in slow inactivators.
Other neurotoxic effects, which are uncommon with conventional doses, are convulsions, toxic encephalopathy, optic neuritis and atrophy, memory impairment and toxic psychosis.

## Hepatic Reactions
See boxed warning. Elevated serum transaminase (SGOT; SGPT), bilirubinemia, bilirubinuria, jaundice and occasionally severe and sometimes fatal hepatitis. The common prodromal symptoms of hepatitis are anorexia, nausea, vomiting, fatigue, malaise and weakness. Mild hepatic dysfunction, evidenced by mild and transient elevation of serum transaminase levels occurs in 10 to 20 percent of patients taking isoniazid. This abnormality usually appears in the first 1 to 3 months of treatment but can occur at any time during therapy. In most instances, enzyme levels return to normal, and generally, there is no necessity to discontinue medication during the period of mild serum transaminase elevation. In occasional instances, progressive liver damage occurs, with accompanying symptoms. If the SGOT value exceeds three to five times the upper limit of normal, discontinuation of the isoniazid should be strongly considered. The frequency of progressive liver damage increases with age. It is rare in persons under 20, but occurs in up to 2.3 percent of those over 50 years of age.

## Gastrointestinal Reactions
Nausea, vomiting and epigastric distress.

## Hematologic Reactions
Agranulocytosis; hemolytic, sideroblastic or aplastic anemia; thrombocytopenia; and eosinophilia.

## Hypersensitivity Reactions
Fever, skin eruptions (morbilliform, maculopapular, purpuric, or exfoliative), lymphadenopathy and vasculitis.

## Metabolic And Endocrine Reactions
Pyridoxine deficiency, pellagra, hyperglycemia, metabolic acidosis and gynecomastia.

## Miscellaneous Reactions
Rheumatic syndrome and systemic lupus erythematosus-like syndrome.
Italian Plague of 1629-1631
The Italian Plague of 1629-1631 was a series of outbreaks of bubonic plague from 1629 through 1631 in northern Italy. This epidemic, often referred to as Great Plague of Milan, claimed the lives of approximately 280,000 people, with the cities of Lombardy experiencing particularly high death rates. This episode is considered one of the last outbreaks of the centuries long pandemic of bubonic plague which began with the Black Death.
German and French troops carried the plague to the city of Mantua in 1629, as a result of troop movements associated with the Thirty Years' War (1618-1648). Venetian troops, infected with the disease, retreated into northern and central Italy, spreading the infection.
In October 1629, the plague reached Milan, Lombardy's major commercial center. Although the city initiated effective public health measures, including quarantine and limiting the access of German soldiers and trade goods, the plague smoldered. A major outbreak in March 1630 was due to relaxed health measures during the carnival season. This was followed by a second wave in the spring and summer of 1631. Overall, Milan suffered approximately 60,000 fatalities out of a total population of 130,000.
East of Lombardy, the Republic of Venice was infected in 1630-31. The city of Venice was severely hit, with recorded casualties of 46,000 people out of a population of 140,000. Some historians believe the drastic loss of life, and its impact on commerce, ultimately resulted in the downfall of Venice as a major commercial and political power.  The papal city of Bologna lost an estimated 15,000 citizens to the plague, with neighboring smaller cities of Modena and Parma also being heavily affected. This outbreak of plague also spread north into Tyrol, an alpine region of western Austria and northern Italy.
Later outbreaks of bubonic plague in Italy include the city of Florence in 1630-1633 and the areas surrounding Naples, Rome and Genoa in 1656-1657.

# Literature
The 1630 plague in Milan is the backdrop for several chapters of Alessandro Manzoni's novel The Betrothed (Italian: I promessi sposi). Although a work of fiction, Manzoni's description of the conditions and events in plague-ravaged Milan are completely historical and extensively documented from primary sources researched by Manzoni.
An expunged section of the book, describing the historical trial and execution of three alleged "plague-spreaders," was later published in a booklet entitled Storia della colonna infame (History of the infamous pillar).
Ivermectin clinical studies

# Clinical Studies

### Strongyloidiasis
Two controlled clinical studies using albendazole as the comparative agent were carried out in international sites where albendazole is approved for the treatment of strongyloidiasis of the gastrointestinal tract, and three controlled studies were carried out in the U.S. and internationally using thiabendazole as the comparative agent. Efficacy, as measured by cure rate, was defined as the absence of larvae in at least two follow-up stool examinations 3 to 4 weeks post-therapy. Based on this criterion, efficacy was significantly greater for STROMECTOL (a single dose of 170 to 200 mcg/kg) than for albendazole (200 mg b.i.d. for 3 days). STROMECTOL administered as a single dose of 200 mcg/kg for 1 day was as efficacious as thiabendazole administered at 25 mg/kg b.i.d. for 3 days.
In one study conducted in France, a non-endemic area where there was no possibility of reinfection, several patients were observed to have recrudescence of Strongyloides larvae in their stool as long as 106 days following ivermectin therapy. Therefore, at least three stool examinations should be conducted over the three months following treatment to ensure eradication. If recrudescence of larvae is observed, retreatment with ivermectin is indicated. Concentration techniques (such as using a Baermann apparatus) should be employed when performing these stool examinations, as the number of Strongyloides larvae per gram of feces may be very low.

### Onchocerciasis
The evaluation of STROMECTOL in the treatment of onchocerciasis is based on the results of clinical studies involving 1278 patients. In a double-blind, placebo-controlled study involving adult patients with moderate to severe onchocercal infection, patients who received a single dose of 150 mcg/kg STROMECTOL experienced an 83.2% and 99.5% decrease in skin microfilariae count (geometric mean) 3 days and 3 months after the dose, respectively. A marked reduction of >90% was maintained for up to 12 months after the single dose. As with other microfilaricidal drugs, there was an increase in the microfilariae count in the anterior chamber of the eye at day 3 after treatment in some patients. However, at 3 and 6 months after the dose, a significantly greater percentage of patients treated with STROMECTOL had decreases in microfilariae count in the anterior chamber than patients treated with placebo.
In a separate open study involving pediatric patients ages 6 to 13 (n=103; weight range: 17-41 kg), similar decreases in skin microfilariae counts were observed for up to 12 months after dosing.
Juvenile polyposis syndrome
Juvenile polyposis (JPS) are a type of polyp and can present in both children and adults .  The polyps are a growth that projects into the lumen like a mushroom, arising from the tissue underneath the epithelium layer (colonocytes).
The polyps can be solitary or multiple. There is no set number of polyps that yield a diagnosis.  Some experts suggest 5 juvenile polyps, others say 10 or more or even 1 plus a family history.

# Presentation
They normally present at a young age with painful rectal bleeding which can be pretty concerning for the patient and parents.  They can also present as a mass which has prolapsed outside the anus.

# Pathophysiology
It is not clear if this condition has a genetic predisposition or if they are just sporadic. There has been some association with familial juvenile polyposis and the gene SMAD4 on chromosome 18 and PTEN on chromosome 10

# Differential diagnosis
JPS must be differentiated from other diseases causing multiple polyps such as:

# Prognosis
solitary polyps has no significant risk of cancer.  But multiple polyps, polyposis syndrome, of the colon carry a 10% risk of developing into a cancer.  This is mainly because of juvenile polyps developing adenomatous tissue.

# Monitoring
If the patient has juvenile polyps they require yearly upper and lower endoscopies with the intention of excision and cytology.

# Treatment
If you fear adenomatous tissue developing than you can offer surgery, namely colectomy and ileorectal anastomosis.

# Screening
The siblings of patients with juvenile polyps can be screened, starting in their teens
Kanamycin adverse reactions

# Adverse Reactions
Kanamycin has the potential to induce auditory and sometimes vestibular toxicity, renal toxicity, and neuromuscular blockade.  The risks are higher for patients with a present or past history of renal impairment (especially if hemodialysis is required): for those receiving concomitant or sequential treatment with other ototoxic or nephrotoxic drugs or rapid acting diuretic agents given intravenously (ethacrynic acid, furosemide, and mannitol), and for patients treated for longer periods and/or with higher doses than recommended.

### Ototoxicity
Toxic effects of kanamycin on the eighth cranial nerve can result in partially reversible or irreversible bilateral loss of hearing, loss of balance, or both.  Tinnitus or vertigo may or may not be experienced.  Cochlear damage is usually manifested initially by small changes in audiometric test results at the high frequencies and may not be associated with subjective hearing loss.  Vestibular dysfunction is usually manifested by nystagmus, vertigo, nausea, vomiting, or acute Menieres syndrome.

### Nephrotoxicity
Albuminuria, presence of red and white cells, and granular casts; azotemia and oliguria have been reported.  Renal function changes are usually reversible when the drug is discontinued.  Renal impairment may be characterized by a rise in serum creatinine and may be accompanied by oliguria, presence of casts, cells, and protein in the urine, by rising levels of BUN or by decrease in creatinine clearance.

### Neuromuscular Blockage
Acute muscular paralysis and apnea can occur following treatment with aminoglycoside antibiotics.  Neurotoxicity can occur after intrapleural and interperitoneal instillation of large doses of an aminoglycoside; however, the reaction has followed intravenous, intramuscular, and even the oral administration of these agents.

### Other
Some local irritation or pain may follow the intramuscular injection of kanamycin.  Other adverse reactions of the drug reported on rare occasions are skin rash, drug fever, headache, paresthesia, nausea, vomiting, and diarrhea.  The malabsorption syndrome characterized by an increase in fecal fat, decrease in serum carotene, and fall in xylose absorption, reportedly has occurred with prolonged therapy.
Knee pain/swelling overview

# Overview
Knee pain is a common symptom in people of all ages. It may start suddenly, often after an injury or exercise. Knee pain may also began as a mild discomfort, then slowly worsen.

# Diagnosis

## Laboratory Findings
If the knee is swollen, red and warm to the touch when compared to the other knee, inflammation due to rheumatoid arthritis or a crystalline arthritis, such as gout or pseudogout, or joint infection can be considered. Besides sending the joint fluid to a laboratory for analysis, white blood cell count, erythrocyte sedimentation rate, and perhaps the level of C-reactive protein or uric acid must also be monitored.  If blood tests reveal Lyme's disease antibodies forming, the condition may be attributed to it.

## X-Ray
An X-ray is useful to verify that there is no break or dislocation when there is a history of trauma.  May show signs of osteoarthritis.

## MRI
Magnetic Resonance Imaging is for confirmation of suspected diagnosis. It detects abnormalities of the bone or knee joint, such as a tear in the ligaments, tendons or cartilage.

# Treatment

## Medical Therapy
Treatment of fluid in the knee depends on the underlying cause of the swelling. General measures such as rest, ice, and analgesics such as acetaminophen and NSAIDSare often recommended.
Law of definite proportions
In chemistry, the law of definite proportions and also the elements states that a chemical compound always contains exactly the same proportion of elements by mass.  An equivalent statement is the law of constant composition, which states that all samples of a given chemical compound have the same elemental composition.  For example, oxygen makes up 8/9 of the mass of any sample of pure water, while hydrogen makes up the remaining 1/9 of the mass.  Along with the law of multiple proportions, the law of definite proportions forms the basis of stoichiometry.

# History
This observation was first made by the French chemist Joseph Proust based on several experiments conducted between 1797 and 1804. Based on such observations, Proust made statements like this one, in 1806:
The law of definite proportions might seem obvious to the modern chemist, inherent in the very definition of a chemical compound.  At the end of the 18th century, however, when the concept of a chemical compound had not yet been fully developed, the law was novel.  In fact, when first proposed, it was a controversial statement and was opposed by other chemists, most notably Proust's fellow Frenchman Claude Louis Berthollet, who argued that the elements could combine in any proportion. The very existence of this debate underscores that at the time, the distinction between pure chemical compounds and mixtures had not yet been fully developed.
The law of definite proportions contributed to, and was placed on a firm theoretical basis by, the atomic theory that John Dalton promoted beginning in 1803, which explained matter as consisting of discrete atoms, that there was one type of atom for each element, and that the compounds were made of combinations of different types of atoms in fixed proportions.

# Non-stoichiometric compounds
It may be noted that although very useful in the foundation of modern chemistry, the laws of definite proportions is not universally true.  There exist non-stoichiometric compounds whose elemental composition can vary from sample to sample.  An example is the iron oxide wustite, which can contain between 0.83 and 0.95 iron atoms for every oxygen atom, and thus contain anywhere between 23% and 25% oxygen.  In general, Proust's measurements were not accurate enough to detect such variations.
In addition, the isotopic composition of an element can vary depending on its source, hence its weight in a pure stoichiometric compound may vary.  This fact is used in geochemical dating since astronomical, atmospheric, oceanic, crustal and deep Earth processes may concentrate lighter or heavier isotopes preferentially.  With the exception of hydrogen and its isotopes, the effect is usually small but measurable with modern instrumentation.  An additional note: many natural polymers vary in composition (for instance RNA, proteins, carbohydrates) even when "pure".  Polymers are generally not considered "pure chemical compounds" except when their molecular weight is uniform (monodisperse) and their stoichiometry is constant.  In this unusual case, they still may violate the "Law" due to isotopic variations.
Lidocaine adverse reactions

# Adverse Reactions
Adverse experiences following the administration of lidocaine are similar in nature to those observed with other amide local anesthetic agents. Adverse experiences may result from high plasma levels caused by excessive dosage or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature. The following types are those most commonly reported. The adverse experiences under Central Nervous System and Cardiovascular System are listed, in general, in a progression from mild to severe.

## Central Nervous System
CNS reactions are excitatory and/or depressant, and may be characterized by light-headedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory reactions may be very brief or may not occur at all, in which case, the first manifestation of toxicity may be drowsiness, merging into unconsciousness and respiratory arrest.

## Cardiovascular System
Cardiovascular reactions are usually depressant in nature and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest.
Allergic reactions as a result of sensitivity to lidocaine are extremely rare and, if they occur, should be managed by conventional means.

## Drug Abuse and Dependence
Although specific studies have not been conducted, Xylocaine has been used clinically without evidence of abuse of this drug or of psychological or physical dependence as a result of its use.