Persius/hicric huggingface dataset:
Erlenmeyer-Plochl azlactone and amino acid synthesis

# Overview
The Erlenmeyer-Plochl azlactone and amino acid synthesis, named after Friedrich Gustav Carl Emil Erlenmeyer who partly discovered the reaction, is a series of chemical reactions which transform glycine to various other amino acids via an oxazolone and an azlactone.
Hippuric acid self-condenses in the presence of acetic anhydride to 2-phenyl-oxazolone. This intermediate also has two acidic protons and reacts with benzaldehyde, acetic anhydride and sodium acetate to a so-called azlactone. This compound on reduction gives access to phenylalanine.

# Scope
In one study the Erlenmeyer amino acid synthesis was used in the heart of an L-m-tyrosine synthesis
Branched-chain alpha-keto acid dehydrogenase complex
The branched-chain alpha-keto acid dehydrogenase complex is a combination of enzymes responsible for the degradation of the branched chain amino acids.  Examples of these include valine, isoleucine, and leucine.

# Cofactors
This complex requires the following 5 cofactors:
- Thiamine diphosphate
- FAD
- NAD+
- Lipoate
- Coenzyme A

# Similar enzymes
This complex is also analogous to the alpha-ketoglutarate dehydrogenase complex in the citric acid cycle and the pyruvate dehydrogenase complex creating acetyl-CoA prior to the citric acid cycle.

# Pathology
A deficiency in any of the enzymes of this complex as well as an inhibition of the complex as a whole is responsible for maple syrup urine disease.
This enzyme is an autoantigen recognized in primary biliary cirrhosis, a form of acute liver failure. These antibodies appear to recognize oxidized protein that has resulted from inflamatory immune responses. Some of these inflamatory responses are explained by gluten sensitivity.. Other mitochondrial autoantigens
include pyruvate dehydrogenase and branched chain oxoglutarate dehydrogenase, which are antigens recognized by anti-mitochondrial antibodies.
COP9 constitutive photomorphogenic homolog subunit 5
COP9 constitutive photomorphogenic homolog subunit 5 (Arabidopsis), also known as COPS5 or Csn5, is a gene conserved from humans to Saccharomyces cerevisiae.

# Function
The protein encoded by this gene is one of the eight subunits of COP9 signalosome, a highly conserved protein complex that functions as an important regulator in multiple signaling pathways. The structure and function of COP9 signalosome is similar to that of the 19S regulatory particle of 26S proteasome. COP9 signalosome has been shown to interact with SCF-type E3 ubiquitin ligases and act as a positive regulator of E3 ubiquitin ligases. This protein is reported to be involved in the degradation of  cyclin-dependent kinase inhibitor CDKN1B/p27Kip1. It is also known to be a coactivator that increases the specificity of JUN/AP1 transcription factors.

# Interactions
COP9 constitutive photomorphogenic homolog subunit 5 has been shown to interact with Macrophage migration inhibitory factor, GFER, BCL3, Ubiquitin carboxy-terminal hydrolase L1, S100A7 and C-jun.
Chronic Airway-Digestive Inflammatory Disease (CAID)

# Overview
Sinus disease, allergies, and asthma have been shown to be intimately related through recent research. Moreover, gastroesophageal reflux disease (GERD), laryngopharyngeal reflux disease (LPRD) and/or snoring or sleep apnea are often present as well. Chronic Airway-Digestive Inflammatory Disease (CAID) is a phrase which has been coined by Dr. Jordan S. Josephson, M.D., F.A.C.S. and Dr. Jens Ponikeau, M.D. to describe this very complex set of problems which are caused by inflammation. This term was first described in a book entitled Sinus Relief Now .CAID directly affects the upper respiratory system (the nose and the sinuses), the lower airway (the lungs) and the GI tract and these areas are intimately connected.
CAID begins when bacteria, virus, fungus (mold), pollutants or other irritants, or an allergen initiate an inflammatory response in the airway (both upper and lower). Inflammatory responses may then lead to a number of related reactions. For example, allergies often worsen sinus problems, and sinus problems and allergies can trigger or worsen asthma. Reflux can be set off by sinus problems and reflux can also send acids up to the upper airway and worsen the inflammation already occurring secondary to infection. Inflammation in these different areas are all related and the reaction can cause the symptoms to worsen in a vicious cycle.
CAID can also impact organs beyond the respiratory (breathing) and digestive systems. Heart disease, stroke, infertility, painful headaches and chronic fatigue syndrome may be linked to CAID. CAID must first be diagnosed before each of these conditions can be properly treated.
Available treatment options include over the counter remedies, holistic medicines and allopathic treatments, prescription medications, surgery and lifestyle changes.
Unfortunately, CAID is a chronic disease, which is not cured by medicines and/or surgery but definitely can be controlled with good comprehensive care. However, symptoms may be controlled and unnecessary pain alleviated.
One treatment option is the so-called Five Part Plan for treatment described in the book Sinus Relief Now which includes:
Using irrigation to care for sinuses,
Managing the level of mould, allergens, and other pollutants in homes, offices, and cars, by cleaning up your environment
Knowing which foods trigger CAID symptoms, and removing them from your diet
Being compliant with your treatment. Both Eastern Alternative and Western Traditional Medicine Treatments complement each other and should be investigated to provide a comprehensive holistic approach.
Embracing life-altering changes to enjoy your health (ie. smoking cessation).
Dependent personality disorder (patient information)
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# Overview
Dependent personality disorder is a long-term (chronic) condition in which people depend too much on others to meet their emotional and physical needs.

# What are the symptoms of Dependent personality disorder?
- People with this disorder do not trust their own ability to make decisions. They may be very upset by separation and loss. They may go to great lengths, even suffering abuse, to stay in a relationship.
- Symptoms of dependent personality disorder may include:
- Avoiding being alone
- Avoiding personal responsibility
- Becoming easily hurt by criticism or disapproval
- Becoming overly focused on fears of being abandoned
- Becoming very passive in relationships
- Feeling very upset or helpless when relationships end
- Having difficulty making decisions without support from others
- Having problems expressing disagreements with others

# What causes Dependent personality disorder?
- Dependent personality disorder usually begins in childhood.
- The causes of this disorder are unknown.
- It is one of the most common personality disorders, and is equally common in men and women.

# When to seek urgent medical care?
Call for an appointment with your health care provider or a mental health professional if you or your adolescent has symptoms of dependent personality disorder.

# Diagnosis
Like other personality disorders, dependent personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms.

# Treatment options
- Talk therapy (psychotherapy) is considered to be the most effective treatment for gradually helping people with this condition make more independent choices in life.
- Medication may help treat other conditions, such as anxiety or depression.

# Where to find medical care for Dependent personality disorder?
Directions to Hospitals Treating Dependent personality disorder

# What to expect (Outlook/Prognosis)?
Improvements are usually seen only with long-term therapy.

# Possible complications
- Alcohol or drug abuse
- Depression
- Increased likelihood of physical, emotional, or sexual abuse

# Source
Diabetes primary prevention of cardiovascular events

# Overview
Diabetics are 2-4 times more likely to sustain a cardiovascular event when compared to age and sex matched controls   Given the high risk of diabetic patients for cardiovascular events, there is tremendous ongoing interest in identifying therapies that might prevent a first event. In 2004, the U.S. Preventive Services Task Force recommended low dose aspirin as a primary preventive strategy in men aged 45 to 79 years and in women age 55 to 79 years, irrespective of the presence of diabetes. The safety and efficacy of low-dose aspirin in the primary prevention of cardiovascular events in patients with type 2 diabetes remains controversial.

# Primary Prevention with Aspirin
In one prospective, randomized, multicenter, blinded trial, 2,539 type 2 diabetes patients with no history of atherosclerotic events were followed for a median of 4.4 years were randomized to either  low-dose aspirin (81 or 100 mg per day) or placebo control. There was no difference in the risk of fatal or nonfatal ischemic heart disease, fatal or nonfatal stroke, and peripheral arterial disease:
13.6 events per 1000 person-years in the aspirin group vs 17.0 per 1000 person-years in the non-aspirin group, hazard ratio , 0.80; 95% confidence interval , 0.58-1.10; log-rank test, P = .16).  For the secondary endpoint of fatal coronary events and fatal cerebrovascular events, there was a significant advantage of low dose aspirin:  there was 1 stroke among the patients treated with aspirin and there were 5 fatal myocardial infarctions and 5 fatal strokes in the nonaspirin group (HR, 0.10; 95% CI, 0.01-0.79; P = .0037). With respect to all cause mortality, 34 aspirin patients and 38 non-aspirin patients died from any cause (HR, 0.90; 95% CI, 0.57-1.14; log-rank test, P = .67).  Thus, although the results were somewhat mixed, the primary endpoint did not favor aspirin, among patients with type 2 diabetes, and the use of low-dose aspirin was not judged to be effective in primary prevention of atherosclerotic events.
Differentiating cryoglobulinemia from other diseases

# Overview
Cryoglobulinemia should be differentiated from hemolytic uremic syndrome, antiphospholipid syndrome, churg-strauss syndrome, polyarteritis nodosa, microscopic polyangitis and temporal arteritis.

# Differentiating Cryoglobulinemia from other Diseases
Cryoglobulinemia should be differentiated from hemolytic uremic syndrome, antiphospholipid syndrome, churg-strauss syndrome, polyarteritis nodosa, microscopic polyangitis and temporal arteritis.
Abbreviations:
ABG= Arterial blood gas, ANA= Antinuclear antibody, ANP= Atrial natriuretic peptide, ASO= Antistreptolysin O antibody, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure, PCR= Polymerase chain reaction, PFT= Pulmonary function test.
Disorder of written expression (patient information)
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Synonyms and Keywords: Written expression disorder

# Overview
Disorder of written expression is a childhood condition that involves poor writing skills.

# What are the symptoms of Disorder of written expression?
- Errors in grammar and punctuation
- Poor handwriting
- Poor spelling

# What causes Disorder of written expression?
- Although no studies have been conducted to determine how common this disorder is, it is thought to be about as common as learning and reading disorders.
- This disorder appears by itself or along with other learning disabilities, such as:
- Developmental coordination disorder
- Expressive language disorder
- Mathematics disorder
- Reading disorder

# When to seek urgent medical care?
Parents who are concerned about their child's language ability should have their child tested by educational professionals.

# Diagnosis
Other causes of learning disabilities must be ruled out before the diagnosis can be confirmed.

# Treatment options
Remedial education is the best approach to this type of disorder.

# Where to find medical care for Disorder of written expression?
Directions to Hospitals Treating Disorder of written expression

# What to expect (Outlook/Prognosis)?
- The degree of recovery depends on the severity of the disorder.
- Marked improvement is often seen after treatment.

# Possible complications
- Learning problems
- Low self-esteem
- Problems with socializing

# Prevention
- Learning disorders often run in families.
- Affected or potentially affected families should make every effort to recognize problems early.
- Intervention can begin as early as preschool or kindergarten.

# Source
Equipment used in diagnostic cardiac catheterizaiton

# Selection of Sheaths for Diagnostic Catheterization

# Selection of Catheters Used for Diagnostic Angiography

## Left and Right Judkins Catheters
- Constructed from polyethylene or polyurethane with a fine wire braid within the wall to allow advancement and directional control and to prevent kinking.
- The left Judkins catheter: This catheter is preshaped to allow entry into the left coronary ostium from the femoral approach with minimal catheter manipulation.
A preformed left Judkins catheter can also be used from the left brachial or radial artery, but a catheter with 0.5 cm less curvature than required for the femoral approach is generally better suited for coronary cannulation.
- A preformed left Judkins catheter can also be used from the left brachial or radial artery, but a catheter with 0.5 cm less curvature than required for the femoral approach is generally better suited for coronary cannulation.
- The right Judkins catheter: This catheter is shaped to permit entry into the right coronary artery (RCA) with a small amount of rotational catheter manipulation from any vascular approach.

## Judkings Technique

## Left and Right Amplatz
Amplatz catheters can be used for the femoral or brachial approach to coronary arteriography.

## Hockey Stick

## Extra-Backup (EBU)

## (Sones)
Hydroxychloroquine sulfate Dosage And Administration

# Dosage And Administration
One tablet of 200 mg of hydroxychloroquine sulfate, USP is equivalent to 155 mg base.

## Malaria Suppression
In adults, 400 mg (=310 mg base) on exactly the same day of each week. In infants and children, the weekly suppressive dosage is 5 mg, calculated as base, per kg of body weight, but should not exceed the adult dose regardless of weight.
If circumstances permit, suppressive therapy should begin two weeks prior to exposure. However, failing this, in adults an initial double (loading) dose of 800 mg (=620 mg base), or in children 10 mg base/kg may be taken in two divided doses, six hours apart. The suppressive therapy should be continued for eight weeks after leaving the endemic area.

## Treatment of the acute attack
In adults, an initial dose of 800 mg (=620 mg base) followed by 400 mg (=310 mg base) in six to eight hours and 400 mg (=310 mg base) on each of two consecutive days (total 2 g hydroxychloroquine sulfate, USP or 1.55 g base). An alternative method, employing a single dose of 800 mg (=620 mg base), has also proved effective.
The dosage for adults may also be calculated on the basis of body weight; this method is preferred for infants and children. A total dose representing 25 mg of base per kg of body weight is administered in three days, as follows:
- First dose: 10 mg base per kg (but not exceeding a single dose of 620 mg base).
- Second dose: 5 mg base per kg (but not exceeding a single dose of 310 mg base) 6 hours after first dose.
- Third dose: 5 mg base per kg 18 hours after second dose.
- Fourth dose: 5 mg base per kg 24 hours after third dose.
For radical cure of vivax and malariae malaria concomitant therapy with an 8-aminoquinoline compound is necessary.
Meropenem compatibility reconstitution and stability

# Compatibility, Reconstitution, and Stability
Compatibility of MERREM I.V. with other drugs has not been established.MERREM I.V. should not be mixed with or physically added to solutions containing other drugs.
Freshly prepared solutions of MERREM I.V. should be used whenever possible.However, constituted solutions of MERREM I.V. maintain satisfactory potency at controlled room temperature 15-25oC (59-77F) or under refrigeration at 4C (39F) as described below.  Solutions of intravenous MERREM I.V. should not be frozen.

### Intravenous Bolus Administration
MERREM I.V. injection vials constituted with sterile Water for Injection for bolus administration (up to 50 mg/mL of MERREM I.V.) may be stored for up to 2 hours at controlled room temperature 15-25C (59-77F) or for up to 12 hours at 4C (39F).

### Intravenous Infusion Administration
Stability in Infusion Vials: MERREM I.V. infusion vials constituted with Sodium Chloride Injection 0.9% (MERREM I.V. concentrations ranging from  2.5 to 50 mg/mL) are stable for up to 2 hours at controlled room temperature 15-25C (59-77F) or for up to 18 hours at 4C (39F).  Infusion vials of MERREM I.V. constituted with Dextrose Injection 5% (MERREM I.V. concentrations ranging from  2.5 to 50 mg/mL) are stable for up to 1 hour at controlled room temperature 15-25C (59-77F) or for up to 8 hours at 4C (39F).
Stability in Plastic I.V. Bags:  Solutions prepared for infusion (MERREM I.V. concentrations ranging from 1 to 20 mg/mL) may be stored in plastic intravenous bags with diluents as shown below:
Stability in Baxter Minibag Plus:  Solutions of MERREM I.V. (MERREM I.V. concentrations ranging from 2.5 to 20 mg/mL) in Baxter Minibag Plus bags with Sodium Chloride Injection 0.9% may be stored for up to 4 hours at controlled room temperatures 15-25C (59-77F) or for up to 24 hours at 4C (39F).  Solutions of MERREM I.V. (MERREM I.V. concentrations ranging from 2.5 to 20 mg/mL) in Baxter Minibag Plus bags with Dextrose Injection 5.0% may be stored up to 1 hour at controlled room temperatures 15-25C (59-77F) or for up to 6 hours at 4C (39F).
Stability in Plastic Syringes, Tubing and Intravenous Infusion Sets:  Solutions of MERREM I.V. (MERREM I.V. concentrations ranging from 1 to 20 mg/mL) in Water for Injection or Sodium Chloride Injection 0.9% (for up to 4 hours) or in Dextrose Injection 5.0% (for up to 2 hours) at controlled room temperatures 15-25C (59-77F) are stable in plastic tubing and volume control devices of common intravenous infusion sets.
Solutions of MERREM I.V. (MERREM I.V. concentrations ranging from 1 to 20 mg/mL) in Water for Injection or Sodium Chloride Injection 0.9% (for up to 48 hours) or in Dextrose Injection 5% (for up to 6 hours) are stable at 4oC (39oF) in plastic syringes.
NOTE:  Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and
container permit.
Methicillin resistant staphylococcus aureus overview
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# Overview
Methicillin-resistant Staphylococcus Aureus is a type of staphylococcus that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems (see healthcare-associated MRSA).
MRSA infections that are acquired by patients who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are known as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.

# Epidemiology and Demographics
Worldwide, an estimated 2 billion people carry some form of S. aureus. Of these 2 billion, up to 53 million (2.7% of carriers) are thought to carry MRSA. In the United States, 95 million carry S. aureus in their noses; of these 2.5 million (2.6% of carriers) carry MRSA. A population review conducted in 3 communities in the US showed the annual incidence of CA-MRSA during 20012002 to be 1825.7/100,000 ; most CA-MRSA isolates were associated with clinically relevant infections, and 23% of patients required hospitalization.

# Diagnosis

## Symptoms
S. aureus most commonly colonizes the anterior nares (the nostrils) although the respiratory tract, open wounds, intravenous catheters and urinary tract are also potential sites for infection. MRSA infections are usually asymptomatic in healthy individuals and may last from a few weeks to many years.

# Treatment

## Surgery
The surgery for MRSA infections may be as simple and minimally invasive as a biopsy, but they can be more extreme when infected areas are surgically removed.
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Neuronal ceroid lipofuscinosis (patient information)
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# Overview
Neuronal ceroid lipofuscinoses (NCLS) refers to a group of rare, inherited disorders of the nerve cells.
There are three main types of NCLS:
- Adult (Kufs' or Parry's disease)
- Juvenile (Batten disease)
- Late infantile (Jansky-Bielschowsky)

# What are the symptoms of Neuronal ceroid lipofuscinoses?
- Abnormally increased muscle tone or spasm (myoclonus)
- Blindness or vision problems
- Dementia
- Lack of muscle coordination
- Mental retardation with decreasing mental function
- Movement disorder (choreoathetosis)
- Seizures
- Unsteady gait (ataxia)

# What causes Neuronal ceroid lipofuscinoses?
NCLS is a type of neurodegenerative disorder. It involves the buildup of an abnormal material called lipofuscin in the brain. Evidence suggests that NCLS is caused by problems with the brain's ability to remove and recycle proteins.

# Who is at highest risk?
Lipofuscinoses are inherited as autosomal recessive traits. That means if both parents carry the trait, each child has:
- A 1 in 4 chance of having the disease
- A 2 in 4 chance of not having the disease but carrying the trait
- A 1 in 4 chance of not having the disease and not being a carrier

# When to seek urgent medical care?
Call your health care provider if your child shows symptoms of blindness or retardation.

# Diagnosis
The disorder may be seen at birth, but it is usually diagnosed much later.
Tests include:
- Autofluorescence (a light technique)
- EEG
- Electron microscopy of a skin biopsy
- Electroretinogram
- Genetic testing
- MRI or CT scans of the brain
- Tissue biopsy

# Treatment options
Treatment depends on the type and extent of symptoms. You may need lifelong assistance and care.

# Where to find medical care for Neuronal ceroid lipofuscinoses?
Directions to Hospitals Treating Neuronal ceroid lipofuscinosis

# What to expect (Outlook/Prognosis)?
The younger the person is when the disease appears, the greater the risk for disability and early death. Those who develop the disease early can have vision problems that progress to blindness, and problems with mental function that get worse. If the disease emerges in the first year of life, death by age 10 is likely.
If the disease occurs in adulthood, symptoms will be milder with no vision loss and a normal life expectancy.

# Possible complications
- Vision impairment or blindness (with the early-onset forms of the disease)
- Mental impairment, ranging from severe retardation at birth to dementia later in life
- Rigid muscles (due to severe problems with the nerves that control muscle tone)
The person may become totally dependent on others for help with daily activities.

# Sources