Persius/hicric huggingface dataset:
Omeprazole overdose

# Overdosage topics
Human experience
Multiple drug ingestion
Animal data

## Human experience
Reports have been received of overdosage with Omeprazole in humans. Doses ranged up to
2400 mg (120 times the usual recommended clinical dose). Manifestations were variable, but included confusion, drowsiness, blurred vision, tachycardia, nausea, vomiting, diaphoresis, flushing, headache, dry mouth, and other adverse reactions similar to those seen in normal clinical experience. Symptoms were transient, and no serious clinical outcome has been reported when Omeprazole was taken alone. No specific antidote for Omeprazole overdosage is known. Omeprazole is extensively protein bound and is, therefore, not readily dialyzable. In the event of overdosage, treatment should be symptomatic and supportive. Return to top

## Multiple drug ingestion
As with the management of any overdose, the possibility of multiple drug ingestion should be considered. For current information on treatment of any drug overdose, a certified Regional Poison Control Center should be contacted. Telephone numbers are listed in the Physicians Desk Reference (PDR) or local telephone book. Return to top

## Animal data
Single oral doses of Omeprazole at 1350, 1339, and 1200 mg/kg were lethal to mice, rats, and dogs, respectively. Animals given these doses showed sedation, ptosis, tremors, convulsions, and decreased activity, body temperature, and respiratory rate and increased depth of respiration. Return to top
Adapted from the FDA Package Insert.
Onchocerca volvulus

# Overview
Onchocerca volvulus is a nematode that causes onchocerciasis or "river blindness" mostly in Africa. Long-term corneal inflammation, or keratitis, leads to thickening of the corneal stroma which ultimately leads to blindness. Humans are the only definitive host for O. volvulus. The intermediate host or vector is the black fly (Simulium).
O. volvulus, along with most filarial nematodes, share an endosymbiotic relationship with the bacterium Wolbachia. In the absence of Wolbachia, larval development of the O. volvulus is disrupted or ceased.
The life cycle of O. volvulus begins when a parasitised female black fly of the genus Simulium takes a blood meal. The microfilariae form of the parasite found in the dermis of the host is ingested by the black fly. Here the microfilariae then penetrates the gut and migrates to thoracic flight muscles of the black fly, entering its first larval phase (J1). After maturing into J2, the second larval phase, it migrates to the proboscis where it can be found in the saliva. Saliva containing stage three (J3S) O. volvulus larvae passes into the blood of the host. From here the larvae migrate to the subcutaneous tissue where they form nodules and then mature into adult worms over a period of six to twelve months. After maturation, the smaller adult males migrate from nodules to subcutaneous tissue where they mate with the larger adult females, which then produce between 1,000 and 3,000 microfilariae per day. The normal adult worm lifespan is up to fifteen years. The eggs mature internally to form stage one microfilariae, which are released from the female's body one at a time and remain in the subcutaneous tissue.
These stage one microfilariae are taken up by black flies upon a blood meal, in which they mature over the course of one to three weeks to stage three larvae, thereby completing the life cycle.
The normal microfilariae lifespan is 12 years; however, their presence in the bloodstream causes little or no immune response until death or degradation of the microfilariae or adult worms.
Operation Berkshire
Millions of pages of declassified tobacco industry internal documents reveal a decades-long international campaign of disinformation. In 2000, a jury awarded $145 billion in punitive damages in a class action lawsuit against U.S. cigarette manufacturers (Ciresi et al).
In November 1998, as part of the Master Settlement Agreement between the U.S. tobacco industry and various states' attorneys general, U.S. tobacco companies were compelled to publicly disclose approximately 40 million pages of previously confidential documents. During the course of the Minnesota Attorney General litigation (State of Minnesota, et al) the district court ordered the domestic parties to establish a document depository in Minnesota for the documents produced in that action.
These internal tobacco industry documents disclose collusion among the major tobacco companies with the primary objectives of 1) promoting false controversy over the issue of smoking and disease, 2) reassuring smokers, and 3) distorting and discrediting valid scientific research on the adverse effects of smoking. The tobacco archive provides clear and irrefutable evidence of the implementation and objectives of this international conspiracy, referred to by former tobacco industry executives as Operation Berkshire.
Operation Berkshire was created as a unified defensive strategy among international tobacco companies. The code name was initially suggested in a confidential memorandum to the then President of Phillip Morris International, Hugh Cullman, by the then Chairman of Imperial Tobacco in the UK, A. G. (Tony) Garrett. A similar scheme, which served as the model for Operation Berkshire, was implemented within the United States in 1954 at a now well known meeting at the Plaza Hotel in New York City (Glantz et al, 2000).
Orthovoltage X-rays

# Overview
Orthovoltage X-rays are produced by linear accelerators operating at voltages in the 200500 kV range, and therefore an energy in the 200500 keV range (see External beam radiotherapy for an explanation of the maximum and mean energies as a function of voltage). When used to treat patients, radiation oncologists find that they penetrate to a useful depth of about 46 cm. That makes them good for treating skin, superficial tissues, and ribs, but not for deeper structures such as lungs or pelvic organs.
Orthovoltage X-rays are sometimes termed "deep" X-rays (DXR). Historically, as radiation machines were improved in the 1930s'40s, the beam energy (and so its penetration) were increased. So as the new 200500 kV beams became available, they were considered 'deep'. Now, with modern linear accelerators being able to produce X-rays of much higher energy, the penetration of orthovoltage X-rays is considered quite shallow.
By convention, the voltage is used to characterize X- and gamma-ray beams (in volts), whilst electron beams are characterized by their energies (in electronvolts).
Otosclerosis causes
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# Causes
- The cause of otosclerosis is unknown. However, there is some evidence that it may be passed down through families.
- People who have otosclerosis have an abnormal sponge-like bone growing in the middle ear. This growth prevents the ear bones from vibrating in response to sound waves. Such vibrations are needed in order for you to hear.
- Otosclerosis is the most common cause of middle ear hearing loss in young adults. It typically begins in early to mid-adulthood. It is more common in women than in men. The condition may affect one or both ears.
Overweight overview
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# Overview
The term overweight is generally used to indicate that a human has more body fat than is considered useful for the optimal functioning of the body.  Being overweight is a fairly common condition for many people, especially those in developed nations where food supplies are plentiful and lifestyles often do not involve a lot of activities that generate caloric expenditure. Recent studies have indicated that as much as 64% of the adult US population is overweight, and this number is increasing. A series of graphics from the CDC also describes the obesity prevalence trends in the U.S. in the past 2 decades: Obesity Epidemic: U.S. Temporal Trends 1985-2004
A healthy body requires a minimum amount of fat for the proper functioning of the hormonal, reproductive, and immune systems, as thermal insulation, as shock absorption for sensitive areas, and as excess energy for future use. But the accumulation of too much storage fat can impair movement and flexibility, and can alter the appearance of the body.

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Type chapter name here from other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications and Prognosis

# Diagnosis

## History and Symptoms

## Physical Examination

## Laboratory Findings

## Electrocardiogram

## Chest X Ray

## CT

## MRI

## Echocardiography or Ultrasound

## Other Imaging Findings

## Other Diagnostic Studies

# Treatment

## Surgery

## Medical Therapy

## Primary Prevention

## Secondary Prevention

## Cost-Effectiveness of Therapy

## Future or Investigational Therapies

# Case Studies

## Case #1
Plasmodium malariae
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Plasmodium malariae is a parasitic protozoa that causes malaria in both humans and dogs.  It is closely related to Plasmodium falciparum and Plasmodium vivax which are responsible for most malarial infection.  It is a so-called "benign malaria" and is not nearly as dangerous as that produced by P. falciparum or P. vivax.  P. malariae causes fevers that recur at approximately three-day intervals (a quartan fever), longer than the two-day intervals of the other malarial parasites.
Microscopically, the parasitised red blood cell (erythrocyte) is never enlarged and may even appear smaller than that of normal red blood cells.  The cytoplasm is not decolorized and no dots are visible on the cell surface.  The food vacuole is small and the parasite is compact.  Cells seldom host more than one parasite.  Band forms, where the parasite forms a thick band across the width of the infected cell, are characteristic of this species (and some would say is diagnostic).  Large grains of malarial pigment are often seen in these parasites: more so than any other Plasmodium species.  8 merozoites
P. vivax and P. ovale that has been sitting in EDTA for more than half-an-hour before the blood film is made will look very similar in appearance to P. malariae, which is an important reason to warn the laboratory immediately when the blood sample is drawn so they can process the sample as soon as it arrives.
hr:Plasmodium malariae
TIMI thrombus grade

# Overview
In order to more objectively and quantitatively characterize thrombus on a coronary angiogram, Dr. C. Michael Gibson of the TIMI study group developed and popularized the following thrombus grading system:

## TIMI Thrombus Grade 0
No cineangiographic characteristics of thrombus present.

## TIMI Thrombus Grade 1
Hazy, possible thrombus present. Angiography demonstrates characteristics such as reduced contrast density, haziness, irregular lesion contour, or a smooth convex "meniscus" at the site of total occlusion suggestive but not diagnostic of thrombus.

## TIMI Thrombus Grade 2
Thrombus present  small size: Definite thrombus with greatest dimensions less than or equal to 1/2 vessel diameter.

## TIMI Thrombus Grade 3
Thrombus present  moderate size: Definite thrombus but with greatest linear dimension greater than 1/2 but less than 2 vessel diameters.

## TIMI Thrombus Grade 4
Thrombus present  large size: As in Grade 3 but with the largest dimension greater than or equal to 2 vessel diameters.

## TIMI Thrombus Grade 5
Recent total occlusion, can involve some collateralization but usually does not involve extensive collateralization, tends to have a beak shape and a hazy edge or appearance of distinct thrombus.

## TIMI Thrombus Grade 6
Chronic total occlusion, usually involving extensive collateralization, tends to have distinct, blunt cut-off/edge and will generally clot up to the nearest proximal side branch.

# Natural History, Complications, Prognosis
The presence of angiographically evident thrombus (AET) as assessed using the TIMI Grade described above is associated with embolization and impaired myocardial perfusion.
The Proteolysis Map
The Proteolysis MAP (PMAP) is an integrated web resource focused on proteases.

# Rationale
PMAP is to aid the protease researchers in reasoning about proteolytic networks and metabolic pathways.

# History & Funding
PMAP was originally created at the Burnham Institute for Medical Research, La Jolla, California. In 2004 the National Institutes of Health (NIH) selected a team led by Jeffrey W. Smith, Ph.D., to establish the Center on Proteolytic Pathways (CPP). As part of the NIH Roadmap for Biomedical research, the center develops technology to study the behavior of proteins and to disburse that knowledge to the scientific community at large. Funding: National Institutes of Health (RR020843, CA108959 GenBank , CA30199). Funding for open access charge: National Institutes of Health (RR020843, CA108959 GenBank , CA30199).

# Focal point
Proteases are a class of enzymes that regulate much of what happens in the human body, both inside the cell and out, by cleaving peptide bonds in proteins. Extensive on-line classification system for proteases (also referred as peptidases) is deposited in MEROPS database. Through this activity, they govern the four essential cell functions: differentiation, motility, division and cell death  and activate important extracellular episodes, such as the biochemical cascade effect in blood clotting. Simply stated, life could not exist without them.

# The goal
Proteolytic pathways, or proteolysis, are the series of events controlled by proteases that occur in response to specific stimuli. In addition to the clotting of blood, the production of insulin can be viewed as a proteolytic pathway, as the activation, regulation and inhibition of that protein is the result of proteases reacting to changing glucose levels and triggering other proteases downstream.

# Database Content
PMAP integrates five databases (DBs), linked together in one environment.
(1)ProteaseDB and (2)SubstrateDB, are driven by an automated annotation pipeline that generates dynamic Molecule Pages, rich in molecular information. (3)CutDB has information on more than 6,600 proteolytic events, and (4)ProfileDB is dedicated to information of the substrate recognition specificity of proteases. (5)PathwayDB, just begun accumulation of metabolic pathways whose function can be dynamically modeled in a rule-based manner.  Hypothetical networks are inferred by semi-automated culling of the literature. Additionally, protease software tools are available for the analysis of individual proteases and proteome-wide data sets.

# Usage
Popular destinations in PMAP are Protease Molecule Pages and Substrate Molecule Pages. Protease Molecule Pages show recent news in PubMed literature of the protease, known proteolytic events, protein domain location and protein structure view, as well as a cross annotation in other bioinformatic databases section. Substrate Molecule Pages display protein domains and experimentally derived protease cut-sites for a given protein target of interest.
Pregnane X receptor
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In the field of molecular biology, the pregnane X receptor (PXR), also known as the steroid and xenobiotic sensing nuclear receptor (SXR) or nuclear receptor subfamily 1, group I, member 2 (NR1I2) is a protein that in humans is encoded by the NR1I2 (nuclear Receptor subfamily 1, group I, member 2) gene.

# Function
PXR is a nuclear receptor whose primary function is to sense the presence of foreign toxic substances and in response up regulate the expression of proteins involved in the detoxification and clearance of these substances from the body.  PXR belongs to the nuclear receptor superfamily, members of which are transcription factors characterized by a ligand-binding domain and a DNA-binding domain. PXR is a transcriptional regulator of the cytochrome P450 gene CYP3A4, binding to the response element of the CYP3A4 promoter as a heterodimer with the 9-cis retinoic acid receptor RXR. It is activated by a range of compounds that induce CYP3A4, including dexamethasone and rifampicin.

# Ligands

## Agonists
PXR is activated by a large number of endogenous and exogenous chemicals including steroids (e.g., progesterone, 17-hydroxyprogesterone, 17-hydroxypregnenolone, 5-dihydroprogesterone, 5-dihydroprogesterone, allopregnanolone, corticosterone, cyproterone acetate, spironolactone, dexamethasone, mifepristone), antibiotics (e.g., rifampicin, rifaximin), antimycotics, bile acids, hyperforin (a constituent of the herbal antidepressant St. John's Wort), and many herbal and other compounds (e.g. meclizine, paclitaxel). Cafestol found in coffee is also an agonist.
Forskolin is another case example of a PXR agonist.

## Antagonists
Ketoconazole is an example of one of the relatively few-known antagonists of the PXR.  SPA70 (also known as LC-1) was recently identified and characterized as a potent and selective PXR antagonist.

# Mechanism
Like other type II nuclear receptors, when activated, it forms a heterodimer with the retinoid X receptor, and binds to hormone response elements on DNA which elicits expression of gene products.
One of the primary targets of PXR activation is the induction of CYP3A4, an important phase I oxidative enzyme that is responsible for the metabolism of many drugs. In addition, PXR up regulates the expression of phase II conjugating enzymes such as glutathione S-transferase and phase III transport uptake and efflux proteins such as OATP2 and MDR1.
Pacemaker potential
In the heart, the pacemaker potential is the voltage created by impulses from an artificial electronic pacemaker or the SA node which drives the rhythmic firing of the heart.
The pacemaker potential brings the membrane potential to the threshold potential and initiates an action potential.

# Distinctions among autonomic foci
In reality, the heart has several pacemakers known as autonomic foci, each which fires at its own intrinsic rate:
- SA node: 80 - 100 bpm
- Atrial foci: 60 - 80 bpm
- Junctional foci: 40 - 60 bpm
- Ventrical foci: 20 - 40 bpm
The potentials will normally travel in order
SA node -> atrial foci -> junctional foci -> ventricular foci
Pacemaker potentials are fired not only by SA node, but the other foci. However, the other firing frequencies are slower than the one of the AV node (as seen above). Normally, all the foci will end up firing at the SA node rate, not their intrinsic rate. The other foci attempt to fire at their intrinsic rate, but they are activated by the SA node before they can fire. This rapid firing causes all the foci to fire faster than their intrinsic rates, a phenomenon known as overdrive-suppression. Thus, in the normal, healthy  heart, only the SA node intrinsic rate is observable.

# Pathology
However, in pathological conditions, the intrinsic rate becomes apparent. Consider a heart attack which damages the region of the heart between the SA node and the atrial foci.
SA node -> |block| atrial foci -> junctional foci -> ventricular foci
The other foci will not see the SA node firing; however, they will see the atrial foci. The heart will now beat at the intrinsic rate of the atrial foci.

# Induction
The firing of the pacemaker cells is induced, as the firing of action potentials in any human action-potential rising cell (like nerve cells), electrically, by the reaching of the threshold potential of the cell membrane. It is reached by the constant increase of membrane potential (induced by the special "funny channel", which by its Na+-channel activity giving rise to a current, the "funny current"). Upon the reaching of the threshold potential, the action potential is fired, and then reset.
Pedro Alborna Soler
Pedro Alborna Soler was the first Spanish  DC  (Doctor of Chiropractic).  30 year old Peter A. Soler matriculated into Palmer School of Chiropractic and Infirmary on August 2, 1916. He listed his home address at the time as Springfield, Massachusetts.  He as issued matriculation number 2958 and paid $250 for a 12 month course of study. Prior to entering Palmer his occupation was steward in a hotel.  He was referred to Palmer School by Dr. Cary.
On 28 September 1916, Pedro transferred to the 36 month program being offered at that time. Subsequently he was permitted, by faculty decision, to return to the 12 month program from which he graduated on November 11, 1917. It was noted that he remained eligible to complete the longer program if he wished.
He achieve 17 A's ; 7 B's and 4 C's.  He moved to Spain to practice chiropractic after graduation and was the first chiropractor to practice there, in Plaza Ledesma in Barcelona.
File:1 Pedro Soler 1st DC 1917.jpg
Pericyclic reaction
In organic chemistry, a pericyclic reaction is a type of organic reaction wherein the transition state of the molecule has a cyclic geometry, and the reaction progresses in a concerted fashion.   Pericyclic reactions are usually rearrangement reactions. The major classes of pericyclic reactions are:
- Electrocyclic reactions
- Cycloadditions
- Sigmatropic reactions
- Group transfer reactions
- Cheletropic reactions
In general, these are considered to be equilibrium processes, although it is possible to push the reaction in one direction by designing a reaction by which the product is at a significantly lower energy level; this is due to a unimolecular interpretation of Le Chatelier's principle.
Pericyclic reactions often have related stepwise radical processes associated with them.  Some pericyclic reactions, such as the  cycloaddition, are 'controversial' because their mechanism is not definitively known to be concerted (or may depend on the reactive system).  Pericyclic reactions also often have metal-catalyzed analogs, although usually these are also not technically pericyclic, since they proceed via metal-stabilized intermediates, and therefore are not concerted.
The 'largest' pericyclic reaction was the  ring closure on a corrin performed by Albert Eschenmoser.
Due to the principle of microscopic reversibility, there is a parallel set of "retro" pericyclic reactions, which perform the reverse reaction.

# Pericyclic reactions in biochemistry
Pericyclic reactions also occur in several biological processes.
- Claisen rearrangement of chorismate to prephenate in almost all prototrophic organisms.
- -sigmatropic shift in the transformation of precorrin-8x to hydrogenobyrinic acid
- non-enzymatic, photochemical electrocyclic ring opening and a (1,7) sigmatropic hydride shift in vitamin d synthesis.
- a conversion of Isochorismate into salicylate and Pyruvate in a catalyzed, true pericyclic reaction  .
Perinatal assistant

# Background
Perinatal Assistants are support professionals for the childbearing year. The services of a Perinatal Assistant includes a combination of doula services, childbirth education, postpartum support and breastfeeding support.
The training of a Perinatal Assistant includes a minimum of ten months instruction, including anatomy and physiology, childbirth physiology, labour support, breastfeeding management, postpartum support, education and teaching skills, a thesis and a final exam. This is a Diploma or Associate Degree program.
Currently the only registered Perinatal Assistant education program is offered through the Global birth institute.