Persius/hicric huggingface dataset:
Co-amoxiclav overdose

# Overdose topics
Manifestations
Treatment
Interstitial nephritis

## Manifestations
Following overdosage, patients have experienced primarily gastrointestinal
symptoms including stomach and abdominal pain, vomiting, and diarrhea.
Rash, hyperactivity, or drowsiness have also been observed in a small
number of patients. Return to top

## Treatment
In the case of overdosage, discontinue AUGMENTIN, treat symptomatically,
and institute supportive measures as required. If the overdosage is
very recent and there is no contraindication, an attempt at emesis or other
means of removal of drug from the stomach may be performed. A prospective
study of 51 pediatric patients at a poison center suggested that
-verdosages of less than 250 mg/kg of amoxicillin are not associated with
significant clinical symptoms and do not require gastric emptying. Return to top

## Interstitial nephritis
Interstitial nephritis resulting in oliguric renal failure has been reported in
a small number of patients after overdosage with amoxicillin. Crystalluria
has also been reported after amoxicillin overdosage. Renal impairment
appears to be reversible with cessation of drug administration. High blood
levels may occur more readily in patients with impaired renal function
because of decreased renal clearance of both amoxicillin and clavulanate.
Both amoxicillin and clavulanate are removed from the circulation by
hemodialysis. Return to top
Adapted from the FDA Package Insert.
Coffin-Lowry syndrome

# Overview
Coffin-Lowry syndrome is a condition associated with mental retardation and delayed development, characteristic facial features, and skeletal abnormalities. Males are usually more severely affected than females, but the condition can range from very mild to severe in affected women. This condition is inherited in an X-linked dominant pattern. Males usually carry this disease more often than females because males only have one X chromosome, while females have two.
Mutations in the RPS6KA3 gene cause Coffin-Lowry syndrome. The RPS6KA3 gene makes a protein that is involved with signaling within cells. Researchers believe that the protein helps control the activity of other genes and may play an important role in the central nervous system. Mutations in the RPS6KA3 disturb the function of the protein, but it is not well understood how mutations lead to the signs and symptoms of Coffin-Lowry syndrome. Some people with the features of Coffin-Lowry syndrome do not have identified mutations in the RPS6KA3 gene. In these cases, the cause is unknown.
This condition is inherited in an X-linked dominant pattern. A condition is considered X-linked if the gene that causes the disorder is located on the X chromosome (one of the two sex chromosomes). The inheritance is dominant if one copy of the altered gene is sufficient to cause the condition. In most cases, males experience more severe symptoms of the disorder than females. A striking characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to their sons.
A majority of boys with Coffin-Lowry syndrome have no history of the condition in their families. These cases are caused by new mutations in the RPS6KA3 gene. A new mutation means that neither parent has the altered gene, but the affected individual could pass it on to his children.
There is no cure and no standard course of treatment for Coffin-Lowry syndrome. Treatment is symptomatic and supportive, and may include physical and speech therapy and educational services.
This article incorporates public domain text from The U.S. National Library of Medicine and the National Institute of Neurological Disorders and Stroke.

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Coffin-Lowry syndrome from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

# Diagnosis

## Diagnostic Criteria

## History and Symptoms

## Physical Examination

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

# Treatment

## Medical Therapy

## Surgery

## Prevention
Coffin-Siris syndrome
Coffin-Siris Sydrome is a rare genetic disorder which causes mental retardation and absent fifth finger and toe nails.
Synonyms include Dwarfism-Onychodysplasia, Fifth Digit Syndrome, Mental Retardation with Hypoplastic 5th Fingernails and Toenails, and Short Stature-Onychodysplasia.

# Characteristics
- feeding difficulties upon birth
- frequent respiratory infections during infancy
- hypotonia
- joint laxity
- delayed bone age
- mental retardation
- short fifth digits with hypoplastic or absent nails
- microcephaly
- coarse facial features, including wide nose, wide mouth, and thick eyebrows and lashes

# Causes
Autosomal recessive inheritance is the most likely, but sporadic mutations and autosomal dominant cases may also occur.
Cold water extraction
Cold water extraction is the process whereby a substance is extracted from a mixture via cold water. It is a type of fractional crystallization.
The process generally involves taking a mixture of substances, and dissolving them into warm water, and then cooling the mixture. The insoluble compounds precipitate out of the water, while the soluble ones stay dissolved. The solution can then be separated through filtration or decantation.
This process works by exploiting the differences in solubility (with respect to temperature) of varying substances.

# Opioid extraction
In some countries tablets are available over the counter (in others these are available only by medical prescription)  that contain aspirin, paracetamol (acetaminophen) or ibuprofen in combination with codeine, an opiate. Cold water extraction of codeine has become popular amongst recreational drug users because it speeds up absorption and reduces hepatotoxicity caused by paracetamol and gastrointestinal irritation caused by aspirin and ibuprofen.  However, without careful measurement of the insoluble product removed during the process, it is conceivable that one could actually cause damage to the liver by using many low dose tablets in an inefficient process.   This method is also used to extract hydrocodone and oxycodone from similar (usually prescription-only) compounds.
These extractions are possible because opioid salts (codeine phosphate , hydrocodone bitartrate , oxycodone hydrochloride ) have a higher solubility in water at lower temperatures than paracetamol  and ibuprofen . The more water cools, the less paracetamol and ibuprofen the solution will retain in proportion to the opioid salts.
Ichthyosis lamellaris

# Overview
Ichthyosis lammellaris, also known as (recessive) lamellar ichthyosis and nonbullous congenital ichthyosis, is a rare inherited skin disorder, affecting less than 1 person in 300,000.

# Pathophysiology

## Genetics
This condition is an autosomal recessive genetic disorder, which means the defective gene is located on an autosome, and both parents must carry one copy of the defective gene in order to have a child born with the disorder. Carriers of a recessive gene usually do not show any signs or symptoms of the disorder.
Ichthyosis lamellaris is associated with a deficiency of the enzyme keratinocyte transglutaminase.

# Diagnosis

## Symptoms
Affected babies are born in a collodion membrane, a shiny waxy outer layer to the skin. This is shed  10-14 days after birth, revealing the main symptom of the disease, extensive scaling of the skin caused by hyperkeratosis. As the child grows, other symptoms manifest themselves, including rapid nail and hair growth. The skin can be put under tension by the scaling, possibly resulting in small ears, inflexible fingers and ectropion, the turning outwards of the eyelids or lips.
With increasing age, the scaling tends to be concentrated around joints in areas such as the groin, the armpits, the inside of the elbow and the neck. The scales often tile the skin and may resemble fish scales.

## Physical Examination

### Skin
- Collodin baby. Adapted from Dermatology Atlas.
- Collodin baby. Adapted from Dermatology Atlas.
- Collodin baby. Adapted from Dermatology Atlas.
- Collodin baby. Adapted from Dermatology Atlas.
- Collodin baby. Adapted from Dermatology Atlas.
- Collodin baby. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.
- Lamellar Icthyosis. Adapted from Dermatology Atlas.

# See Also
- Ichthyosis
- Bullous congenital ichthyosiform erythroderma
Common hepatic artery
In anatomy, the common hepatic artery is a short blood vessel that supplies oxygenated blood to the liver, pylorus (a part of the stomach), duodenum (a part of the small intestine) and pancreas.
It arises from the celiac artery and has the following branches:

# Additional images
- The celiac artery and its branches; the stomach has been raised and the peritoneum removed.
- The portal vein and its tributaries.
- Abdominal portion of the sympathetic trunk, with the celiac and hypogastric plexuses.
- Horizontal disposition of the peritoneum in the upper part of the abdomen.
Complement deficiency
Synonyms and keywords: Hypocomplementemia

# Overview
Complement deficiency is an immunodeficiency of absent or suboptimal functioning of one of the complement system proteins.
The disorders can be divided into two categories:
- Disorders of the proteins that act to inhibit the complement system (such as C1-inhibitor) can lead to an overactive response, causing conditions such as hereditary angioedema and hemolytic-uremic syndrome.
- Disorders of the proteins that act to activate the complement system (such as C3) can lead to an underactive response, causing greater susceptibility to infections.
Because there are redundancies in the immune system, many complement disorders are never diagnosed. A recent study estimated that less than 10% are identified.

# Hypocomplementemia
The term "hypocomplementemia" is a more general term used to describe decreased complement levels. The term "secondary complement disorder" is sometimes used to refer to low complement levels that are not directly due to a genetic cause but secondary to another medical condition.
These levels can be used to distinguish conditions:
- Systemic lupus erythematosus causes low C3 and C4
- Membranoproliferative glomerulonephritis causes low C3, but normal C4
Compression stockings

# Overview
Compression stockings are used to support the venous and lymphatic systems of the leg. They offer graduated compression where maximum compression is achieved at the ankle and decreases as you move up the leg.  This compression, when combined with the muscle pump effect of the calf, aids in circulating blood and lymph fluid through the legs.
Today, compression stockings are available in a wide range of opacities, colors, styles and sizes making them virtually indistinguishable from regular hosiery or socks.

# Indications for use
- Tired, Aching Legs
- Varicose Veins
- Venous Insufficiency
- Edema (swelling)
- Lymphedema
- Burn Scar
- Prevention of Deep Vein Thrombosis (DVT)

# Compression classes
Compression stockings are constructed using elastic fibers or rubber. These fibers help compress the limb, aiding in circulation.
Compression stockings are offered in different levels of compression.  The unit of measure used to classify the pressure of the stockings is mmHg.  They are often sold in one of the following pressure ranges:
Support  over-the-counter
- 10-15 mmHg
- 15-20 mmHg
With the advice or prescription of a physician or medical professional and proper sizing from a trained fitter.
- 20-30 mmHg
- 30-40 mmHg
- 40-50 mmHg
- 50+ mmHg
Compression levels used by some manufacturers for custom made, flat knitted products in the US. Also used in Europe.
- 18-21 mmHg
- 23-32 mmHg
- 34-46 mmHg
- >50 mmHg

# Styles
- knee-high (AD)
- thigh-high (AG)
- pantyhose (AT)

# Commonly used terms for compression stockings
Anti-embolism - Worn when non-ambulatory or post-surgical to help prevent pooling of blood in the legs that could lead to a venous thrombosis.
Custom - uniquely made for a specific individual.
Circular Knit  Seamless stockings that offer greater aesthetic appeal.
Flat Knit  Stockings made with a seam that can be constructed in virtually any shape or size. Most often used in higher compression classes.
Silver  Stockings constructed using special silver textile fibers.  Silver offers natural anti-microbial protection.
Lymphedema  compression stockings used to manage edema resulting from the onset of Lymphedema
Support  - mild compression stockings sold over-the-counter and without a physicians prescription

# Manufacturers
- Credenhill
- Venosan
- Activa
- Juzo
- Jobst

# Resources
- American Venous Forum
- American College of Phlebology
- Vascular Disease Foundation
- National Lymphedema Network
- MyLymphedema
de:Kompressionsstrumpf
Condensation reaction

# Overview
A condensation reaction is a chemical reaction in which two molecules or moieties combine to form one single molecule, together with the loss of a small molecule. When this small molecule is water, it is known as a dehydration reaction; other possible small molecules lost are hydrogen chloride, methanol, or acetic acid.
A condensation reaction may be considered as the opposite of a hydrolysis reaction (the cleavage of a chemical entity into two parts by the action of water).

# Mechanism
Many condensation reactions follow a nucleophilic acyl substitution or an aldol condensation reaction mechanism. Other condensations, such as the acyloin condensation are triggered by radical or single electron transfer conditions.
The synthesis of polymers, where monomers react and become covalently bonded with one another through the loss of a water molecule.

# Condensation reactions in polymer chemistry
In polymer chemistry, a series of condensation reactions take place whereby monomers or monomer chains add to each other to form longer chains.  This may also be termed as 'condensation polymerization' or 'step-growth polymerization'. It occurs either as a homopolymerization of an A-B monomer or a polymerization of two co-monomers A-A and B-B.  Small molecule condensates are usually liberated, unlike in polyaddition where there is no liberation of small molecules.
A high conversion rate is required to achieve high molecular weights as per Carothers' equation.
In general, condensation polymers form more slowly than addition polymers, often requiring heat. They are generally lower in molecular weight.  Monomers are consumed early in the reaction; the terminal functional groups remain active throughout and short chains combine to form longer chains.  Bifunctional monomers lead to linear chains (and therefore thermoplastic polymers), but when the monomer functionality exceeds two, the product is a thermoset polymer.

# Applications
This type of reaction is used as a basis for the making of many important polymers for example: nylon, polyester and other condensation polymers and various epoxies. It is also the basis for the laboratory formation of silicates and polyphosphates. The reactions that form acid anhydrides from their constituent acids are typically condensation reactions. Other organic condensation reactions are Aldol condensations, self-condensation,  the acyloin condensation and the benzoin condensation.
Many biological transformations are condensation reactions. Polypeptide synthesis, polyketide synthesis, terpene syntheses, phosphorylation, and glycosylations are a few examples.
Congenital amputation
Congenital amputation is a congenital disorder caused by fibrous bands of the amnion that constrict foetal limbs to such an extent, that they fall off due to missing blood supply. The child is born without one or more limbs or without parts of limbs (amelia).

# Causes
The inner fetal membrane (amnion) ruptures without injury to the outer membrane (chorion). Fibrous bands from the ruptured amnion float in the amniotic fluid and can entangle the fetus, reducing blood supply of limbs to such an extent, that they fall off and get absorbed in the amniotic fluid.
Amnion ruptures might be caused by:
- teratogenic drugs (e.g. thalidomide, which causes phocomelia), or environmental chemicals
- ionizing radiation (atomic weapons, radioiodine, radiation therapy)
- infections
- metabolic imbalance
- trauma

# Treatment
In rare cases, if diagnosed in utero, fetal surgery may be considered to save a limb which is in danger of amputation.

# Literature
- Gabos PG. (Department of Orthopedic Surgery, Alfred I. duPont Hospital for Children, Wilmington, DE 19899, USA) Modified technique for the surgical treatment of congenital constriction bands of the arms and legs of infants and children Orthopedics. 2006 May;29(5):401-4
- Walter JH Jr, Goss LR, Lazzara AT. (Department of Orthopedics, Pennsylvania College of Podiatric Medicine, Philadelphia 19107, USA.) Amniotic band syndrome J Foot Ankle Surg. 1998 Jul-Aug;37(4):325-333
- Light TR, Ogden JA. (Dept. of Orthopaedic Surgery, Loyola University School of Medicine, Maywood, Illinois 60153, USA) Congenital constriction band syndrome. Pathophysiology and treatment Yale J Biol Med. 1993 May-Jun;66(3):143-155
- Further literature available e.g. via PubMed, free medical literature database of the US health authority (search for: congenital amputation or amniotic band or congenital constriction bands or other synonyms) via
Congenital cystic eye
Congenital cystic eye (CCE) is a rare ocular malformation where the eye fails to develop correctly in utero and is replaced by benign, fluid-filled tissue.  Its incidence is unknown, due to the very small number of cases reported.  An audit by Duke-Elder of the medical literature in English from 1880 to 1963 discovered only 28 cases.
Embryologically, the defect is thought to occur around day 35 of gestation, when the vesicle fails to invaginate. Dysgenesis of the vesicle later in development may result in coloboma, a separate and less severe malformation of the ocular structures.
CCE is almost always unilateral, but at least 2 cases of bilateral involvement have been described. Patients may also present with cutaneous appendages attached to the skin surrounding the eyes.
Treatment of CCE is usually by enucleation, followed by insertion of an ocular implant and prosthesis.
Contraction alkalosis

# Overview
Contraction alkalosis refers to the increase in blood pH that occurs as a result of fluid losses.  The change in pH is especially pronounced with acidic fluid losses caused by problems like vomiting.

# Pathophysiology
Extracellular fluid (ECF) volume contraction is associated with decreased blood volume and decreased renal perfusion pressure.  Three compensation mechanisms engage as a result:
- Renin secretion is increased
- Production of angiotensin II is increased
- Secretion of aldosterone is increased
Increases in angiotensin II causes increased Na+-K+ exchange and increased HCO3- (bicarbonate) reabsorption in the proximal tubule.  Increased aldosterone secretion causes increased collecting duct - alpha intercalated cell H+ secretion, worsening the metabolic alkalosis.  Additionally, increased aldosterone secretion causes increased distal tubule K+ secretion, causing the hypokalemia seen with contraction alkalosis.

# Treatment
Treatment consists of NaCl infusion to correct ECF volume contraction and administration of K+ to replace urinary losses.
Right coronary artery
Synonyms and keywords: RCA

# Overview
The right coronary artery (RCA) originates above the right cusp of the aortic valve.  It travels down the right atrioventricular groove, towards the crux of the heart.  In addition to supplying blood to the right ventricle (RV), the RCA supplies 25% to 35% of the left ventricle (LV).

# Branches
The main branches of the RCA are the following:

### Conus artery
The right coronary artery branches into the conus artery at the origin of the RCA.

### SA branch
The RCA supplies the SA nodal artery in 60% of patients.  The other 40% of the time, the SA nodal artery is supplied by the left circumflex artery.

### Acute marginal artery
It supplies the right ventricular wall.

### Posterior descending artery
- In 85% of patients, the RCA gives off the posterior descending artery (PDA).  In the other 15% of cases, the PDA is given off by the left circumflex artery.
- It supplies the inferior wall, posterior interventricular septum and posteromedial papillary muscle.
Shown below is an image depicting the right coronary artery and its different segments.  The RCA has a C shape appearance and divides into 10 segments.
R1= Proximal right coronary artery; R2= Mid right coronary artery; R3= Distal right coronary artery; R4= Right posterolateral artery; A1, A2, A3= Acute marginal arteries; RD= Right posterior descending artery; RI= Right inferior artery; RP= Right posterior artery.  For a full description of the labels, refer to the table at bottom of the page.

## Right Coronary Artery Anatomic Classification Scheme
In order to objectively characterize the location of coronary obstructions, the right coronary artery segments can be categorized using an anatomic scheme.  Shown below is an anatomic classification scheme developed by the PERFUSE Study Group listing all the 10 segments of the RCA in terms of corresponding numbers, labels, locations and anatomic descriptions.

# Coronary Angiography of the RCA

# Additional Images
- Base of ventricles exposed by removal of the atria.
- The arch of the aorta, and its branches.
- Plan of the branches.
- Diagram of a myocardial infarction.
- Aorta and coronary arteries at autopsy. The proximal portion of the RCA and its ostium can be seen at the lower left.
Coronary drug project

# Official Title
Coronary Drug Project

# Objective
To determine whether regular administration of lipid modifying drugs (clofibrate, nicotinic acid, estrogen, dextrothyroxine) to men with a documented myocardial infarction would result in significant reduction in total mortality over a five year period. Secondarily, to determine whether the degree to which these drugs changed serum lipids was correlated with any effect on mortality and morbidity rates; to gain further information on the long-term prognosis of myocardial infarction (by studying the control group as intensively as the treatment group); to acquire further experience and knowledge concerning the techniques and methodology of long-term clinical trials; to determine, in a substudy, the effectiveness of aspirin, a platelet inhibitor, in reducing recurrences of myocardial infarction.

# Sponsor
National Heart, Lung, and Blood Institute (NHLBI)

# Timeline
The previous information was derived from ClinicalTrials.gov on 08/18/2014 using the identification number NCT00000482.

# Study Description
The previous information was derived from ClinicalTrials.gov on 09/19/2013 using the identification number NCT00000482.

# Eligibility Criteria

## Inclusion Criteria
Men, ages 30-64, three months beyond most recent myocardial infarction