Persius/hicric huggingface dataset:
Malonyl-CoA decarboxylase deficiency
Malonyl-CoA decarboxylase deficiency (or Malonic aciduria) is an autosomal recessive metabolic disorder caused by a genetic mutation which disrupts the activity of Malonyl-Coa decarboxylase. This enzyme breaks down Malonyl-CoA (a fatty acid precursor and a fatty acid oxidation blocker) into Acetyl-CoA and carbon dioxide.

# Diagnosis
Without the enzymatic activity of Malonyl-CoA decarboxylase, cellular Mal-CoA increases so dramatically that at the end it is instead broken down by an unspecific short-chain acyl-CoA hydrolase which produces malonic acid and CoA. Malonic acid is a krebs cycle inhibitor preventing the cells to make ATP through oxidation.
In this condition, the cells, to make ATP, are forced to increase glycolysis which produces lactic acid as a by-product. The increase of lactic and malonic acid drastically lowers blood pH, and causes both lactic and malonic aciduria (acidic urine).
The signs and symptoms of this disorder typically appear in early childhood. Almost all affected children have delayed development. Additional signs and symptoms can include weak muscle tone (hypotonia), seizures, diarrhea, vomiting, and low blood sugar (hypoglycemia). A heart condition called cardiomyopathy, which weakens and enlarges the heart muscle, is another common feature of malonyl-CoA decarboxylase deficiency. This condition is very rare, as fewer than 20 cases have been reported.

# Pathophysiology
Mutations in the MLYCD gene cause malonyl-CoA decarboxylase deficiency. The MLYCD gene provides instructions for making an enzyme called malonyl-CoA decarboxylase. Within cells, this enzyme helps regulate the formation and breakdown of a certain group of fats called fatty acids.
Many tissues, including heart muscle, use fatty acids as a major source of energy. Mutations in the MLYCD gene reduce or eliminate the function of malonyl-CoA decarboxylase. A lack of this enzyme disrupts the normal balance of fatty acid formation and breakdown. As a result, fatty acids cannot be converted to energy, which can lead to characteristic features of this disorder such as low blood sugar and cardiomyopathy. By-products of fatty acid processing build up in tissues, which also contributes to the signs and symptoms of malonyl-CoA decarboxylase deficiency.
Malonyl-CoA decarboxylase deficiency is inherited in an autosomal recessive pattern. This means the defective gene is located on an autosome, and two copies of the defective gene - one inherited from each parent - are required to be born with the disorder. The parents of a child with an autosomal recessive disorder both carry one copy of the defective gene, but are usually not affected by the disorder.
Material properties (thermodynamics)
The thermodynamic properties of materials are intensive thermodynamic parameters which are specific to a given material. Each is directly related to a second order differential of a thermodynamic potential. Examples for a simple 1-component system are:
- Compressibility (or its inverse, the bulk modulus)
- Isothermal compressibility
\quad = -\frac{1}{V}\,\frac{\partial^2 G}{\partial P^2}
- Adiabatic compressibility
\quad = -\frac{1}{V}\,\frac{\partial^2 H}{\partial P^2}
- Specific heat (Note - the extensive analog is the heat capacity)
- Specific heat at constant pressure
\quad = -\frac{T}{N}\,\frac{\partial^2 G}{\partial T^2}
- Specific heat at constant volume
\quad = -\frac{T}{N}\,\frac{\partial^2 A}{\partial T^2}
- Coefficient of thermal expansion
\quad = \frac{1}{V}\,\frac{\partial^2 G}{\partial P\partial T}
where P  is pressure, V  is volume, T  is temperature, S  is entropy, and N  is the number of particles.
For a single component system, only three second derivatives are needed in order to derive all others, and so only three material properties are needed to derive all others. For a single component system, the "standard" three parameters are the isothermal compressibility \beta_T, the specific heat at constant pressure c_P, and the coefficient of thermal expansion \alpha.
For example, the following equations are true:
The three "standard" properties are in fact the three possible second derivatives of the Gibbs free energy with respect to temperature and pressure.
Mebendazole warnings and precautions

# Warnings and Precautions

## Warnings
There is no evidence that mebendazole, even at high doses, is effective for hydatid disease. There have been rare reports of neutropenia and agranulocytosis when mebendazole was taken for prolonged periods and at dosages substantially above those recommended.

## Precautions

### General
Periodic assessment of organ system functions, including hematopoietic and hepatic, is advisable during prolonged therapy.

### Information for Patients
Patients should be informed of the potential risk to the fetus in women taking mebendazole during pregnancy, especially during the first trimester (See Pregnancy).
Patients should also be informed that cleanliness is important to prevent reinfection and transmission of the infection.

### Carcinogenesis, Mutagenesis, Impairment of Fertility
In carcinogenicity tests of mebendazole in mice and rats, no carcinogenic effects were seen at doses as high as 40 mg/kg (one to two times the human dose, based on mg/m2) given daily over two years. Dominant lethal mutation tests in mice showed no mutagenicity at single doses as high as 640 mg/kg (18 times the human dose, based on mg/m2). Neither the spermatocyte test, the F1 translocation test, nor the Ames test indicated mutagenic properties. Doses up to 40 mg/kg in mice (equal to the human dose, based on mg/m2), given to males for 60 days and to females for 14 days prior to gestation, had no effect upon fetuses and offspring, though there was slight maternal toxicity.

### Pregnancy Category: C
Teratogenic Effects
Mebendazole has shown embryotoxic and teratogenic activity in pregnant rats at single oral doses as low as 10 mg/kg (approximately equal to the human dose, based on mg/m2). In view of these findings the use of mebendazole is not recommended in pregnant women. Although there are no adequate and well-controlled studies in pregnant women, a postmarketing survey has been done of a limited number of women who inadvertently had consumed mebendazole during the first trimester of pregnancy. The incidence of spontaneous abortion and malformation did not exceed that in the general population. In 170 deliveries on term, no teratogenic risk of mebendazole was identified.

### Nursing Mothers
It is not known whether mebendazole is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when mebendazole is administered to a nursing woman.

### Pediatric Use
The drug has not been extensively studied in children under two years; therefore, in the treatment of children under two years the relative benefit/risk should be considered.
Menkes disease (patient information)
For the WikiDoc page for this topic, click here

# Overview
Menkes syndrome is an inborn error of metabolism in which cells in the body cannot absorb enough copper.

# What are the symptoms of Menkes disease?
- Bone spurs
- Brittle, kinky hair
- Feeding difficulties
- Irritability
- Lack of muscle tone, floppiness (hypotonia)
- Low body temperature
- Mental deterioration
- Pudgy, rosy cheeks
- Seizures
- Skeletal changes

# What causes Menkes disease?
Menkes syndrome is caused by a defect in the ATP7A gene. The defect makes it hard for the body to distribute and absorb copper. As a result, the brain and other parts of the body do not get enough copper.
Low copper levels can affect the structure of bone, skin, hair, and blood vessels and interfere with nerve function. Copper also builds up in the small intestine and kidneys.
Menkes syndrome is inherited, which means it runs in families.

# Who is at risk for Menkes disease?
Menkes disease is a genetic disorder, so anyone with a family history of the disease is at risk.

# When to seek urgent medical care?
Talk to your health care provider if you have a family history of Menkes syndrome and you plan to have children. A baby with this condition will often show symptoms early in infancy.

# Diagnosis
There is often a history of Menkes syndrome in a male relative.
Signs include:
- Abnormal appearance of the hair under the microscope
- Abnormally low body temperature
- Bleeding in the brain
- Slow growth in the womb
In males, all of the hairs will be abnormal. In females who carry this trait, only half of the hairs may be abnormal.
Tests include:
- Serum ceruloplasmin
- Serum copper level
- Skin cell (fibroblast) culture
- X-ray of the skeleton or x-ray of the skull
Genetic testing may show a change (mutation) in the ATP7A gene.

# Treatment options
Treatment usually only helps when started very early in the course of the disease. Injections of copper into a vein or under the skin have been used with mixed results.

# Where to find medical care for Menkes disease?
Directions to Hospitals Treating Menkes disease

# What to expect (Outlook/Prognosis)?
Most persons with this condition die within the first few years of life.

# Possible complications
- Seizures
- Death

# Sources
Miconazole dosage and administration

# Dosage And Administration

### Basic Dosing Information
The recommended dosing schedule for ORAVIG is the application of one 50 mg buccal tablet to the upper gum region (canine fossa) once daily for 14 consecutive days.

### Administration Instructions
- ORAVIG should be applied in the morning, after brushing the teeth. The tablet should be applied with dry hands. The rounded side surface of the tablet should be placed against the upper gum just above the incisor tooth (canine fossa) and held in place with slight pressure over the upper lip for 30 seconds to ensure adhesion. The tablet is round on one side for comfort, but either side of the tablet can be applied to the gum.
- Once applied, ORAVIG stays in position and gradually dissolves.  Subsequent applications of ORAVIG should be made to alternate sides of the mouth. Before applying the next tablet, the patient should clear away any remaining tablet material. In addition,
- ORAVIG should not be crushed, chewed or swallowed.
- Food and drink can be taken normally when ORAVIG is in place but chewing gum should be avoided.
- If ORAVIG does not adhere or falls off within the first 6 hours, the same tablet should be repositioned immediately. If the tablet still does not adhere, a new tablet should be placed.
- If ORAVIG is swallowed within the first 6 hours, the patient should drink a glass of water and a new tablet should be applied only once.
- If ORAVIG falls off or is swallowed after it was in place for 6 hours or more, a new tablet should not be applied until the next regularly scheduled dose.
Muscarinic acetylcholine receptor M4
The muscarinic acetylcholine receptor M4, also known as the cholinergic receptor, muscarinic 4 (CHRM4), is a protein that, in humans, is encoded by the  CHRM4 gene.

# Function
M4 muscarinic receptors are coupled to Gi/o heterotrimeric proteins.
They function as inhibitory autoreceptors for acetylcholine. Activation of M4 receptors inhibits acetylcholine release in the striatum. The M2 subtype of acetylcholine receptor functions similarly as an inhibitory autoreceptor to acetylcholine release, albeit functioning actively primarily in the hippocampus and cerebral cortex.
Muscarinic acetylcholine receptors possess a regulatory effect on dopaminergic neurotransmission. Activation of M4 receptors in the striatum inhibit D1-induced locomotor stimulation in mice. M4 receptor-deficient mice exhibit increased locomotor simulation in response to D1 agonists, amphetamine and cocaine. Neurotransmission in the striatum influences extrapyramidal motor control, thus alterations in M4 activity may contribute to conditions such as Parkinson's Disease.

# Ligands

## Orthosteric agonists
- acetylcholine
- carbachol
- oxotremorine

## Positive allosteric modulators
- LY-2033298 
- VU-0152100 (ML-108) 
- VU-0152099 

## Antagonists
- AFDX-384 (mixed M2/M4 antagonist, N--1-piperidinyl]ethyl]-5,6-dihydro-6-oxo-11H-pyridobenzodiazepine-11-carboxamide, CAS# 118290-27-0)
- Dicycloverine
- Himbacine
- Mamba toxin 3
- PD-102,807 (3,6a,11,14-Tetrahydro-9-methoxy-2-methyl-(12H)-isoquinopyrrolobenzoxazine-1-carboxylic acid ethyl ester, CAS# 23062-91-1)
- PD-0298029
- Tropicamide - moderate selectivity over other muscarinic subtypes (2-5x approx)
Nabothian cyst (patient information)
For the WikiDoc page for this topic, click here

# Overview
A nabothian cyst is a mucus-filled lump on the surface of the cervix.

# What are the symptoms of Nabothian cyst?
Each nabothian cyst appears as a small, white raised bump. There can be more than one.

# What causes Nabothian cyst?
The cervix is lined with glands and cells that release mucus. The glands can become covered by a type of skin cells called squamous epithelium. When this happens, the secretions build up in the plugged glands. They form a smooth, rounded bump on the cervix. The bump is called a nabothian cyst.

# When to seek urgent medical care?
This condition is usually discovered during a routine pelvic examination.

# Diagnosis
- During a pelvic exam, the doctor will see a small, smooth, rounded lump (or collection of lumps) on the surface of the cervix.
- Rarely, a colposcopy is necessary to distinguish nabothian cysts from other bumps and sores that can occur on the cervix.
- Sometimes the cyst is opened to confirm that it is a nabothian cyst.

# Treatment options
- No treatment is necessary. Nabothian cysts do not cause any problems.
- Rarely they may be opened and drained if they are large enough to cause problems with the shape of the cervical canal, which can examinations more difficult.

# Where to find medical care for Nabothian cyst?
Directions to Hospitals Treating Nabothian cyst

# What to expect (Outlook/Prognosis)?
Nabothian cysts do not cause any harm. They are a benign condition.

# Possible complications
Rarely, cysts become so numerous or enlarged that the cervix becomes enlarged or blocked, making it difficult to take a Pap smear.

# Prevention
There is no known prevention.

# Source
National Institutes of Health campus
The National Institutes of Health (NIH) campus is located in Bethesda, Maryland. Most of the institutes house their Divisions of Intramural Research on this campus spread out among various buildings.

# Location
The campus is located between Old Georgetown Road on the west, Wisconsin Avenue on the east, West Cedar Lane on the North, and downtown Bethesda on the south. The National Naval Medical Center is located directly across Wisconsin Ave. from the campus, and the Washington, D.C. border is only several miles south. The Medical Center Metro stop is located just beyond the campus fence along Wisconsin Ave.

# History
The Bethesda campus has been occupied since 1938 when the original National Institute of Health began to expand outside of Washington, D.C. The Clinical Center, Building 10, opened in 1953 with 540 beds, thus allowing for clinical research. Launched in the wake of Nazi medical experiments done during World War II, research protocols here fell under ethical review by a review board.

# Buildings
There are over fifty buildings on the Bethesda campus, designated numbers based on the order of their construction.

# Security
As a federal government facility housing sensitive research, the Bethesda campus has security measures for the safety of  employees, patients, and visitors. A Department of Health and Human Services identification card is needed for immediate access. Visitors must have a government issued photo ID for a pass, and their vehicles and/or persons undergo inspections.
Nelfinavir dosage and administration

# Dosage and Administration
- Adults and Adolescents (13 years and older)
The recommended dose is 1250 mg (five 250 mg tablets or two 625 mg tablets) twice daily or 750 mg (three 250 mg tablets) three times daily. VIRACEPT should be taken with a meal. Patients unable to swallow the 250 or 625 mg tablets may dissolve the tablets in a small amount of water .
- Pediatric Patients (2 to less than 13 years)
In children 2 years of age and older, the recommended oral dose of VIRACEPT Oral Powder or 250 mg tablets is 45 to 55 mg/kg twice daily or 25 to 35 mg/kg three times daily. All doses should be taken with a meal. Doses higher than the adult maximum dose of 2500 mg per day have not been studied in children.
For children unable to swallow tablets, VIRACEPT 250 mg tablet(s) may be dissolved in a small amount of water or, VIRACEPT Oral Powder may be administered .
The healthcare provider should assess appropriate formulation and dosage for each patient. Tables 1 and 2 provide dosing guidelines for VIRACEPT tablets and powder based on age and body weight.

## Method of Administration
- For Patients Unable to Swallow Viracept Tablets
Place VIRACEPT tablet(s) in small amount of water.
Once dissolved, mix the cloudy liquid well, and consume it immediately.
The glass should be rinsed with water and the rinse swallowed to ensure the entire dose is consumed.
- Viracept Oral Powder
Mix VIRACEPT Oral Powder with a small amount of water, milk, formula, soy formula, soy milk, or dietary supplements
Once mixed, the entire contents must be consumed in order to obtain the full dose.
If the mixture is not consumed immediately, it must be stored under refrigeration, but storage must not exceed 6 hours.
Acidic food or juice (e.g., orange juice, apple juice, or apple sauce) are not recommended for mixing VIRACEPT Oral Powder because the combination may result in a bitter taste.
VIRACEPT Oral Powder should not be reconstituted with water in its original container.

## Hepatic Impairment
VIRACEPT can be used in patients with mild hepatic impairment without any dose adjustment. VIRACEPT should not be used in patients with either moderate or severe hepatic impairment .

## Dosage forms and Strengths
VIRACEPT 250 mg Tablet: Light-blue, capsule-shaped tablets with a clear film coating engraved with "VIRACEPT" on one side and "250 mg" on the other.
VIRACEPT 625 mg Tablet: White oval tablet with a clear film coating engraved with "V" on one side and "625" on the other.
VIRACEPT Oral Powder: Off-white powder containing 50 mg (as nelfinavir-free base) in each level scoopful (1 gram).
Niacin/Simvastatin contraindications

# Contraindications
SIMCOR is contraindicated in the following conditions:
- Active liver disease, which may include unexplained persistent elevations in hepatic transaminase levels 
- Patients with active peptic ulcer disease
- Patients with arterial bleeding
- Concomitant administration of strong CYP3A4 inhibitors (e.g. itraconazole, ketoconazole, posaconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin,clarithromycin, telithromycin and nefazodone) 
- Concomitant administration of gemfibrozil, cyclosporine, or danazol 
- Concomitant administration of verapamil or diltiazem 
- Women who are pregnant or may become pregnant. SIMCOR may cause fetal harm when administered to a pregnant woman. Serum cholesterol and triglycerides increase during normal pregnancy, and cholesterol or cholesterol derivatives are essential for fetal development. Atherosclerosis is a chronic process and discontinuation of lipid-lowering drugs during pregnancy should have little impact on long-term outcomes of primary hypercholesterolemia therapy. There are no adequate and well-controlled studies of SIMCOR use during pregnancy; however in rare reports congenital anomalies were observed following intrauterine exposure to HMG-CoA reductase inhibitors. If SIMCOR is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus . In rat and rabbit animal reproduction studies, simvastatin revealed no evidence of teratogenicity. There are no animal reproductive studies conducted with niacin.
- Nursing mothers. SIMCOR contains simvastatin and nicotinic acid. Nicotinic acid is excreted into human milk and it is not known whether simvastatin is excreted into human milk; however a small amount of another drug in this class does pass into breast milk. Because of the potential for serious adverse reactions in nursing infants, women who require SIMCOR treatment should not breastfeed their infants .
- Patients with a known hypersensitivity to any component of this product. Hypersensitivity reactions including one of more of the following adverse reactions have been reported for simvastatin and/or niacin extended-release: anaphylaxis, angioedema, urticaria, fever, dyspnea, tongue edema, larynx edema, face edema, peripheral edema, laryngismus, and flushing .
Nitrofurantoin indications and usage

# Indications and Usage
Macrobid is indicated only for the treatment of acute uncomplicated urinary tract infections (acute cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus.
Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Macrobid and other antibacterial drugs, Macrobid should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Nitrofurantoins lack the broader tissue distribution of other therapeutic agents approved for urinary tract infections. Consequently, many patients who are treated with Macrobid are predisposed to persistence or reappearance of bacteriuria. (See CLINICAL STUDIES). Urine specimens for culture and susceptibility testing should be obtained before and after completion of therapy. If persistence or reappearance of bacteriuria occurs after treatment with Macrobid, other therapeutic agents with broader tissue distribution should be selected. In considering the use of Macrobid, lower eradication rates should be balanced against the increased potential for systemic toxicity and for the development of antimicrobial resistance when agents with broader tissue distribution are utilized.