Persius/hicric huggingface dataset:
Birdshot chorioretinopathy

# Overview
Birdshot chorioretinopathy, also called birdshot retinochoroidopathy, is a rare form of bilateral posterior uveitis affecting the eye. It causes severe, progressive inflammation of both the choroid and retina.
Affected individuals are usually diagnosed around age 45, a common age of onset.

# Pathophysiology
Birdshot chorioretinopathy is an autoimmune disease associated with the Human leukocyte antigen haplotype (HLA)-A29 in 95 to 97.5% of the cases. When birdshot chorioretinopathy is suspected, a person is usually tested to determine if they are HLA-A29 positive. A smaller percentage of the general population is positive for this allele.

# Symptoms
Symptoms of this disorder include: abundant floaters, uveitis, chorioretinitis, retinitis, papillitis, retinal vasculitis, vitreous inflammation, macular edema, "flashing" lights in eyes, nyctalopia, loss of color vision, and small light-colored spots on the retina. Complete loss of visual acuity is the common prognosis.
The name of the condition comes from the small light-colored fundus spots on the retina, scattered in a pattern like birdshot from a shotgun, but these spots might not be present in early stages.

# Treatment
Birdshot chorioretinopathy is quite resistant to treatment. Immunosuppressant therapy with corticosteroid-sparing drugs has been somewhat effective in slowing down the progessive inflammation associated with the disorder, preserving visual intregrity as much as possible. Long-term use of such medications must be closely monitored, however, due to the discomforting, and potentially debilitating and life-threatening side-effects.
Recently, the therapeutic monoclonal antibody daclizumab has proven to be a quite effective treatment option for birdshot chorioretinopathy. Substantial reduction, and even stabilization of both vitreous inflammation and retinal vasculitis has been evident via electroretinography, during daclizumab therapy. Loss of visual acuity unrelated to the inflammation caused by the disorder, however, often remains unchanged despite usage of the drug. Contraindications and adverse side-effects are always a factor, as well.
Blood Pressure Association
The Blood Pressure Association (or BPA) is a British charitable organisation, established in October 2000, that seeks to provide information and support to people with high blood pressure (also known as hypertension) and to educate the general public about the importance of blood pressure to health.
The Association sends out free information packs about high blood pressure and how to lower to it to everyone in the UK on request and offers free membership to everyone in the UK, which gives them full access to the Association's information services.
Every 2nd week of September the Association runs "Know Your Numbers Week", where doctors, nurses, pharmacists and trainers offer free blood pressure tests in hospitals, pharmacies, health centres and shopping centres throughout the UK. It also publishes a quarterly subscription magazine called Positive Pressure.
The BPA's patron is the broadcaster and naturalist Sir David Attenborough.

# Links
- Free Information Pack and Free Membership - available to people in the UK
- Official site
Bolivian hemorrhagic fever
Synonyms and keywords: Machupo, Machupo virus
Bolivian hemorrhagic fever (BHF), also known as black typhus or Machupo virus, is a hemorrhagic fever and zoonotic infectious disease occurring in Bolivia. First identified in 1959, black typhus is caused by infection with machupo virus, a negative single-stranded RNA virus of the Arenaviridae family. The infection has a slow onset with fever, malaise, headache and muscular pains. Petechiae (blood spots) on the upper body and bleeding from the nose and gums are observed when the disease progresses to the hemorrhagic phase, usually within seven days of onset. The mortality rate is estimated at 5 to 30 percent. Due to its pathogenicity, Machupo virus requires Biosafety Level Four conditions, the highest level.
The vector is the vesper mouse (Calomys callosus), a rodent indigenous to northern Bolivia. Infected animals are asymptomatic and shed virus in excretions, by which humans are infected. Evidence of person-to-person transmission of Machupo virus exists but is believed to be rare (Kilgore, et. al, 1995).
Measures to reduce contact between the vesper mouse and humans have effectively limited the number of outbreaks, with no cases identified between 1973 and 1994. A vaccine being developed for the genetically related Junin virus which causes Argentine hemorrhagic fever has shown evidence of cross-reactivity with Machupo virus and may be an effective prophylactic measure for people at high risk of infection.
There are no cures or immunisations for this disease, although those who have contracted it are immune.  Treatment options are limited, mostly to supportive care, but are sometimes successful if started early.

# Gallery
- This transmission electron micrograph depicted eight virions (viral particles) of a newly-discovered virus, which was determined to be a member of the genus, Arenavirus. A cause of fatal hemorrhagic fever, it was confirmed that this virus was responsible for causing illness in five South Africans, four of whom died having succumbed to its devastating effects. From Public Health Image Library (PHIL).
Bone morphogenetic protein

# Overview
Bone Morphogenetic Proteins (BMPs) are a group of growth factors and cytokines known for their ability to induce the formation of bone and cartilage.

# Types
Originally, seven such proteins were discovered. Of these, six of them (BMP2 through BMP7) belong to the Transforming growth factor beta superfamily of proteins.
Since then, thirteen more BMPs have been discovered, bringing the total to twenty.

# Function
BMPs interact with specific receptors on the cell surface, referred to as bone morphogenetic protein receptors (BMPRs).
Signal transduction through BMPRs results in mobilization of members of the SMAD family of proteins. The signaling pathways involving BMPs, BMPRs and Smads are important in the development of the heart, central nervous system, and cartilage, as well as post-natal bone development.
They have an important role during embryonic development on the embryonic patterning and early skeletal formation. As such, disruption of BMP signaling can affect the body plan of the developing embryo. For example, BMP4 and its inhibitors noggin and chordin help regulate polarity of the embryo (i.e. back to front patterning).
Mutations in BMPs and their inhibitors (such as sclerostin) are associated with a number of human disorders which affect the skeleton.
Several BMPs are also named 'cartilage-derived morphogenetic proteins' (CDMPs), while others are referred to as 'growth differentiation factors' (GDFs).

# Discovery
The seminal paper reporting the initial discovery of bone morphogenetic protein activity was published in 1965 by Marshall R. Urist in Science.

# List of Bone Morphogenetic Proteins

# Clinical uses
Members of the BMP family are potentially useful as therapeutics in areas such as spinal fusion.  BMP-2 and BMP-7 have been shown in clinical studies to beneficial in the treatment of a variety of bone-related conditions including delayed union and non-union. BMP-2 and BMP-7 have received Food and Drug Administration (FDA) approval for human clinical uses. At between $6000 and $10,000 for a typical treatment, BMPs can be costly compared with other techniques such as bone grafting. However, this cost is often far less than the costs required with orthopaedic revision in multiple surgeries.
BMP-7 has also recently found use in the treatment of chronic kidney disease (CKD). BMP-7 has been shown in murine animal models to reverse the loss of glomeruli due to sclerosis. Curis has been in the forefront of developing BMP-7 for this use. In 2002, Curis licensed BMP-7 to Ortho Biotech Products, a subsidiary of Johnson & Johnson.
Branched-chain amino acids
The phrase branched-chain amino acids or BCAA is sometimes used to refer to the amino acids having aliphatic side-chains that are non-linear.
These are leucine, isoleucine and valine. 
The combination of these three essential amino acids make up approximately 1/3 of skeletal muscle in the human body, and play an important role in protein synthesis. BCAAs are currently used clinically to aid in the recovery of burn victims, as well as for supplementation for strength athletes.

# Metabolic Pathway

# Description of Pathway
The BCAAs affect this metabolic pathway in three different manners. The first manner through which the metabolic pathway is affected is the increased production of insulin.  It has been demonstrated that BCAA supplementation in accordance with carbohydrate intake following resistance exercise increases insulin output by 221%, which is much greater than the 66% supplementation without leucine. Leucine is the most readily oxidized BCAA and therefore the most effective at causing insulin secretion from the pancreas, and stimulating the metabolic pathway. This is important because insulin is the initiating factor that begins the signalling cascade.  The second effect is outlined with the red arrows clearly indicating a phosphorylation cascade beginning with the activation of the Ras Rhed and ending with rpS6. The importance of rpS6 is that it induces mRNA translation.  This translation leads to the production of proteins to build muscle.  The other side of the pathway indicated by the blue arrow induces the action of eIF4G. This initiation factor causes the binding of mRNA within the ribosome thus providing the intial products needed for translation.  This leads down to the final product via protein binding and phosphorylation, resulting in eIF4E which induces mRNA translation which in turn leads to chain elongation, and termination, resulting in net protein growth.

# Importance of BCAAs
BCAAs play an important role in protein synthesis.  In general terms, after a bout of resistance training the muscle will be in a catabolic state, with a protein synthesis deficit.  This is because post exercise the MAPK signaling pathway is activated to induce muscle growth.  While this is a pathway that will increase protein synthesis, it is not as effective as when combined with the BCAA signaling cascade.  The two pathways act independent of each other.  Because of this, when adequate amounts of BCAAs are ingested post workout (studies demonstrate that as little as 3g can be sufficient) the body is placed in a greater state of hypertrophy with a positive amount of protein synthesis.  This is extremely important for athletes because it will decrease recovery time as it increases the rate at which lean body mass is gained.  The use of BCAAs in burn victims results in the same positive protein synthesis.  This allows victims to heal faster and return to normal activities at an increased rate, which is the treatment goal.
Braxton Hicks contractions

# Overview
Braxton Hicks' contractions, also known as false labour (British English, false labor in American English) or practice contractions. Braxton Hicks are sporadic uterine contractions that actually start at about 6 weeks, although one will not feel them that early. Most women start feeling them during the second or third trimester of pregnancy.

# Cause
Braxton Hicks contractions is a tightening of the uterine muscles for one to two minutes and is thought to be an aid to the body in its preparation for birth.  Not all expectant mothers have these contractions. They are thought to be part of the process of effacement, the thinning and dilation of the cervix.

# History
Braxton Hicks are named after the English doctor who first described them. In 1872, John Braxton Hicks investigated the latter stages of pregnancy and noted that many women felt contractions without being near birth. This process was usually painless but caused women confusion as to whether or not they were going into actual labor. It has since been found that Braxton Hicks' contractions are much less noticeable during exercise, whereas real contractions are not.

# Worsening factors
Dehydration is thought to be a contributing factor in extended Braxton Hicks contractions.

# Relieving factors
Methods for ceasing Braxton Hicks contractions include: changing position; taking a warm bath or shower; drinking water; resting; or changing activities.
British National Formulary
The British National Formulary (BNF) contains a wide spectrum of information on prescribing and pharmacology, among others indications, side effects and costs of the prescription of all medications available on the National Health Service. It is used by doctors and other prescribers (such as nurses and pharmacists) to help them select appropriate treatments for their patients; and is used as a general reference book on the wards by nurses who administer medications.
The BNF is jointly published by the Royal Pharmaceutical Society of Great Britain and the British Medical Association.  It is published biannually under the authority of a Joint Formulary Committee which comprises representatives of the two professional bodies and the Department of Health (United Kingdom).
Information on drugs is drawn from the manufacturers' product literature, medical and pharmaceutical literature, regulatory authorities and professional bodies. Advice is constructed from clinical literature and reflects, as far as possible, an evaluation of the evidence from diverse sources. The BNF also takes account of authoritative national guidelines and emerging safety concerns. In addition, the Joint Formulary Committee takes advice on all therapeutic areas from expert clinicians; this ensures that the BNF's recommendations are relevant to practice. Many individuals and organisations contribute towards the preparation of the BNF.
There are several sister publications - The British National Formulary for Children (BNF-C), is produced, and details drugs and their doses/uses in children; as well as two editions specially for nurses - The Nurse Prescriber's Formulary and the Extended Nurse Prescriber's Formulary, although with the recent changes to allow Extended Nurse Prescribers to prescribe from the full BNF, the fate of the latter publication is in some doubt.

# Sections
The BNF is divided into various sections with the main sections on drugs and preparations being organised by body system.
Table of Contents
- Preface
- General information and late changes
- General Reference
- Guidance on prescribing
- Emergency treatment of poisoning
Notes on drugs and preparations
- 1 Gastro-intestinal system
- 2 Cardiovascular system
- 3 Respiratory system
- 4 Central nervous system
- 5 Infections
- 6 Endocrine system
- 7 Obstetrics, gynaecology, and urinary-tract disorders
- 8 Malignant disease and immunosuppression
- 9 Nutrition and blood
- 10 Musculoskeletal and joint diseases
- 11 Eye
- 12 Ear, nose, and oropharynx
- 13 Skin
- 14 Immunological products and vaccines
- 15 Anaesthesia
Appendixes and indexes
- Appendix 1 Interactions
- Appendix 2 Liver disease
- Appendix 3 Renal impairment
- Appendix 4 Pregnancy
- Appendix 5 Breast-feeding
- Appendix 6 Intravenous additives
- Appendix 7 Borderline substances
- Appendix 8 Wound management products and elastic hosiery
- Appendix 9 Cautionary and advisory labels for dispensed medicines
- Dental Practitioners Formulary
- Nurse Prescribers Formulary
- Index of manufacturers
- Special-order manufacturers
- Yellow Card

# Current editions
As of September 2007 the current edition is v54.
Burkholderia thailandensis
Burkholderia thailandensis is a non-fermenting motile Gram-negative bacillus that occurs naturally in soil.  It is closely related to Burkholderia pseudomallei, but unlike B. pseudomallei, it does not cause disease in humans or animals.  It is usually distinguished from B. pseudomallei by its ability to assimilate arabinose.  The phenotypic differences have been summarised by Woods (1999).

# Gallery
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of sheeps blood agar (SBA) 48hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of MacConkey agar 48hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of SBA 48hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of Pseudomonas cepacia (PC) agar 48hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of chocolate agar 24hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of MacConkey agar 24hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of Pseudomonas cepacia (PC) agar 24hrs. From Public Health Image Library (PHIL). 
- Gram-negative Burkholderia thailandensis bacteria, which was grown on a medium of SBA 24hrs. From Public Health Image Library (PHIL).
C4 glomerulopathy overview

# Overview
Complement system activation includes three pathways  the classical pathway,  alternate pathway, and lectin pathway. C4d is a split product of C4 glomerulopathy, which itself results by overactivation of the lectin pathway. C4 glomerulopathy is further categorized into dense deposit disease and C4 glomerulonephritis.

# Historical Perspective
There is limited information about the historical perspective of C4 glomerulopathy.

# Classification
C4 glomerulopathy may be classified based on complement deposition into dense deposit disease and C4 glomerulonephritis.

# Pathophysiology
It is thought that C4 glomerulopathy is the result of the activation of immune complex glomerulonephritis or lectin pathway of the complement.

# Differential Diagnosis
C4 glomerulopathy must be differentiated from other diseases that cause proteinuria, hematuria, and peripheral edema, such as IgA nephropathy, membranous nephropathy, focal segmental glomerulus /minimal change disease, membranoproliferative glomerulonephritis, and lupus nephritis.

# Causes
C4 glomerulopathy may be caused by mutation of complement factor,anti-factor H, anti-factor B, or C4 nephritic factor.

# Risk Factors
There are no established risk factors for C4 glomerulopathy.

# Screening
There is insufficient information to recommend routine screening for C4 glomerulopathy.

# Epidemiology and Demographics
There is not much information available about the incidence and prevalence.

# Natural History, Complications, and Prognosis
If left untreated, C4 glomerulopathy may progress to develop renal failure.

# Diagnosis

## History and Symptoms
The most common symptoms of C4 glomerulopathy include hematuria, proteinuria, and hypertension.

## Physical Examination
Physical examination of patients with C4 glomerulopathy is usually remarkable for high blood pressure, peripheral edema, pale skin, and periorbital edema.

## Laboratory Findings
Laboratory findings consistent with the diagnosis of C4 glomerulopathy include abnormal urinalysis, abnormal BUN: Creatinine ratio, and abnormal serum C3 and C4 levels

## Imaging Studies
There are no other imaging findings associated with C4 glomerulopathy.

## Other Diagnostic Studies
A kidney biopsy may be helpful in the diagnosis of C4 glomerulopathy. Findings diagnostic of C4 glomerulopathy include glomerular capillary walls thickening, large subendothelial osmiophilic dense deposits, and ribbonlike material on the glomerular basement membrane.

# Treatment

## Medical Therapy
The mainstay of treatment for C4 glomerulopathy is antihypertensive and lipid-lowering drugs.

## Surgery
Surgical intervention is not recommended for the management of C4 glomerulopathy.

## Prevention
There are no established measures for the primary or secondary prevention of C4 glomerulopathy.
CMR in cardiac amyloidosis

# Cardiac MR (CMR) and Cardiac Amyloidosis: An Overview
- The primary method of diagnosing cardiac amyloidosis is myocardial biopsy, which is both invasive and cumbersome
- CMR is a noninvasive imaging modality, offering considerable information which may support or question the diagnosis of cardiac amyloidosis before the necessary (or unnecessary) biopsy

# ACC/AHA Guidelines- ACCF/ACR/AHA/NASCI/SCMR 2010 Expert Consensus Document on Cardiovascular Magnetic Resonance (DO NOT EDIT)

# Left and Right Atrial Size
- The 4-chamber cine sequence allows for proper visualization of the atria
- A maximum length is usually taken in an end-systolic frame
The right atrium can be measured from the annulus of the tricuspid valve back to the right atrial wall, and similarly, the left atrium can be measured from the annulus of the mitral valve back to the left atrial wall
- The right atrium can be measured from the annulus of the tricuspid valve back to the right atrial wall, and similarly, the left atrium can be measured from the annulus of the mitral valve back to the left atrial wall
- This is particularly useful in cardiac amyloidosis, as the atria are typically enlarged

# Left and Right Ventricular Mass and Volumes
- Using the functional cine sequence known as the Short-Axis (SHAX) Stack, both left and right ventricular volumes and mass can be quantified
Using Simpson's Rule, and by planimetering the endocardial and epicardial borders of the left and right ventricles (LV and RV, respectively) in both end-diastole (ED) and end-systole (ES), we can easily assess volumes and mass
- Using Simpson's Rule, and by planimetering the endocardial and epicardial borders of the left and right ventricles (LV and RV, respectively) in both end-diastole (ED) and end-systole (ES), we can easily assess volumes and mass
- This method is extremely beneficial for a differential diagnosis, as patients with cardiac amyloidosis tend to have increased mass and volumes (particularly systolic volumes)
- CMR also allows for sharpened visualization of the RV (as opposed to 2D-echocardiography)
Cardiac amyloidosis affects both the LV and RV, in that fibrillary protein deposition does not discriminate between ventricles
- Cardiac amyloidosis affects both the LV and RV, in that fibrillary protein deposition does not discriminate between ventricles

# Regional Myocardial Function

# Myocardial Delayed Enhancement
- Delayed enhancement (DE) imaging provides relevant information on both the pathology and morphology of patients with cardiac amyloidosis
- Gadolinium is an inert extracellular contrast agent that cannot penetrate intact sarcomere
- Normal, healthy myocardium is primarily intracellular
This is why hyperenhancement is absent in normal myocardium
- This is why hyperenhancement is absent in normal myocardium
- Amyloid infiltration in cardiac amyloidosis causes gross expansion of the interstitial space
- DE imaging using Gd allows for the Gd to pool or accumulate in these expanded areas of amyloid infiltration, usually causing large, diffuse areas of hyperenhancement (see image)