Persius/hicric huggingface dataset:
American Board of Internal Medicine
The American Board of Internal Medicine (ABIM) is a non-profit, independent physician organization in the U.S. that certifies physicians who practice in internal medicine and its sub-specialties.  More than 180,000 physicians are ABIM certified  about one out of every three physicians practicing in the United States.  Christine K. Cassel, MD is the current president and CEO of the ABIM.

# History
Established in 1936, ABIM certificates are recognized throughout the world as signifying a high level of physician competence.  The certificate demonstrates that a doctor has met rigorous standards through intensive training and systematic evaluation of competence.  ABIM is the only recognized U.S. board in the specialty of internal medicine and is one of 24 certifying boards recognized by the American Board of Medical Specialties (ABMS).

# Certification
Physicians may earn a certificate when they have successfully completed residency or fellowship training and have passed a secure examination of knowledge.  Board certification is widely accepted as a marker of excellence.  Most hospitals require internists to be board certified in order to have admitting privileges, and many health plans require certification for contracting or eligibility for select networks.

## Maintenance of Certification (MOC)
Beginning in 1990, certificates were time-limited to ten years, and have to be renewed through ABIMs Maintenance of Certification (MOC) program.  There are four elements to this program:
- Verification of Credentials:  Physicians must have a valid, unrestricted license to practice medicine .  An action against a license compromises the most basic professional credential.
- Self-Evaluation of Medical Knowledge:  Physicians use open-book tests of knowledge developed by ABIM or others to self-assess their own clinical knowledge in a particular field.  These stimulate learning but also require that learning be documented.  Medical knowledge and the technology essential to care are evolving at an incredible rate.  Physicians need to keep up.
- Self-Evaluation of Practice Performance:  Physicians use ABIMs Practice Improvement Modules (PIMs) to assess their performance in a clinical area relevant to their practice, compare their performance to clinical guidelines, develop a plan to improve important aspects of their practice, and assess the impact of that improvement plan.  Self-assessment of performance in practice helps physicians see that the quality of care they provide is not always what they expected, and establishes measurement and improvement as valuable parts of practice (rather than externally imposed requirements).
- Secure Examination:  Physicians are required to pass a closed-book, proctored, computer-based exam.  The exam includes 180 questions that are pre-tested for relevance, and create a simulated environment in which critical aspects of clinical knowledge and judgment can be evaluated.  It is not just what physicians knowbut how they use what they know to promote health, and to diagnose and treat illness effectively and efficientlythat matters.
American Society for Cytotechnology
Founded in 1979, the American Society for Cytotechnology is a professional organization dedicated to the field of cytotechnology.  According to the association's website, the ASCT promotes cytotechnology by:
- Developing practice standards;
- Monitoring and evaluating legislative/regulatory issues and emerging technologies affecting the profession; and
- Providing unique, practical educational opportunities pertinent to the practice of cytotechnology.
Memory loss resident survival guide
Synonyms and keywords: approach to amnesia, approach to dementia, amnesia workup, dementia workup, approach to pseudodementia, pseudodementia workup

# Overview
Amnesia is a condition in which memory is disturbed or lost. The causes of amnesia can be organic or functional. Organic causes include damage to the brain through trauma or disease or the use of certain (generally sedative) drugs. Functional causes are psychological factors, such as defense mechanisms. Hysterical post-traumatic amnesia is an example of this. Amnesia may also be spontaneous, in the case of transient global amnesia. This global type of amnesia is more common in middle-aged to elderly people, particularly males, and usually lasts less than 24 hours. Memory loss can be partial or total and is normally expected as we get older.

# Causes

## Life Threatening Causes
- Death or permanent disability may occur within 24 hours if left untreated. Most acute causes of amnesia are considered life-threatening, among them, are the following:
Electrolyte imbalances
Head trauma
Hypoglycemia
Infections
Intoxications
- Electrolyte imbalances
- Head trauma
- Hypoglycemia
- Infections
- Intoxications

## Common Causes
- Alzheimer disease.
- Vascular dementia
- Frontotemporal dementia
- Vitamin deficiency
- Depression

# Diagnosis
Shown below is an algorithm summarizing the diagnosis of amnesia according to the the American Academy of Neurology guidelines:

# Do's
- Perform laboratory testing to exclude potentially reversible causes of amnesia. Initial tests should include a CBC, urine toxicology, thyroid function, folate, and vitamin B12 level.
- When a history of head trauma exists, perform an immediate non-contrasted CT scan of the head to rule out intracerebral hemorrage. Neuroimaging may diagnose vascular disease, normal pressure hydrocephalus, tumors, abscess.
- Perform a minimental status test on physical examination and pay especial attention in concentration domain. Minimental testing has the potential distinguish mild cognitive impairment from dementia.
- Always have in mind depression as a possible cause of memory impairmant. Depression is common cause of amnesia; a SIGE CAPS evaluation may disclose an underlying mood disorder.

# Don'ts
- If alcoholism and thiamine deficiency is suspected, do not administer glucose before thiamine. Administration of glucose before thiamine may lead to Wernicke encephalopathy.
Anidulafungin indications and usage

# Indications and Usage
ERAXIS is indicated for use in adults for the treatment of the following fungal infections listed below. Specimens for fungal culture and other relevant laboratory studies (including histopathology) should be obtained prior to therapy to isolate and identify causative organism(s). Therapy may be instituted before the results of the cultures and other laboratory studies known. However, once these results become available, antifungal therapy should be adjusted accordingly.

### Candidemia and Other Forms of Candida Infections (Intra-abdominal Abscess and Peritonitis)
ERAXIS is indicated for the treatment of candidemia and the following Candida infections: intra-abdominal abscess and peritonitis .

### Esophageal Candidiasis
ERAXIS is indicated for the treatment of esophageal candidiasis .

### Limitation of Use
ERAXIS has not been studied in endocarditis, osteomyelitis, and meningitis due to Candida, and has not been studied in sufficient numbers of neutropenic patients to determine efficacy in this group.
Ankyloglossia (patient information)
For the WikiDoc page for this topic, click here

# Overview
Ankyloglossia, also known as tongue tie, is the improper positioning of tongue tissue in the mouth, which restricts the tongue's free movement.

# What are the symptoms of Ankyloglossia?
Symptoms of ankyloglossia include an inability to stick the tongue forward, difficulty feeding, excessive attachment of tongue to bottom of the mouth, V-shaped notch in tip of tongue.

# What causes Ankyloglossia?
Tongue tie occurs when the tissue on the underside of the front of the tongue is positioned too far forward on the tongue, making it difficult to move the tongue. This tissue is called the lingual frenulum.
If the tissue reaches the tip of the tongue, a V-shaped notch may be seen.
Tongue tie may cause feeding problems, tooth problems, and speech problems.

# Who is at highest risk?
Ankyloglossia may be genetic.

# Diagnosis
A doctor can diagnose this condition during a physical exam. The exam will show that the tongue tissue is attached too far forward.

# When to seek urgent medical care?
If you are concerned that your child may have tongue tie, have your health care provider examine it during a routine well-baby examination.

# Treatment options
Surgery is seldom necessary but if it is needed, it involves cutting the abnormally placed tissue. If the child has a mild case of tongue tie, the surgery may be done in the doctor's office. More severe cases are done in a hospital operating room. A surgical reconstruction procedure called a z-plasty closure may be required to prevent scar tissue formation.

# Where to find medical care for Ankyloglossia?
Directions to Hospitals Treating Ankyloglossia

# Prevention of Ankyloglossia
As a hereditary disorder, there is no way to prevent ankyloglossia.

# What to expect (Outlook/Prognosis)?
Surgery, if performed, is usually successful.

# Possible complications
The complications are rare, but recurrence of tongue tie, tongue swelling, bleeding, infection, and damage to the ducts of the salivary glands may occur.

# Sources
Aortic insufficiency surgery videos
For the WikiPatient page for this topic, click here; For the main page of aortic insufficiency, click here
Related Key Words and Synonyms: Aortic valve replacement.

# Aortic Insufficiency Surgery Videos

## Severe aortic insufficiency in patient after aortic valve replacement 1

## Severe aortic insufficiency in patient after aortic valve replacement 2

## Severe aortic insufficiency in patient after aortic valve replacement 3

## Severe aortic insufficiency in patient after aortic valve replacement 4

## Severe aortic insufficiency in patient after aortic valve replacement 5

## Severe aortic insufficiency in patient after aortic valve replacement 6

## Severe aortic insufficiency in patient after aortic valve replacement 7

## Severe aortic insufficiency in patient after aortic valve replacement 8
Aromatic L-amino acid decarboxylase
Aromatic L-amino acid decarboxylase (AADC or AAAD), also known as DOPA decarboxylase (DDC), tryptophan decarboxylase, and 5-hydroxytryptophan decarboxylase, is a lyase enzyme (EC 4.1.1.28).

# Reactions
AADC catalyzes several different decarboxylation reactions:
- L-DOPA to dopamine  a neurotransmitter
- L-Phenylalanine to phenethylamine  a trace amine neuromodulator
- L-Tyrosine to tyramine  a trace amine neuromodulator
- L-Histidine to histamine  a neurotransmitter
- L-Tryptophan to tryptamine  a trace amine neuromodulator
- 5-HTP to serotonin (5-hydroxytryptamine)  a neurotransmitter
The enzyme uses pyridoxal phosphate, the active form of vitamin B6, as a cofactor.

# As a rate-limiting step
In normal dopamine and serotonin (5-HT) neurotransmitter synthesis, AADC is not the rate-limiting step in either reaction. However, AADC becomes the rate-limiting step of dopamine synthesis in patients treated with L-DOPA (such as in Parkinson's disease), and the rate-limiting step of serotonin synthesis in people treated with 5-HTP (such as in mild depression or dysthymia).  AADC is inhibited by carbidopa outside of the blood brain barrier to inhibit the premature conversion of L-DOPA to dopamine in the treatment of Parkinson's.
In humans, AADC is also the rate-limiting enzyme in the formation of trace amines. Deficiency of AADC is associated with various symptoms as severe developmental delay, oculogyric crises and autonomic dysfunction. The molecular and clinical spectrum of AAAC deficiency is heterogeneous. The first case of AADC deficiency was described in twin brothers 1990. Patients can be treated with dopamine agonists, MAO inhibitors, and pyridoxine (vitamin B6). Clinical phenotype and response to treatment is variable and the long-term and functional outcome is unknown. To provide a basis for improving the understanding of the epidemiology, genotypephenotype correlation and outcome of these diseases their impact on the quality of life of patients, and for evaluating diagnostic and therapeutic strategies a patient registry was established by the noncommercial International Working Group on Neurotransmitter Related Disorders (iNTD).

# Genetics
The gene encoding the enzyme is referred to as DDC and located on chromosome 7 in humans. Single nucleotide polymorphisms and other gene variations have been investigated in relation to neuropsychiatric disorders, e.g., a one-base pair deletion at 601 and a four-base pair deletion at 722725 in exon 1 in relation to bipolar disorder and autism. No direct correlation between gene variation and autism was found.
Artemether lumefantrine description

# Description
Coartem Tablets contain a fixed combination of two antimalarial active ingredients, artemether, an artemisinin derivative, and lumefantrine. Both components are blood schizontocides. The chemical name of artemether is (3R,5aS,6R,8aS,9R,10S,12R,12aR)-10-methoxy-3,6,9-trimethyldecahydro-3,12-epoxypyrano-1,2-benzodioxepine. Artemether is a white, crystalline powder that is freely soluble in acetone, soluble in methanol and ethanol, and practically insoluble in water. It has the empirical formula C16H26O5 with a molecular weight of 298.4, and the following structural formula:
The chemical name of lumefantrine is (1RS)-2-(dibutylamino)-1-{(9Z)-2,7-dichloro-9--9H-fluorene-4-yl}ethanol. Lumefantrine is a yellow, crystalline powder that is freely soluble in N,N-dimethylformamide, chloroform, and ethyl acetate; soluble in dichloromethane; slightly soluble in ethanol and methanol; and insoluble in water. It has the empirical formula C30H32Cl3NO with a molecular weight of 528.9, and the following structural formula:
Coartem Tablets are for oral administration. Each Coartem Tablet contains 20 mg of artemether and 120 mg lumefantrine. The inactive ingredients are colloidal silicon dioxide, croscarmellose sodium, hypromellose, magnesium stearate, microcrystalline cellulose, and polysorbate 80.
Aryl hydrocarbon receptor repressor
The aryl-hydrocarbon receptor repressor also known as AHRR is a human gene.

# Function
Dioxins and dioxin-like compounds are teratogens that exert their effects through the aryl hydrocarbon receptor (AhR) in conjunction with the receptor's binding partner, aryl hydrocarbon receptor nuclear translocator (ARNT). The protein encoded by this gene represses signal transduction by the AhR by competing with the arylhydrocarbon receptor for binding to the ARNT. Expression of the repressor is stimulated by the receptor/translocator heterodimer, thereby regulating receptor function through a negative feedback mechanism. In addition, the encoded protein can bind to nuclear factor-kappa B.
The AhRR gene may act as a tumor suppressor.

# Tissue distribution
The expression of AhRR is high in testis, lung, ovary, spleen and pancreas in adults, whereas expression is low in all tissues in fetuses.
Ascorbic Acid (patient information)

# Why this medication is prescribed
Ascorbic acid is used to prevent and treat scurvy, a disease caused by a lack of vitamin C in the body.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How this medication should be used
Ascorbic acid comes in extended-release (long-acting) capsules and tablets, lozenges, syrup, chewable tablets, and liquid drops to be given by mouth. It usually is taken once a day. Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ascorbic acid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Some tablets should be chewed; other tablets and capsules should be swallowed with a full glass of water.
It may take up to 3 weeks for symptoms of scurvy to improve.

# Special precautions
Before taking ascorbic acid:
- tell your doctor and pharmacist if you are allergic to ascorbic acid or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including other vitamins.
- tell your doctor if you have or have ever had kidney stones. Diabetics should talk to their doctor or pharmacist for the correct way to test their urine while taking large amounts of ascorbic acid.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ascorbic acid, call your doctor.

# Special dietary instructions
Some forms of ascorbic acid contain sodium and should be avoided if you are on a sodium- or salt-restricted diet.
Your doctor may suggest changes in your diet to give you more vitamin C.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects
Ascorbic acid may cause side effects. Tell your doctor if either of these symptoms is severe or does not go away:
- diarrhea
- upset stomach

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Cecon Drops
- Cenolate
- Cevi-Bid
- Vicks Vitamin C Drops

# Other names
- Vitamin C
Atrial natriuretic peptide receptor
An atrial natriuretic peptide receptor is a receptor for atrial natriuretic peptide.

# Mechanism
NPRA and NPRB are linked to guanylyl cyclases, while NPRC is G-protein-linked and is a "clearance receptor" that acts to internalise and destroy the ligand.
ANP activation of the ANP catalytic receptor will stimulate its intracellular guanylyl cyclase activity to convert GTP to cGMP.  cGMP will then stimulate cGMP-dependent protein kinase (PKG), which will then induce smooth muscle relaxation.  This is particularly important in the vasculature, where vascular smooth muscle will bind ANP released as a result of increasing right atrial pressure and will cause the walls of the vasculature to relax.  This relaxation will decrease total peripheral resistance, which will in turn decrease venous return to the heart.  The decrease in venous return to the heart will reduce the preload and will result in the heart's having to do less work.
There is also a soluble guanylyl cyclase that cannot be stimulated by ANP. Instead, vascular endothelial cells will use L-arginine to make nitric oxide via nitric oxide synthase.  The nitric oxide  will then diffuse into the vascular smooth muscle and will activate the soluble guanylyl cyclase.  The subsequent increase in cGMP will cause vasodilation with the same effects as described above.  This is why nitroglycerine is given to a person  having a heart attack.  The nitroglycerine will be metabolized to nitric oxide, which will stimulate soluble guanylyl cyclase.  This will result in a decrease in total peripheral resistance and a decrease in preload on the heart.  As a result, work done by the heart will decrease and will allow the heart to contract less strongly.  Weaker contractions will lead to more blood flow in the coronary arteries, which will help the ischemic cardiac myocytes.

# Types
There are three distinct atrial natriuretic factor receptors identified so far in mammals: natriuretic peptide receptors 1, 2, and 3.
Atypical small acinar proliferation
Steven C. Campbell, M.D., Ph.D.

# Overview
In urologic pathology, atypical small acinar proliferation, abbreviated ASAP, is a collection of small prostatic glands, on prostate biopsy, whose significance is uncertain and cannot be determined to be benign or malignant.
ASAP, generally, is not considered a pre-malignancy, or a carcinoma in situ; it is an expression of diagnostic uncertainty, and analogous to the diagnosis of ASCUS (atypical squamous cells of undetermined significance) on the Pap test.

# Association with adenocarcinoma
On a subsequent biopsy, given the diagnosis of ASAP, the chance of finding prostate adenocarcinoma is approximately 40%; this is higher than if there is high-grade prostatic intraepithelial neoplasia (HGPIN).

# Management
ASAP is considered an indication for re-biopsy.
Aztreonam dosage and administration

# Dosage And Administration

## Dosage in Adult Patients
AZACTAM may be administered intravenously or by intramuscular injection. Dosage and route of administration should be determined by susceptibility of the causative organisms, severity and site of infection, and the condition of the patient.
Because of the serious nature of infections due to Pseudomonas aeruginosa, dosage of 2 g every six or eight hours is recommended, at least upon initiation of therapy, in systemic infections caused by this organism.
The intravenous route is recommended for patients requiring single doses greater than 1 g or those with bacterial septicemia, localized parenchymal abscess (eg, intra-abdominal abscess), peritonitis, or other severe systemic or life-threatening infections.
The duration of therapy depends on the severity of infection. Generally, AZACTAM should be continued for at least 48 hours after the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. Persistent infections may require treatment for several weeks. Doses smaller than those indicated should not be used.

## Renal Impairment in Adult Patients
Prolonged serum levels of aztreonam may occur in patients with transient or persistent renal insufficiency. Therefore, the dosage of AZACTAM should be halved in patients with estimated creatinine clearances between 10 and 30 mL/min/1.73 m2 after an initial loading dose of 1 or 2 g.
When only the serum creatinine concentration is available, the following formula (based on sex, weight, and age of the patient) may be used to approximate the creatinine clearance (Clcr). The serum creatinine should represent a steady state of renal function.
In patients with severe renal failure (creatinine clearance less than 10 mL/min/1.73 m2), such as those supported by hemodialysis, the usual dose of 500 mg, 1 g, or 2 g should be given initially. The maintenance dose should be one-fourth of the usual initial dose given at the usual fixed interval of 6, 8, or 12 hours. For serious or life-threatening infections, in addition to the maintenance doses, one-eighth of the initial dose should be given after each hemodialysis session.

## Dosage in the Elderly
Renal status is a major determinant of dosage in the elderly; these patients in particular may have diminished renal function. Serum creatinine may not be an accurate determinant of renal status. Therefore, as with all antibiotics eliminated by the kidneys, estimates of creatinine clearance should be obtained and appropriate dosage modifications made if necessary.

## Dosage in Pediatric Patients
AZACTAM should be administered intravenously to pediatric patients with normal renal function. There are insufficient data regarding intramuscular administration to pediatric patients or dosing in pediatric patients with renal impairment. (See Precautions: Pediatric Use.)