Persius/hicric huggingface dataset:
Trinity Mother Frances Health System
Trinity Mother Frances Health System is a non-profit regional health care provider headquartered in Tyler, Texas that operates two hospitals and twenty-two regional health clinics in north-central and northeast Texas.

# History

## Mother Frances Hospital
In the early 1930s, the Sisters of the Holy Family of Nazareth saw the need for an area hospital in Tyler, Texas. The hospital was built cooperatively between the Sisters, the City of Tyler, and some local medical professionals. The hospital was named in honor of Frances Siedliska, the founder of the Sisters of the Holy Family of Nazareth.
Mother Frances Hospital opened its doors on March 18, 1937, one day before its scheduled opening and elaborate dedication on March 19th, due to an  explosion in nearby  New London.
Several years later, in 1948, the Sisters of the Holy Family of Nazareth completed the purchase of the hospital from the City of Tyler and in October of 1965, Mother Frances Week is celebrated in Tyler, dedicating a new 140,000 square foot wing. This $4.5 million wing added 110 new patient beds and a new cafeteria to the hospital.

## Trinity Clinic
Drs. William Howard Bryant and Sidney W. Bradford founded the Bryant Clinic in 1934. The clinic was, along with the new Mother Frances Hospital, among the first responders to the New London School Explosion.
In 1948, the clinic was renamed to the Medical and Surgical Clinic and later, with the addition of two other Tyler-area medical practices, became Trinity Clinic.

## Merger
In 1995, Mother Frances Hospital and Trinity Clinic merged, creating Trinity Mother Frances Health System, one of the country's first integrated health care systems.

# Facilities
The system's flagship hospital, Mother Frances Hospital - Tyler, is a 392 bed acute care facility located on 'Hospital Row' in Tyler, Texas. The facility has a  Level II Trauma Center and accredited Chest Pain Center.
Tuscan Emergency Medicine Initiative

# Overview
The Tuscan Emergency Medicine Initiative (TEMI) is a collaborative effort between American emergency physicians from Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center and the Tuscan Ministry of Health to create standardized training in emergency medicine for that region. As of September 2007, the program has trained more than 450 Tuscan emergency physicians, and may serve as the model for future training programs elsewhere in the world.  A detailed description of the program appears in the Annals of Emergency Medicine.
Italy lacks standardized specialty training in emergency medicine, leading to variability of emergency medical care delivery not only between hospital emergency departments, but also within individual emergency departments.  The Tuscan Minister of Health sought to develop a partnership with emergency medicine specialists from the United States to help expedite the growth of the specialty in Tuscany.  The collaboration involved the regional healthcare service, the Tuscan university system, Harvard Medical International and the Beth Israel Deaconess Medical Center.  Administrators combined the emergency medicine training curricula from the European Society of Emergency Medicine and the American Board of Emergency Medicine into a Train-the-Trainers course, qualification track and Masters degree program.
TEMI has three objectives: to train future emergency medicine educators, to qualify all physicians working in regional hospital emergency departments and to start a regional university emergency medicine masters program as a future bridge to emergency medicine specialty training.
University of Ottawa Heart Institute
The University of Ottawa Heart Institute was founded in 1976 on the site of the Ottawa Civic Hospital by Dr Wilbert J. Keon.
What started as a department in a hospital has evolved into Canada's only complete cardiac centre, encompassing prevention, diagnosis, treatment, rehabilitation, research and education.
The Institute is affilaited with The Ottawa Hospital and the University of Ottawa.
Vascular endothelial growth factor B
Vascular endothelial growth factor B also known as VEGF-B is a protein that, in humans, is encoded by the VEGF-B gene.  VEGF-B is a growth factor that belongs to the vascular endothelial growth factor family, of which VEGF-A is the best-known member.

# Function
In contrast to VEGF-A, VEGF-B plays a less pronounced  role in the vascular system: Whereas VEGF-A is important for the formation of blood vessels, such as during development or in pathological conditions, VEGF-B seems to play a role only in the maintenance of newly formed blood vessels during pathological conditions. 
VEGF-B plays also an important role on several types of neurons. It is important for the protection of neurons in the retina  and the cerebral cortex during stroke  and of motoneurons during motor neuron diseases such as amyotrophic lateral sclerosis.
VEGF-B exerts its effects via the FLT1 receptor.
VEGF-B has also been found to control endothelial uptake and transport of fatty acids in heart and skeletal muscle.

# Interactions
Vascular endothelial growth factor B has been shown to interact with FLT1.
Vitamin D deficiency medical therapy

# Overview
The mainstay of therapy for vitamin D deficiency is vitamin D, either vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol). Vitamin D supplements could be used as a daily loading regimen followed by the maintenance. The alternative regimen is high weekly dose (stoss therapy) and maintenance therapy.

# Medical therapy
There are two major forms of vitamin D; ergocalciferol (vitamin D2), cholecalciferol (vitamin D3). Both of them are commonly used. However, a systematic review and meta-analysis of Tripkovic L et al. in 2011, indicated that vitamin D3 compared to vitamin D2 is more effective to raise the serum level of 25OHD and is preferred for treatment and prevention of vitamin D deficiency.
- Endocrine Society published a clinical practice guideline for the treatment of vitamin D deficiency to reach and sustain a serum 25(OH)D level of 30 ng/ml.
- High risk patients include African American, obese, patients with malabsorption syndromes and who are on anticonvulsants.
- The American Academy of Pediatrics (AAP) recommends an initial phase of treatment with high dose of vitamin D for 2-3 months to treat vitamin D deficiency rickets. The recommended dose is 1000 IU/d in neonates, 1000-5000 IU/d in infants, and 5000 IU/d for children over 1-year-old. After raising the serum 25 OHD levels to 30 ng/ml, a maintenance dose of 400 IU/d is required for all age groups. Higher maintenance dose (800 IU/d) might be needed in at risk groups.
- An alternative strategy for treatment, also known as stoss therapy, is a single dose therapy in patients over 1 month old. 100,000  600,000 IU of ergocalciferol orally single dose followed by maintenance therapy is recommended, especially in noncompliant patients.
A more recent randomized controlled trial showed that, among white women with vitamin D insufficiency and deficiency (levels 13 to 50 nmol/L;5 to 20 ng/mL ), a dose of 600 to 800 IU per day of vitamin D3 will raise the level above Institute of Medicine recommendations (20 ng/mL or 50 nmol/L) in 97% of women.
Regarding choice of preparation, D3 (cholecalciferol) may be more effective than D2 (ergocalciferol).
Obese patients need more vitamin D to raise their level.
Does higher than at least 800 IU daily may be best for the prevention of fractures.

## Special circumstances
- Patients on anticonvulsant drugs are at risk of vitamin D deficiency. If osteopenia occurs, treatment with 2000-4000 IU/d must be started. In case of osteomalacia, a larger dose of vitamin D, 5000-15000 IU/d is required.
Wernicke-Korsakoff syndrome overview

# Overview
Wernicke-Korsakoff syndrome is a is a degenerative brain disorder cause by thiamine deficiency.  This is usually secondary to alcohol abuse. Although Wernicke's and Korsakoff's may appear to be two different disorders, they are generally considered to be different stages of the same disorder, which is called Wernicke-Korsakoff syndrome(WKS).  Wernicke's encephalopathy represents the acute phase of the disorder, and Korsakoff's amnesic syndrome represents the chronic phase.

# Historical Perspective
The syndrome is a combined manifestation of two eponymous disorders, Korsakoff's Psychosis and Wernicke's encephalopathy, named for Drs. Sergei Korsakoff and Carl Wernicke.

# Daignosis

## MRI
MRI may show changes in the brain tissue - atrophy of mammilary body.

# Treatment

## Medical Therapy
Treatment consists of reversing the thiamine deficiency by giving supplemental thiamine, usually by starting with an initial intravenous or intramuscular dose followed by supplemental oral doses. It is important to start the thiamine treatment before giving any glucose as the encephalopathy will be worsened by the glucose. (Glucose administration promotes dehydrogenation of pyruvate, a biochemical reaction which consumes thiamine.)  By the time amnesia and psychosis have occurred, complete recovery is unlikely.

## Primary Prevention
Not drinking alcohol or drinking in moderation and getting enough nutrition reduce the risk of developing Wernicke-Korsakoff syndrome. Thiamine supplements and a good diet may reduce the chance of getting this condition, but do not eliminate the risk.
WikiDoc scholar program introduction
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Zidovudine dosage and administration

# Dosage And Administration

## Treatment of HIV-1 Infection
Adults: The recommended oral dose of RETROVIR is 600 mg/day in divided doses in combination with other antiretroviral agents.
Pediatric Patients (Aged 4 Weeks to <18 Years): Healthcare professionals should pay special attention to accurate calculation of the dose of RETROVIR, transcription of the medication order, dispensing information, and dosing instructions to minimize risk for medication dosing errors.
Prescribers should calculate the appropriate dose of RETROVIR for each child based on body weight (kg) and should not exceed the recommended adult dose.
Before prescribing RETROVIR Capsules or Tablets, children should be assessed for the ability to swallow capsules or tablets. If a child is unable to reliably swallow a RETROVIR Capsule or Tablet, the RETROVIR Syrup formulation should be prescribed.
The recommended dosage in pediatric patients aged 4 weeks to <18 years and weighing 4 kg is provided in Table 1. RETROVIR Syrup should be used to provide accurate dosage when whole tablets or capsules are not appropriate.
Alternatively, dosing for RETROVIR can be based on body surface area (BSA) for each child. The recommended oral dose of RETROVIR is 480 mg/m2/day in divided doses (240 mg/m2 twice daily or 160 mg/m2 three times daily). In some cases the dose calculated by mg/kg will not be the same as that calculated by BSA.

## Prevention of Maternal-Fetal HIV-1 Transmission
The recommended dosage regimen for administration to pregnant women (>14 weeks of pregnancy) and their neonates is:
Maternal Dosing: 100 mg orally 5 times per day until the start of labor . During labor and delivery, intravenous RETROVIR should be administered at 2 mg/kg (total body weight) over 1 hour followed by a continuous intravenous infusion of 1 mg/kg/hour (total body weight) until clamping of the umbilical cord.
Neonatal Dosing: Start neonatal dosing within 12 hours after birth and continue through 6 weeks of age. Neonates unable to receive oral dosing may be administered RETROVIR intravenously. See Table 2.

## Patients With Severe Anemia and/or Neutropenia
Significant anemia (hemoglobin 25% of baseline) and/or significant neutropenia (granulocyte count 50% from baseline) may require a dose interruption until evidence of marrow recovery is observed . In patients who develop significant anemia, dose interruption does not necessarily eliminate the need for transfusion. If marrow recovery occurs following dose interruption, resumption in dose may be appropriate using adjunctive measures such as epoetin alfa at recommended doses, depending on hematologic indices such as serum erythropoetin level and patient tolerance.

## Patients With Renal Impairment
End-Stage Renal Disease: In patients maintained on hemodialysis or peritoneal dialysis, the recommended dosage is 100 mg every 6 to 8 hours .

## Patients With Hepatic Impairment
There are insufficient data to recommend dose adjustment of RETROVIR in patients with mild to moderate impaired hepatic function or liver cirrhosis.
2-Methyl-4-Chlorophenoxyacetic Acid

# Overview
MCPA or 2-methyl-4-chlorophenoxyacetic acid is a powerful, selective, widely used phenoxy herbicide. The pure compound is a brown-colored powder.

# History
In 1936 investigations began at ICIs Jealott's Hill research centre into the effects of synthetic hormones on plant growth looking specifically for a way to kill weeds without harming crops such as corn. 
Synthesis of MCPA was first reported by Synerholme and Zimmerman in 1945 and by Templeman and Foster in 1946. Templeman and Foster were searching for compounds with similar or greater selective activity than 1-naphthaleneacetic acid in inhibiting the growth of weeds while not adversely affecting the growth of cereal grains. They synthesized MCPA from the corresponding phenol by exposing it to chloroacetic acid and dilute base in a straightforward substitution reaction:

# Commercial use
MCPA is used as an herbicide, generally as its salt or esterified forms. Used thus, it controls broadleaf weeds, including thistle and dock, in cereal crops and pasture. It is selective for plants with broad leaves, and this includes most deciduous trees. Clovers are tolerant at moderate application levels. It is currently classified as a restricted use pesticide in the United States. Its toxicity and biodegradation are topics of current research. One formulation is described by its manufacturer as "designed for specific markets that require the safest possible phenoxy product, primarily for use in the Pacific Northwest".  Though not extremely toxic, it has recently been determined that MCPA can form complexes with metal ions and thereby increase their bioavailability, though there is also work being done to utilize this ability.

# Chemical use
Because it is inexpensive, MCPA is used in various chemical applications. Its carboxylic acid group allows the formation of conjugated complexes with metals (see below). The acid functionality makes MCPA a versatile synthetic intermediate for more complex derivatives.

# Brand names
The following commercial products contain MCPA.
- Agritox, Agroxone, Chiptox, Chwastox, Cornox, Methoxone, Rhonox, Spurge Power, Tigrex, Verdone Extra (UK), Weed-Rhap, Weed'n'Feed, Weed-B-Gone, Zero Bindii & Clover Weeder (Aus)
Alternating hemiplegia of childhood
Alternating hemiplegia of childhood (AHC) is a rare genetic disease which causes intermittent paralysis and progressive mental retardation starting in childhood.
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# Overview

# Historical Perspective

# Classification

# Pathophysiology

## Etiology
Some cases of AHC are thought to be the result of a channelopathy - the gene ATP1A2 (an isoform of the sodium-potassium ATPase) has been implicated in at least one family. There is overlap with the syndrome of familial hemiplegic migraine in which the ATP1A2 gene undergoes a different mutation.

# Causes

# Differentiating Alternating hemiplegia of childhood from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural history

# Complications

# Prognosis
Children with the benign form of alternating hemiplegia have a good prognosis. However, those who experience the more severe form have a poor prognosis because intellectual and mental capacity do not respond to drug therapy, and balance and gait problems continue. Over time, walking unassisted becomes difficult or impossible.

# Diagnosis

## Diagnostic Criteria

## History and Symptoms
AHC usually occurs before four years of age and can present in either a severe or a less severe form.
- The less severe form has a good prognosis and is indicated by episodes occurring primarily at night, and can often be related to migraines.  There is no neurological impairment in this form of AH.
- The severe form is indicated by the usual paralysis, mental impairment, gait and balance impairment, excessive sweating, and changes in body temperature.  Seizures and movement disorders can also be present.

## Physical Examination

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

## Treatment
Drug therapy includes flunarizine, a calcium channel blocker. It may help to reduce the severity and duration of attacks of paralysis associated with the more serious form of alternating hemiplegia.

## Medical Therapy

## Surgery

## Prevention

# Sources
- Template:NINDS
- Template:ENotes
Abrupt closure and no-reflow case 1

# Abrupt Closure and Loss of Side Branch
Shown below is a pre-intervention angiogram with multiple significant lesions in the proximal and mid RCA.
Shown below is an angiogram with occlusion at the mid RCA depicting abrupt closure.
Shown below is a pre-intervention angiogram with significant lesion in the SVG (saphenous vein graft) to RCA.
Shown below is an angiogram with ongoing intervention on the significant lesion described above.
Shown below is a post-intervention angiogram with acute reduction in blood flow (TIMI flow grade 1) in the absence of dissection, thrombus, spasm, or high-grade residual stenosis in the SVG (saphenous vein graft) depicting no-reflow.
Shown below is a post-intervention angiogram with a complete restoration of blood flow (TIMI flow grade 3) after transient no-reflow as depicted above.
Acyclovir dosage and administration

# Dosage And Administration

## Acute Treatment of Herpes Zoster
800 mg every 4 hours orally, 5 times daily for 7 to 10 days.

## Genital Herpes
Treatment of Initial Genital Herpes: 200 mg every 4 hours, 5 times daily for 10 days.
Chronic Suppressive Therapy for Recurrent Disease: 400 mg 2 times daily for up to 12 months, followed by re-evaluation. Alternative regimens have included doses ranging from 200 mg 3 times daily to 200 mg 5 times daily.
The frequency and severity of episodes of untreated genital herpes may change over time. After 1 year of therapy, the frequency and severity of the patients genital herpes infection should be re-evaluated to assess the need for continuation of therapy with ZOVIRAX.
Intermittent Therapy: 200 mg every 4 hours, 5 times daily for 5 days. Therapy should be initiated at the earliest sign or symptom (prodrome) of recurrence.

## Treatment of Chickenpox
Children (2 years of age and older): 20 mg/kg per dose orally 4 times daily (80 mg/kg/day) for 5 days. Children over 40 kg should receive the adult dose for chickenpox.
Adults and Children over 40 kg: 800 mg 4 times daily for 5 days.
Intravenous ZOVIRAX is indicated for the treatment of varicella-zoster infections in immunocompromised patients.
When therapy is indicated, it should be initiated at the earliest sign or symptom of chickenpox. There is no information about the efficacy of therapy initiated more than 24 hours after onset of signs and symptoms.

## Patients With Acute or Chronic Renal Impairment
In patients with renal impairment, the dose of ZOVIRAX Capsules, Tablets, or Suspension should be modified as shown in Table 3.

## Hemodialysis
For patients who require hemodialysis, the mean plasma half-life of acyclovir during hemodialysis is approximately 5 hours. This results in a 60% decrease in plasma concentrations following a 6-hour dialysis period. Therefore, the patients dosing schedule should be adjusted so that an additional dose is administered after each dialysis.

## Peritoneal Dialysis
No supplemental dose appears to be necessary after adjustment of the dosing interval.

## Bioequivalence of Dosage Forms
ZOVIRAX Suspension was shown to be bioequivalent to ZOVIRAX Capsules (n = 20) and 1 ZOVIRAX 800-mg tablet was shown to be bioequivalent to 4 ZOVIRAX 200-mg capsules (n = 24).
Adrenocortical secondary prevention

# Overview

# Adrenocortical carcinoma secondary prevention
- Patients should be followed at 3-month intervals after initial treatment for 2 to 3 years.
- Surveillance intervals may be increased to 6 months for the next 5 years.
- Surveillance should also include:
Cross-sectional imaging of chest, abdomen, and pelvis
The use of FDG-PET for lesions of an unclear nature
Laboratory evaluation for steroid hormones
Evaluation of side effects is also important in case of adjuvant mitotane therapy
- Cross-sectional imaging of chest, abdomen, and pelvis
- The use of FDG-PET for lesions of an unclear nature
- Laboratory evaluation for steroid hormones
- Evaluation of side effects is also important in case of adjuvant mitotane therapy