Persius/hicric huggingface dataset:
WT limb blood syndrome

# Overview
WT limb-blood syndrome is a rare syndrome characterized by hematological and musculoskeletal anomalies often appearing in childhood.

# Historical Perspective
WT limb-blood syndrome is named after two families with surnames starting with W and T, in which multiple members had features characteristic of the disease.

# Pathophysiology

## Genetics
WT limb-blood syndrome has an autosomal dominant pattern of inheritance.

## Associated Conditions
- Fanconi anemia
- Leukemia
- Lymphoma

# Differentiating from other Disease
WT limb-blood syndrome is differentiated from Fanconi anemia by the autosomal dominant pattern of inheritance and absence of chromosome breakage.

# Epidemiology and Demographics
- The prevalence of this disease is <0.1/100 000.
- The disease often appears in childhood.

# Diagnosis

## Physical Examination

### Extremities
- Syndactyly
- Bifid or hypoplastic thumbs
- Ulnar and radial defects
Wellbutrin SR overdose

# Overdosage topics
Treating overdose
Managing overdosage
Antidote
Seizures

## Treating overdose
Ensure an adequate airway, oxygenation, and ventilation.
Monitor cardiac rhythm and vital signs. EEG monitoring is also recommended for the first
48 hours post-ingestion. General supportive and symptomatic measures are also recommended.
Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with
appropriate airway protection, if needed, may be indicated if performed soon after ingestion or in
symptomatic patients. Activated charcoal should be administered.  Return to top

## Managing overdosage
In managing overdosage, consider the possibility of multiple drug involvement. The physician
should consider contacting a poison control center for additional information on the treatment of
any overdose. Telephone numbers for certified poison control centers are listed in the
Physicians Desk Reference (PDR). Return to top

## Antidote
No specific antidotes for bupropion are known.

## Seizures
Due to the dose-related risk of seizures with WELLBUTRIN SR, hospitalization following
suspected overdose should be considered. Based on studies in animals, it is recommended that
seizures be treated with intravenous benzodiazepine administration and other supportive
measures, as appropriate. Return to top
Adapted from the FDA Package Insert.
Whole bowel irrigation
Whole bowel irrigation (WBI) is a medical process involving the rapid administration of large volumes of an osmotically balanced polyethylene glycol solution (GoLYTELY, CoLyte), either orally or via a nasogastric tube, to flush out the entire gastrointestinal tract.

# History
Whole bowel irrigation was originally developed to cleanse the large bowel before surgery or colonoscopy. Initially a solution of sodium chloride, potassium chloride, and sodium bicarbonate was used but this electrolyte solution was shown to be absorbed by the body, sometimes leading to complications. To solve this problem a specialized irrigation fluid was developed consisting mainly of an iso-osmolar solution of polyethylene glycol. With the polyethylene glycol solution there is negligible fluid or electrolyte absorption and several studies have shown the overall safety of the procedure. Whole bowel irrigation was also suggested as a possible treatment for toxic ingestions. WBI has the effect of mechanically flushing the ingested poison out of the gastrointestinal tract before it can be absorbed into the body. A study provided evidence that whole bowel irrigation is an effective and safe gastrointestinal decontamination procedure for acute poisoning.

# Technique
Whole bowel irrigation is undertaken either by having the patient drink the solution or a nasogastric tube is inserted and the solution is delivered down the tube into the stomach. The solution is administered at a rate of  500 mL/h in children 9 months to 6 years, 1000 mL/h in children 6 to 12 years, and 1500 to 2000 mL/h in adolescents and adults. The patient is usually seated on a toilet and the procedure continues until the rectal effluent is clear. The entire procedure usually takes 4 to 6 hours. Often patients vomit (especially if ipecac was given prior to the procedure or following ingestion of a drug that produces vomiting such as aspirin or theophylline), indicating that the rate of infusion may need to be slowed or an antiemetic such as metoclopramide given.

# Indications
Whole bowel irrigation is indicated prior to surgery, colonoscopy, or a barium enema to cleanse the bowel. Whole bowel irrigation is not used routinely in poisoning situations. It is usually reserved for patients who have ingested toxic doses of medications not absorbed by activated charcoal (such as iron and lithium), potentially toxic ingestions of sustained-release or enteric-coated drugs, or in the situation of packaged drug ingestion (body packing/stuffing).

# Contraindications
Major gastrointestinal dysfunction precludes the use of whole bowel irrigation. WBI is specifically contraindicated in the presence of ileus, significant gastrointestinal hemorrhage, hemodynamic instability, uncontrollable intractable vomiting, bowel obstruction, bowel perforation, and in patients with a decreased level of consciousness with a compromised unprotected airway.

# Complications
Minor complications include nausea, vomiting, abdominal cramps, and bloating. Patients with altered mental status or a compromised and unprotected airway are at risk for pulmonary aspiration.
World Tuberculosis Day
World Tuberculosis Day, falling on 24 March each year, is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of about 1.6 million people each year, mostly in the third world.  24 March commemorates the day in 1882 when Dr Robert Koch astounded the scientific community by announcing that he had discovered the cause of tuberculosis, the TB bacillus.  At the time of Koch's announcement in Berlin, TB was raging through Europe and the Americas, causing the death of one out of every seven people.  Koch's discovery opened the way toward diagnosing and curing tuberculosis.
In 1982, on the one-hundredth anniversary of Dr Koch's presentation, the International Union Against Tuberculosis and Lung Disease (IUATLD) proposed that 24 March be proclaimed an official World TB Day.  In 1996, the World Health Organization (WHO) joined with the IUATLD and a wide range of other concerned organizations to increase the impact of World TB Day.

# TB and AIDS in South Africa
The occurrence of TB in South Africa has tripled in recent years. The high HIV infection rate in South Africa has made the treatment of TB more difficult. South Africans receive a grant during the six months required for treatment, however treatment is purposefully disrupted to continue receiving the grant.
Xanthine dehydrogenase
Xanthine dehydrogenase, also known as XDH, is a protein that, in humans, is encoded by the XDH gene.

# Function
Xanthine dehydrogenase belongs to the group of molybdenum-containing hydroxylases involved in the oxidative metabolism of purines. The enzyme is a homodimer. Xanthine dehydrogenase can be converted to xanthine oxidase by reversible sulfhydryl oxidation or by irreversible proteolytic modification.
Xanthine dehydrogenase catalyzes the following chemical reaction:
The three substrates of this enzyme are xanthine, NAD+, and H2O, whereas its three products are urate, NADH, and H+.
This enzyme participates in purine metabolism.

# Nomenclature
This enzyme belongs to the family of oxidoreductases, to be specific, those acting on CH or CH2 groups with NAD+ or NADP+ as acceptor. The systematic name of this enzyme class is xanthine:NAD+ oxidoreductase. Other names in common use include NAD+-xanthine dehydrogenase, xanthine-NAD+ oxidoreductase, xanthine/NAD+ oxidoreductase, and xanthine oxidoreductase.

# Clinical significance
Defects in xanthine dehydrogenase cause xanthinuria, may contribute to adult respiratory stress syndrome, and may potentiate influenza infection through an oxygen metabolite-dependent mechanism.
Young Simpson syndrome

# Overview
Young Simpson syndrome (YSS), is a rare congenital disorder with symptoms including hypothyroidism, heart defects, facial dysmorphism, cryptorchidism in males, hypotonia, mental retardation and postnatal growth retardation.
Other symptoms include transient hypothyroidism, macular degeneration and torticollis. The condition was discovered in 1987 and the name arose from the individuals who first reported the syndrome. A individual with 
YSS has been identified with having symptoms to a similar syndrome known as Ohdo Blepharophimosis syndrome showing that it is quite difficult to diagnose the correct condition based on the symptoms present. Some doctors therefore consider the syndrome to be the same. 
The mode of inheritance has had mixed findings based on studies undertaken. One study showed that the parents of an individual with YSS are unrelated and phenotypically normal, indicating a sporadic mutation, thus making it difficult to base the cause of the condition on genetic make up alone. Another study however with an individual of YSS had first cousins as parents, giving the possibility of autosomal recessive inheritance.
Zidovudine description

# Description
RETROVIR is the brand name for zidovudine (formerly called azidothymidine ), a pyrimidine nucleoside analogue active against HIV-1. The chemical name of zidovudine is 3-azido-3-deoxythymidine; it has the following structural formula:
Zidovudine is a white to beige, odorless, crystalline solid with a molecular weight of 267.24 and a solubility of 20.1 mg/mL in water at 25C. The molecular formula is C10H13N5O4.
RETROVIR Tablets are for oral administration. Each film-coated tablet contains 300 mg of zidovudine and the inactive ingredients hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycolate, and titanium dioxide.
RETROVIR Capsules are for oral administration. Each capsule contains 100 mg of zidovudine and the inactive ingredients corn starch, magnesium stearate, microcrystalline cellulose, and sodium starch glycolate. The 100-mg empty hard gelatin capsule, printed with edible black ink, consists of black iron oxide, dimethylpolysiloxane, gelatin, pharmaceutical shellac, soya lecithin, and titanium dioxide.
RETROVIR Syrup is for oral administration. Each mL of RETROVIR Syrup contains 10 mg of zidovudine and the inactive ingredients sodium benzoate 0.2% (added as a preservative), citric acid, flavors, glycerin, and liquid sucrose. Sodium hydroxide may be added to adjust pH.
2,4,6-Trichlorophenol

# Overview
2,4,6-Trichlorophenol, also known as TCP, phenaclor, Dowicide 2S, Dowcide 2S, omal, is a chlorinated phenol that has been used as a fungicide, herbicide, insecticide, antiseptic, defoliant, and glue preservative. It is a yellow solid with a strong, sweet odour. It decomposes on heating to produce toxic and corrosive fumes including hydrogen chloride and chlorine.

# Health effects
2,4,6-Trichlorophenol is carcinogenic in animals, causing lymphomas, leukemia, and liver cancer via oral exposure. It is classified as Group B2 (probable human carcinogen) by the United States Environmental Protection Agency. The technical grade of this substance may contain polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and other contaminants.

# Environmental effects
2,4,6-Trichlorophenol is an environmental pollutant that has been found in fresh water lakes such as the Great Lakes.
Trimethoxyamphetamine
TMAs, also known as trimethoxyamphetamines, are a family of isomeric psychedelic hallucinogenic drugs. There exist six different TMAs that differ only in the position of the three methoxy groups: TMA, TMA-2, TMA-3, TMA-4, TMA-5, and TMA-6. The TMAs are analogs of the phenethylamine cactus alkaloid mescaline. The TMAs are substituted amphetamines, however, their action does not resemble that of the unsubstituted compound amphetamine, which is a stimulant and not a psychedelic. It is reported that some TMA's exhibit a range of emotions ranging from sadness to empathy and euphoria. Several TMAs were first synthesized by the chemist Alexander Shulgin. Synthesis data as well as human activity data has been published in the book PIHKAL.
The most important TMA compound from a pharmacological standpoint is TMA-2, as this isomer has been much more widely used as a recreational drug and sold on the black market and as a "research chemical"; TMA (sometimes referred to as "mescalamphetamine") and TMA-6 have also been used in this way to a lesser extent. These three isomers are significantly more active as hallucinogenic drugs, and have consequently been placed onto the illegal drug schedules in some countries such as Japan. The other three isomers TMA-3, TMA-4 and TMA-5 are not known to have been used as recreational drugs to any great extent, and remain obscure scientific curiosities.

# TMAs

# Chemical data
As they are isomers the TMAs have the same totals formula, C12H19NO3, and the same molecular mass, 225.28 g/mol.

# Properties
Third metacarpal bone
The third metacarpal bone (metacarpal bone of the middle finger) is a little smaller than the second.
The dorsal aspect of its base presents on its radial side a pyramidal eminence, the styloid process, which extends upward behind the capitate; immediately distal to this is a rough surface for the attachment of the extensor carpi radialis brevis muscle.
The carpal articular facet is concave behind, flat in front, and articulates with the capitate.
On the radial side is a smooth, concave facet for articulation with the second metacarpal, and on the ulnar side two small oval facets for the fourth metacarpal.
4-Methylmethcathinone

# Overview
4-Methylmethcathinone is a stimulant drug related to methcathinone. 'Mephedrone' is one street name for this new analogue designer drug similar in
- effects to 'methylone' with more pronounced euphoria.
- effects similar to MDMA with less intesnse stimulation and more dopamine centered activity.
It has been reported to be sold on the illicit market as a controlled substance analogue, but little is known about its pharmacology or toxicology as yet.
4-dimethylaminophenol

# Overview
4-Dimethylaminophenol (abbreviated in medical practice as DMAP) is an aromatic compound containing both phenol and amine functional groups. It has the molecular formula C8H11NO.

# Uses
4-Dimethylaminophenol has been used as an antidote for cyanide poisoning.It has also been shown to be effective in treating hydrogen sulfide toxicity.
It works by generating methemoglobin.
This is suitable as an emergency treatment only; treatment must be followed up with sodium thiosulfate or cobalamin.
In an animal model, it has shown effectiveness when given intramuscularly.Though, intramuscular injection should be avoided due to the probability of muscular necrosis after injection. Intravenous injection is recommended in a dose of 250mg.
Heat shock protein 47
Heat shock protein 47, also known as SERPINH1 is a serpin which serves as a human chaperone protein for collagen.

# Function
This protein is a member of the serpin superfamily of serine proteinase inhibitors. Its expression is induced by heat shock. HSP47 is expressed by cells present in Endoplasmic Reticulum. These cells synthesize and secrete type I and type II collagen.  The protein localizes to the endoplasmic reticulum lumen and binds collagen; thus it is thought to be a molecular chaperone involved in the maturation of collagen molecules. Autoantibodies to this protein have been found in patients with rheumatoid arthritis.

# Interactions
Heat shock protein 47 has been shown to interact with collagens I, II, III, IV and V.
7-Amino-actinomycin D
7-Amino-actinomycin D (also 7-aminoactinomycin D, abbreviated 7-AAD) is a fluorescent chemical compound with a strong affinity for DNA.  It is used as a fluorescent marker for DNA in fluorescence microscopy and flow cytometry.  It intercalates in double-stranded DNA, with a high affinity for GC-rich regions.

# Applications
With an absorption maximum at 546 nm, 7-AAD is efficiently excited using a 543 nm helium-neon laser; it can also be excited with somewhat lower efficiency using th 488 nm or 514 nm argon laser lines.  Its emission has a very large Stokes shift with a maximum in the deep red: 647 nm.  7-AAD is therefore compatible with most blue and green fluorophores  and even many red fluorophones  in multicolour applications.
7-AAD does not readily pass through intact cell membranes; if it is to be used as a stain for imaging DNA fluorescence, the cell membrane must be permeabilized or disrupted.  7-AAD is also used as a cell viability stain.  Cells with compromised membranes will stain with 7-AAD, while live cells with intact cell membranes will remain dark.

# Actinomycin D
The related compound Actinomycin D is nonfluorescent, but binds DNA in the same way as 7-AAD.  Its absorbance changes when bound to DNA, and it can be used as a stain in conventional transmission microscopy.
ACTION ICU risk score
Synonyms and keywords: (add synonyms and create redirects)

# Overview
 is a ( validated) risk assessment tool designed to assess the (30-day/10-year/other timeframe) risk of (bleeding/ischemia/other end point) associated with (antiplatelet/antithrombotic/other treatment) among patients with (coronary heart disease/heart failure/other condition).

# ACTION ICU Risk Score
 was invented by (Author) et al in (year), and has been externally validated in (other populations/subsequent studies).(add references)
 is a (risk assessment tool/risk stratification scheme) designed to assess the (30-day/5-year) risk of (bleeding/ischemia/other end point) associated with (antiplatelet/antithrombotic/other treatment) among patients with (coronary heart disease/heart failure/other condition).
 is a (clinical prediction rule) devised to assess the severity of (acute pancreatitis/other disease) among (hospitalized patients/healthy individuals/other population) in the (outpatient/inpatient/surgical/medical/emergency room) setting.
 is a (prediction model) developed to estimate the (mortality/bleeding rate/pre-test probability) of (acute pulmonary embolism/other disease) among (hospitalized patients/healthy individuals/other population).
 is a (decision tool) designed to assist the decision-making pertaining to the (risk/benefit) of (antiplatelet/antithrombotic/other treatment) for (acute coronary syndrome/other conditions) among (hospitalized patients/healthy individuals/other population).

# ACTION ICU Risk Score Calculator
Shown below is the calculator for  (check all the boxes that apply):
(insert widget here)

# Interpretation
- Score  1: low-risk (< 1% mortality); no treatment or hospital admission is required.
- Score 23: intermediate-risk (1 to 5% mortality); consider treatment or hospitalization.
- Score  4: high-risk (> 5% mortality); treatment/hospitalization is warranted.
Adenosine diphosphate

# Overview
Adenosine diphosphate, abbreviated ADP, is a nucleotide. It is an ester of pyrophosphoric acid with the nucleotide adenine. ADP consists of the pyrophosphate group, the pentose sugar ribose, and the nucleobase adenine.
ADP is the product of ATP dephosphorylation by ATPases. ADP is converted back to ATP by ATP synthases. ATP is an important energy transfer molecule in cells.
ADP is stored in dense bodies inside blood platelets and is released upon platelet activation. ADP interacts with a family of ADP receptors found on platelets (P2Y1, P2Y12 and P2X1), leading to further platelet activation. ADP in the blood is converted to adenosine by the action of ecto-ADPases, inhibiting further platelet activation via adenosine receptors. The anti-platelet drug Plavix (clopidogrel) inhibits the P2Y12 receptor.
ADP is the end-product that results when ATP loses one of its phosphate groups located at the end of the molecule. The conversion of these two molecules plays a critical role in supplying energy for many processes of life. The deletion of one of ATPs phosphorous bonds generates about the same amount of energy derived from human digestion of a single peanut, approximately 7.3 kilocalories per Mole of ATP. ADP can be converted, or powered back to ATP through the process of releasing the chemical energy available in food; in humans this is constantly performed via aerobic respiration in the mitochondria. Plants use photosynthetic pathways to convert and store the energy from sunlight, via conversion of ADP to ATP. Animals use the energy released in the breakdown of glucose and other molecules to convert ADP to ATP, which can then be used to fuel necessary growth and cell maintenance.
AIDS-related lymphoma
For AIDS main page, please click here

# Overview
AIDS-related lymphoma describes lymphomas occurring in patients with acquired immunodeficiency syndrome (AIDS).
A lymphoma is a type of cancer arising from lymphoid cells. In AIDS, the incidences of non-Hodgkin's lymphoma, primary cerebral lymphoma and Hodgkin's disease are all increased.

# Non-Hodgkin's lymphoma
Non-Hodgkin's lymphoma (NHL) is present in about 3% of HIV positive people at the time of their diagnosis of HIV. 20% of HIV positive patients will develop NHL.

# Primary cerebral lymphoma
Primary cerebral lymphoma (or primary central nervous system lymphoma) is a form of NHL. It is very rare in immunocompetent people, with an incidence of 5-30 cases per million person-years. However the incidence in immunocompromised individuals is greatly increased, up to 100 per million person-years.
Primary cerebral lymphoma is strongly associated with Epstein-Barr virus (EBV). The presence of EBV DNA in cerebrospinal fluid is highly suggestive of primary cerebral lymphoma.
Treatment of AIDS patients with antiretroviral drugs reduces the incidence of primary cerebral lymphoma.

# Hodgkin's disease
The incidence of Hodgkin's disease in the general population is about 10-30 per million person-years. This increases to 170 per million person-years in HIV positive patients.
Abrupt closure case 2

# Abrupt Closure

## Pre-intervention
Shown below is a pre-intervention angiogram with significant lesion in the SVG to LCX.

## Intervention
Shown below is an angiogram with ongoing intervention on the significant lesion described above.

## Post-intervention
Shown below is a post-intervention angiogram with occlusion at the proximal part of SVG to LCX depicting abrupt closure.
ARBITER 6-HALTS Trial

# Objective
To study the effects of extended-release niacin or ezetimibe added to statin monotherapy on carotid intima-media thickness.

# Methods
Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies in Atherosclerosis (ARBITER 6-HALTS) trial was an open labeled randomized trial. The study subjects consisted of patients who had coronary artery disease or equivalent on long standing statin therapy with LDL cholesterol levels below 100 mg/dl and HDL cholesterol levels below 50 mg/dl for men and 55 mg/dl in women. The patients were randomly assigned to extended-release niacin (target dose 2000 mg) or ezetimibe (10 mg daily). The primary end point was a change in the carotid intima-media thickness from baseline in both study groups. This trial was terminated early because of side-effects of the drugs which affected compliance.

# Results
- A significant increase in HDL levels, and a decrease in LDL and triglyceride levels was noted in the niacin group.
- Niacin group showed a significant change in terms of CMIT, leading to a reduction in both mean and maximal carotid intima-media thickness.
- A paradoxical increase in the CMIT  was noted along with a reduction in LDL levels in the ezetimibe group. There was also a fall in both HDL and triglyceride levels.

# Conclusion
Extended release niacin causes statistically significant reduction in the carotid intima-media thickness and is superior to ezetimibe.