Persius/hicric huggingface dataset:
Posaconazole microbiology

# Microbiology

## Mechanism of Action
Posaconazole blocks the synthesis of ergosterol, a key component of the fungal cell membrane, through the inhibition of cytochrome P-450 dependent enzyme lanosterol 14-demethylase responsible for the conversion of lanosterol to ergosterol in the fungal cell membrane. This results in an accumulation of methylated sterol precursors and a depletion of ergosterol within the cell membrane thus weakening the structure and function of the fungal cell membrane. This may be responsible for the antifungal activity of posaconazole.

## Activity in vitro
Posaconazole has in vitro activity against Aspergillus fumigatus and Candida albicans, including Candida albicans isolates from patients refractory to itraconazole or fluconazole or both drugs .However, correlation between the results of susceptibility tests and clinical outcome has not been established. Posaconazole interpretive criteria (breakpoints) have not been established for any fungus.

## Drug Resistance
Clinical isolates of Candida albicans and Candida glabrata with decreased susceptibility to posaconazole were observed in oral swish samples taken during prophylaxis with posaconazole and fluconazole, suggesting a potential for development of resistance. These isolates also showed reduced susceptibility to other azoles, suggesting cross-resistance between azoles. The clinical significance of this finding is not known.
Post-exposure prophylaxis

# Overview
Post-exposure prophylaxis (PEP) is any prophylactic treatment started immediately after exposure to a disease (such as a disease-causing virus), in order to prevent the disease from breaking out.
PEP is commonly used, and very effective, to prevent the outbreak of rabies after a bite by a rabid animal. The treatment consists of repeated injections of rabies vaccine and immunoglobulin.
In the case of HIV infection, post-exposure prophylaxis is a course of antiretroviral drugs which is thought to reduce the risk of seroconversion after events with high risk of exposure to HIV (e.g. unprotected anal or vaginal sex, needlestick injuries, or sharing needles). To be effective, it must be started as soon as possible after exposure and ideally within an hour . The treatment for HIV lasts four weeks .
While there is compelling data to suggest that PEP after HIV exposure is extremely effective, there have been cases where it has failed. The regimen can be very demanding and have unpleasant side effects including malaise, fatigue, diarrhoea, headaches, nausea and vomiting .
According to one Australian study, two thirds of people taking PEP experienced mild to moderate side effects and one quarter of people taking PEP experienced severe side effects.
Post anesthesia care unit
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# Overview
A post anesthesia care unit, often abbreviated PACU, is a vital part of hospitals, ambulatory care centers, and other medical facilities.  It is an area, normally attached to operating theatre suites, designed to provide care for patients recovering from anesthesia, whether it be general anaesthesia, regional anaesthesia, or local anesthesia.

## Common activities
The PACU staff, generally comprised of highly trained nurses are charged with many vital tasks for the care of post-anaesthesia and post operative patients.  These essential activities include:-
- monitoring vital signs (heart rate, blood pressure and respiration)
- treating symptoms of postoperative nausea and vomiting (or PONV)
- managing post-operative pain.
These common activities may often need suplementing with more intensive care or treatment.  This may require :-
- Preparation and education for the use of Patient Controlled Analgesia (PCA) units
- Preparation and establishment of IV or epidural infusions
- Preparation and establishment of invasive monitoring such as arterial lines, central venous lines etc
Occasionally, serious life threatening complications, such as laryngospasm or respiratory arrest, can arise post-anesthesia.  Unless complications occur, most patients will only stay in the PACU for a few hours, before returning home or to another department of the hospital.
Posterior labial arteries
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The posterior labial arteries are branches of the internal pudendal artery.
Tibialis posterior muscle

# Overview
The Tibialis posterior is the most central of all the leg muscles.  It is the key stabilising muscle of the lower leg.

# Origin and insertion
It originates on the inner posterior borders of the tibia and fibula. It is also attached to the interosseous membrane, which attaches to the tibia and fibula.
The tendon of tibialis posterior the decends down posterior to the medial malleolus and to the plantar surface of the foot where it inserts on to the tuberosity of the navicular, the first and third cuneiforms, the cuboid and the second, third and fourth metatarsals.

# Function
As well as being a key muscle for stabilisation, the tibialis posterior muscle also contracts to produce inversion of the foot and assists in the plantar flexion of the foot at the ankle.

# Additional images
- Bones of the right leg. Posterior surface.
- Bones of the right foot. Plantar surface.
- Coronal section through right talocrural and talocalcaneal joints.
- Muscles of the back of the leg. Deep layer.
Muscles of the back of the leg. Deep layer.
- Muscles of the sole of the foot. Third layer.
- The popliteal, posterior tibial, and peroneal arteries.
Posterior urethral valves
Steven C. Campbell, M.D., Ph.D.
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# Overview
Posterior urethral valves are an obstructive congenital defect of the male urethra.

# Classification
Posterior urethral obstruction was first classified by Hugh Hampton Young, urology pioneer, in 1919.  More recent evidence suggests that obstruction in the posterior urethra is a COPUM (Congenital Obstructive Posterior Urethral Membrane), while the fibrous obstructive anomalies in the more distal urethra are remnants of the urogenital membrane, also called Cobb's Collar. These are equivalent to Young's type III lesions, which are not in the posterior urethra.

# Diagnosis
- Abdominal ultrasound is of some benefit, but not diagnostic.  Features that suggest posterior urethral valves are:
Bilateral hydronephrosis.
Thickened bladder wall
Bladder diverticula
- Bilateral hydronephrosis.
- Thickened bladder wall
- Bladder diverticula
- Voiding cystourethrogram (VCUG) - diagnostic

# Complications
- Incontinence
- Urinary tract infection
- Renal failure
- Vesicoureteral reflux

# Treatment
There are three treatments of the posterior urethral valves:
- Vesicostomy and then valve ablation - making a stoma (a hole) in the urinary bladder, also known as high diversion, followed by closure of the stoma and valve ablation.
- Pyelostomy and then valve ablation - making a stoma (a hole) in the pelvis of the kidney, also known as high diversion, followed by closure of the stoma and valve abalation.
- Primary (transurethral) Valve ablation - removal of the valves through urethra, without stoma.
The standard treatment is primary (transurethral) ablation of the valves. Urinary diversion is used in selected cases, and its benefit is disputed.

# Female homolog
The female homolog to the male verumontanum from which the valves originate is the hymen.
Potassium sodium tartrate
Potassium sodium tartrate is a double salt first prepared (in about 1675) by an apothecary, Pierre Seignette, of La Rochelle, France. As a result the salt was known as Seignette's salt or Rochelle salt.
It is a colorless to blue-white salt crystallizing in the orthorhombic system. Its molecular formula is KNaC4H4O64H2O. It is slightly soluble in alcohol but more completely soluble in water. It has a specific gravity of about 1.79, a melting point of approximately 75 C, and has a saline, cooling taste.  As a food additive, its E number is E337.
It has been used medicinally as a purgative but in more recent years its piezoelectric properties have been more important and it has found usage in phonograph pickups and other sensing devices. It has also been used in the process of silvering mirrors. It is an ingredient of Fehling's solution, formerly used in the determination of reducing sugars in solutions.
In organic synthesis, it is used in aqueous workups to break up emulsions, particularly for reactions in which an aluminum-based hydride reagent was used.
Rochelle salt can be made from common household goods: cream of tartar and washing soda or baking powder.  In part because of the steep temperature dependence on solubility, large crystals of Rochelle salt are easy to grow.
It is also an ingredient in the Biuret reagent which is used to measure protein concentration.
Praziquantel how supplied

# How Supplied
BILTRICIDE  is supplied as a 600 mg white to orange tinged, film-coated, oblong tablet with three scores. The tablet is coded with BAYER on one side and LG on the reverse side.
When broken, each of the four segments contains 150 mg of active ingredient so that the dosage can be easily adjusted to the patients bodyweight.
Segments are broken off by pressing the score (notch) with thumbnails. If 1/4 of a tablet is required, this is best achieved by breaking the segment from the outer end.
BILTRICIDE is available in bottles of 6 tablets.
Proctalgia fugax overview

# Overview
Proctalgia fugax is a sudden, severe, episodic, anal pain caused by cramp of the pubococcygeus or levator ani muscles. It occurs in 14% of apparently healthy adults, and there are some documented cases of proctalgia fugax associated with the irritable bowel syndrome. 

# Historical Perspective
Proctalgia fugax is intermittent, recurring, and often self-limiting pain in the anorectal region in the absence of organic proctologic disease. It was mentioned first by Myrtle more than a century ago, but its existence was more definitively described by Thaysen (1935).

# Classification

# Pathophysiology
The exact pathogenesis of proctalgia fugax is not completely understood. Several studies suggest that abnormal smooth muscle contractions may be responsible for the pain. A familial form of proctalgia fugax was associated with hypertrophy of the internal anal sphincter. Attacks of proctalgia fugax are often precipitated by stressful life events or anxiety. Psychological testing suggests that many patients are perfectionistic, anxious, and/or hypochondriacal.

# Causes

# Differentiating Proctalgia fugax overview from Other Diseases

# Epidemiology and Demographics
Proctalgia fugax affects twice as many females as males at approximately aged 50 years. Commonly the roughly once-monthly attack occurs as a sudden pain with no trigger factor, diurnally as often as nocturnally. The nonradiating cramp, spasm, or stabbing pain, without concomitant symptoms, is most severe on average after 15 minutes and declines spontaneously.

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

## Natural History

## Complications

## Prognosis

# Diagnosis

## Diagnostic Criteria

## History and Symptoms

## Physical Examination

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

# Treatment

## Medical Therapy

## Surgery

## Prevention
Propylisopropyltryptamine
Propylisopropyltryptamine (PiPT) is a chemical in the tryptamine family, which produces psychedelic and hallucinogenic effects that resemble those of other related dialkyl tryptamine derivatives, although PiPT is reportedly relatively weak and short lasting.

# Chemistry
PiPT is short for N-propyl-N-isopropyl-tryptamine. PiPT is a tryptamine, which all belong to a larger family of compounds known as indolethylamines.  PiPT is closely related to the compounds DPT and DiPT.

# Dosage
PiPT is reported as being active at doses of 50-100mg orally, or 25mg smoked.

# Effects
Very little is known about the psychopharmacological properties of PiPT, but reports suggest it produces psychedelic effects similar to those of other hallucinogenic tryptamine derivatives, that can last around 2-4 hours.

# Dangers
There have been no reported deaths or hospitalizations from PiPT, but its safety profile is unknown.

# Legality
PiPT is unscheduled and uncontrolled in the United States, but possession and sales of PiPT could be prosecuted under the Federal Analog Act because of its structural similarities to other hallucinogenic tryptamine derivatives.
Prostaglandin D2 synthase
Prostaglandin-H2 D-isomerase (PTGDS) is an enzyme that in humans is encoded by the PTGDS gene.

# Function
The protein encoded by this gene is a glutathione-independent prostaglandin D synthase that catalyzes the conversion of prostaglandin H2 (PGH2) to prostaglandin D2 (PGD2). PGD2 functions as a neuromodulator as well as a trophic factor in the central nervous system. PGD2 is also involved in smooth muscle contraction/relaxation and is a potent inhibitor of platelet aggregation. This gene is preferentially expressed in brain. Studies with transgenic mice over-expressing this gene suggest that this gene may be also involved in the regulation of non-rapid eye movement sleep. Furthermore, PTGDS and its product PGD2 are elevated in the bald-scalp areas of men with male pattern baldness (androgenetic alopecia).

# Clinical use
Prostaglandin D2 synthase is used clinically as a diagnostic marker for liquorrhea, that is, to check whether fluid leaking from the nose or ear contains cerebrospinal fluid. This is important in the assessment of head trauma severity. In a medical context, the older term "beta-trace protein" is frequently used to refer to PTGDS.
Pyridinium chlorochromate
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# Overview
Pyridinium chlorochromate, a reddish orange solid reagent, is used to oxidize primary alcohols to aldehydes and secondary alcohols to ketones.  Pyridinium chlorochromate, or PCC, will not fully oxidize the alcohol to the carboxylic acid as does the Jones reagent.  A disadvantage to using PCC is its toxicity.  PCC was developed by Elias James Corey and William Suggs in 1975.
Pyridinium dichromate or PDC is a similar oxidizing agent with chemical formula (C5H5NH)2Cr2O7. In this compound chromium is present as the dichromate ion.  PDC presents the advantage of being less acidic than PCC.

# Preparation
The original preparation by Corey involves adding one equivalent of pyridine to a solution of one equivalent of chromium(VI) trioxide and concentrated hydrochloric acid:
Agarwal et al. presented an alternative synthesis that avoids the harmful side product chromyl chloride (CrO2Cl2).  Chromium(VI) oxide pyridinium chloride:

# Properties and uses
PCC is primarily used as an oxidant.  In particular, it has proven to be highly effective in oxidizing primary and secondary alcohols to aldehydes and ketones, respectively.  Rarely does over-oxidation occur (whether intentionally or accidentally) to form carboxylic acids.  A typical PCC oxidation involves addition of the alcohol to a suspension of PCC in dichloromethane.  A sample reaction would be:
In practice the chromium byproduct deposits with pyridine as a sticky black tar, which can complicate matters. Addition of an inert adsorbent such as crushed molecular sieves or silica gel allows the sticky byproduct to adsorb to the surface, and makes workup easier.
PCC is also remarkable for its high selectivity.  For example, when oxidizing tertiary  allyl alcohols, unsaturated aldehydes are observed as the sole product. This reaction is known as the Babler oxidation. Otherwise such oxidations commonly afford dienes as by-products resulting from dehydration.
Another notable oxidative reaction of PCC is its efficient conversion of unsaturated alcohols or aldehydes to cyclohexenones.  This particular pathway is known as oxidative cationic cyclization.

# Controversy
PCC is controversial as it contains chromium(VI). More environmentally friendly oxidants listed above are therefore favored by green chemists. Other methods for oxidizing alcohols using less toxic reagents have been introduced:
- DMSO-based oxidations (Swern oxidation, Moffatt oxidation)
- hypervalent iodine based oxidation (such as the Dess-Martin periodinane)
Quadriceps femoris muscle

# Overview
The quadriceps femoris (quadriceps, quadriceps extensor, guads or quads) includes the four prevailing muscles on the front of the thigh. It is the great extensor muscle of the knee, forming a large fleshy mass which covers the front and sides of the femur.
It is subdivided into separate portions, which have received distinctive names.
- Rectus femoris occupies the middle of the thigh, covering most of the other three quadriceps muscles. It originates on the ilium. It is named from its straight course.
- The other three lie deep to rectus femoris and originate from the body of the femur, which they cover from the trochanters to the condyles:
Vastus lateralis is on the lateral side of the femur.
Vastus medialis is on the medial side of the femur.
Vastus intermedius lies between vastus lateralis and vastus medialis on the front of the femur.
- Vastus lateralis is on the lateral side of the femur.
- Vastus medialis is on the medial side of the femur.
- Vastus intermedius lies between vastus lateralis and vastus medialis on the front of the femur.
All four parts of the quadriceps muscle attach to the patella via the quadriceps tendon.
The quadriceps is also involved in Lombard's Paradox.

# Actions
All four quadriceps are powerful extensors of the knee joint. They are crucial in walking, running, jumping and squatting. Because rectus femoris attaches to the ilium, it is also a flexor of the hip. This action is also crucial to walking or running as it swings the leg forward into the ensuing step.

# Additional images
- Knee diagram
- Capsule of right knee-joint (distended). Lateral aspect.
- Cross-section through the middle of the thigh.
- Anterior aspect of right leg.
- Front and medial aspect of right thigh.
- Lateral aspect of right leg.
- The leg extension is an isolation exercise.
Quadricuspid aortic valve

# Overview
Quadricuspid aortic valve is a rare congenital anomaly and usually found at surgery or diagnosed preoperatively during echocardiographic examination or aortography. 
The most common hemodynamic abnormality associated with this anomaly is aortic insufficiency.

# Embryology
The semilunar valves are derived from mesenchymal swellings in the aortic and pulmonary trunk after the truncus arteriosus has been partitioned.
It is in the early stages of truncal separation that four subendothelial buds appear instead of three.
The presence of a corpus arnatii on all four cusps indicates that the valve resulted from abnormal embryogenesis. 

# History
The first known case report was written by Balington in 1862. 
The prevalence of quadricuspid aortic valve is (by historical autopsy review) approximately 0.008%.  A modern echocardiography database review showed the prevalence to be somewhat higher, depending on the years reviewed (0.013%0.043%).  

# Pathophysiology
On pathological descriptions the aortic valve has four cusps:
- a posterior cusp,
- a left coronary cusp,
- a right coronary cusp,
- an anterior supernumerary cusp.
Raphes join the supernumerary cusp with the left and right coronary cusps. The raphes have been described as shallow and chordlike. The supernumerary cusp can have multiple fenestrations.
The cusps can vary in;
- Size,
- Thickness
- Pliability

# Classification
- Four equal cusp,
- Three equal large and one small cusp (the most common type),
- Two equal large and two equal small cusps,
- One large, two equal intermediate and one small cusps,
- Three equal small and one larger cusps,
- Two equal large and two unequal smaller cusps,
- Four unequal cusps. 

# Associated cardiac abnormalities
- Displaced coronary ostia
- Single or accessory coronary ostia
- Isolated coronary ostium
- Patent ductus arteriosus
- Congenitally deficient mitral leaflets
- Ventricular septal defect
- Fibromuscular subaortic stenosis
- Non-obstructive hypertrophic cardiomyopathy
- Aortic insufficiency (the most common)

# Diagnosis

## Echocardiography
- Quadricuspid Aortic Valve 1
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- Quadricuspid Aortic Valve 2
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- Quadricuspid Aortic Valve 3
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- Quadricuspid Aortic Valve 4
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- Quadricuspid Aortic Valve 5
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- Quadricuspid Aortic Valve 6
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- Quadricuspid Aortic Valve 7
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- Quadricuspid Aortic Valve 8
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- Quadricuspid Aortic Valve 9
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# Pathological Findings
Image courtesy of Professor Peter Anderson DVM PhD and published with permission  PEIR, University of Alabama at Birmingham, Department of Pathology
- Truncus arteriosus with Subvalvular Interventricular Septal Defect: Gross natural color excellent view of lesion looking at opened aortic ring with quadricuspid aortic valve large subvalvular defect origin of pulmonary arteries is at forceps.