Persius/hicric huggingface dataset:
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# Overview
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# How to get started

## Select a topic
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Promethazine overdose

# Overdosage topics
Signs/symptoms
Stimulation
Atropine-like signs/symptoms
Treatment

## Signs/symptoms
Signs and symptoms of overdosage with Promethazine HCl range from mild depression of the central nervous system and cardiovascular system to profound hypotension, respiratory depression, unconsciousness, and sudden death. Other reported reactions include hyperreflexia, hypertonia, ataxia, athetosis, and extensor-plantar reflexes (Babinski reflex). Return to top

## Stimulation
Stimulation may be evident, especially in children and geriatric patients. Convulsions may rarely occur. A paradoxical-type reaction has been reported in children receiving single doses of 75 mg to 125 mg orally, characterized by hyperexcitability and nightmares. Return to top

## Atropine-like signs/symptoms
Atropine-like signs and symptoms  dry mouth, fixed, dilated pupils, flushing, as well as gastrointestinal symptoms - may occur. Return to top

## Treatment
Treatment of overdosage is essentially symptomatic and supportive. Only in cases of extreme overdosage or individual sensitivity do vital signs, including respiration, pulse, blood pressure, temperature, and EKG, need to be monitored. Activated charcoal orally or by lavage may be given, or sodium or magnesium sulfate orally as a cathartic. Attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. Diazepam may be used to control convulsions. Acidosis and electrolyte losses should be corrected. Note that any depressant effects of Promethazine HCl are not reversed by naloxone. Avoid analeptics which may cause convulsions.
The treatment of choice for resulting hypotension is administration of intravenous fluids, accompanied by repositioning if indicated. In the event that vasopressors are considered for the management of severe hypotension which does not respond to intravenous fluids and repositioning, the administration of norepinephrine or phenylephrine should be considered. EPINEPHRINE SHOULD NOT BE USED, since its use in patients with partial adrenergic blockade may further lower the blood pressure. Extrapyramidal reactions may be treated with anticholinergic antiparkinson agents, diphenhydramine, or barbiturates. Oxygen may also be administered.
Limited experience with dialysis indicates that it is not helpful. Return to top
Adapted from the FDA Package Insert.
Prostacyclin synthase
Prostaglandin-I synthase (EC 5.3.99.4) also known as prostaglandin I2 (prostacyclin) synthase (PTGIS) or CYP8A1 is an enzyme involved in prostanoid biosynthesis that in humans is encoded by the PTGIS gene. This enzyme belongs to the family of cytochrome P450 isomerases.

# Function
This gene encodes a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. However, this protein is considered a member of the cytochrome P450 superfamily on the basis of sequence similarity rather than functional similarity. This endoplasmic reticulum membrane protein catalyzes the conversion of prostaglandin H2 to prostacyclin (prostaglandin I2), a potent vasodilator and inhibitor of platelet aggregation. An imbalance of prostacyclin and its physiological antagonist thromboxane A2 contribute to the development of myocardial infarction, stroke, and atherosclerosis.
Unlike most P450 enzymes, PGIS does not require molecular oxygen (O2).  Instead it uses its heme cofactor to catalyze the isomerization of prostaglandin H2 to prostacyclin.  Prostaglandin H2 is produced by cyclooxygenase in the first committed step of prostaglandin biosynthesis.

# Nomenclature
The systematic name of this enzyme class is (5Z,13E)-(15S)-9alpha,11alpha-epidioxy-15-hydroxyprosta-5,13-dienoate 6-isomerase. Other names in common use include prostacyclin synthase, prostacyclin synthetase, prostagladin I2 synthetase, PGI2 synthase, PGIS, PTGIS, and PGI2 synthetase.

# Pathways
Protein Nitrogen Unit
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The Protein Nitrogen Unit (PNU) measures the potency of the compounds used in allergy skin tests, and is equivalent to 0.01 microgram (g) of phosphotungstic acid-precipitable protein nitrogen.
According to Russ Rowlett at the University of North Carolina at Chapel Hill:
Unfortunately, the potency measurements depend on the technique of measurement used, so results of one manufacturer are not comparable to those of another manufacturer. As a result, although PNU's are still used, they are being replaced by bioequivalent allergy units (BAU), which are measured by actual skin testing using reference preparations of standard potency.
Proteolipid protein 1
Proteolipid protein 1 (PLP1) is a form of myelin proteolipid protein (PLP). Mutations in PLP1 are associated with PelizaeusMerzbacher disease.  It is a 4 transmembrane domain protein which is proposed to bind other copies of itself on the extracellular side of the membrane. In a myelin sheath, as the layers of myelin wraps come together, PLP will bind itself and tightly hold the cellular membranes together.
This gene encodes a transmembrane proteolipid protein that is the predominant myelin protein present in the central nervous system (CNS). The encoded protein functions in myelination. This protein may play a role in the compaction, stabilization, and maintenance of myelin sheaths, as well as in oligodendrocyte development and axonal survival. Mutations associated with this gene cause X-linked PelizaeusMerzbacher disease and spastic paraplegia type 2. Two transcript variants encoding distinct isoforms have been identified for this gene.
In melanocytic cells PLP1 gene expression may be regulated by MITF.

# Interactions
Proteolipid protein 1 has been shown to interact with Myelin basic protein.
Pseudoinfarct pattern
Overview
Different electrocardiographic abnormalities can mimic a heart attack or myocardial infarction.

# Simulation of an Anterior Myocardial Infarction

## Left Bundle Branch Block
- LBBB can cause poor R wave progression. In the presence of LBBB, there is often a decrease in the amplitude of R waves to the mid precordium in the absence of a septal infarct.
- QS complexes are often seen in the right precordial leads in uncomplicated LBBB, and they may even extend as far out as V5 or V6.
- Non infarctional Q waves may be seen in aVL.
- The electrical basis for the appearance of q waves is that LBBB] causes a loss of the normal septal R waves in the right precordial leads. The septum is no longer being depolarized from left to right as it normally does because of the delay in conduction down the left bundle. Therefore, there is a loss of the early R wave.
- There can occasionally be Rs complexes in V1. These unanticipated initial positive forces are due to early RV depolarization and may actually mask the q waves (i.e. loss of initial septal forces) that accompany an anteroseptal MI.

## Poor R Wave Progression
Poor R wave progression can mimic an anterior myocardial infarction.
Pseudohermaphroditism

# Overview
Pseudohermaphroditism or pseudo-hermaphroditism, is a name used to describe the fact that some people are born with external sex organs that look intermediate between the typical vagina or penis. The term was adopted to distinguish between these people, who have typical ovaries or testes, and "true" hermaphrodites, who do not. It is also used for a range of other rare human physicalities. The term pseudohermaphroditism is now restricted to the technical literature, having been replaced by intersex in most public discussion, though this term is also challenged (see External links below).
The inadequency of the term outside technical descriptions can be demonstrated by many examples, but a simple one is the case of women with Complete Androgen Insensitivity Syndrome (CAIS). These women typically have primary and secondary sexual characteristics typical of other women, however they are genetically XY and have internal testes, rather than ovaries. They often marry but cannot have children. However scientifically precise the description "male" pseudohermaphrodite may be for such women, it is clearly socially inappropriate. CAIS is little better. Most intersex conditions are normal (if rare) human physicalities. The S for syndrome in CAIS does not accord with the "normality" CAIS women feel about their bodies.

# Historical Perspective
Use of the term "pseudohermaphroditism" can be problematic. The term "pseudohermaphroditism" was created by Edwin Klebs in 1876,  long before the genetic roles of the X chromosome and Y chromosome and the social components of gender identity were well characterized, which is why the term is usually used to describe the dissonance between gonadal histology and external genital appearance.
The term "intersexuality" was introduced by Richard Goldschmidt in 1923.  However, the term "intersex" has also been challenged; the Lawson Wilkins Pediatric Endocrine Society and the European Society for Pediatric Endocrinology have adopted a nomenclature system based on disorders of sex development which covers "congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical" and thus replaces many disparate terms, including but not limited to those based on "hermaphrodite."
One example of the challenges involved in the use of the term is the case of women with Complete Androgen Insensitivity Syndrome (CAIS). These women typically have primary and secondary sexual characteristics typical of other women; however, they are genetically XY and have internal testes, rather than ovaries. They often marry but cannot have children. However scientifically precise the description "male" pseudohermaphrodite may be for such women, it is clearly socially inappropriate. CAIS is little better. The S for syndrome in CAIS does not accord with the "normality" CAIS women feel about their bodies.

# Treatment

## Surgery
Surgery has sometimes been performed to alter the appearance of the genitals. Modern approaches often involve delaying surgery when possible until the child matures enough to express a preference.
Pseudohypoproteinemia
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: 
There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us  to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Related Key Words and Synonyms:

# Overview

# Epidemiology and Demographics

# Risk Factors

# Screening

# Pathophysiology & Etiology

# Molecular Biology

# Genetics

# Natural History and Complications

# Diagnosis

## Common Causes

## Complete Differential Diagnosis of the Causes of ...
(In alphabetical order)
- a...
- z...
Make sure that each diagnosis is linked to a page.

## Complete Differential Diagnosis of the Causes of ...
(By organ system)

## History and Symptoms

## Physical Examination

### Appearance of the Patient

### Vital Signs

### Skin

### Eyes

### Ear Nose and Throat

### Heart

### Lungs

### Abdomen

### Extremities

### Neurologic

### Other

## Laboratory Findings

### Electrolyte and Biomarker Studies

### Electrocardiogram

### Chest X Ray

### MRI and CT

### Echocardiography or Ultrasound

### Other Imaging Findings

## Pathology

### Gross Pathology

### Microscopic Pathology

## Other Diagnostic Studies

# Risk Stratification and Prognosis

# Treatment

## Pharmacotherapy

### Acute Pharmacotherapies

### Chronic Pharmacotherapies

## Surgery and Device Based Therapy

### Indications for Surgery

### Pre-Operative Assessment

### Post-Operative Management

### Transplantation

## Primary Prevention

## Secondary Prevention

## Cost-Effectiveness of Therapy

## Future or Investigational Therapies

# "The Way I Like To Do It ..." Tips and Tricks From Clinicians Around The World

## Suggested Revisions to the Current Guidelines
Psilocybe australiana
Psilocybe australiana is a species of psychoactive mushroom  found in Victoria, New South Wales, Western Australia, Tasmania and New Zealand. Commonly found growing on Eucalyptus and pine mulch, as well as on soil with wood or leafy debris, on tracks and roadsides, in Pinus radiata plantations, or in temperate rain forests.
The mushroom was originally discovered by Gaston Guzman and Roy Watling. Further research by New Zealand mycologist Peter Buchanan has shown Psilocybe australiana to be a variant of Psilocybe subaeruginosa
Commonly it is large umbonated mushroom with a sharp nipple, orangy brown hydrophanous cap, often with a margin flecked with white veil remnants and strongly visible radial lines. The stem is a strong white with a consistent radius, chestnust brown when the flesh is broken. The gills are very crowded, whitish brown soon dark chocolate brown and ascending towards the stem. Cap and stem often spotted with dark blue stains, and flesh quickly stains bluish/black upon damage. (left image)
Psilocybe tampanensis
Psilocybe tampanensis is a psychedelic mushroom whose only known natural specimen was collected in the wild by Steven Pollock, near Tampa, Florida in 1977. All spores and cultivations of this species nowadays are originated from this only specimen.

# Sightings
Since the collection in 1977, this species has never been seen growing wild in Florida again. Another sighting case was reported in Mississippi, but no culturable material was collected.

# Availability
Psilocybe tampanensis or "philosopher's stones" were commonly sold in smart shops in Amsterdam in their fresh form when this was still legal.

# Effects
Tampanensis has a qualitatively different effect from that of most other species of psilocybin-containing mushrooms. The taste is also very different from others: many find it somewhat tart but not as unpleasant as many mushrooms. The Taste of these truffles can be described as a nutty flavor followed by an aftertase of a tart fruit such as kiwi. Effects often include euphoria and a general feeling of well being. In high doses, experiences can become very profound and "philosophical". According to some, psilocybe tampanensis is a good alternative to magic mushrooms for first time users, because they create good feelings and provide an easily controllable trip compared to other psychedelics.
de:Psilocybe tampanensis
gl:Psilocybe tampanensis
Psilocybe zapotecorum
Psilocybe zapotecorum is a psilocybin mushroom which has psilocybin and psilocin as main active compounds.

# Description
- Cap: 2-13 cm, conical to convex very rarely expanding to plane in age, margin wavy sometimes with an acute papilla or mamilla, usually umbonate or with a depressed center.  In young specimens the margin has a scalloped edge which sometimes curls upwards as the mushroom matures.  The cap is yellowish brown to tan, fading to cream-yellow then brown and finally black in age.  The flesh is white but soon changes to a cyan blue, then quickly to black.
- Gills: Cream color when young, violet brown in age, with an attachment that is sinuate or adnate, sometimes subdecurrent.
- Spores: Dark violet brown, oblong to ellipsoid to subrhomboid, thin walled, 7 x 4 um.
- Stipe: Central, flexuous, cylindric or slightly flattened, hollow, from 3cm to 26cm long, 0.5 to 1 cm thick.  White to grey, turning yellowish, blue and black in age.  The entire stem is covered with many white scales which more pronounced in the lower part of the stem. Partial veil is white and arachnoid, disappearing in age.  Often a long pseudorrhiza can be found attached the base of the stem.   Strongly bruising blue then black where damaged.
- Taste: Farinaceous and very slightly like radish or spice.
- Odor: Farinaceous.and slightly sweet.
- Microscopic features:

# Distribution and habitat
Grows solitary or gregariously in groups, sometimes in cespitose clusters of almost a hundred mushrooms, terrestrial, growing directly from soils rich in organic matter.  Found near rivers, creaks and ravines, sometimes growing directly from steep mossy ravine walls.   Found in humid and shadowed places in mesophytic forests, oak and pine forests, or cloud forests.
Often found in subtropical forests containing Alnus sp., Magnolia sp., Fraxinus sp., Quercus sp., large pines and blackberry bushes.
Known to occur in Argentina, Brazil, Chile, Colombia, Mexico, and Peru.
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
- Psilocybe zapotecorum
Psilocybe zapotecorum
Psychosomatic illness

# Overview
Psychosomatic disorder, now more commonly referred to as psychophysiologic illness, is an illness whose symptoms are caused by mental processes of the sufferer rather than immediate physiological causes.  If a medical examination can find no physical or organic cause, or if an illness appears to result from emotional conditions such as anger, anxiety, depression or guilt, then it might be classified as psychosomatic.

# History
Sigmund Freud famously studied psychosomatic illnesses, which informed his theories of the unconscious mind and repression.  Many identifiable illnesses have previously been labelled as 'hysterical' or 'psychosomatic', for example asthma, allergies, false pregnancy, and migraines. Some illnesses are under debate, including multiple chemical sensitivity, Gulf War syndrome, and chronic fatigue syndrome.  Some people suggest that stigmatics suffer a psychosomatic illness based on identifying with the biblical crucified Jesus.

### Modern connotations
The term "psychosomatic" has developed a negative connotation in modern medicine, being confused with malingering, mental illness or outright fakery.  Psychosomatic pain is difficult to differentiate from the above conditions but actual psychosomatic pain is real pain caused by unconscious mind rather than symptoms of illness or injury.  Psychosomatic illness can result from problems with relationships, stress or other non-physical causes, often influenced by external factors or individuals.

# Treatment
Various types of psychotherapy and alternative therapies are used to treat psychosomatic disorders.  In some cases, psychosomatic problems may improve or disappear following suggestion by a recognized authority.
Treatment is typically anti-anxiety medications and/or anti-depressants in conjuntion with therapy of some kind.  Unlike hypochondria (which some mistakenly think is the same thing as psychosomatic illness), sufferers of a psychosomatic illness are experiencing real pain, real nausea, or other real physically felt symptoms, but with no diagnosable cause.

# Related Chapters
- Illness as Metaphor
- Theory of Deadly Initials
- Placebo
- Nocebo
- Placebo (origins of technical term)
Publication committee
The Publication Committee is responsible for identifying opportunities for publishing work derived from the Societys activities.
Its main task is to manage the publication of papers from the biennial International Symposium on the Biosafety of Genetically Modified Organisms. The Committee may also assist in publishing the proceedings of smaller, regionally or technically focused meetings held by the Society. The Committee periodically reviews the desirability and feasibility of establishing a peer-reviewed journal on biosafety research.
The Publication Committee comprises the Chairman and other interested members. Members may be co-opted to help manage the publication of material in their area of expertise.
The Chairman of the Publications Committee has several responsibilities:
To inform the ISBR Board of opportunities for publishing the Societys work;
To act as the editor-in-chief of publications arising from the Societys activities;
To co-opt members to act as editors of publications as necessary;
To ensure that publications are cost effective; and
To work with the Communication and Outreach Committee to ensure that publications further the aims of the Society.