Persius/hicric huggingface dataset:
Sulfonylurea receptor
In molecular biology, the sulfonylurea receptors (SUR) are membrane proteins which are the molecular targets of the sulfonylurea class of antidiabetic drugs whose mechanism of action is to promote insulin release from pancreatic beta cells.  More specifically, SUR proteins are subunits of the inward-rectifier potassium ion channels Kir6.x (6.1 and 6.2).  The association of four Kir6.x and four SUR subunits form an ion conducting channel commonly referred to as the KATP channel.
Three forms of the sulfonylurea receptor are known, SUR1 encoded by the ABCC8 gene, and SUR2A and SUR2B, which are splice variants arising from a single ABCC9 gene.

# Function
The primary function of the sulfonylurea receptor is to sense intracellular levels of the nucleotides ATP and ADP and in response facilitate the open or closing its associated Kir6.x potassium channel. Hence, the KATP channel monitors the energy balance within the cell.
Depending on the tissue in which the KATP channel is expressed, altering the membrane potential can trigger a variety of downstream events. For example, in pancreatic beta cells, high levels of glucose lead to increased production of ATP, which, in turn, binds to the KATP channel resulting in channel closure. The relative depolarization (decrease in membrane  hyperpolarization), in turn, opens voltage-dependent calcium channels increasing intracellular calcium concentrations, which triggers exocytosis of insulin.
Under cerebral ischemic conditions, SUR1, the regulatory subunit of the KATP and the NCCa-ATP channels, is expressed in neurons, astrocytes, oligodendrocytes, endothelial cells and by reactive microglia. Blockade of SUR1 receptors with glibenclamide has been involved in improved outcome in animal stroke models and investigational human studies by preventing brain swelling and enhancing neuroprotection.

# Tissue distribution
The isoforms of the sulfonylurea receptor have the following tissue distribution:
- Adipose tissue - SUR2B/Kir6.1
- Pancreatic beta cells - SUR1/Kir6.2
- Cardiac myocytes - SUR2A
- Skeletal muscle - SUR2A
- Smooth muscle - SUR2B
- Brain - SUR1, SUR2A and SUR2B 

# Disease linkage
The SUR1 protein is coded by the ABCC8 gene and is associated with congenital hyperinsulinism and susceptibility to type 2 diabetes.
Sacral spinal nerve 1
The sacral spinal nerve 1 (S1) is a spinal nerve of the sacral segment..
It originates from the spinal column from below the 1st body of the sacrum

# Muscles
S1 supplies many muscles, either directly or through nerves originating from S1. They are not innervated with S1 as single origin, but partly by S1 and partly by other spinal nerves. The muscles are:
- gluteus maximus muscle
- gluteus medius muscle
- gluteus minimus muscle
- tensor fasciae latae
- piriformis
- obturator internus muscle
- inferior gemellus
- superior gemellus
- quadratus femoris
- semitendinosus
- gastrocnemius
- flexor hallucis longus
- abductor digiti minimi
- quadratus plantae
Sacral spinal nerve 2
The sacral spinal nerve 2 (S2) is a spinal nerve of the sacral segment..
It originates from the spinal column from below the 2nd body of the sacrum

# Muscles
S2 supplies many muscles, either directly or through nerves originating from S2. They are not innervated with S2 as single origin, but partly by S2 and partly by other spinal nerves. The muscles are:
- sphincter urethrae membranaceae
- gluteus maximus muscle
- piriformis
- obturator internus muscle
- superior gemellus
- semitendinosus
- gastrocnemius
- flexor hallucis longus
- abductor digiti minimi
- quadratus plantae
Sacral spinal nerve 3
The sacral spinal nerve 3 (S3) is a spinal nerve of the sacral segment..
It originates from the spinal column from below the 3rd body of the sacrum

# Muscles
S3 supplies many muscles, either directly or through nerves originating from S3. They are not innervated with S3 as single origin, but partly by S3 and partly by other spinal nerves. The muscles are:
- iliococcygeus
- puborectalis
- coccygeus
- sphincter urethrae membranaceae
- superior gemellus
Sacral spinal nerve 4
The sacral spinal nerve 4 (S4) is a spinal nerve of the sacral segment..
It originates from the spinal column from below the 4th body of the sacrum

# Muscles
S4 supplies many muscles, either directly or through nerves originating from S4. They are not innervated with S4 as single origin, but partly by S4 and partly by other spinal nerves. The muscles are:
- iliococcygeus
- puborectalis
- coccygeus
- Sphincter ani externus muscle
- sphincter urethrae membranaceae
Safe Patient Handling
The 10th Annual Safe Patient Handling and Movement Conference will begin March 29, 2010 and will run through April 2. The event, sponsored in part by the American Nurses Association (ANA), will be held at Lake Buena Vista, FL at the Buena Vista Palace Hotel & Spa in the Walt Disney World Resort.
In an effort to keep down injuries, organizations such as the ANA are sponsoring this event so that Safe Patient Handling information will be readily available. Safe Patient Handling is the terminology used to describe programs and research that attempts to alleviate work-related injuries in the health care setting. Nurses, aids, orderlies and others who must lift patients often incur knee, back, shoulder and other joint and muscle injuries because of their job.
These common injuries affect a significant portion of the health care labor force at any given time. Surprisingly, the risk of injury to healthcare workers is even higher than that of timber cutters and construction workers.
Direct health care providers, administrators, risk managers, educators, managers, industrial hygienists/safety professionals, and researchers interested in safety issues in a patient setting will find plenty of information at this event.
Those attending the conference will learn Safe Patient Handling methods via workshops and hands-on practice sessions. Conference attendees will have the chance to view cutting-edge innovations from all over the world. Conference materials include a Safe Patient Handling textbook, cognitive aids and tools, and other educational materials.
Session topics include "Low Back Pain Development and Patient Handling," "Top Ten Research Findings for Safe Patient Handling: Readers Digest Version of Science over the Past Decade," "Linking Patient Safety to Caregiver Safety," "American Nurses Association (ANA) Initiatives for Safe Patient Handling in the USA," "Practical Implementation of Patient Lift Teams," "Challenges in Safe Patient Handling in Emergency Departments," "Risks and Solutions for Safe Patient Handling in Operating Rooms," and many others. A complete list of the conference agenda is available at the conference website.
After attending this conference, participants, at a minimum, should be able to utilize best practices for patient care, assess possible solutions for moving a patient, and describe the common ergonomic hazards in patient care. Additionally, participants will be able to create risk reduction strategies and assess the cost and need for intervention in routine patient movement activities.
Links
Safe Patient Handling
Safe Patient Handling: American Nursing Association (ANA)
Sources
Background of Safe Patient Handling
American Nursing Association
State Legislation
Federal Legislation
Safe Patient Handling Quick Resources
Solutions for Safe Patient Handling
State Legislative Agenda for Safe Patient Handling
Handle with Care Recognition Program
Safe Patient Handline and Moving Toolkit
Preventing Back Injuries
Saidu Group Hospitals
Saidu Group of Hospitals swat is the 5th largest hospital of khyber pukhtoonkhwa Pakistan.
It is located on saidu road and just a couple of mile away from Mingora the main city of swat.
Saidu Group of swat is consist of two wings,The central wing and Saidu wing.
Sandbox:Marufa Marium

# Overview
Von Willebrands Disease:

# Historical Perspective
Von Willebrands Disease(vWD) was first discovered by Erik Adolf von Willebrand, a Finnish Physician, in 1926, in a Swedish-language article Hereditar pseudohemofili ("Hereditary pseudohemophilia") after assessing a 5 year-old Finnish Girl and 66 members of her family from 1924-1926. In 1957, decreased level of a plasma factor  Factor viii later called Von Willebrand factor were first identified in the pathogenesis of Von Willebrands Disease. In early 1970s Ristocetin was used to diagnose vWD after inducing platelet aggregation  . Later immunoprecipitation techniques were used to understand vWD and its varieties.

# Classification
vWD may be classified according to Hereditary and Aquired causes. 
vWD is sub-classified according to Hereditary in four types.
- Type 1
- Type 2: Type 2 is further divided into 4 subtypes: 2A, 2B, 2M, 2N
- Type 3
- Pseudo or platelet-type
Aquired  vWD is thought to be caused by Autoantibodies. It can be subclassified into lymphoproliferative, cardiovascular, myeloproliferative, neoplastic, autoimmune disorders .
Another classification has been made by The International Society On Thrombosis And Hemostasis on the basis of Qualitative and Quantitative defects of vWF .
Sandbox: Hypertension

# 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

## Accurate Measurement of Blood Pressure (BP) in the Office

## Out-of-Office and Self-Monitoring of Blood Pressure (BP)

## Masked and White Coat Hypertension

## Secondary Forms of Hyperpertension

## Primary Aldosteronism

## Renal Artery Stenosis

## Obstructive Sleep Apnea

## Nonpharmacological Interventions

## Treatment Threshold and the Use of Cardiovascular Disease (CVD) Risk Estimation to Guide Drug Treatment of Hypertension

## Follow-Up After Initial BP Evaluation

## General Principles of Drug Therapy

## Blood Pressure (BP) Goal for Patients With Hypertension

## Choice of Initial Medication

## Choice of Initial Monotherapy Versus Initial Combination Drug Therapy

## Follow-Up After Initiating Antihypertensive Drug Therapy

## Monitoring Strategies to Improve Control of Blood Pressure (BP) in Patients on Drug Therapy for High BP

## Stable Ischemic Heart Disease (SIHD)

## Heart Failure

## Heart Failure With Reduced Ejection Fraction

## Heart Failure With Preserved Ejection Fraction

## Chronic Kidney Disease (CKD)

## Recommendations for Treatment of Hypertension in Patients With CKD

## Hypertension After Renal Transplantation

## Recommendations for Treatment of Hypertension After Renal Transplantation

## Acute Intracerebral Haemorrhage (ICH)

## Acute Ischemic Stroke

## Secondary Stroke Prevention

## Peripheral Arterial Disease (PAD)

## Diabetes Mellitus

## Atrial Fibrillation (AF)

## Valvular Heart Disease (VHD)

## Aortic Disease

## Racial and Ethnic Differences in Treatment

## Pregnancy

## Older Persons

## Hypertensive CrisesEmergencies and Urgencies

## Cognitive Decline and Dementia

## Patients Undergoing Surgical Procedures

## Antihypertensive Medication Adherence Strategies

## Strategies to Promote Lifestyle Modification

## Structured, Team-Based Care Interventions for Hypertension Control

## Electronic Health Record (EHR) and Patient Registries

## Telehealth Interventions to Improve Hypertension Control

## Telehealth Interventions to Improve Hypertension Control

## Quality Improvement Strategies

## Quality Improvement Strategies

## The Plan of Care for Hypertension
Sandbox: IMPROVEScore
function calcScore(){
var score = 0;
if(document.forms.checked == 1){score += 3;}
if(document.forms.checked == 1){score += 2;}
if(document.forms.checked == 1){score += 2;}
if(document.forms.checked == 1){score += 2;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 2;
document.forms.value = score;
if(score == 0){document.forms.value = "0.4% at 3542 days; 0.5% at 77 days";}
if(score == 1){document.forms.value = "0.6% at 3542 days; 0.7% at 77 days";}
if(score == 2){document.forms.value = "0.8% at 3542 days; 1.0% at 77 days";}
if(score == 3){document.forms.value = "1.2% at 3542 days; 1.4% at 77 days";}
if(score == 4){document.forms.value = "1.6% at 3542 days; 1.9% at 77 days";}
if(score >= 5 && score <= 10){document.forms.value = "2.2% at 3542 days; 2.7% at 77 days";}
Sandbox Impetigo ammu

# Impetigo
- Impetigo, adult
- Empiric antimicrobial therapy (covering methicillin-susceptible Staphylococcus aureus and -hemolytic streptococci)
- Limited number of lesions
- Preferred regimen: Mupirocin topically bid for 5 days OR Retapamulin topically bid for 5 days
- Numerous lesions or outbreaks of post streptococcal glomerulonephritis
- Preferred regimen: Dicloxacillin 250 mg PO qid for 7 days OR Amoxicillin-Clavulanate 875/125 mg PO bid for 7 days OR Cephalexin 250 mg PO qid for 7 days
- Alternative regimen (for penicillin-allergic patients): Doxycycline 100 mg PO bid for 7 days OR Clindamycin 300400 mg PO qid for 7 days OR Sulfamethoxazole-Trimethoprim 12 double-strength tablets PO bid for 7 days
- Culture-directed antimicrobial therapy
- Streptococcus alone
- Preferred regimen: Penicillin V 250500 mg PO qid for 7 days
- Alternative regimen (for penicillin-allergic patients): Erythromycin 250 mg PO qid for 7 days OR Clindamycin 300400 mg PO qid for 7 days
- Methicillin-resistant Staphylococcus aureus
- Preferred regimen: Doxycycline 100 mg PO bid for 7 days OR Clindamycin 300450 mg PO qid for 7 days OR Sulfamethoxazole-Trimethoprim 12 double-strength tablets PO bid for 7 days
- Impetigo, pediatric
- Empiric antimicrobial therapy (covering methicillin-susceptible Staphylococcus aureus and -hemolytic streptococci)
- Limited number of lesions
- Preferred regimen: Mupirocin topically bid for 5 days OR Retapamulin topically bid for 5 days
- Numerous lesions or outbreaks of poststreptococcal glomerulonephritis
- Preferred regimen: Amoxicillin-Clavulanate 25 mg/kg/day of amoxicillin component PO bid for 7 days OR Cephalexin 2550 mg/kg/day PO tidqid for 7 days
- Alternative regimen (for penicillin-allergic patients): Clindamycin 2530 mg/kg/day PO tid for 7 days OR Sulfamethoxazole-Trimethoprim 812 mg/kg/day PO bid for 7 days
- Culture-directed antimicrobial therapy
- Streptococcus alone
- Preferred regimen: Penicillin V 60,000100,000 U/kg PO qid for 7 days
- Alternative regimen (for penicillin-allergic patients): Erythromycin 40 mg/kg/day PO tidqid for 7 days OR Clindamycin 20 mg/kg/day PO tid for 7 days
- Methicillin-resistant Staphylococcus aureus
- Preferred regimen: Clindamycin 2530 mg/kg/day PO tid for 7 days OR Sulfamethoxazole-Trimethoprim 812 mg/kg/day PO bid for 7 days
Sandbox ammu MEN 1 PE

# Overview

# Physical Examination

## Appearance of the Patient
- This section should give a general description of what a patient with the disease you are describing may look like. You may include a physical description such as obese, thin, cachectic, well appearing, ill appearing, diaphoretic etc.
- For an example of the appearance of a patient section in the physical examination page, click here.

## Vitals

### Pulse
- Tachycardia may be present
- Bradycardia may be present

### Blood Pressure
- Hypertension may be present

### Respiratory Rate
- Tachypnea may be present

## Skin
- A rash may be present
- Pallor may be present
- Lesions may be present

## Head
- Headache

## Eyes
- Icteric sclera may be present
- Nystagmus may be present.
- Extra-ocular movements may be abnormal
- Pupils may not react to light
- Ophthalmoscopic exam may be abnormal with findings of ___

## Ears
- Hearing acuity may be reduced
- Weber test may be positive
- Rinne test may be positive
- There may be exudate from the ear canal
- There may be tenderness on movement of the pinnae

## Nose
- Nares may be inflamed
- There may be epistaxis
- There may be purulent exudate from the nares
- There may be tenderness to percussion of the sinuses
- The nares may be congested

## Throat
- The throat may be erythematous
- There may be exudate in the throat
- There may be petechiae seen in the throat
- There may be tonsillar inflammation

## Neck
- Jugular venous pressure may be elevated
- Carotid bruits may be present
- Lymph nodes may be present
- Thyromegaly may be present
- Hepatojugular reflux may be present

## Lungs
- Pulmonary edema and rales may be present
- Wheezing may be present
- Consolidation may be present with reduced breath sounds auscultated
- Rales may be present
- Egophony may be present
- Chest movement may be assymetric

## Heart
- A heave may be present
- A thrill may be present
- A friction rub may be present
- Shortened QT interval.

### Auscultation
- S1
- S2
- S3
- S4
- Gallops
- A systolic murmur best heard at the base may be present
- A systolic murmur best heard at the apex may be present
- A diastolic murmur may be present

## Abdomen
- Abdominal distention may be present
- Abdominal tenderness may be present
- Rebound tenderness may be present
- An acute abdomen may be present
- An abdominal mass may be present
- Guarding may be present
- Hepatomegaly may be present
- Splenomegaly may be present
- Genitourinary exam if relevant

## Extremities
- Clubbing may be present
- Cyanosis may be present
- Edema may be present

## Neurologic
- Mental status may be altered
- Confusion
- Lethargy
- Depression
Sandbox elastofibroma

# Patholophysiology

## Microscopy
In general, the tumor is an ill defined, nonencapsulated, rubbery, and firm, white lesion with interspersed fat. The tumors can be quite large (up to 20 cm), although most are around 5 cm. 
By microscopic view, there is an admixture of heavy dense bands of collagenous tissue dissected by fat and abnormal elastic fibers. The elastic fibers are often quite large and are easily identified. The elastic fibers are coarse, thick, and darkly eosinophilic, often fragmented into globules, creating a "string of pearls" or "pipe cleaner" appearance. Because of degeneration, the elastic fibers will appear as globules with a serrated or "prickled" edge. 

## Histochemistry
The elastic fibers will be highlighted by a Weigert or von Gieson elastic stains. 
Images courtesy of Professor Peter Anderson DVM PhD and published with permission  PEIR, University of Alabama at Birmingham, Department of Pathology
- Elastofibroma
- Elastofibroma
- Papillary Fibroelastoma: When located on the mitral valve, these tumors are usually on the anterior leaflet of the atrial surface.
-  Jump up to: 1.0 1.1 PMID 17462431 (.mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}PMID 17462431)Citation will be completed automatically in a few minutes. 
Jump the queue  or expand by hand
-  PMID 1636353 (PMID 1636353)Citation will be completed automatically in a few minutes. 
Jump the queue  or expand by hand
Sandbox endocarditis2

# Medical Therapy

## Pharmacotherapy

### Community-Acquired Meningitis
Add Ampicillin 2 g IV q4h (50 mg/kg IV q6h for children) if meningitis caused by Listeria monocytogenesis also suspected.
Adapted from Advances in treatment of bacterial meningitis. Lancet. 2012;380(9854):1693-702.

### Empiric Treatment
- Do not wait for the results of the CT scan and the lumbar puncture; empiric treatment should be started as soon as possible.
- Blood cultures should be drawn before starting the antibiotic therapy, and then the antibiotic treatment should be changed once the blood culture results are out.
- Empiric antibiotic treatment should be started within 30 minutes after the patient presentation.
- In case of high suspicion of pneumococcal meningitis in adult patients, 0.15 mg/kg IV Q6H dexomethasone should be administered for 2 to 4 days.
The first dose of dexomethasone is given along with or 20 minutes prior to starting the antibiotics treatment.
- The first dose of dexomethasone is given along with or 20 minutes prior to starting the antibiotics treatment.
Save Huddersfield NHS
Save Huddersfield NHS is a broad based campaign against the Kirklees and Calderdale NHS Trust Board's proposals to close St. Lukes Hospital and transfer services (including maternity care) from Huddersfield to Halifax and Wakefield, led by Dr. Jackie Grunsell. The campaign was initially formed after a public meeting organised by the Huddersfield branch of the Socialist Party (England and Wales) .
The campaign has organised, amongst other things, a mock-ballot on the issue, three demonstrations (with the largest being over 2000 people) and a petition signed by over 60,000 people. One of its key demands was for Kirklees Council to organise a referendum, allowing the people of Huddersfield to decide upon the issue. When the council declined to undertake this, the campaign stood three candidates in the local government elections of 2006. Dr. Grunsell was elected to the council with a majority of 800, after declaring her campaign to be a referendum on the local council. 
The campaign linked up with others across the country through the 'People United Saving Hopsitals' (PUSH) umbrella group, who called for a national demonstration on Saturday 3rd March 2007 against all NHS cuts.  They already had the support of AMICUS, 'Keep Our NHS Public' and two regions of UNISON. PUSH had previously organised a united day of action across the country on 15th December 2006 against NHS cuts.  The campaign also began campaigning against further cuts to health services in the district, such as the threatened closure of Princess Royal hospital, cuts to district nursing and a freeze on recruitment.
The campaign stond another candidate in the 2007 local elections in the Crosland Moor and Netherton ward of Kirklees Council, Ian Slattery. Although he did not win, he received over 1000 votes. 
Threats to close Princess Royal, have now been ended, partially due to the pressure of the camapign.
Near Princes Royal (near Greenhead Park) an unknown graffitist had painted Save the NHS on the wall outside the hospital. At the same time a similar message was painted on the Labour Party offices, but was swiftly removed. The painting on the wall outside Princess Royal remains.
Scrub typhus overview

# Overview
Scrub typhus or Bush typhus  is a form of typhus caused by the intracellular parasite Orientia tsutsugamushi, a Gram-negative -proteobacterium of family Rickettsiaceae first isolated and identified in 1930 in Japan.
Although the disease is similar in presentation to other forms of typhus, its pathogen is not anymore included in genus Rickettsia with the typhus bacteria proper, but in Orientia. The disease is thus frequently classified separately from the other typhi.

# Diagnosis

## Physical Examination
Maculopapular rash, eschar, splenomegaly and lymphadenopathies are typical signs.

## Laboratory Findings
In endemic areas, diagnosis is generally made on clinical grounds alone.  Where there is doubt, the diagnosis may be confirmed by a laboratory test such as serology.