Persius/hicric huggingface dataset:
Posthepatic jaundice

# Overview
Post-hepatic jaundice, also called obstructive jaundice, is caused by an interruption to the drainage of bile in the biliary system. The most common causes are gallstones in the common bile duct, and pancreatic cancer in the head of the pancreas.  Also, a group of parasites known as "liver flukes" can live in the common bile duct, causing obstructive jaundice.  Other causes include strictures of the common bile duct, biliary atresia, cholangiocarcinoma, pancreatitis and pancreatic pseudocysts. A rare cause of obstructive jaundice is Mirizzi's syndrome.
In complete obstruction of the bile duct, no urobilinogen is found in the urine, since bilirubin has no access to the intestine  and it is in the intestine that bilirubin gets converted to urobilinogen to be later released into the general circulation. In this case, presence of bilirubin (conjugated) in the urine without urine-urobilinogen suggests obstructive jaundice, either intra-hepatic or post-hepatic.
The presence of pale stools and dark urine suggests an obstructive or post-hepatic cause as normal feces get their color from bile pigments. However, although pale stools and dark urine are a feature of biliary obstruction, they can occur in many intra-hepatic illnesses and are therefore not a reliable clinical feature to distinguish obstruction from hepatic causes of jaundice.
Patients also can present with elevated serum cholesterol, and often complain of severe itching or "pruritus" because of the deposition of bile salts.

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Posthepatic jaundice from Other Diseases

# Epidemiology and Demographics

# 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
Potassium bitartrate
Potassium bitartrate also potassium hydrogen tartrate has formula KC4H5O6. It is a byproduct of winemaking. It is also known as cream of tartar. It is the potassium acid salt of tartaric acid.

# Occurrence
Potassium bitartrate crystallises in wine casks during the fermentation of grape juice. In wines bottled before they are fully ripe, argol can precipitate on the side of the bottle in a sort of crust, thus forming what is called "crusted wine".
This crude form (known as beeswing) is collected and purified to produce the white, odorless, acidic powder used for many culinary and other household purposes.

# Applications

## In food
In food, potassium bitartrate is used for:
- Stabilizing egg whites, increasing their heat tolerance and volume;
- Preventing sugar syrups from crystallising;
- Reducing discolouration of boiled vegetables;
- Frequent combination with baking soda (which needs an acid ingredient to activate it) in formulations of baking powder.
- Commonly used in combination with potassium chloride in sodium-free salt substitutes
A similar acid salt sodium acid pyrophosphate is confused with cream of tartar due to their similar function in baking powder.

## Chemistry
Potassium acid tartrate, also known as potassium hydrogen tartrate, is also used as a primary reference standard for a pH buffer, according to NIST. Using an excess of salt in water, a saturated solution is created with a pH of 3.557 at 25C. Upon dissolution in water, potassium bitartrate will dissociate into acid tartrate, potassium cation, and the tartarate dianion. Thus, a saturated solution creates a buffer with standard pH. Before use as a standard, it is recommended that the solution be filtered or decanted between 22 and 28C.

## Folk Remedy
Cream of Tartar mixed with orange juice is a folk remedy for smoking cessation, the purpose being to replace the potassium that smoking depletes.
Presbycusis overview
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# Overview
Presbycusis, or age-related hearing loss, is the cumulative effect of aging on hearing. Also known as presbyacusis, it is defined as a progressive bilateral symmetrical age-related sensorineural hearing loss. The hearing loss is confined to higher frequencies.

# Cultural Aspects
Recently, this condition has led to the development of technologies to stop younger people from loitering near British stores (The Mosquito), and the development of a cell phone ringtone, Teen Buzz, for students to use in school, that many older instructors are unable to hear. In September 2006 this technique was used to make a dance track called 'Buzzin'. The track had two melodies, one that everyone could hear and one that only younger people could hear.

# Diagnosis

## History and Symptoms
Hearing loss usually begins gradually after the age of sixty, and is usually found more often in men than women. This can be miscontributed to men having a greater exposure to environmental noise. However, exposure to environmental noise can lead to noise-induced hearing loss (NIHL), a hearing issue that is separate from presbycusis.  
Over time, the detection of high-pitched sounds becomes more difficult and both ears tend to be affected.

## Physical Examination
The physical examination is usually normal with exception of cerumen which is a common problem in elderly people and a frequent cause of hearing loss and hearing aid malfunction. The physical examination includes otoscopy, whispered ear test and tuning forks for the assessment of hearing loss. The physical examination of the outer ears is usually normal in presbycusis. The otoscopic examination is helpful for finding other potential causes of hearing loss such as cerumen impaction, tympanic membrane perforation, infection or tumors.
Yellow nail syndrome
Synonyms and keywords: Primary lymphedema associated with yellow nails and pleural effusion

# Overview
Yellow nail syndrome is a medical syndrome that includes pleural effusions, lymphedema and yellow dystrophic nails. Sometimes yellow nails are referred to as smoker's fingers.

# Pathophysiology

## Associated Conditions
- Bronchiectasis in about 40% of people with yellow nail syndrome.
- Chronic sinusitis
- Congenital hypoplasia / dysplasia of peripheral lymph vessels

# Treatment

## Pharmacotherapy

### Chronic Pharmacotherapies
Normal treatment for swelling and any respiratory problems is appropriate. Nutritional supplementation with Vitamin E in some studies has been shown to be effective in controlling nail changes.
Primitive heart tube
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The primitive heart tube is the earliest stage of heart development.
From the inflow to the outflow, it consists of sinus venosus, primitive atrium, the primitive ventricle, the bulbus cordis, and truncus arteriosus.
It forms primarily from splanchnic mesoderm. More specifically, they form from endocardial tubes, starting at day 21.
Prolyl endopeptidase
Prolyl endopeptidase (PE) also known as prolyl oligopeptidase or post-proline cleaving enzyme is an enzyme that in humans is encoded by the PREP gene.

# Function
Prolyl endopeptidase is a large cytosolic enzyme that belongs to a distinct class of serine peptidases. It was first described in the cytosol of rabbit brain as an oligopeptidase, which degrades the nonapeptide bradykinin at the Pro-Phe bond. The enzyme is involved in the maturation and degradation of peptide hormones and neuropeptides such as alpha-melanocyte-stimulating hormone, luteinizing hormone-releasing hormone (LH-RH), thyrotropin-releasing hormone, angiotensin, neurotensin, oxytocin, substance P and vasopressin. PREP cleaves peptide bonds at the C-terminal side of proline residues. Its activity is confined to action on oligopeptides of less than 10 kD and it has an absolute requirement for the trans-configuration of the peptide bond preceding proline.
Prolyl endopeptidases are involved in the maturation and degradation of peptide hormones and neuropeptides.

# Structure
Prolyl endopeptidase is a cytosolic prolyl endopeptidase that cleaves peptide bonds on the C-terminal side of prolyl residues within peptides that are up to approximately 30 amino acids long. Only short protein residues are able to enter the active site of prolyl endopeptidase due to the distinct beta-propeller region that acts as a gating filter mechanism.

# Clinical significance
Altered PREP activity may be associated with autism spectrum disorders and various psychological diseases such as schizophrenia, mania and clinical depression.
However, there is conflicting information as to the exact role that prolyl endopeptidase plays in the pathophysiology of depression, with earlier studies documenting a decreased activity of the enzyme in depressed patients, but more recent studies demonstrating that inhibition of the same enzyme actually results in alleviation of depressive symptoms.
Some types of prolyl endopeptidase have been used in studies to decrease the propensity of gluten-containing wheat products to aggravate coeliac disease. However, orally administered enzymes are potentially subject to inactivation in the gastrointestinal tract.

# Inhibitors
Several prolyl endopeptidase inhibitors are known, and have been suggested as possible nootropic and antidepressant drugs. Notable compounds include
- Pramiracetam
- Baicalin
- JTP-4819
- KYP-2047
- S-17092
- Berberine
Prostatic congestion
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Prostatic congestion is a medical condition of the prostate gland (prostatosis) that happens when the prostate becomes swollen by excess fluid. The condition often results in a sufferer feeling the urge to urinate frequently.
Some physicians recommend reducing congestion in the prostate by ejaculating more frequently or by massaging the prostate regularly. Excessive alcohol intake, perineal injury, and certain sexual practices (particularly anal sex without a condom) may cause congestion of the prostate gland.

# Possible causes of prostatic congestion
- Benign prostatic hyperplasia
- Blue balls
- Chronic prostatitis - infection of the prostate
- Excessive drinking of alcoholic beverages
- Prostate Cancer
- Urinary tract cysts
Proteasome inhibitor
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# Overview
Proteasome inhibitors are drugs that block the action of proteasomes, cellular complexes that break down proteins, like the p53 protein. Proteasome inhibitors are being studied in the treatment of cancer. In 2003, bortezomib was the first proteasome inhibitor to be approved for use in the U.S.
A derivative of epigallocatechin-3-gallate has been proposed as another proteasome inhibitor.
Proteomics (journal)
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The journal Proteomics covers topics including whole proteome analysis of organisms, protein expression profiling, disease, pharmaceutical, agricultural and biotechnological applications, and analysis of cellular systems, organelles and protein complexes. The 2005 impact factor was 6.088.
Prune belly syndrome
Steven C. Campbell, M.D., Ph.D.
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# Overview
Prune belly syndrome is a rare birth defect affecting about 1 in 30,000 births.  About 96% of those affected are male.  Prune belly syndrome is a congenital disorder of the urinary system, characterized by a triad of symptoms.  The syndrome is named for the mass of wrinkled skin that is often (but not always) present on the abdomens of those with the disorder.  Other names for the syndrome include Abdominal Muscle Deficiency Syndrome, Congenital Absence of the Abdominal Muscles, Eagle-Barrett Syndrome, Obrinsky Syndrome, Frohlich Syndrome, or rarely, Triad Syndrome.

# Symptoms
- A partial or complete lack of abdominal muscles.  There may be wrinkly folds of skin covering the abdomen.
- Undescended testicles in males
- Urinary tract abnormality such as unusually large ureters, distended bladder, accumulation and backflow of urine from the bladder to the ureters and the kidneys
- Frequent urinary tract infections due to the inability to properly expel urine.

# Diagnosis
Prune belly syndrome can be diagnosed via ultrasound while a child is still in-utero.  An abnormally large abdominal mass is the key indicator, as the abdomen swells with the pressure of accumulated urine.  In young children, frequent urinary tract infections often herald prune belly syndrome, as they are normally uncommon.  If a problem is suspected, doctors can perform blood tests to check kidney function.  Another test that may reveal the syndrome is the "voiding cystourethrogram," in which a catheter is inserted into the urethra to fill the bladder with dye.  An X-ray can detect if urine has a reverse flow into the ureters and kidneys (see example x-ray teaching file).
Prune belly syndrome can also result in the distending and enlarging of internal organs such as the bladder and intestines. Surgery is often required to return these organs to their natural sizes.
A genetic predisposition has been suggested, and PBS is much more common when the baby is a twin, although all reported twin births have been discordant.

# Treatment
The type of treatment, like that of most disorders, depends on the severity of the symptoms. One option is to perform a vesicostomy, which allows the bladder to drain through a small hole in the abdomen. A more drastic procedure is a surgical "remodeling" of the abdominal wall and urinary tract. Boys may have an orchiopexy, which moves the testicles to their proper place in the scrotum.
Even with treatment, many patients experience renal failure.
Psilocybe aucklandii
Psilocybe aucklandii is a psychedelic mushroom, which has psilocybin and psilocin as main active compounds.

# Description
- Cap: 2-5 cm, conical to plane, chestnut brown, hygrophanous, bruising blue/green where damaged, often with a broad umbo.
- Gills: Cream color when young, violet yellowish brown in age, with adnate attachment.
- Spores: Dark violet brown, oblong to ellipsoid, 7 x 4 um.
- Stipe: 4 to 9 cm long, .2 to .5 cm thick, brown, bruising blueish, pruinose, with fibrils near the base.
- Taste: Farinaceous.
- Odor: Farinaceous.
- Microscopic features:

# Distribution and habitat
Grows in leaf litter and woody debris near Auckland, New Zealand.
Psilocybe azurescens
Psilocybe azurescens is a psychedelic mushroom whose main active compounds are  psilocybin and psilocin. It is among the most potent of the tryptamine-bearing mushrooms, containing up to 1.8% psilocybin, 0.5% psilocin, and 0.4% baeocystin by dry weight, averaging to about 1.1% psilocybin and 0.15% psilocin. It belongs to the family Strophariaceae in the order Agaricales.

# Appearance
Pileus 30-100 mm in diameter, conic to convex, expanding to broadly convex and eventually flattening with age with a pronounced, persistent broad umbo; surface smooth, viscous when moist, covered by a separable gelatinous pellicle; chestnut to ochraceous brown to caramel in color often becoming pitted with dark blue or bluish black zones, hygrophanous, fading to light straw color in drying, strongly bruising blue when damaged; margin even, sometimes irregular and eroded at maturity, slightly incurved at first, soon decurved, flattening with maturity, translucent striate and often leaving a fibrillose annular zone in the upper regions of the stem. Lamellae ascending, sinuate to adnate, brown, often stained info-black where injured, close, with two tiers of lamellulae, mottled, edges withish. Spore-print dark purplish brown to purplish black in mass. Stipe 90-200 mm long by 3-6 mm thick, silky white, dingy brown from the base or in age, hollow at maturity. Composed of twisted, cartilaginous tissue. Base of stem thickening downwards, often curved, and characterized by coarse white aerial tufts of mycelium, often with azure tones. Mycelium surrounding stipe base densely rhizomorphic (i.e., root-like), silky white, tenaciously holding the wood-chips together, strongly bruising bluish upon disturbance. They have no odor to slightly farinaceous. Their taste is extremely bitter.

# Habitat and distribution
Cespitose to gregarious on deciduous wood-chips and/or in sandy soils rich in lignicolous debris. Aspect collyboid, generating an extensive, dense and tenacious mycelial mat, Psilocybe azurescens causes the whitening of wood. Fruitings begin in late September and continue until harsh frost, usually mid-November.
Cultivated patches occurr worldwide, but natural patches are found along the US Pacific coast, north of Seaside, Oregon.

# Legal status
Possession and/or cultivation of this species is illegal in a number of countries.

# Effects
See Psilocybin: Effects.
Psilocybe caerulipes
Psilocybe caerulipes, also known as Bluefoot is a psilocybin mushroom of the Agaricales family, having psilocybin and 
psilocin as main active compounds.

# Description
- Cap:   Less than 4 cm across, conic to plane in age, viscid when mist, often with greenish stains near the margin and sometimes with an umbo.  It is rusty brown to buff, fading to a lighter shade of buff as it dries.
- Gills: Close, with adnate attachment.  They are light brown at first, becoming a dark rusty brown as the spores mature.
- Spores: Dark purple brown, 8x4x4 um, ellipsoid, thick walled, with a broad germ pore.
- Stipe: 2 to 7 cm long, 2.5 mm thick, white.  Slowly stains blue where bruised, taking a few hours for the color change to occur.
- Taste: Farinaceous.
- Odor: Slightly farinaceous.
- Microscopic features: Basidia 2 and 4 spored. Pleurocystidia absent.  Cheilocystidia 20-35 x 5-7 um.

# Habitat and formation
Psilocybe caerulipes is found growing on decaying wood and wood chips throughout the midwest and east coast.  This mushroom is found most commonly on maple, beech or birch wood.  They are most prolific in deciduous forests near river valleys, preferring flood planes and overflow areas.  They tend to grow in areas with a lot of elevation change and are rarer in flat locations.
Psilocybe cyanescens
For information on the effects of this mushroom see the Psilocybin article.
Wavy cap or Caramel-capped psilocybe (Psilocybe cyanescens Wakef.) is a psychedelic mushroom whose main active compounds are psilocybin and psilocin.  It belongs to the family Strophariaceae in the order Agaricales. It was described from Kew Gardens, United Kingdom, by E. M. Wakefield in the 1940s. It is one of the most popular psychoactive fungi. There are two concepts of this species as Psilocybe cyanescens Wakef. emend. Krieglst. (Krieglsteiner 1984) and Psilocybe cyanescens Wakef. sensu stricto (Borovicka 2005). The most related species is Psilocybe azurescens Stamets & Gartz which differs by conical and acutely umbonated pileus, mottled stipe with remains of veil building a well-developed fibrillose annular zone, large fruit bodies and somewhat longer spores. Some European (EU) or Australian (AU) species are close to Psilocybe cyanescens, especially Psilocybe serbica (EU), Psilocybe arcana (EU), Psilocybe moravica (EU), Psilocybe aucklandii (AU), Psilocybe eucalypta (AU) and others.

# Appearance
Psilocybe cyanescens has a hygrophanous pileus that is fawn-brown or chestnut-brown when moist, fading to pale ochraceous or slightly yellowish. It bruises with a bluish or blue-green color, often still visible on dried stipe. Cap is usually 2-5 cm across, distinctly wavy in maturity. Lamellae adnate to sligtly subdecurrent, chocolate brown or ochraceous in maturity, with white edge. Fibrillose annular zone on stipe is absent. Microscopically, this species is characterized by common clavate-mucronate pleurocystidia.

# Habitat and distribution
Psilocybe cyanescens grows on woody debris - in the presence of woodchips and mulched plant beds (particularly under rhododendrons). In the U.S., P. cyanescens occurs mainly in the Pacific Northwest, south to northern California. It can be found as well as in Western and Central Europe. This species was likely introduced to Europe, where it occurs mainly in cemeteries, botanic gardens and city parks.

# Legal status
Possession and/or cultivation of this species is illegal in a number of countries, including the United States.
Psilocybin mushrooms are not specifically named in the U.S.A. federal scheduling system, however their two primary active chemicals Psilocybin and Psilocin are both Schedule I in the United States. This means they are illegal to manufacture, buy, possess, or distribute (sell, trade or give) without a DEA license. Fresh and dried psilocybin mushrooms are considered containers of Psilocybin and Psilocin, making them illegal to possess as well.
Because spores contain no psilocybin or psilocin, they are legal to sell and possess (in all states except California, Georgia and Idaho). But in most states, it is illegal to cultivate or propagate spores into mycelium since mycelium generally contains both psilocybin and psilocin.
Some states in the U.S. and some countries have ruled that growing psilocybe mushrooms does not qualify as 'manufacturing' a controlled substance (psilocybin).