Persius/hicric huggingface dataset:
Anterior pituitary
The anterior pituitary (also called the adenohypophysis, from Greek adeno, "gland"; hypo, "under"; physis, "growth"; hence, glandular undergrowth) comprises the anterior lobe of the pituitary gland and is part of the endocrine system. Unlike the posterior lobe, the anterior lobe is genuinely glandular, hence the root adeno in its name.
Under the influence of the hypothalamus, the anterior pituitary produces and secretes several peptide hormones that regulate many physiological processes including stress, growth, and reproduction.

# Regions
The term "pars distalis" is sometimes used as a synonym for the the anterior pituitary, but this is not quite correct. The anterior pituitary is usually divided into three regions:
- pars distalis ("distal part") - the majority of the anterior pituitary
- pars tuberalis ("tubular part") - a sheath extending up from the pars distalis and wrapping around the pituitary stalk
- pars intermedia ("intermediate part") - sits between the bulk of the anterior pituitary and the posterior pituitary and is often very small in humans
The function of the tuberalis is not well characterized, and most of the rest of this article refers primarily to the distalis.

# Embryology
Unlike the posterior pituitary (pars nervosa), which originates from neural ectoderm, the anterior pituitary arises from an invagination of the oral mucosa called Rathke's pouch (which is itself ectoderm derived).
This differentiation is exhibited by the fact that while the posterior pituitary merely secretes those hormones produced in the hypothalamus (ADH and oxytocin), the anterior pituitary actually produces its hormones, while being under control of the hypothalamus as to when they should be secreted.

# Major hormones secreted
A useful acronym for the hormones secreted by the anterior pituitary is 'FLAT PEG' (FSH, LH, ACTH, TSH, Prolactin, Endorphins, GH).

# Hypothalamic releasing and release-inhibiting factors
Hormone secretion from the anterior pituitary gland is regulated by hormones secreted by the hypothalamus. Neuroendocrine neurons in the hypothalamus project axons to the median eminence, at the base of the brain. At this site, these neurons can release substances into small blood vessels that travel directly to the anterior pituitary gland (the hypothalamo-hypophysial portal vessels).

# Additional images
- The anterior pituitary is the anterior, glandular lobe of the pituitary gland.
Adrenergic agonist

# Overview
An adrenergic is a drug, or other substance, which has effects similar to, or the same as, epinephrine (adrenaline). Thus, they are a kind of sympathomimetic agents. Alternatively, it may refer to something which is susceptible to epinephrine, or similar substances, such as a biological receptor (specifically, the adrenergic receptors).
Beta blockers block the action of epinephrine and norepinephrine in the body.  Adrenergic drugs either stimulate a response (agonists) or inhibit a response (antagonists). The five categories of adrenergic receptors are: 1, 2, 1, 2, and 3, and agonists vary in specificity between these receptors, and may be classified respectively. However, there are also other mechanisms of adrenergic agonism. Epinephrine and norepinephrine are endogenous and broad-spectrum. More selective agonists are more useful in pharmacology.

# 1 agonists
1 agonists: stimulates phospholipase C activity. (vasoconstriction and mydriasis; used as vasopressors, nasal decongestants & eye exams). Selected examples are:
- Methoxamine
- Methylnorepinephrine
- Oxymetazoline
- Phenylephrine

# 2 agonists
2 agonists: inhibits adenylyl cyclase activity. (reduce brainstem vasomotor center-mediated SNS activation; used as antihypertensives, sedatives & treatment of opiate & alcohol withdrawal symptoms). Selected examples are:
- Clonidine (mixed alpha2-adrenergic and imidazoline-I1 receptor agonist)
- Guanfacine (preference for alpha2A-subtype of adrenoceptor)
- Guanabenz (most selective agonist for alpha2-adrenergic as opposed to imidazoline-I1)
- Guanoxabenz (metabolite of guanabenz)
- Guanethidine (periferal alpha2-receptor agonist)

# 1 agonists
1 agonists: stimulates adenylyl cyclase activity; opening of calcium channel. (cardiac stimulants; used to treat cardiogenic shock, acute heart failure, bradyarrhythmias). Selected examples are:
- Dobutamine
- Isoproterenol (1 and 2)

# 2 agonists
2 agonists: stimulates adenylyl cyclase activity; closing of calcium channel (smooth muscle relaxants; used to treat asthma and COPD). Selected examples are:
- salbutamol (albuterol in USA)
- Fenoterol
- Formoterol
- Isoproterenol (1 and 2)
- Metaproterenol
- Salmeterol
- Terbutaline
- Clenbuterol

# Other mechanisms
- Indirect action
Amphetamine
Tyramine
- Amphetamine
- Tyramine
- Mixed action
Ephedrine
- Ephedrine
Adult vaccinations

# Overview
Vaccinations are very important in adult population. A relatively small proportion of younger adults i.e 18-64 years old, are vaccinated every year. The number being 18.5% for those at risk of pneumococcal infection being vaccinated to 40% individuals at risk of influenza being vaccinated againts influenza, according to the National Health Interview Survey (NHIS) details. There has been marked improvement in adult population over 65 years with respect to the adherence to the vaccaine schedule. Recommended schedule of vaccination for adults with respect to age and medical conditions has been discussed in detail along with recommendations for special populations and contraindications associated with adult vaccinations.

# Recommended Schedule of Vaccination

## Recommended schedule of vaccination for adults aged 19 and older, by age group, in the United States 
Abbreviations:
Td/Tdap: Tetanus, diphtheria, and pertussis, MMR: Measles, Mumps, and Rubella, VAR: varicella, HZV: Herpes zoster virus, HPV: Human papillomavirus, PCV13: Pneumococcal conjugate vaccine, PPSV23: Pneumococcal polysaccharide vaccine, HepA: Hepatitis A, HepB: Hepatitis B, Men: Meningitis, Hib: Haemophilus influenzae type b

## Recommended schedule of vaccination for adults aged 19 and older, by medical condition and other indications, in the United States
Abbreviations:
Td/Tdap: Tetanus, diphtheria, and pertussis, MMR: Measles, Mumps, and Rubella, VAR: varicella, HZV: Herpes zoster virus, HPV: Human papillomavirus, PCV13: Pneumococcal conjugate vaccine, PPSV23: Pneumococcal polysaccharide vaccine, HepA: Hepatitis A, HepB: Hepatitis B, Men: Meningitis, Hib: Haemophilus influenzae type b

# Recommendations for Special Populations
Abbreviations:
Td/Tdap: Tetanus, diphtheria, and pertussis, MMR: Measles, Mumps, and Rubella, VAR: varicella, HZV: Herpes zoster virus, HPV: Human papillomavirus, PCV13: Pneumococcal conjugate vaccine, PPSV23: Pneumococcal polysaccharide vaccine, HepA: Hepatitis A, HepB: Hepatitis B, Men: Meningitis, Hib: Haemophilus influenzae type b
*IIV-Inactivated influenza vaccine
*RIV-Recombinant influenza vaccine

# Contraindications and Precautions for Adult Vaccinations
Affective spectrum

# Overview
The affective spectrum is a grouping of related psychiatric and medical disorders which may accompany bipolar, unipolar, and schizoaffective disorders at statistically higher rates than would normally be expected.  These disorders are identified by a common positive response to the same types of pharmacologic treatments. They also aggregate strongly in families and may therefore share common heritable underlying physiologic anomalies.
Affective spectrum disorders include:
- Attention-deficit hyperactivity disorder
- Bipolar disorder
- Body dysmorphic disorder
- Bulimia nervosa and other eating disorders
- Cataplexy
- Dysthymia
- General anxiety disorder
- Hypersexuality
- Impulse-control disorders
- Kleptomania
- Migraine
- Major Depressive Disorder
- Narcolepsy
- Obsessive-compulsive disorder
- Panic disorder
- Posttraumatic stress disorder
- Premenstrual dysphoric disorder
- Social phobia
The following may also be part of the spectrum accompanying affective disorders.
- Chronic pain
- Intermittent explosive disorder
- Pathological gambling
- Personality disorder
- Pyromania
- Substance abuse and addiction (includes alcoholism)
- Trichotillomania
Also, there are now studies linking heart disease.
Please note that many of the terms above overlap.  The generally accepted definition of these terms can be found in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

# Resources
International Society for Bipolar Disorders
Afferent arteriole
The afferent arterioles are a group of blood vessels that supply the nephrons in many excretory systems. They play an important role in the regulation of blood pressure.
The afferent arterioles branch from the renal artery which supplies blood to the kidneys.
The afferent arterioles later diverge into the capillaries of the glomerulus.
When renal blood flow is reduced (indicating hypotension), the macula densa releases prostaglandins, which cause the juxtaglomerular cells lining the afferent arterioles to release renin, activating the renin-angiotensin-aldosterone system, to increase blood pressure.
Agathosma betulina
Agathosma betulina (previously Barosma betulina) is a flowering plant in the family Rutaceae, native to the lower elevation mountains of western South Africa, where it occurs near streams in fynbos habitats. It is an evergreen shrub growing to 2 m tall. The leaves are opposite, rounded, about 20 mm long and broad. The flowers are white or pale pink, with five petals; the fruit is a five-parted capsule which splits open to release the seeds.
It is known by the common name round leaf buchu and has historically been used as a flavoring agent and an herbal remedy. The very similar plant Agathosma crenulata (previously Barosma crenulata) is known as the oval leaf buchu, and has been used for the same purposes.
Wild plants of this species are still plentiful but are being harvested faster than they can reproduce. The threat of their becoming scarce has led to efforts to cultivate them. The essential oils and extracts of the leaves are used as flavoring for teas, candy, and a liquor known as buchu brandy in South Africa. The two main oils of A. betulina are isomenthone and disphenol. The extract is said to taste like blackcurrant. It has historically been used as a medicine for urinary tract disorders and wounds.
Agonal respiration

# Overview
Agonal respiration is an abnormal pattern of breathing characterized by shallow, slow (3-4 per minute), irregular inspirations followed by irregular pauses. They may also be characterized as gasping, labored breaths, accompanied by strange vocalizations and myoclonus. The cause is due to cerebral ischemia, due to extreme hypoxia or even anoxia.  Agonal breathing is an extremely serious medical sign requiring immediate medical attention, as the condition generally progresses to complete apnea and heralds death.

# Causes
Agonal respirations are also commonly seen in cases of cardiac arrest, and may persist for several minutes after cessation of heartbeat. The presence of agonal respirations in these cases indicates a more favorable prognosis than in cases of cardiac arrest without agonal respirations.

# Differentiating Agonal Respirations from other Diseases
Agonal respiration is not the same as, and is unrelated to, the phenomenon of death rattle.  The term is sometimes (inaccurately) used to refer to labored, gasping breathing patterns accompanying organ failure (e.g. liver failure and  renal failure), SIRS, septic shock, and metabolic acidosis, or in general any labored breathing, including Biot's respirations and ataxic respirations. Correct usage would restrict the term to the last breaths before death.

# Related Chapters
- Cheyne-Stokes Respiration
Albuterol overdose

# Overdosage topics
Manifestations
Treatment
Lethal dose

## Manifestations
The expected symptoms with overdosage are those of excessive beta-adrenergic stimulation and/or occurrence or exaggeration of any of the symptoms listed under side effects, e.g., seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, and sleeplessness. Hypokalemia may also occur. As with all sympathomimetic medications, cardiac arrest and even death may be associated with abuse of Albuterol tablets. Return to top

## Treatment
Treatment consists of discontinuation of Albuterol tablets together with appropriate symptomatic therapy.The judicious use of a cardioselective beta-receptor blocker may be considered, bearing in mind that such medication can produce bronchospasm. There is insufficient evidence to determine if dialysis is beneficial for overdosage of Albuterol tablets. Return to top

## Lethal dose
The oral median lethal dose of Albuterol sulfate in mice is greater than 2000 mg/kg (approximately 250 times the maximum recommended daily oral dose for adults on a mg/m2 basis, or, approximately 200 times the maximum recommended daily oral dose for children on a mg/m2 basis). In mature rats, the subcutaneous (sc) median lethal dose of Albuterol sulfate is approximately 450 mg/kg (approximately 110 times the maximum recommended daily oral dose for adults on a mg/m2 basis, or, approximately 90 times the maximum recommended daily oral dose for children on a mg/m2 basis). In small young rats, the subcutaneous median lethal dose is approximately 2000 mg/kg (approximately 500 times the maximum recommended daily oral dose for adults on a mg/m2 basis, or, approximately 400 times the maximum recommended daily oral dose for children on a mg/m2 basis). Return to top
Adapted from the FDA Package Insert.
Alicyclic compound
An alicyclic compound is an organic compound that is both aliphatic and cyclic. They contain one or more all-carbon rings which may be either saturated or unsaturated, but do not have aromatic character. Alicyclic compounds may or may not have aliphatic side chains attached.
Simple alicyclic compounds are the cycloalkanes cyclopropane, cyclobutane and cyclohexane. A polycyclic cycloalkane is Decalin. Bicyclic alkanes are norbornene and norbornadiene. Spiro compounds have bicyclic connected through one carbon atom.
The mode of ring-closing in the formation of many alicyclic compounds can be predicted by Baldwin's rules.
An exocyclic group is always placed outside the ring structure, take for instance the exocyclic double bond on the left:
See for an example isotoluene.

# Cycloalkenes
Monocyclic Cycloalkenes are cyclobutene, cyclopropene and cyclohexene.
The placement of double bonds in many alicyclic compounds can be predicted with Bredt's Rule.
Alpha Bungarotoxin
-bungarotoxin is one of the components of the venom of the elapid snake Taiwanese banded krait (Bungarus multicinctus).  It binds irreversibly to the acetylcholine receptor found at the neuromuscular junction, causing paralysis, respiratory failure and death in the victim.
-bungarotoxin is also a selective antagonist of the 7 nicotinic acetylcholine receptor in the brain, and as such has applications in neuroscience research.
In addition to the -type bungarotoxin, a -bungarotoxin is fairly common in some snake venom.  The target of this neurotoxin is at the presynaptic terminal, where it prevents release of acetylcholine by binding to proteins, most commonly actin.

# History
Bungarotoxin was discovered by Chuan-Chiung Chang and Chen-Yuan Lee of the National Taiwan University in 1963.
Aluminium fluoride
Aluminium fluoride is the inorganic compound with the formula AlF3. It can be prepared by treating aluminium hydroxide or aluminium metal with HF.  As a solid, its structure resembles that of rhenium trioxide, ReO3, consisting of distorted AlF6 octahedra.
AlF3 is refractory, in strong contrast to the other halides of aluminium.  AlCl3, AlBr3, and AlI3 are dimeric in the liquid and evaporate as dimers as well.  In the gas phase, at ca. 1000 C, aluminium fluoride exists as trigonal molecules of D3h symmetry group.  The Al-F bond lengths are 163 pm.
Aluminium fluoride is an important additive during electrolyte aluminium production because it lowers the melting point of the alumina feed and increases the electrolyte's conductivity.
Amanita pantherina
The Panther cap (Amanita pantherina), also known as the False Blusher due to its similarity to the true Blusher (Amanita rubescens), is a poisonous mushroom found in woodland throughout Europe, western Asia and North America.

# Description
A. pantherina has a bronze or pale orange-brown pileus (cap) bearing small white warts and between 5 and 15 cm (2-6 inches) in diameter. In younger specimens the cap is domed, becoming flatter with age. The upper remains of the velum form a ring around the cap margin in younger mushrooms. In moist conditions the pileus is often viscid, with a farinaceous (or starchy) odor.
The stipe (stem) grows to a length of between 6-10 cm and between 1212 cm in diameter, with a narrow hoop-like ring low down. The lower remains of the velum form a volva (sheath) around the basal bulb, often with one or two narrow rings.
The white spores are smooth, elliptical, non-amyloid and 9121379.5 m in size.

## Similar species
Although not normally fatal, Amanita pantherina should be studied with caution. It can also be misidentified as Amanita gemmata and confused with the Blusher (Amanita rubescens), though the latter's flesh turns red or 'blushes'.

# Distribution and habitat
The Panther cap is an uncommon mushroom, found in both deciduous, especially beech and, less frequently, coniferous woodland and RARELY meadows throughout Europe, western Asia and North America in late summer and autumn. It is an ectomycorrhizal fungus, living in root symbiosis with a tree, deriving photosynthesised nutrients from it and providing soil nutrients in return.

# Toxicity
The Panther cap contains muscarine and is generally regarded as more poisonous than the related Fly Agaric, having been the cause of some fatalities.
Aminohippuric acid

# Overview
Aminohippuric acid or para-aminohippuric acid (PAH), a derivative of hippuric acid, is a diagnostic agent useful in medical tests involving the kidney used in the measurement of renal plasma flow.  It is an amide derivative of the amino acid glycine and para-aminobenzoic acid that is not naturally found in humans; it needs to be IV infused before use diagnostically.

# Uses

## Diagnostics
PAH is useful for the measurement of renal plasma flow because it is secreted primarily by the renal tubules; only 20-30% is filtered by the glomerulus.  PAH is freely filtered from plasma in the glomerulus and not reabsorbed by the tubules, similar to inulin.  PAH differs from inulin in that the fraction of PAH that bypasses the glomerulus and enters the nephron's tubular cells (via the peritubular capillaries) is completely secreted. Thus, through the above two mechanisms, PAH is completely filtered from the plasma reaching the nephron. For this reason, renal clearance of PAH is useful in calculation of renal plasma flow (RPF), which empirically is (1  hematocrit)  renal blood flow. The clearance of PAH, however, is reflective only of RPF to portions of the kidney that deal with urine formation, and thus underestimates actual RPF by about 10%.
The renal extraction ratio of PAH in a normal individual is approximately 0.92.

## Pharmaceuticals
Aminohippuric acid is often used as the sodium salt sodium para-aminohippurate.  During World War II, para-aminohippurate was given along with penicillin in order to prolong the time penicillin circulated in the blood.  Because both penicillin and para-aminohippurate compete for the same transporter in the kidney, administering para-aminohippurate with penicillin decreased the clearance of penicillin from the body by the kidney, providing better antibacterial therapy. Transporters found in the kidney eliminate organic anions and cations from the blood by moving substances, in this case, drug metabolites, from blood into urine.

# Other
In vultures, the NSAID diclofenac, which is extraordinarily toxic to vultures, interferes with the renal transport of uric acid via the PAH channel.
pKa = 3.83
Ammonium hydroxide

# Overview
Ammonium hydroxide(NH4OH), also known as ammonia water, aqua ammonia, or aqueous ammonia, is a solution of ammonia in water. Technically, the use of the term "ammonium hydroxide" is incorrect because such a chemical compound is not isolatable. However, this term does give a fair description of how an ammonia solution behaves, and is commonly used even by scientists and engineers.

# Chemistry
In aqueous solution, ammonia deprotonates some small fraction of the water to give ammonium and hydroxide ions according to the following equilibrium:
With a base ionization constant (Kb) of 1.810-5, in a 1M ammonia solution about 0.42% of the ammonia will gain protons to become ammonium ions (equivalent to a pH of 11.63).
Aqueous ammonia is used in traditional qualitative inorganic analysis. Like many amines, it gives a deep blue coloration with copper(II) solutions. Ammonia solution can dissolve silver residues, such as that formed from Tollens' reagent.
Solutions of ammonium can also dissolve reactive metals such as aluminum and zinc, with the liberation of hydrogen gas. When ammonium hydroxide is mixed with dilute hydrogen peroxide in the presence of a metal ion, such as Cu2+, the peroxide will undergo rapid decomposition
Amsterdam criteria
The Amsterdam criteria identify families likely to have Hereditary nonpolyposis colorectal cancer (HNPCC).
At least 3 relatives with a HNPCC-associated cancer: colorectal cancer, or cancer of the endometrium, small intestine, ureter or renal pelvis.
- One patient should be a first degree relative of the other two
- At least two successive generations should be affected
- At least one tumour should be diagnosed <50 years of age
- Familial adenomatous polyposis should be excluded in the colorectal cancer case (if any)
- Tumours should be verified by histopathologic examination