Persius/hicric huggingface dataset:
Antley-Bixler syndrome
Antley-Bixler syndrome, also called trapezoidocephaly-synostosis syndrome, is a rare, very severe autosomal recessive malformation disorder.

# Presentation
The syndrome is characterized by malformations and deformities affecting the majority of the skeleton, and other areas of the body. Presenting at birth, and even prenatally, symptoms include: brachycephaly (flat forehead), craniosynostosis (complete skull-joint closure) of both coronal and lambdoid sutures, facial hypoplasia (under-development); bowed ulna (forearm bone) and femur (thigh bone), synostosis of the radius (forearm bone), humerus (upper arm bone), and trapezoid (hand bone);   camptodactyly (fused interphalangeal joints in the fingers), thin ilial wings (outer pelvic plate), and renal malformations.
Other symptoms, such as cardiac malformations, proptotic exophthalmos (bulging eyes), arachnodactyly (spider-like fingers), as well as nasal, anal, and vaginal atresia (occlusion) have also been reported.

# Pathophysiology
There are two distinct genetic mutations associated with the Antley-Bixler syndrome phenotype, which suggests the disorder may be heterogeneous. A missense mutation in the cytochrome p450 oxydoreductase (POR) gene results in abnormal steroidogenesis related to the genital malformations often found in Antley-Bixler, while mutations
found in the FGFR2 gene have been shown to cause synostosis and other formal skeletal, poly and syndactylic abnormalities found in Antley-Bixler and similar disorders.
Antley-Bixler syndrome is inherited in an autosomal recessive pattern, which means the defective gene is located on an autosome, and two copies of the gene - one copy inherited from each parent - are required to be born with the disorder. The parents of an individual with an autosomal recessive disorder both carry one copy of the defective gene, but are usually not affected by the disorder.

# Eponym
Antley-Bixler syndrome is named after Drs. Ray M. Antley and David Bixler, who first described the disorder in a journal report from 1975.
Apneustic respirations
Synonyms and keywords: Apneusis

# Overview
Apneustic respiration is an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release.

# Causes
It is caused by damage to the pons or upper medulla caused by strokes or trauma. Specifically, concurrent removal of input from the vagus nerve and the pneumotaxic center causes this pattern of breathing.  It is an ominous sign, with a generally poor prognosis.
It can also be temporarily caused by some drugs, such as ketamine.

# Diagnosis

## Physical Examination

### Appearance
- Accompanying signs and symptoms may include decerebrate or decorticate posturing
- Coma or profound stupor

### Eyes
- Fixed, dilated pupils
- Absent corneal reflex
- Absent doll's eye sign
- Negative oculocephalic reflex

### Neurologic
- Obliteration of the gag reflex
- Quadriparesis;

# Related Chapters
- Apneustic center
Central retinal artery
The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball.

# Anatomy
It pierces the optic nerve close to the eyeball, sending branches over the internal surface of the retina, and these terminal branches are the only blood supply to the larger part of it.
The central part of the retina where the light rays are focussed after passing through the pupil and the lens is a circular area called the macula.  The center of this circular area is the fovea.  The fovea and a small area surrounding it are not supplied by the central retinal artery or its branches.
The central retinal artery still supplies all the nerve fibers that form the optic nerve that carries the visual information to the occipital lobe cerebral cortex.

# Pathology
Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye even though the fovea is not affected.  The entire retina (with the exception of the fovea) becomes pale and swollen and opaque while the central fovea still appears reddish (this is because the choroid color shows through).  This is the basis of the famous "Cherry red spot" seen on examination of the retina on funduscopy of a central retinal artery occlusion (CRAO).
In some cases - approximately 20% of the population - there is a branch of the ciliary circulation called the cilio-retinal artery which supplies the retina between the macula and the optic nerve, including the nerve fibers from the foveal photoreceptors.  If this artery is present, the central vision will be preserved even in case of CRAO.
- Central Retinal Artery Occlusion (embolus; painless, unilateral vision loss)
- Central Retinal Vein Occlusion: HTN, DM, Leukemia  (unilateral painless vision loss)
- Cherry Red Spot. Baby: Tay-Sachs. Adult: Central retinal artery occlusion (sudden painless unilateral vision loss) HTN, DM, Leukemia.  

# Additional images
- Horizontal section of the eyeball.
- The terminal portion of the optic nerve and its entrance into the eyeball, in horizontal section.
Atazanavir description

# Description
REYATAZ (atazanavir sulfate) is an azapeptide inhibitor of HIV-1 protease.
The chemical name for atazanavir sulfate is (3S,8S,9S,12S)-3,12-Bis(1,1-dimethylethyl)-8-hydroxy-4,11-dioxo-9-(phenylmethyl)-6-methyl]-2,5,6,10,13-pentaazatetradecanedioic acid dimethyl ester, sulfate (1:1). Its molecular formula is C38H52N6O7H2SO4, which corresponds to a molecular weight of 802.9 (sulfuric acid salt). The free base molecular weight is 704.9. Atazanavir sulfate has the following structural formula:
Atazanavir sulfate is a white to pale yellow crystalline powder. It is slightly soluble in water (45 mg/mL, free base equivalent) with the pH of a saturated solution in water being about 1.9 at 24  3 C.
REYATAZ Capsules are available for oral administration in strengths containing the equivalent of 150 mg, 200 mg, or 300 mg of atazanavir as atazanavir sulfate and the following inactive ingredients: crospovidone, lactose monohydrate, and magnesium stearate. The capsule shells contain the following inactive ingredients: gelatin, FD&C Blue No. 2, titanium dioxide, black iron oxide, red iron oxide, and yellow iron oxide. The capsules are printed with ink containing shellac, titanium dioxide, FD&C Blue No. 2, isopropyl alcohol, ammonium hydroxide, propylene glycol, n-butyl alcohol, simethicone, and dehydrated alcohol.
Auriculotemporal nerve

# Overview
The auriculotemporal nerve is a branch of the mandibular nerve that runs with the superficial temporal artery and vein, and provides sensory innervation to various regions on the side of the head.

# Structure

## Origin
The auriculotemporal nerve arises as two roots from the posterior division of the mandibular nerve.  These roots encircle the middle meningeal artery (a branch of the mandibular part of the maxillary artery, which is in turn a terminal branch of the external carotid artery).  The roots then converge to form a single nerve.

## Course
The auriculotemporal nerve passes medially to the neck of the mandible, gives off parotid branches and then turns superiorly, posterior to its head and moving anteriorly, gives off anterior branches to the auricle. It then crosses over the root of the zygomatic process of the temporal bone, deep to the superficial temporal artery

## Innervation
The somatosensory root (superior) originates from branches of the mandibular nerve, which pass through the otic ganglion without synapsing. Then they form the somatosensory (superior) root of the auriculotemporal nerve. The two roots re-unite and shortly after the branching of secretomotor fibers to the parotid gland (parotid branches) the auriculotemporal nerve comprises exclusively somatosensory fibers, which ascend up to the superficial temporal region. Supplies the auricle, external acoustic meatus, outer side of the tympanic membrane and the skin in the temporal region (superficial temporal branches).
The parasympathetic root (inferior) carries postganglionic fibers to the parotid gland. These parasympathetic, preganglionic secretomotor fibers originate from the glossopharyngeal nerve (CN IX) as one of its branches, the lesser petrosal nerve. This nerve synapses in the otic ganglion and its postganglionic fibers from the inferior, parasympathetic root of the auriculotemporal nerve. The two roots re-unite and shortly after the "united" auriculotemporal branch gives off parotid branches, which serve as secretomotor fibers for the parotid gland.

# Clinical significance
This nerve as it courses posteriorly to the condylar head, is frequently injured in temporomandibular joint surgery, causing an ipsilateral parasthesia of the auricle and skin surrounding the ear.
Autoimmune enteropathy

# Overview
Autoimmune enteropathy is a rare condition that happens usually to infants, young children and sometimes adults make them to have several diarrhea and sometimes so much that the children need intravenous fluids.  Food and vitamins are also be effected because the body attacks to the own intestinal wall, irritating the lining of the intestine.  Sometimes it attacks to others places as thyroid or others glands in the body or kidneys.

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Autoimmune Enteropathy from other Diseases

# Epidemiology and Demographics

## Age

## Gender

## Race

# Risk Factors

# Natural History, Complications and Prognosis

# Diagnosis

## Diagnostic Criteria
- Diagnosis can be done based on the serology.  Antibodies such as IgG or IgA against enterocytes are diagnostic of autoimmune enteropathy.

## Symptoms
- The main symptoms are:
Diarrhea (losing fluids all the time)
Intestinal inflammation
Intestinal bleeding
Poor weight gain and weight loss
Decreased urine output
Skin rash
- Diarrhea (losing fluids all the time)
- Intestinal inflammation
- Intestinal bleeding
- Poor weight gain and weight loss
- Decreased urine output
- Skin rash

## Physical Examination

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

# Treatment

## Medical Therapy
- Main modality of treatment are the drugs suppressing immune system.
- Intravenous nutrition and a special diet are the requirements for children.

## Surgery
- Surgery is not needed in many cases.

## Prevention
Bacillary angiomatosis

# Overview
Bacillary angiomatosis (BA) is a bacterial infection caused by either Bartonella henselae or Bartonella quintana. Bartonella henselae is most often transmitted through a cat scratch or bite, though ticks and fleas may also act as a vector. On the other hand, Bartonella quintana is usually transmitted by lice.

# Pathophysiology
Bacillary angiomatosis is characterized by the proliferation of blood vessels, resulting in them forming tumor-like masses in the skin and other organs. It most commonly manifests in people with AIDS, rarely appearing in those who are immunocompetent.  While curable, it is potentially fatal if not treated.

# Differential Diagnosis
Bacillary angiomatosis should be differentiated from other diseases presenting as purplish papules or nodules on extremities. The differentials include the following:

# Symptoms
Cutaneous BA is characterized by the presence of lesions on or under the skin. Appearing in numbers from one to hundreds, these lesions may take several forms:
- papules or nodules which are red, globular and non-blanching, with a vascular appearance
- purplish nodules sufficiently similar to Kaposi's sarcoma that a biopsy may be required to verify which of the two it is
- a purplish lichenoid plaque
- a subcutaneous nodule which may have ulceration, similar to a bacterial abscess
While cutaneous BA is the most common form of BA, BA can also affect several other parts of the body, such as the brain, bone, bone marrow, lymph nodes, gastrointestinal tract, respiratory tract, spleen and liver.
Symptoms vary depending on which parts of the body are affected; for example, those whose livers are affected may have an enlarged liver and fever, while those with osseous BA will experience intense pain in the affected area.

# Medical Therapy

## Pharmacotherapy
BA responds dramatically to several antibiotics.  Usually, erythromycin will cause the skin lesions to gradually fade away in the next four weeks, resulting in complete recovery. Doxycycline may also be used. However, if the infection does not respond to either of these, the medication is usually changed to tetracycline. If the infection is serious, then a bactericidal medication may be coupled with the antibiotics.
Bacillary angiomatosis
- Preferred regimen (1): Erythromycin 500 mg PO qid for 2 months at least
- Preferred regimen (2): Doxycycline 100 mg PO bid for 2 months at least

# Prevention
If a cat is carrying Bartonella henselae, then it may not exhibit any symptoms. Cats may be bacteremic for weeks to years, but infection is more common in young cats.  Transmission to humans is thought to occur via flea feces inoculated into a cat scratch or bite, and transmission between cats occurs only in the presence of fleas.  Therefore, elimination and control of fleas in the cat's environment are key to prevention of infection in both cats and humans.

# Related Chapters
- Cat scratch fever
- Trench fever
- Angiomatosis
Bacitracin (opthalmic)

# Dosing Information
- The ointment should be applied directly into the conjunctival sac 1 to 3 times daily. In blepharitis all scales and crusts should be carefully removed and the ointment then spread uniformly over the lid margins. Patients should be instructed to take appropriate measures to avoid gross contamination of the ointment when applying the ointment directly to the infected eye.
- Bacitracin ophthalmic ointment should not be used in deep-seated ocular infections or in those that are likely to become systemic. The prolonged use of antibiotic containing preparations may result in overgrowth of nonsusceptible organisms particularly fungi. If new infections develop during treatment appropriate antibiotic or chemotherapy should be instituted.
NDC 48102-007-35 3.5 g (1/8 oz.) sterile tamper evident tubes with ophthalmic tip.
NDC 48102-007-13
Rx only
BACITRACIN OPHTHALMIC 
OINTMENT USP, 500 units/g 
STERILE
3 x 1 g tubes
Sterile Ophthalmic Ointment
Weighing 1 gram each
USUAL DOSAGE: Apply 1 to 3 times daily. 
See package insert for full prescribing information.
EACH GRAM CONTAINS: 500 units of Bacitracin per gram, White Petrolatum, Mineral Oil.
Keep tightly closed.
Store at 20-25 C (68-77 F) (See USP
Controlled room temperature).
Keep out of reach of children.
NDC 48102-007-11
STERILE
Rx only
BACITRACIN
OPHTHALMIC 
OINTMENT USP
500 units/g
NET WT 1 gm
NDC 48102-007-35
Rx only
BACITRACIN OPHTHALMIC 
OINTMENT USP 
STERILE
CONTAINS: 500 units of Bacitracin per gram, White Petrolatum, Mineral Oil.
NET WT 3.5 g (1/8 Oz)
USUAL DOSAGE: 3 applications daily. 
See insert for complete information.
KEEP TIGHTLY CLOSED
STORE AT ROOM TEMPERATURE
KEEP OUT OF REACH OF CHILDREN
See crimp of tube for Lot No. & Exp. Date
NDC 48102-007-35
BACITRACIN
OPHTHALMIC 
OINTMENT USP 
STERILE
Rx only
USUAL DOSAGE: 3 applications daily. 
See insert for complete information.
WARNING: Keep out of reach of children.
See crimp for Lot No. and Exp. Date
CONTAINS: 500 units of Bacitracin per gram, White Petrolatum, Mineral Oil.
NET WT 3.5 g (1/8 Oz)
KEEP TIGHTLY CLOSED
STORE AT ROOM TEMPERATURE
Bartonellosis overview

# Overview
Bartonellosis is an infectious disease produced by bacteria of the genus Bartonella. Bartonella cause diseases such as Carrion s disease, trench fever, cat-scratch disease, severe obesity, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

# Causes
Bartonellosis is caused by the bacteria belonging to the Bartonella genus containing 23 identified species, all of them within family Bartonellaceae.

# Epidemiology and Demographics
Carrion's disease, or Oroya fever, or Peruvian Wart is a rare infectious disease found only in Peru, Ecuador, and Colombia. It is endemic in some areas of Peru, and is caused by infection with the bacterium Bartonella bacilliformis and transmitted by sandflies of genus Lutzomyia.
Cat scratch disease is a worldwide disease. Cats are the main reservoir of Bartonella henselae (etiologic agent), and the bacterium is transmitted to cats by the cat flea Ctenocephalides felis.
Trench fever is produced by Bartonella quintana infection, and the bacterium is transmitted by the human body louse Pediculus humanus corporis.  Humans are the only known reservoir.
In November 2011, Bartonella rochalimae, B. quintana, and B. elizabethae DNA was first reported in Rhipicephalus sanguineus and Dermacentor nitens ticks in Peru; a possible role for ticks in transmission of Bartonella species remains to be elucidated.
Baruch Samuel Blumberg
Baruch Samuel Blumberg (born July 28, 1925) is a scientist fromt the United States and recipient of the 1976 Nobel Prize in Medicine for "discoveries concerning new mechanisms for the origin and dissemination of infectious diseases." Blumberg identified the Hepatitis B virus, and later developed the diagnostic test and vaccine for it.
Blumberg first attended Far Rockaway High School in the early 40s, a school that also produced fellow laureates Burton Richter and Richard Feynman. He then attended Union College in Schenectady, NY and graduated with honors in 1945. He then entered the graduate program in mathematics at Columbia University but his interests turned to medicine and he enrolled at Columbia's College of Physicians and Surgeons, from which he received his M.D. in 1951. He remained at Columbia Presbyterian Medical Center for the next four years, first as a resident and then as an intern. He then began graduate work in biochemistry at Balliol College, Oxford and earned his Ph.D. in 1957.
He has been a member of the Fox Chase Cancer Center in Philadelphia since 1964 and has held the rank of University Professor of Medicine and Anthropology at the University of Pennsylvania since 1977. Concurrently, he was Master of Balliol College from 1989 to 1994. From[1999 to 2002, he was also director of the NASA Astrobiology Institute at the Ames Research Center, Moffett Field, California.
Basal body temperature
Basal body temperature is the body temperature measured immediately after awakening and before any physical activity has been undertaken. In women, ovulation causes an increase of one-half to one degree Fahrenheit (one-quarter to one-half degree Celsius) in basal body temperature (BBT); monitoring of BBTs is one way of estimating the day of ovulation.  The tendency of a woman to have lower temperatures before ovulation, and higher temperatures afterwards, is known as a biphasic pattern.  Charting of this pattern may be used as a component of fertility awareness.

# Hormonal causes of biphasic patterns
The higher levels of estrogen present during the pre-ovulatory (follicular) phase of the menstrual cycle lower BBTs.  The higher levels of progesterone released by the corpus luteum after ovulation raise BBTs.  The rise in temperatures can most commonly be seen the day after ovulation, but this varies and BBTs can only be used to estimate ovulation within a three day range.
If pregnancy does not occur, the disintegration of the corpus luteum causes a drop in BBTs that roughly coincides with the onset of the next menstruation.  If pregnancy does occur, the corpus luteum continues to function (and maintain high BBTs) for the first trimester of the pregnancy.  After the first trimester, the woman's body temperature drops to her pre-ovulatory normal as the placenta takes over functions previously performed by the corpus luteum.
Very rarely, the corpus luteum may form a cyst.  A corpus luteum cyst will cause BBTs to stay elevated and prevent menstruation from occurring until it resolves, which could take weeks or months.

# While trying to conceive
Regular menstrual cycles are often taken as evidence that a woman is ovulating normally, and irregular cycles as evidence she is not.  However, many women with irregular cycles do ovulate normally, and some with regular cycles are actually annovulatory or have a luteal phase defect.  Records of basal body temperatures can be used to accurately determine if a woman is ovulating, and if the length of the post-ovulatory (luteal) phase of her menstrual cycle is sufficient to sustain a pregnancy.
Pregnancy tests are not accurate until 1-2 weeks after ovulation.  Knowing an estimated date of ovulation can prevent a woman from getting false negative results due to testing too early.  Also, 18 consecutive days of elevated temperatures means a woman is almost certainly pregnant.
Tracking basal body temperatures are a more accurate method of estimating gestational age than tracking menstrual periods.

# While avoiding pregnancy
Charting of basal body temperatures is used in some methods of fertility awareness, and may be used to determine the onset of post-ovulatory infertility.  However, BBTs only show when ovulation has occurred; they do not predict ovulation.  Normal sperm life is up to five days, making prediction of ovulation several days in advance necessary for avoiding pregnancy.  BBT methods often use a rule similar to that of the Calendar Method to determine the beginning of the pre-ovulatory fertile phase.
Basilar skull fracture
A basilar skull fracture (or Basal skull fracture) is a linear skull fracture involving the base of the skull. This type of fracture is rare, occurring as the only fracture in just 4% of severe head injury patients.  Moreover, it is most often associated with leakage in the cerebrospinal fluid of the brain into the ear (CSF otorrhea) or the nose (CSF rhinorrhea).  These signs are pathognomonic for basilar skull fracture. .
Basilar skull fractures can be caused by a blow to the back of the head, or by sudden deceleration of torso but not head (as in traffic accidents), resulting in separation of the suture between the occipital and temporal bones.

# Anatomy
Basilar skull fractures commonly involve the roof of the orbits, the sphenoid bone, or portions of the temporal bone.
Bones may be broken around the foramen magnum, the hole in the base of the skull through which the spinal cord enters and becomes the brain stem, creating the risk that blood vessels and nerves exiting the hole may be damaged.
Due to the proximity of the cranial nerves, injury to those nerves may occur. This can cause palsy of the facial nerve or oculomotor nerve or hearing loss due to damage of cranial nerve VIII.

# Clinical manifestations
- Battle's sign - is ecchymosis of the mastoid process of the temporal bone.
- Raccoon eyes - is periorbital ecchymosis i.e. "black eyes"
- Cerebrospinal fluid rhinorrhea
- Cranial nerve palsy
- Bleeding from the nose and ears
- In 1 to 10% of patients, ocular nerve entrapment occurs: the ocular nerve is pressed by the broken skull bones, causing irregularities in vision.

# Prognosis
Non-displaced fractures usually heal without intervention.  Patients with basilar skull fractures are especially likely to get meningitis.

# Notable cases
Basilar skull fracture is a common cause of death in auto racing accidents, notably that of Dale Earnhardt in the 2001 Daytona 500, Roland Ratzenberger in the 1994 San Marino Formula One Grand Prix, Gonzalo Rodriguez in practice for the 1999 Laguna Seca Grand Prix, Tony Bettenhausen in practice for the 1961 Indy 500, and Greg Moore at the 1999 Marlboro 500 at California Motor Speedway.