Persius/hicric huggingface dataset:
Tramadol how supplied

# How supplied
ULTRACET tablets
Storage

## ULTRACET tablets
ULTRACET (37.5 mg tramadol hydrochloride/ 325 mg acetaminophen) Tablets (light yellow, filmcoated
capsule-shaped tablet) debossed O-M on one side and 650 on the other are available as
follows:
- NDC 0045 0650 50 (Bottles of 20 tablets)
- NDC 0045 0650 60 (Bottles of 100 tablets).
- NDC 0045 0650 70 (Bottles of 500 tablets).
- NDC 0045 0650 10 (Packages of 100 unit doses in blister packs, 10 cards of 10 tablets
each).
Return to top

## Storage
Store at 25C (77F); excursions permitted to 15  30C (59 - 86F). Return to top
Adapted from the FDA Package Insert.
Transparency (optics)
In optics, transparency is the material property of allowing light to pass through.  In mineralogy, another term for this property is diaphaneity.  The opposite property is opacity.  Transparent materials are clear:  they can be seen through.  Translucent materials allow light to pass through them only diffusely: they cannot be seen through; contrary to popular belief, translucency does not include see-through colored objects such as (for instance) emerald in its cut state (which is transparent) but does include things such as frosted glass which allow light to come through but no images.

# Transparency
Though transparency usually refers to visible light in common usage, it may correctly be used to refer to any type of radiation. For example, flesh is transparent to X-rays, while bone is not, making X-ray imaging useful for medicine.
Examples of transparent materials are air and some other gases, liquid such as water, most glasses, and plastics such as Perspex. Where the degree of transparency varies according to the wavelength of the light, the image seen through the material is tinted. This may be due to certain metallic oxide molecules in glass, or larger colored particles, as in a thin smoke. If many such particles are present the material may become opaque, as in thick smoke.
From electrodynamics it results that only a vacuum is really transparent in the strict meaning, any matter has a certain absorption for electromagnetic waves.
There are transparent glass walls that can be made opaque by the application of an electric charge, a technology known as electrochromics.
Certain crystals are transparent because there are straight lines through the crystal structure. Light passes unobstructed along these lines.
There is a complicated theory "predicting" (calculating) absorption and its spectral dependence of different materials.  See: absorption (optics) - absorption of photons by a material and absorption spectroscopy.
Trench fever overview

# Overview
Trench fever is an intermittent fever characterized by intervals of chills, fever, and splenomegaly each of which may last as long as 40 hours. It is caused by bartonella quintana and transmitted by the human louse.

# Historical Perspective
It infected the armies in Flanders, France, Poland, Galicia, Italy, Slonika, Macedonia, Mesopotamia, and Egypt in World War I (including J.R.R. Tolkien) and the German army in Russia during World War II. From 1915-1918 between one-fifth and one-third of all British troops reported ill were caused by Trench Fever while about one-fifth of ill German and Austrian troops had the disease.

# Pathophysiology
Rickettsia quintana is transmitted by the by contamination of a skin abrasion or of a louse-bite wound with the faeces of an infected body louse(Pediculus humanus corporis), there has also been reports of an infected louse bite passing on the infection.

# Causes
The disease is caused by the organism Rickettsia quintana, found in the stomach walls of the body louse. Rickettsia is closely related to the more dangerous microbes of Rocky Mountain spotted fever and typhus

# Epidemiology and Demographics
Outbreaks have been documented, for example, in Seattle, Washington and Baltimore, Maryland in the United States among injection drug users and in Marseille, France and Burundi.

# Natural History, Complications and Prognosis
Lethal cases are rare, but in a few cases the persistent fever might lead to heart failure. After effects may include neurasthenia, cardiac disturbances and myalgia.

# Diagnosis

## History and Symptoms
The disease is classically a five-day fever of the relapsing type, rarely with a continuous course instead.  Latent period is relatively long (about two weeks). The onset of symptoms is usually sudden with high fever, severe headache, pain on moving the eyeballs, soreness of the muscles of the legs and back, and frequently hyperaesthesia of the shins. The initial fever is usually followed in a few days by a single short rise but there may be many relapses between periods without fever.The most constant symptom is pain in the legs. Recovery takes a month or more.

## Laboratory Findings
Serological testing (e.g., the Weil-Felix test) is typically used to obtain a  definitive diagnosis.  Most serological tests would succeed only after a certain period of time past the symptom onset (usually a week).

# Treatment

## Medical Therapy
Tetracycline-group antibiotics (doxycycline, tetracycline) are commonly used. Chloramphenicol is an alternative medication  recommended under circumstances that render tetracycline derivates usage undesirable (such as severe liver malfunction, kidney deficiency, in children under  nine years and pregnant women). The drug is administered for seven to ten days.
The treatment for bacillary angiomatosis is erythromycin given for three to four months.
Trench mouth overview

# Overview
Trench mouth is a polymicrobial infection of the gums leading to inflammation, bleeding, deep ulceration, necrotic gum tissue, and possibly fever.

# Historical Perspective

# Classification

# Pathophysiology

# Causes
Causative organisms include anaerobes such as Bacteroides and Fusobacterium as well as spirochetes (Borrelia and Treponema spp.). The condition is caused by an overpopulation of established mouth bacteria due to a number of interacting factors such as poor hygiene, poor diet, smoking, other infections.

# Differentiating Trench Mouth from Other Diseases
Primary herpetic gingivostomatitis is the most important differential diagnosis of trench mouth. Further, differentiating necrotizing ulcerative gingivitis (NUG) from acute herpetic gingivostomatitis is also necessary.

# 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
There may be a gray film caused by broken down (decomposed) gum tissue. Occasionally, there may be fever and swollen lymph nodes of the head and neck.  This disease may also be tested for by a throat swab culture.

## Imaging Findings

### Electrocardiogram

### X Ray
Dental x-rays or x-rays of the face may be done to determine how severe the infection is and how much tissue has been destroyed.

### CT

### MRI

### Ultrasound

## Other Diagnostic Studies

# Treatment

## Medical Therapy

## Surgery

## Prevention
Trimethyltin chloride
Trimethyltin chloride ((CH3)3SnCl) is a moisture sensitive organotin compound having a strong unpleasant stench that is soluble in organic solvents, but hydrolyzes.

# Synthesis
Trimethyltin chloride  can be prepared by reaction of tetramethyltin with tin tetrachloride.
This is the Kocheshkov redistribution reaction. It is performed under an inert atmosphere, such as argon, typically with no solvent.
A second route to Me3SnCl is by reacting the related tin hydroxide or oxide with a halogenating agent like either HCl or SOCl2.

# Uses
Timethyltin chloride is used with Grignard reagents to generate tin-carbon bonds.  An example is:
Another example of a Grignard reagent reacting with Me3SnCl to form a tin-carbon bond is
Organotin compounds derived from Me3SnCl are used extensively in organic syntheses, especially in  radical chain reactions. Me3SnCl is a precursor to compounds used in PVC stabilization. 
Reduction of trimethyltin chloride gives tin-tin bonds.
Triterpenoid saponins
Triterpenoid saponins are triterpenes which belong to the group of saponin compounds. Triterpenes belong to a large group of compounds arranged in a four or five ring configuration of 30 carbons with several oxygens attached. Triterpenes are assembled from a C5 isoprene unit through the cytosolic mevalonate pathway to make a C30 compound and are steroidal in nature. Cholesterol is one example of a triterpene. Phytosterols and phytoecdysteroids are also triterpenes. The triterpenes are subdivided into some 20 groups, depending on their particular structures. Though all terpenoid compounds have bioactivity in mammals, it is the triterpenes that are most important to the adaptogenic effect found in plants such as Panax ginseng or Eleutherococcus senticosus.  Most triterpenoid compounds in adaptogenic plants are found as saponin glycosides which refers to the attachment of various sugar molecules to the triterpene unit. These sugars can be easily cleaved off in the gut by bacteria, allowing the aglycone (triterpene) to be absorbed.  This allows them insert into cell membranes  and modify the composition, influence membrane fluidity , and potentially affect signaling by many ligands and cofactors . Saponin glycosides reduce surface tension of water with foaming and will break down lipids. Usually triterpene saponins are designated as such by the suffix ending side, such as ginsenoside, or astragaloside, named for the plant genera they were first discovered in. Some, such as the ginsenosides and eleutherosides are designated Rx where the suffix x = a, a1, b2, is indicative of
the relative position of the saponin spots from top to bottom of a thin layer chromatogram. 

# Common Medicinally Active Triterpenoid Saponins from Adaptogenic Plants
Triterpenoids in Plants
Chemical compound:	   Common Name 	 (Latin Name)
- 20-hydroxyecdysone:	maral root	(Rhaponticum carthamoides)
- araloside:	       spikenard	(Aralia mandshurica)
- astragaloside:	       huang qi	        (Astragalus membranaceus}
- bacoside:	       brahmi	        (Bacopa monniera)
- cucurbitacin:	       bryonia	        (Bryonia alba)
- eleutheroside:	       Siberian ginseng	(Eleutherococcus senticosus)
- ginsenoside:	       ginseng	        (Panax ginseng)
- gypenoside:	       jiaogulan	(Gynostemma pentaphyllum)
- tanshenoside:	       bellflower	(Codonopsis pilosula)
- tinosporoside:	       guruchi	        (Tinospora cordifolia)
- withanolide:	       ashwagandha	(Withania somnifera)
Tubulin beta-4A chain
Tubulin beta-4A chain is a protein that in humans is encoded by the TUBB4A gene. Two tubulin beta-4 chain proteins are encoded in the human genome by the genes TUBB4A (this entry) and TUBB4B. Tubulin is the major constituent of microtubules, a key components of the cytoskeleton. It binds two moles of GTP, one at an exchangeable site on the beta-chain and one at a non-exchangeable site on the alpha-chain. TUBB4A is preferentially and highly expressed in the central nervous system.

# Clinical significance
Mutations in TUBB4A have been associated with two neurological disorders.
An R2G substitution in the autoregulatory MREI domain of TUBB4A has been identified as the cause of 'hereditary whispering dysphonia' or DYT4.
A de novo D249N mutation has been identified as the cause of a rare leukoencephalopathy, hypomyelination with atrophy of basal ganglia and cerebellum (H-ABC).
Mutations in TUBB4A are associated with                 PelizaeusMerzbacher disease            .
Tumor suppressor gene

# Overview
A tumor suppressor gene is a gene that reduces the probability that a cell in a multicellular organism will turn into a tumor cell. A mutation or deletion of such a gene will increase the probability of the formation of a tumor.

# Two-hit hypothesis
Unlike oncogenes, tumor suppressor genes generally follow the 'two-hit hypothesis,' which implies that both alleles that code for a particular gene must be affected before an effect is manifested. This is due to the fact that if only one allele for the gene is damaged, the second can still produce the correct protein. In other words, tumor suppressors are usually not haploinsufficient, although there are notable exceptions (the p53 gene product).

# Functions
Tumor suppressor genes, or more precisely, the proteins for which they code, either have a dampening or repressive effect on the regulation of the cell cycle or promote apoptosis, and sometimes do both. The functions of tumor suppressor proteins fall into several categories including the following:
- Repression of genes that are essential for the continuing of the cell cycle. If these genes are not expressed, the cell cycle will not continue, effectively inhibiting cell division.
- Coupling the cell cycle to DNA damage. As long as there is damaged DNA in the cell, it should not divide. If the damage can be repaired, the cell cycle can continue.
- If the damage can not be repaired, the cell should initiate apoptosis, or programmed cell death, to remove the threat it poses for the greater good of the organism.
- Some proteins involved in cell adhesion prevent tumor cells from dispersing, block loss of contact inhibition, and inhibit metastasis.

# Examples
The first tumor suppressor protein discovered was the pRb protein in human retinoblastoma; however, recent evidence has also implicated pRb as a tumor survival factor.
Another important tumor suppressor is the p53 tumor suppressor protein produced by the TP53 gene.
PTEN acts by opposing the action of PI3K, which is essential for anti-apoptotic, pro-tumorogenic Akt activation.
Tungsten(VI) fluoride
Tungsten(VI) fluoride, also known as tungsten hexafluoride, is a colorless gas. It is nonflammable, but highly corrosive and very toxic.
The molecule itself is octahedral with the symmetry point group of Oh.
The gas is most commonly used in the production of semiconductor circuits and circuit boards, through the process of chemical vapor deposition.

# Industrial Synthesis
Tungsten hexafluoride of a purity high enough for semiconductor CVD is produced by the reaction of fluorine gas with tungsten metal.  The metal is placed in a heated reactor, slightly pressurized to 1.2 to 2.0 psi, with a constant flow of WF6 infused with a small amount of fluorine gas.

# Reactions
WF6(g) + H2(g) + Al(s)  W(s) + HF(g) + AlF3(s)
This reaction occurs when tungsten is deposited on an aluminum.
One application of this would be in the production of studs for semiconductor circuits.
Tungsten can also be deposited on a silicon wafer or other semiconducting material via chemical vapor deposition, or CVD, as follows:
WF6(g) + W-  WF6*
2 SiH4(g) + WF6-  W(s) + 2 SiHF3 (g) + 3 H2(g)
The silane SiH4 reduces the tungsten from an oxidation state of 6+ (VI) to its elemental state of zero.

# Safety
On contact with water tungsten(VI) fluoride forms hydrofluoric acid (HF), which can penetrate the skin and cause damage to the subdermal tissues and bone. Inhalation burns the respiratory tract and can be toxic. WF6 is a lachrymator which causes tearing and irritation of the eyes. Contact causes burns to the eyes, skin and mucous membranes.
In Uncle Tungsten, Oliver Sacks comments on how he wanted WF6-filled balloons for his 65th birthday, but the gas was too reactive. Had one of the balloons popped, the tungsten(VI) fluoride would have reacted with moisture in the air to form hydrogen fluoride.
Tweedie distributions
In probability and statistics, the Tweedie distributions are a family of probability distributions which include continuous distributions such as the normal and gamma, the purely discrete scaled Poisson distribution, and the class of mixed compound Poisson-Gamma distributions which have positive mass at zero, but are otherwise continuous.  
Tweedie distributions belong to the exponential dispersion model family of distributions, a generalization of the exponential family, which are the response distributions for generalized linear models.
Tweedie distributions have a mean \mu and a variance \phi \mu^p, where \phi>0 is a dispersion parameter, and p, called the index parameter, (uniquely) determines the  distribution in the Tweedie family.  Special cases include:
- p=0 is the normal distribution
- p=1 with \phi=1 is the Poisson distribution
- p=2 is the gamma distribution
- p=3 is the inverse Gaussian distribution.
Tweedie distributions exist for all real values of p except for 0. 
Apart from the four special cases identified above, their probability density function have no closed form.  However, software is available that enables the accurate computation of the Tweedie densities (and probability distribution functions).
The Tweedie distributions were so named by Bent Jrgensen after M.C.K. Tweedie, a medical statistician at the University of Liverpool, UK, who presented the first thorough study of these distributions in 1984.
The index parameter p defines the type of distribution:
- For p, the data y are supported on the whole real line (but, interestingly, \mu>0).  Applications for these distribution are unknown.
- For p=0 (the normal distribution), the data y and the mean \mu are supported on the whole real line.
- For 0, no distributions exist
- For p=1, the distribution exist on the non-negative integers
- For 1, the distribution is continuous on the positive reals, plus an added mass (exact zero) at Y=0.  For example, consider monthly rainfall.  When no rain is recorded, an exact zero is recorded.  If rain is recorded, a continuous amount results.  These distributions are also called the Poisson-gamma distributions, since they can be represented as the Poisson sum of gamma distributions. They are therefore a type of compound Poisson distribution.
- For p>2, the data y are supported on the non-negative reals, and \mu>0.  These distribution are like the gamma distribution (which corresponds to p=2), but are progressively more right-skewed as p gets larger.

# Applications
Applications of Tweedie distributions (apart from the four special cases identified) include:
- actuarial studies 
- assay analysis  
- survival analysis
- ecology 
- analysis of alcohol consumption in British teenagers 
- medical applications 
- meteorology and climatology 
- fisheries
USMLE step 1 genetics

# DNA synthesis
Histone  Contain lysine and arginine
DNA is negatively charged because of the negatively charged phosphate groups
Cytosine minus aminogroup = Uracil (Deamination)
G-C : 3 Hydrogen bonds. Higher melting points
A-T: 2 Bonds

## Purine synthesis:
- You need glycine, glutamine and aspartate + tetrahydrofolate (Folic acid) + CO2
- Rate limiting step : Glutamine PRPP amidotransferase
- Carbon sources:
CO2, glycine, tetrahydrofolate
- CO2, glycine, tetrahydrofolate
- Nitrogen sources
Aspartate + Glutamine
- Aspartate + Glutamine

## Pyrimidines:
Aspartate + carbamoyl phosphate (1 carbon and 1 nitrogen ) + ATP
- Carbamoyl phosphate  Has 1 carbon and 1 nitrogen
- You need aspartate + CO2 + glutamine + ATP (Last 3 come from carbamoyl phosphate)
- Carbamoyl phosphate synthetase 2 (RATE LIMITING STEP)
- Start with orotic acid then add a base
- Carbon sources:
Aspartate
CO2
- Aspartate
- CO2
- Glutamine  Gives nitrogen
CPS 1 + CPS 2
- CPS 1
Mitochondria
Urea cycle
Use nitrogen from ammonia
- Mitochondria
- Urea cycle
- Use nitrogen from ammonia
- CPS 2
Cytosol
Pyrimidine synthesis
Use nitrogen from glutamine
- Cytosol
- Pyrimidine synthesis
- Use nitrogen from glutamine

### Orotic aciduria
- Deficiency of UMP synthase
- AR
- Elevated oritic acid
- Megaloblastic anemia
Not corrected with B12 or folic acid
- Not corrected with B12 or folic acid
- No hyperammonemia
- Treat with uridine

### Ornithine Transcarbomylase Deficiency
- Causes hyperammonemia
- Elevated orotic acid
- Problem with urea cycle
Ribosomes are synthesized in the nucleus and transported into the cytoplasm.
Urethral diverticulum

# Overview
Urethral diverticulum has been reported in 1.4% of women with stress urinary incontinence. Female urethral diverticulum is currently thought to be acquired. It is usually located posterolateral to the urethra.

# Classification
Female urethral diverticula have a variety of shapes and configurations.
- Diverticula may be single or multiple, unilocular or multicompartmental.
- Urethral diverticula may have either a wide or narrow neck.
- Urethral diverticula may surround the urethra ("saddle" diverticula).

# Diagnosis
The classic manifestation of urethral diverticulum has been described as the three Ds (dysuria, postvoid dribbling, and dyspareunia).
- Urethral diverticula may be complicated by infection, stone formation (up to 10% of patients), and malignant degeneration.
Patient #1: CT image demonstrates a urethral diverticulum
Patient #2: MR images demonstrate a urethral diverticulum in a male patient

# Treatment
The definitive treatment of urethral diverticula is transvaginal diverticulectomy.
Uridine monophosphate
Uridine monophosphate, also known as 5'-uridylic acid and abbreviated UMP, is a nucleotide that is found in RNA. It is an ester of phosphoric acid with the nucleoside uridine. UMP consists of the phosphate group, the pentose sugar ribose, and the nucleobase uracil.
Another common shorthand for the molecule is uridylate - the deprotonated form of the molecule, which is predominant in aqueous solution.

# Biosynthesis
Uridine monophosphate is formed from orotidylic acid in a decarboxylation reaction catalyzed by the enzyme orotidylate decarboxylase. Uncatalyzed, the decarboxylation reaction is extremely slow (estimated to occur on average one time per 78 million years). Adequately catalyzed, the reaction takes place once per second, an increase of 1017-fold.
Uridine phosphorylase
In enzymology, an uridine phosphorylase (EC 2.4.2.3) is an enzyme that catalyzes the chemical reaction
Thus, the two substrates of this enzyme are uridine and phosphate, whereas its two products are uracil and alpha-D-ribose 1-phosphate.
This enzyme belongs to the family of glycosyltransferases, specifically the pentosyltransferases.  The systematic name of this enzyme class is uridine:phosphate alpha-D-ribosyltransferase. Other names in common use include pyrimidine phosphorylase, UrdPase, UPH, and UPase.  This enzyme participates in pyrimidine metabolism.

# Structural studies
As of late 2007, 27 structures have been solved for this class of enzymes, with PDB accession codes 1K3F, 1LX7, 1RXC, 1RXS, 1RXU, 1RXY, 1RYZ, 1SJ9, 1SQ6, 1T0U, 1TGV, 1TGY, 1U1C, 1U1D, 1U1E, 1U1F, 1U1G, 1Y1Q, 1Y1R, 1Y1S, 1Y1T, 1ZL2, 2HN9, 2HRD, 2HSW, 2HWU, and 2I8A.
Vancomycin overdosage
Supportive care is advised, with maintenance of glomerular filtration. Vancomycin is poorly removed by dialysis.
Hemofiltration and hemoperfusion with polysulfone resin have been reported to result in increased vancomycin clearance. The median lethal intravenous dose is 319 mg/kg in rats and 400 mg/kg in mice.
To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Telephone numbers of certified poison control centers are listed in the Physicians Desk Reference (PDR). In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient.