Persius/hicric huggingface dataset:
Isolation (health care)
Assistant Editor-In-Chief: Michelle Lew

# Overview
In health care, isolation refers to various measures taken to prevent contagious diseases from being spread from a patient to other patients, health care workers, and visitors, or from others to a particular patient. Various forms of isolation exist, some of which contact procedures are modified, and others in which the patient is kept away from all others.
Isolation is most commonly used when a patient has a viral illness.
Special equipment is used in the treatment of patients on the various forms of isolation. These most commonly include gowns, masks, and gloves.

# Forms of isolation

## Strict isolation
Strict isolation is used for diseases spread through the air and in some cases by contact
Patient is kept in a room separate from other patients, health care staff contact is minimal, and in some cases, visitors are not allowed. Is used for the most contagious diseases of all.
Those who are kept in strict isolation are often kept in a special room at the facility designed for that purpose. Such rooms are equipped with a special lavatory and caregiving equipment, and a sink and waste disposal are provided for workers upon leaving the area.

## Contact isolation
Is used to prevent the spread of diseases that can be spread through contact with open wounds. Health care workers making contact with a patient on contact isolation are required to wear gloves, and in some cases, a hospital gown.

## Respiratory isolation
Respiratory isolation is used for diseases that are spread through particles that are exhaled. Those having contact with or exposure to such a patient are required to wear a mask.

## Blood and body fluids precautions
Used when there is concern about communicable diseases found in a patient's body fluid. Health care workers making contact with the patient when body fluids are involved must wear gloves.

## Reverse isolation
Reverse isolation is a method to prevent a patient in a compromised health situation from being contaminated by other people or objects.

# Effects of isolation
Isolation can have the following effects on patients:
- Patient may not be able to receive visitors
- Patient may become lonely
- Patient may be anxious
- Small children may feel their isolation is a punishment
- Staff may need to spend more time with patients
- Patients may not be able to receive certain types of care due to the risk that other patients may become contaminated. This includes forms of care that involve use of equipment common to all patients at the facility, or that involve transporting the patient to an area of the facility common to all patients.

# Diseased workers
Health care workers who become invested with certain contagious illnesses are not permitted in many places to work with patients. While facility rules and laws vary, a common guideline that has been set is 48 hours.
Ivermectin microbiology

# Microbiology
Ivermectin is a member of the avermectin class of broad-spectrum antiparasitic agents which have a unique mode of action. Compounds of the class bind selectively and with high affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to an increase in the permeability of the cell membrane to chloride ions with hyperpolarization of the nerve or muscle cell, resulting in paralysis and death of the parasite. Compounds of this class may also interact with other ligand-gated chloride channels, such as those gated by the neurotransmitter gamma-aminobutyric acid (GABA).
The selective activity of compounds of this class is attributable to the facts that some mammals do not have glutamate-gated chloride channels and that the avermectins have a low affinity for mammalian ligand-gated chloride channels. In addition, ivermectin does not readily cross the blood-brain barrier in humans.
Ivermectin is active against various life-cycle stages of many but not all nematodes. It is active against the tissue microfilariae of Onchocerca volvulus but not against the adult form. Its activity against Strongyloides stercoralis is limited to the intestinal stages.
Jean-Baptiste Bouillaud
Jean-Baptiste Bouillaud (September 16, 1796 - October 29, 1881) was a French physician who was born near the town of Angouleme. He received his medical doctorate in 1823 and afterwards was a professor at the Charite in Paris.
Bouillaud performed research of many medical diseases and conditions, including cancer, cholera, heart disease and encephalitis, to name a few. He is remembered for providing a correlation between rheumatism and heart disease, and French medical dictionaries still refer to acute rheumatoid endocarditis as Bouillaud's disease. He describes this condition in his treatise Traite clinique des maladies du coeur. Bouillaud was also an early practitioner of the drug digitalis for treatment of heart ailments. He referred to digitalis as the "opium of the heart".
In 1825 Bouillaud published Traite clinique et physiologique de l'encephalite, ou inflammation du cerveau in which he includes one of the earliest studies regarding localization of brain functions. He maintained that loss of articulate speech was associated with lesions of the anterior lobes. Also, along with cardiologist Pierre Potain (1825-1901) he performed studies regarding "heart sounds" and the differentiation between normal and abnormal heart rhythms. Bouilland was an ardent follower of Francois-Joseph-Victor Broussais (1772-1838) concerning the dubious practice of bloodletting.
Puerto Rican independence leader, surgeon and Legion d'honneur laureate, Ramon Emeterio Betances, was one of his prominent students.
Klebsiella granulomatis

# Overview
Klebsiella granulomatis, originally classified as Calymmatobacterium granulomatis,  is a fastidious Gram-negative pleomorphic bacteria causing donovanosis, a gential ulcer disease.

# Organism
- Aragao and Vianna classified the bacteria causing donovanosis as Calymmatobacterium granulomatis in 1913. However, DNA sequencing of 16S rRNA and phoE genes revealed similarity to Klebsiella.
- There is 99% homology between the etiologic agent of donovanosis and members of Klebsiella.
- A proposal has been put forth to reclassify the bacteria to Klebsiella granulomatis.
- K. granulomatis morphology:
- Pleomorphic ranging from coccus to bacillus
- 1-2 X 0.5-0.7 m
- May or may not be capsulated
- Non-motile

# Human Pathogen
- K. granulomatis is an obligate, intracellular human pathogen.
- K. granulomatis is typically transmitted through sexual contact but may also be transmitted through direct contact and fecal contamination.

# Gallery
- This image reveals some of the cytoarchitectural features seen in a lymph node specimen that had been extracted from a patient suspected of a Hantavirus illness. Note the concentration of lymphohistiocytic infiltrates, almost all cases have expanded paracortical regions, or T-cell regions with immunoblasts, which sometimes extend into the cortex and into the medulla. From Public Health Image Library (PHIL). 
- Donovan bodies in a tissue sample used to diagnose granuloma inguinale. From Public Health Image Library (PHIL). 
- Donovan bodies in a tissue sample used to diagnose granuloma inguinale. From Public Health Image Library (PHIL). 
- Dieterles silver stain under photomicrographic examination, image reveals presence of numerous Donovan bodies. From Public Health Image Library (PHIL).
Krishna Heart Institute
The Krishna Heart and Super Specialty Institute, located in Ahmedabad, India, was established in 2000 as a high-end medical facility, specializing in heart diseases. It was conceived by Dr. Atul Chokshi, an Interventional Cardiologist practicing in New York, and other Indian physicians living in the United States. The primary purpose of establishing Krishna was to provide life-saving technologies to the people of India and the rest of the world at an affordable cost.
Krishna is one of the state of Gujarats leading medical facilities. Its known for innovative diagnostic and treatment procedures and extensive work in cardiology and joint replacement. The institute offers pioneering medical techniques in the field of cardiac care, including beating heart bypass surgeries and radial angiography.
Maintaining its tradition of providing a high level of care and advanced medical technology, the institute is the first in India to set up a specialized operating theater, where air is changed 130 times per hour to provide a hygienic and infection-free environment.
Krishna welcomes patients from around the world and is a major destination for medical tourists. They are partnered with MedSolution, a medical tourism company located in Vancouver, Canada. Patients rooms are completely furnished and feature air-conditioning, attached bathrooms and television. Other services available to the international patient include pick-up and drop-off from the airport, laundry services and a 24-hour concierge.
One of the main objectives of Krishna is to provide aid to non-affording people of India, who are in dire need of cardiac care. As a result, they have set up the Divya Jyot Charitable Trust, which helps deserving people pay for their cardiac treatment  in some cases paying for it completely. It has also set up a free cardiac check-up camp for people in rural areas and free preventative health check-up camps in various parts of the city.
The trust was also able to provide 600 meal packets and water pouches a day for a week to the victims of the 2001 Gujarat earthquake. They also sent medicine, tents and food to the people of Bhuj immediately following the earthquake.
Kyasanur Forest disease

# Overview
Kyasanur forest disease is a tick-borne viral hemorrhagic fever endemic to South Asia. The disease is caused by a virus belonging to the family flaviviridae.

# History
The disease was first reported from Kyasanur Forest of Karnataka in India. The disease was first manifested as an epizootic outbreak among monkeys killing several of them in the year 1957. Hence the disease is also known as Monkey Disease.

# Transmission
The reservoir hosts for the disease are porcupines, rats and mice. The vector for disease transmission is Haemaphysalis spinigera, a forest tick. Humans contract infection from the bite of nymphs of the tick.

# Presentation
The disease has a high morbidity rate of 10 %.
The clinical manifestations of the disease in humans are:
- High fever
- Headache
- Haemorrhages from nasal cavity and throat
- Vomiting
An affected person may recover in two weeks time, but the convalescent period is typically very long, lasting for several months. There will be muscle aches and weakness during this period and the affected person is unable to engage in physical activities.

# Prevention and treatment
Prophylaxis by vaccination, as well as preventive measures like protective clothing, tick control, and mosquito control are advised. An attenuated live vaccine is now available. Specific treatments are not available.
de:Kyasanur-Wald-Fieber
Langer-Giedion syndrome
Langer-Giedion syndrome is a very rare genetic disorder caused by a deletion of chromosomal material.  It is named after the two doctors who undertook the main research into the condition in the 1960s. Diagnosis is usually made at birth or in early childhood.
The syndrome occurs when a small piece of chromosome 8s long arm, which contains a number of genes is missing. The loss of these genes is responsible for some of the overall characteristics of Langer-Giedion syndrome.  This disorder is also called  trichorhinophalangeal syndrome, or LGCR (for Langer-Giedion Chromosome Region).

# Symptoms
The features associated with this condition include mild to moderate learning difficulties, short stature, unique facial features, small head and skeletal abnormalities including bony growths projecting from the surfaces of bones. These may include benign bony growths on various bones of the body or cone-shaped extensions on the growing ends of certain bones, particularly in the hands, and specific craniofacial features. Typically individuals with Langer-Giedion syndrome have fine scalp hair, ears, which may be large, or prominent, broad eyebrows,deep-set eyes, a bulbous nose, long narrow upper lip and missing teeth.
Other features associated with this condition may include loose-wrinkled skin and joint laxity or floppiness, hearing loss and delayed speech. Individuals with Langer-Giedion syndrome may show a susceptibility to infections during the first years of life, especially chest infection. Individuals may show some or all of these features and, in addition, may be differently affected by the severity of their symptoms. The outlook for children with Langer-Giedion syndrome depends greatly on the severity of the features.

# Occurrence
Most cases of Langer-Giedion syndrome occur at irregular intervals, which means that the loss of genetic material is often not present in the parent and usually other family members are not affected.

# Treatment
While no genetic syndrome can be 'cured', treatments are available for some symptoms. External fixators, for instance, have been used for limbic and facial reconstructions. Some patients with this syndrome are known to have had short life spans, but there are also healthy adult patients who require little treatment.
Lactate dehydrogenase A
Lactate dehydrogenase A (LDHA) is an enzyme which in humans is encoded by the LDHA  gene. It is a monomer of lactate dehydrogenase, which exists as a tetramer. The other main subunit is lactate dehydrogenase B (LDHB).

# Function
Lactate dehydrogenase A catalyzes the inter-conversion of pyruvate and L-lactate with concomitant inter-conversion of NADH and NAD+. LDHA is found in most somatic tissues, though predominantly in muscle tissue and tumours, and belongs to the lactate dehydrogenase family. It has long been known that many human cancers have higher LDHA levels compared to normal tissues. It has also been shown that LDHA plays an important role in the development, invasion and metastasis of malignancies. Mutations in LDHA have been linked to exertional myoglobinuria.

# Interactive pathway map
Click on genes, proteins and metabolites below to link to respective articles. 
-  The interactive pathway map can be edited at WikiPathways: "GlycolysisGluconeogenesis_WP534"..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}

# Model organisms
Model organisms have been used in the study of LDHA function. A conditional knockout mouse line, called Ldhatm1a(EUCOMM)Wtsi was generated as part of the International Knockout Mouse Consortium program  a high-throughput mutagenesis project to generate and distribute animal models of disease to interested scientists.
Male and female animals underwent a standardized phenotypic screen to determine the effects of deletion. Twenty seven tests were carried out on mutant mice and five significant abnormalities were observed. Few homozygous mutant embryos were identified during gestation, and none survived until weaning. The remaining tests were carried out on heterozygous mutant adult mice. Animals of both sex had  abnormal plasma chemistry, males also had improved glucose tolerance and increased red blood cell distribution width.

# LDHA
The following compounds have been demonstrated to inhibit the LDHA enzyme:
- Oxamate
- Epigallocatechin gallate
- Quinoline 3-sulfonamide
Lamivudine how supplied

# How Supplied
EPIVIR Scored Tablets, 150 mg
White, diamond-shaped, scored, film-coated tablets debossed with GX CJ7 on both sides.
Bottle of 60 tablets (NDC 49702-203-18) with child-resistant closure.
EPIVIR Tablets, 300 mg
Gray, modified diamond-shaped, film-coated tablets engraved with GX EJ7 on one side and plain on the reverse side.
Bottle of 30 tablets (NDC 49702-204-13) with child-resistant closure.
Recommended Storage:
Store EPIVIR Tablets at 25C (77F); excursions permitted to 15 to 30C (59 to 86F) .
EPIVIR Oral Solution, 10 mg/mL
A clear, colorless to pale yellow, strawberry-banana-flavored liquid, contains 10 mg of lamivudine in each 1 mL.
Plastic bottle of 240 mL (NDC 49702-205-48) with child-resistant closure. This product does not require reconstitution.
Recommended Storage:
Store in tightly closed bottles at 25C (77F) .
Lanoxin tablet/warnings

# Warnings

## Sinus Node Disease and AV Block
Because digoxin slows sinoatrial and AV conduction, the drug commonly prolongs the PR interval. The drug may cause severe sinus bradycardia or sinoatrial block in patients with pre-existing sinus node disease and may cause advanced or complete heart block in patients with pre-existing incomplete AV block. In such patients consideration should be given to the insertion of a pacemaker before treatment with digoxin.

## Accessory AV Pathway (Wolff-Parkinson-White Syndrome)
After intravenous digoxin therapy, some patients with paroxysmal atrial fibrillation or flutter and a coexisting accessory AV pathway have developed increased antegrade conduction across the accessory pathway bypassing the AV node, leading to a very rapid ventricular response or ventricular fibrillation. Unless conduction down the accessory pathway has been blocked (either pharmacologically or by surgery), digoxin should not be used in such patients. The treatment of paroxysmal supraventricular tachycardia in such patients is usually direct-current cardioversion.

## Use in Patients With Preserved Left Ventricular Systolic Function
Patients with certain disorders involving heart failure associated with preserved left ventricular ejection fraction may be particularly susceptible to toxicity of the drug. Such disorders includerestrictive cardiomyopathy, constrictive pericarditis, amyloid heart disease, and acute cor pulmonale. Patients with idiopathic hypertrophic subaortic stenosis may have worsening of the outflow obstruction due to the inotropic effects of digoxin. Digoxin should generally be avoided in these patients, although it has been used for ventricular rate control in the subgroup of patients with atrial fibrillation.
Lanthanum(III) chloride
Lanthanum chloride (LaCl3) is a chemical compound. It is used as a mild Lewis acid to perform chemical reactions that usually require acidic conditions, such as converting aldehydes to acetals, under nearly neutral conditions.
The lanthanide ions are 9 coordinate in the trichloride.
The compound has been identified as a catalyst for the high pressure oxidative chlorination of methane to chloromethane with hydrochloric acid and oxygen . Interestingly in this process the +3 oxidation state of lanthanum remains unchanged.

# Uses
Lanthanum chloride can be used to remove phosphates in swimming pools, which helps prevent algae growth.
Laryngomalacia overview

# Overview
Laryngomalacia is the most common cause of stridor in infancy. It occurs when the soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction.  It can also be seen in older patients, especially those with neuromuscular conditions resulting in weakness of the muscles of the throat.  However, the infantile form is much more common.

# Pathophysiology
In infantile laryngomalacia, the supraglottic larynx (the part above the vocal cords) is tightly curled, with a short band holding the cartilage shield in the front (the epiglottis) tightly to the mobile cartilage in the back of the larynx (the arytenoids).  These bands are known as the aryepiglottic folds; they create the movements that opens and closes the vocal cords for phonation.  The shortened aryepiglottic folds cause the epiglottis to be curled on itself.  This is the well known "omega shaped" epiglottis in laryngomalacia.

# Causes
Although laryngomalacia is not associated with a specific gene, there is evidence that some cases may be inherited.  Relaxation or a lack of muscle tone in the upper airway may be a factor. It is often worse when the infant is on his or her back, because the floppy tissues can fall over the airway opening more easily in this position.

# Diagnosis

## History and Symptoms
Laryngomalacia results in partial airway obstruction, most commonly causing a characteristic high-pitched squeaking noise on inhalation (inspiratory stridor).  Some infants have feeding difficulties related to this problem.  Rarely, children will have significant life threatening airway obstruction.  The vast majority, however, will only have stridor without other more serious symptoms such as dyspnea (difficulty breathing).
Laryngomalacia becomes symptomatic after the first few weeks of life, and may get louder over the first year, as the child moves air more vigorously.

## Endoscopy
Flexible laryngoscopy may be done to further evaluate the infant's condition.

# Treatment
Time is the only treatment necessary in more than 90% of infant cases. In other cases, surgery may be necessary. Most commonly, this involves cutting the aryepiglottic folds to let the supraglottic airway spring open.  Treatment of gastroesophageal reflux disease can also help in the treatment of laryngomalacia, since gastric contents can cause the back part of the larynx to swell and collapse even further into the airway.  In some cases, a temporary tracheostomy may be necessary.
Left auricular appendix

# Overview
The left auricular appendix (left auricula, left auricle, left atrial appendage) is a conical muscular pouch connected to the left atrium of the heart. It is somewhat constricted at its junction with the principal cavity; it is longer, narrower, and more curved than the right auricular appendix, and its margins are more deeply indented.
It is directed forward and toward the right and overlaps the root of the pulmonary artery.
In older texts, the term "left auricle" was often used to describe the structure now known as the left atrium.
In atrial fibrillation, thrombi are thought to arise from the left auricle, which may lead to ischaemic damage to the brain, kidneys, or other organs supplied by the systemic circulation.
Functions as a reservoir for the left ventricle.
Left inferior vena cava
- A left IVC results from regression of the right supracardinal vein with persistence of the left supracardinal vein.
- The prevalence is 0.2%0.5% .
- The major clinical significance of this anomaly is the potential for misdiagnosis as left-sided paraaortic lymphadenopathy.
- Spontaneous rupture of an abdominal aortic aneurysm into a left IVC has been reported.
- Transjugular access to the infrarenal IVC for placement of an IVC filter may be difficult.

# Diagnostic Findings
- Typically, the left IVC joins the left renal vein, which crosses anterior to the aorta in the normal fashion, uniting with the right renal vein to form a normal right-sided prerenal IVC.

# See Also
- Azygous continuation of the inferior vena cava
- Double inferior vena cava
- Left superior vena cava