Persius/hicric huggingface dataset:
Fractional sodium excretion

# Overview
The fractional excretion of sodium (FENa) is a measure of the percentage of sodium excreted in the urine versus the sodium reabsorbed by the kidney.  It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water resorption.  Therefore the urinary and plasma concentrations of sodium must be compared to get an accurate picture of renal clearance.  FENa can be calculated by multiplying the plasma sodium concentration by the glomerular filtration rate.  It may also be calculated by multiplying the urine sodium concentration by the urinary flow rate.  This translates into the formula:
(SodiumurinaryFlow rateurinary)(Sodiumplasma(CreatinineurinaryFlow rateurinaryCreatinineplasma)100
Sodium (mmol/l)
Creatinine (mg/dl)
The flow rates cancel out in the above equation, simplifying to the standard equation:
(SodiumurinaryCreatinineplasma)(SodiumplasmaCreatinineurinary)100
This can also be rearranged in a more intuitive ratio of fractions:
(SodiumurinaryCreatinineurinary)(SodiumplasmaCreatinineplasma)100

# Interpretation
FENa is an accurate screening test for differentiating prerenal failure versus acute tubular necrosis.  A value below 1 percent suggests prerenal disease, as the physiologic response to a decrease in renal perfusion is an increase in sodium reabsorption to control hypovolemia. Values above 2 percent usually indicate acute tubular necrosis: either excess sodium is lost due to tubular damage, or the damaged glomeruli result in hypervolemia resulting in the normal response of sodium wasting.  Values between 1 and 2 may be seen in either disorder.  In renal tract obstruction, values may be either higher or lower than 1%.

# Alternatives
Fractional excretion of other substances can be measured to determine renal clearance including urea, uric acid, and lithium.  These can be used in patients undergoing diuretic therapy, where the urinary sodium concentrations may be higher despite possible prerenal pathology.
Fibroblast growth factor 23
Fibroblast growth factor 23 or FGF23 is a protein that in humans is encoded by the FGF23 gene. FGF23 is a member of the fibroblast growth factor (FGF) family which is responsible for phosphate and vitamin D metabolism.

# Function
The main function of FGF23 seems to be regulation of phosphate concentration in plasma. FGF23 is secreted by osteocytes in response to elevated calcitriol. FGF23 acts on the kidneys, where it decreases the expression of NPT2, a sodium-phosphate cotransporter in the proximal tubule. Thus, FGF23 decreases the reabsorption and increases excretion of phosphate. FGF23 may also suppress 1-alpha-hydroxylase, reducing its ability to activate vitamin D and subsequently impairing calcium absorption.

# Clinical significance
FGF23 is located on chromosome 12 and is composed of three exons. Mutations in FGF23 that render the protein resistant to proteolytic cleavage leads to increased activity of FGF23 and the renal phosphate loss found in the human disease autosomal dominant hypophosphatemic rickets. FGF23 is also overproduced by some types of tumors, such as the benign mesenchymal neoplasm Phosphaturic mesenchymal tumor causing tumor-induced osteomalacia, a paraneoplastic syndrome.
Loss of FGF23 activity is thought to lead to increased phosphate levels and the clinical syndrome of familial tumor calcinosis.  This gene was identified by its mutations associated with autosomal dominant hypophosphatemic rickets.

# History
Prior to its discovery in 2000, it was hypothesized that a protein existed which performed the functions subsequently shown for FGF23. This putative protein was known as phosphatonin.  Several types of effects were described including impairment of sodium dependent phosphate transport in both intestinal and renal brush border membrane vesicles, inhibition of production of calcitriol, stimulation of breakdown of calcitriol, and inhibition of production/secretion of parathyroid hormone.
Familial amyloid neuropathy
The familial amyloid neuropathies (or familial amyloidotic neuropathies, neuropathic heredofamilial amyloidosis, familial amyloid polyneuropathy) are a rare group of autosomal dominant neuropathies of autonomic and peripheral nerves.

# Classification
The precursor proteins are: transthyretin (ATTR, the most commonly implicated protein), apolipoprotein A1, and gelsolin.
Due to the rareness of the other types, it is sometimes associated with transthyretin alone.
"FAP-I" and "FAP-II" are associated with transthyretin. (Senile systemic amyloidosis is also associated with transthyretin.)
"FAP-III" is also known as "Iowa-type", and involves apolipoprotein A1.
"FAP-IV" is also known as "Finnish-type", and involves gelsolin.
Fibrinogen, apolipoprotein A1, and lysozyme are associated with a closely related condition, familial visceral amyloidosis.

# Treatment
Liver transplantation has demonstrated moderate improvement in ATTR familial amyloidosis.
Fashion brands (cigarettes)
Historically considered a masculine habit, the feminization of smoking occurred in tandem with the advent of fashion brands or premium brands of cigarettes specifically marketed toward ladies who see the use of these brands as a way to increase or enhance their sexual appeal. Most often this is focused on young fashion-conscious professional ladies who are the target demographic for these brands, which are differentiated by slimness and added length over traditional brands of cigarettes.
These brands include decorative ones like Eve, marketed strictly toward women like Virginia Slims, or as evening-out styles like Sobranie Cocktail or Sobranie Black Russian. Many fashion houses have lent their name (through a licensing agreement) to cigarettes; Yves Saint Laurent is probably the most successful of these, (even though he admitted in a 1968 interview he smokes, but not his namesake brand, as he "does not like the flavour"), though many other brands have been marketed, from time to time, in select international markets: Givenchy, Versace, Pierre Cardin, Christian Lacroix and Cartier (a jewelry house).
In the 1980s and early 1990s, manufacturers created longer, 164 millimeter versions of several ladies' cigarettes, an example of which can be seen in the Madonna video Vogue.  However, finding only a small niche market, the machines that produced them have since been dismantled.
With the anti-smoking movement in the United States, cigarette manufacturers have turned to Asia, where there is a distinct market for female oriented brands, and to the nouveau riche in Russia.
Fleas (patient information)
For the WikiDoc page for this topic, click here

# Overview
Fleas are blood-sucking insects that feed on humans, dog, cats, and other animals. Fleas do not have wings

# What are the symptoms of Fleas?
- Hives
- Itching (can be severe, and may be all over or just where the rash is located)
- Rash with small bumps that itch and may bleed
- Located on the armpit or fold of a joint (at the elbow, knee, or ankle)
- The amount of skin affected increases over time (enlarging skin rash or lesion) or the rash spreads to other areas
- When pressed the area turns white (blanches to touch)
Skin folds, such as under the breasts or in the groin may be affected (intertrigo)
Swelling only around a sore or injury
Note: Symptoms often begin suddenly (within hours).

# What causes Fleas?
Fleas prefer to live on dogs and cats, but may also be found on humans and other available animals.

# Who is at highest risk?
Pet owners may not be bothered by fleas until their pet is gone for a long period of time, and the fleas must find another place to go. This is when they begin to bite humans. Bites often occur around the waist, ankles, armpits, and in the bend of the elbows and knees.

# Diagnosis
No testing is necessary.

# Treatment options
The goal of treatment is to get rid of the fleas by treating the home, pets, and outside areas with insecticide. Small children should not be in the home when insecticides are being used. Birds and fish must be protected during spraying. Home foggers and flea collars do not always work. If home treatments do not work, professional extermination may be needed.
If flea bites occur, an over-the-counter 1% hydrocortisone cream can help relieve itching.

# Where to find medical care for Fleas?
Directions to Hospitals Treating Fleas

# What to expect (Outlook/Prognosis)?
Getting rid of fleas can be difficult and takes persistence.

# Possible complications
Scratching can lead to a skin infection.

# Prevention of Fleas
Prevention may not be possible in all cases. Use of insecticides may be helpful if fleas are common in your area. Professional extermination may be necessary in some cases

# Sources
Water-electrolyte imbalance
Electrolytes play a vital role in maintaining homeostasis within the body. They help to regulate myocardial and neurological function, fluid balance, oxygen delivery, acid-base balance and much more. Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished elimination of an electrolyte; diminished ingestion or excessive elimination of an electrolyte. The most common cause of electrolyte disturbances is renal failure.
The most serious electrolyte disturbances involve abnormalities in the levels of sodium, potassium, and/or calcium. Other electrolyte imbalances are less common, and often occur in conjunction with major electrolyte changes.  Chronic laxative abuse or severe diarrhea or vomiting can lead to electrolyte disturbances along with dehydration. People suffering from bulimia or anorexia are at especially high risk for an electrolyte imbalance.

# Nomenclature
There is a standard nomenclature for electrolyte disorders:
- The name starts with a prefix denoting whether the electrolyte is abnormally elevated ("hyper-") or depleted ("hypo-").
- The word stem then gives the name of the electrolyte in Latin. If no Latin equivalent exists, then the corresponding term in English is used.
- The name ends with the suffix "-emia," meaning "in the blood." (Note, this doesn't mean that the disturbance is only in the blood; usually, electrolyte disturbance is systemic. However, since the disturbance is usually detected from blood testing, the convention has developed.)
For instance, elevated potassium in the blood is called "hyperkalemia" from the Latin term for potassium, "kalium".

# Table of common electrolyte disturbances

# General Function
Electrolytes are important because they are what cells (especially nerve, heart, muscle) use to maintain voltages across their cell membranes and to carry electrical impulses (nerve impulses, muscle contractions) across themselves and to other cells. Kidneys work to keep the electrolyte concentrations in blood constant despite changes in your body. For example, during heavy exercise, electrolytes are lost in sweat, particularly sodium and potassium. These electrolytes must be replaced to keep the electrolyte concentrations of the body fluids constant.

# Electrolyte abnormalities and ECG changes
The most notable feature of hyperkalemia is the "tent shaped" or "peaked" T wave. Delayed ventricular depolarization leads to a widened QRS complex and the P wave becomes wider and flatter. When hyperkalemia becomes severe, the ECG resembles a sine wave as the P wave disappears from view. In contrast, hypokalemia is associated with flattening of the T wave and the appearance of a U wave.  When untreated, hypokalemia may lead to severe arrhythmias.
The fast ventricular depolarization and repolarization associated with hypercalcemia lead to a characteristic shortening of the QT interval.  Hypocalcemia has the opposite effect, lengthening the QT interval.
Folylpolyglutamate synthase
Folylpolyglutamate synthase, mitochondrial is an enzyme that in humans is encoded by the FPGS gene.
This gene encodes the folylpolyglutamate synthetase enzyme. This enzyme has a central role in establishing and maintaining both cytosolic and mitochondrial folylpolyglutamate concentrations and, therefore, is essential for folate homeostasis and the survival of proliferating cells. This enzyme catalyzes the ATP-dependent addition of glutamate moieties to folate and folate derivatives. While several transcript variants may exist for this gene, the full-length natures of only two have been biologically validated to date. These two variants encode distinct isoforms.

# Interactive pathway map
Click on genes, proteins and metabolites below to link to respective articles.
-  The interactive pathway map can be edited at WikiPathways: "FluoropyrimidineActivity_WP1601"..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}
Foscarnet adverse reactions

# Adverse Reactions
THE MAJOR TOXICITY OF FOSCAVIR IS RENAL IMPAIRMENT (see WARNINGS section). Approximately 33% of 189 patients with AIDS and CMV retinitis who received FOSCAVIR (60 mg/kg TID), without adequate hydration, developed significant impairment of renal function (serum creatinine  2.0 mg/dL). The incidence of renal impairment in subsequent clinical trials in which 1000 mL of normal saline or 5% dextrose solution was given with each infusion of FOSCAVIR was 12% (34/280).
FOSCAVIR has been associated with changes in serum electrolytes including hypocalcemia (15-30%), hypophosphatemia (826%) and hyperphosphatemia (6%), hypomagnesemia (1530%), and hypokalemia (1648%) (see WARNINGS section). The higher percentages were derived from those patients receiving hydration.
FOSCAVIR treatment was associated with seizures in 18/189 (10%) AIDS patients in the initial five controlled studies (see WARNINGS section). Risk factors associated with seizures included impaired baseline renal function, low total serum calcium, and underlying CNS conditions predisposing the patient to seizures. The rate of seizures did not increase with duration of treatment. Three cases were associated with overdoses of FOSCAVIR (see OVERDOSAGE section).
In five controlled U.S. clinical trials the most frequently reported adverse events in patients with AIDS and CMV retinitis are shown in Table 5. These figures were calculated without reference to drug relationship or severity.
Foscarnet drug interactions

# Drug Interactions
A possible drug interaction of FOSCAVIR and intravenous pentamidine has been described. Concomitant treatment of four patients in the United Kingdom with FOSCAVIR and intravenous pentamidine may have caused hypocalcemia; one patient died with severe hypocalcemia. Toxicity associated with concomitant use of aerosolized pentamidine has not been reported.
Since FOSCAVIR decreases serum concentrations of ionized calcium, concurrent treatment with other drugs known to influence serum calcium concentrations should be used with particular caution. Fatalities have been reported in post-marketing surveillance during concomitant therapy with FOSCAVIR and pentamidine.
Because of foscarnet's tendency to cause renal impairment, the use of FOSCAVIR should be avoided in combination with potentially nephrotoxic drugs such as aminoglycosides, amphotericin B and intravenous pentamidine (see above) unless the potential benefits outweigh the risks to the patient.
Abnormal renal function has been observed in clinical practice during the use of FOSCAVIR and ritonavir, or FOSCAVIR, ritonavir, and saquinavir. (See DOSAGE and ADMINISTRATION.)
Ganciclovir: The pharmacokinetics of foscarnet and ganciclovir were not altered in 13 patients receiving either concomitant therapy or daily alternating therapy for maintenance of CMV disease.
Fraction of inspired oxygen

# Overview
Fraction of inspired oxygen (FiO2) is the fraction or percentage of oxygen in the space being measured. Medical patients experiencing difficulty breathing are provided with oxygen-enriched air, which means a higher-than-atmospheric FiO2. Natural air includes 20.9% oxygen, which is equivalent to FiO2 of 0.21. Oxygen-enriched air has a higher FiO2 than 0.21, up to 1.00, which means 100% oxygen. FiO2 is typically maintained below 0.5 even with mechanical ventilation, to avoid oxygen toxicity.
Often used in medicine the FiO2 is used to represent the percentage of oxygen participating in gas-exchange.  If the barometric pressure changes, the FiO2 may remain constant while the partial pressure of oxygen changes with the change in barometric pressure.

# Equations
PAO2, PEO2, and PiO2 are the partial pressures of oxygen in alveolar, expired, and inspired gas, respectively, and VD/VT is the ratio of physiologic dead space over tidal volume.

# Medicine
In medicine the FiO2 is the assumed percentage of oxygen concentration participating in gas exchange in the alveoli.

# Uses
The ratio between partial pressure of oxygen in arterial blood (PaO2) and FiO2 is used as an indicator of hypoxemia per the American-European Consensus Conference on lung injury.  A high FiO2 has been shown to alter the ratio of PaO2/FiO2.

# PaO2/FiO2 ratio
The ratio of partial pressure arterial oxygen and fraction of inspired oxygen, sometimes called the Carrico index, is a comparison between the oxygen level in the blood and the oxygen concentration that is breathed.  This helps to determine the degree of any problems with how the lungs transfer oxygen to the blood. A sample of arterial blood is collected for this test. A PaO2/FiO2 ratio less than or equal to 200 mmHg is necessary for the diagnosis of acute respiratory distress syndrome by the AECC criteria.  The more recent Berlin criteria defines mild ARDS at a ratio of <300.
A PaO2/FiO2 ratio less than or equal to 250 mmHg is one of the minor criteria for severe community acquired pneumonia (i.e., possible indication for inpatient treatment).
A PaO2/FiO2 ratio less than or equal to 333 mmHg is one of the variables in the SMART-COP risk score for intensive respiratory or vasopressor support in community-acquired pneumonia.

# Related mathematics

## Alveolar air equation
The alveolar air equation is the following formula, used to calculate the partial pressure of alveolar gas:
HallermannStreiff syndrome
Synonyms and keywords: oculomandibulofacial syndrome; Francois dyscephalic syndrome; HallermannStreiffFrancois syndrome; oculomandibulodyscephaly with hypotrichosis; Aubry syndrome and Ullrich-Fremery-Dohna syndrome

# Overview
HallermannStreiff syndrome is a congenital disorder that affects growth, cranial development, hair growth and dental development.
There are fewer than 200 people with the syndrome worldwide. An organization supporting people with the HallermannStreiff syndrome is the Germany-based "Schattenkinder e.V."

# Presentation
Patients with this syndrome are shorter than the average person and may not develop hair in many places, including in the facial, leg and pubic areas. Patients also have eye problems including clouded eyes or reduced eye size, bilateral cataracts and glaucoma.
It can be associated with sleep apnea.
It can complicate intubation.

# Genetics
It may be associated with GJA1.

# Eponym
It is named for Wilhelm Hallermann and Enrico Streiff.
Hallermann-Streiff syndrome
Hallermann-Streiff syndrome (also known as the Francois Dyscephalic Syndrome, Hallermann-Streiff-Francois syndrome, Oculomandibulodyscephaly with hypotrichosis and Oculomandibulofacial syndrome) is a congenital disorder that affects growth, cranial development, hair growth and dental development.
There are fewer than 200 people with the syndrome worldwide. An organisation supporting people with the Hallermann Streiff Syndrome is the Germany based "Schattenkinder e.V."

# Presentation
Patients with this syndrome are shorter than the average person and may not develop hair in many places, including in the facial, leg and pubic areas. Patients also have eye problems including clouded or reduced eye size, bilateral cataracts and glaucoma.
It can be associated with sleep apnea.
It can complicate intubation.

# Eponym
It is named for Wilhelm Hallermann and Enrico Streiff.
Gestational choriocarcinoma

# Overview
Gestational choriocarcinoma is a malignant trophoblastic tumour arising from any gestational event during pregnancy in the reproductive female.
Women with gestational choriocarcinoma may present with abnormal vaginal bleeding, persistent markedly elevated hCG, or a history of prior pregnancy.
Most patients develop gestational choriocarcinoma shortly after gestational anomalies, but pathology may occur after a long latency of years.

# Diagnosis
Grossly, a red hemorrhagic mass is seen in the uterus, though it may vary in size. Often, diagnosis is presumptive, and based on clinical findings and the identification of a malignant trophoblast.

# Outcome
At the time of diagnosis, more than 90% of patients already have lung metastases, though there are also less frequent metastases to the brain and liver.
With chemotherapy, there is an 80% 5-year survival rate.
Ultimately, death is related to liver and brain metastases.
Gilbert's syndrome overview

# Overview
Gilbert's syndrome (pr. Zhil-bear), often shortened to the acronym GS, is the most common hereditary cause of increased bilirubin, and is found in up to 5% of the population. The main symptom is otherwise harmless jaundice which does not require treatment, caused by elevated levels of unconjugated bilirubin in the bloodstream (hyperbilirubinemia).
The source of this hyperbilirubinemia is reduced activity of the enzyme glucuronyltransferase which conjugates bilirubin and some other lipophilic molecules. Conjugation renders the bilirubin water-soluble and suitable for excretion via the kidneys.

# Historical Perspective
Gilbert's syndrome was first described by French gastroenterologist Augustin Nicolas Gilbert and co-workers in 1901. In German literature, it is commonly associated with Jens Einar Meulengracht.

# Pathophysiology
Gilbert's syndrome is caused by approximately 30%-50% reduced glucuronidation activity of the enzyme Uridine-diphosphate-glucuronosyltransferase isoform 1A1 (UGT1A1).  The gene which encodes UGT1A1 normally has a promoter region TATA box containing the allele A(TA6)TAA.  Gilbert's syndrome is associated with homozygous A(TA7)TAA alleles.  The allele polymorphism is referred to as UGT1A1*28.

# Epidemiology and Demographics
Gilbert's syndrome affects up to 10% of people in some Caucasian populations. The condition is usually noncancerous (benign).