Persius/hicric huggingface dataset:
DURACLON overdosage

# Overdosage
Hypertension may develop early and may be followed by hypotension, bradycardia, respiratory depression, hypothermia, drowsiness, decreased or absent reflexes, weakness, irritability and miosis. The frequency of CNS depression may be higher in children than adults. Large overdoses may result in reversible cardiac conduction defects or dysrhythmias, apnea, coma and seizures. Signs and symptoms of overdose generally occur within 30 minutes to 2 hours after exposure. As little as 0.1 mg of clonidine has produced signs of toxicity in children.
If symptoms of poisoning occur following dermal exposure, remove all Clonidine Transdermal Systems. After their removal, the plasma clonidine levels will persist for about 8 hours, then decline slowly over a period of several days. Rare cases of Clonidine Transdermal System poisoning due to accidental or deliberate mouthing or ingestion of the patch have been reported, many of them involving children.
There is no specific antidote for clonidine overdosage. Ipecac syrup-induced vomiting and gastric lavage would not be expected to remove significant amounts of clonidine following dermal exposure. If the patch is ingested, whole bowel irrigation may be considered and the administration of activated charcoal and/or cathartic may be beneficial. Supportive care may include atropine sulfate for bradycardia, intravenous fluids and/or vasopressor agents for hypotension and vasodilators for hypertension. Naloxone may be a useful adjunct for the management of clonidine-induced respiratory depression, hypotension and/or coma; blood pressure should be monitored since the administration of naloxone has occasionally resulted in paradoxical hypertension. Tolazoline administration has yielded inconsistent results and is not recommended as first-line therapy. Dialysis is not likely to significantly enhance the elimination of clonidine.
The largest overdose reported to date, involved a 28-year old male who ingested 100 mg of clonidine hydrochloride powder. This patient developed hypertension followed by hypotension, bradycardia, apnea, hallucinations, semicoma, and premature ventricular contractions. The patient fully recovered after intensive treatment. Plasma clonidine levels were 60 ng/mL after 1 hour, 190 ng/mL after 1.5 hours, 370 ng/mL after 2 hours, and 120 ng/mL after 5.5 and 6.5 hours. In mice and rats, the oral LD50 of clonidine is 206 and 465 mg/kg, respectively.
Dapsone description
DESCRIPTION
Dapsone-USP, 4,4'-diaminodiphenylsulfone (DDS), is a primary treatment for Dermatitis herpetiformis. It is an antibacterial drug for susceptible cases of leprosy. It is a white, odorless crystalline powder, practically in-soluble in water and insoluble in fixed and vegetable oils.
Dapsone is issued on prescription in tablets of 25 and 100 mg for oral use.
Inactive Ingredients: Colloidal silicone dioxide, magnesium stearate, microcrystalline cellulose and corn starch.
User:Dayana Davidis
Dayana K Davidis is a medical doctor specialized in nutrition, with subspecialties in genetics and preventive medicine. She is also a certified health and wellness coach.
She operates clinics in different countries including France and USA, and would see patients in person or virtually.
Davidis is a pioneer in combining different metabolic screenings, tests, blood works, and other diagnostic tools to tailor a preventive and personalized health plan and/or to treat existing metabolic,  hormonal or other health related problems.
Contact ddavidis@wikidoc.org, or at her clinics, dayana@lifeandhealthstyling.com, website www.lifeandhealthsyting.com,
Appointments 

# Education And Training
DayAna Davidis went to high school in Switzerland, and did her undergraduate medical dietetics and genetics and medical studies at AUA Athens, Greece and LAU Beirut, Lebanon. She went on to do postgraduate studies in natural medicine at CPH in London, England and Health and Wellness coaching at Duke university, Durham, NC, USA.
She has treated and helped thousands of patients from around the world to regain their health using interventional and preventive methods, and has worked in research on nutrition, weight loss and metabolic related topics. She operates medical offices in Europe and the United States.
Davidis is multilingual, she is fluent in French, English, Arabic, Greek and Spanish and she can understand and speak some Italian.
She is an avid skier and her hobbies include botanics, tennis, waterski, biking, travel and site seeing and enjoys reading more now thanks to her e reader.
Wide pulse pressure

# Overview
A wide pulse pressure is defined as a difference between the systolic blood pressure and the diastolic blood pressure that exceeds 60 - 70 mm Hg.

# Causes

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Aortic dissection
- Atrial fibrillation
- Dengue fever
- Endocarditis
- ST elevation myocardial infarction

## Common Causes
- Anemia
- Anxiety
- Aortic dissection
- Aortic regurgitation
- Arteriovenous fistula
- Atherosclerosis
- Complete heart block
- Endocarditis
- Fever
- Isolated systolic hypertension
- Patent ductus arteriosus
- Raised intracranial pressure
- Thyrotoxicosis

## Causes by Organ System

## Causes in Alphabetical Order

# Diagnosis

## Physical Examination

### Heart
Chronic Aortic Regurgitation
- Diastolic murmur
- Corrigan pulse
- Rapid rise and fall
- Hill's sign
- Systolic BP of lower limbs >20mmHg than Systolic BP in arms

### Other
Chronic Aortic Regurgitation
- de Musset's sign
- head bobs back and forth with each heartbeat

## Laboratory Findings
Suggested Labs
- CBC: To rule out anemia
- TSH: To rule out thyrotoxicosis
- Blood cultures: To rule out endocarditis
- Free T4: To rule out thyrotoxicosis
- Free T3: To rule out thyrotoxicosis

## Chest X Ray
- May demonstrate aortic dissection if there is aortic knob enlargement and widened mediastinum

## MRI and CT
- CT can indicate aortic dissection
- MRI can also be used to diagnose aortic dissection

## Echocardiography or Ultrasound
- Better than Aortography
- Transesophageal echocardiography measures aortic regurgitation
- detects two additional lumen for diagnosis of aortic dissection

## Other Imaging Findings
- If there is a suspicion of atherosclerosis;
- CAD risk stratification measurement
- Cholesterol screening
- Stress test
- Cardiac catheterization

# Treatment

## Medical Therapy
- Treat underlying causes
- Anemia
- Chronic disease
- Fever
- Hypothyroidism
- Regulate cranial pressure

### Acute Pharmacotherapy
- Emergency blood cultures and IV antibiotic for endocarditis

### Chronic Pharmacotherapies
Hyperthyroidism
- Beta-blockers
- PTU
Chronic aortic regurgitation
- Diuretics
- Pressors
- Vasodilators

## Surgery

## Indications for Surgery
Aortic dissection
- Emergency surgery
Chronic aortic regurgitation
- Aortic valve replacement
- Commonly in patients with low EF
Hyperthyroidism
- Thyroidectomy
Hypolipoproteinemia
Synonyms and keywords: Hypolipidemia, low lipoprotein

# Overview
Hypolipoproteinemia (also known as hypolipidemia or low lipoproteins) is defined as presence of low levels of one or more type of lipoproteins. Hypolipoproteinemia may present as primary genetic disorders or as a secondary complication of underlying medical conditions. After ruling out common secondary causes of hypolipoproteinemia, the clinician must begin the work-up for primary causes.
Patients with hypoproteinemia may present with low LDL, or low HDL. Patients with low LDL commonly present with diarrhea, vomiting, or failure to thrive (in infanthood). Patients with primary low HDL are usually asymptomatic however, patients diagnosed with low HDL due to Tangier's disease, ApoA1 deficiency, or LCAT deficiency have specific clinical findings such as corneal opacities, xanthomas, and renal failure. Work up for primary hypolipoproteinemias begins with careful examination of the lipid panel and may involve screening of family members. Confirmatory gene sequencing is the gold standard diagnostic test for all hypolipoproteinemias.

# Causes
The following are the list of conditions which can cause low LDL C and low HDL C levels:
Primary lipoprotein abnormalities
- Hypoalphalipoproteinemia (Apolipoprotein A-1 deficiency). Low HDL
- Hypobetalipoproteinemia and Abetalipoproteinemia. Low LDL and VLDL, but not low HDL
- Chylomicron retention disease
- Cholesteryl ester transfer protein (CETP) elevation
- Familial combined hypolipidemia (does not increase risk of atherosclerosis)
- LCAT deficiency
- Proprotein convertase subtilisin/kexin type 9 (PCSK9) loss of function or deficiency
- Adenosine triphosphate (ATP)-binding cassette transporter (ABCA1) gene mutations
Familial HDL deficiency. This is the most common cause of low HDL and coronary artery disease.
Tangier disease
- Familial HDL deficiency. This is the most common cause of low HDL and coronary artery disease.
- Tangier disease
Secondary causes
- Anemia
- Chronic inflammation
- Chronic liver disease
- Critical illness
- Hyperthyroidism
- Infection
- Malabsorption
- Malignancy

# Classification
Based on the etiology hypolipoproteinemias are classified into primary and secondary hypolipoproteinemias. The following algorithm is a list of various etiologies under primary and secondary hypolipoproteinemias:

# Differential Diagnosis
The table below provides a brief synopsis of the lipid profile findings in several of the most common primary hypolipidemic disorders affecting the LDL C levels:
The table below is a differential diagnosis for low HDL C disorders:
Approch algorithm to a patient with low HDL C:
Approach algorithm to a patient with low low LDL C:
Deductive reasoning
Deductive reasoning, according to many dictionaries, is the type of reasoning that proceeds from general principles or premises to derive particular information.

# Background
Deductive reasoning was developed by Aristotle, Thales, Pythagoras, and other Greek philosophers of the Classical Period (600 to 300 B.C.). Aristotle, for example, relates a story of how Thales used his skills to deduce that the next season's olive crop would be a very large one. He therefore bought all the olive presses and made a fortune when the bumper olive crop did indeed arrive.
Deductive reasoning is dependent on its premises. That is, a false premise can possibly lead to a false result, and inconclusive premises will also yield an inconclusive conclusion. 
Alternative to deductive reasoning is inductive reasoning. Many incorrectly teach that deductive reasoning goes from general information to specific information and that inductive reasoning travels in the opposite direction. This is not accurate. Deductive reasoning applies general principles to reach specific conclusions, whereas inductive reasoning examines specific information, perhaps many pieces of specific information, to derive a general principle. By thinking about phenomena such as how apples fall and how the planets move, Isaac Newton induced his theory of gravity. In the 19th century, Adams and LeVerrier applied Newton's theory (general principle) to deduce the existence, mass, position, and orbit of Neptune (specific conclusions) from perturbations in the observed orbit of Uranus (specific data).
Both types of reasoning are routinely employed. One difference between them is that in deductive reasoning, the evidence provided must be a set about which everything is known before the conclusion can be drawn.  Since it is difficult to know everything before drawing a conclusion, deductive reasoning has little use in the real world.  This is where inductive reasoning steps in.  Given a set of evidence, however incomplete the knowledge is, the conclusion is likely to follow, but one gives up the guarantee that the conclusion follows.  However it does provide the ability to learn new things that are not obvious from the evidence.

# Deductive logic
Deductive reasoning is supported by deductive logic (which is not quite the same thing).
For example:
Or
Intuitively, one might deny the major premise or the conclusion; yet anyone accepting the premises accepts the conclusion.

# Natural deduction
Deductive reasoning should be distinguished from the related concept of natural deduction, an approach to proof theory that attempts to provide a formal model of logical reasoning as it "naturally" occurs.

# Cultural references
Sherlock Holmes, the fictional detective created by Sir Arthur Conan Doyle, is well known for referring to deductive reasoning in numerous of Doyle's stories.

# Further reading
- Vincent F. Hendricks, Thought 2 Talk: A Crash Course in Reflection and Expression, New York: Automatic Press / VIP, 2005, ISBN 87-991013-7-8
- Zarefsky, David, Argumentation: The Study of Effective Reasoning Parts I and II, The Teaching Company 2002
Deep perineal pouch

# Overview
The deep perineal pouch (also deep perineal space) is an anatomical term that refers to the partially enclosed space in the perineum, located superiorly to the perineal membrane.

# Structure
Unlike the superficial perineal pouch, the deep perineal pouch lacks a superior border.  It extends up into the pelvis.

# Contents
The deep perineal pouch contains:
- muscles
Deep transverse perineal muscle
External sphincter muscle of urethra
- Deep transverse perineal muscle
- External sphincter muscle of urethra
- other
Membranous portion of the urethra (males) / proximal portion of urethra (females)
Bulbourethral gland (males). (Note: The Bartholin gland is the female counterpart to the bulbourethral gland in males, but it is located in the superficial perineal pouch.)
Vagina (females)
- Membranous portion of the urethra (males) / proximal portion of urethra (females)
- Bulbourethral gland (males). (Note: The Bartholin gland is the female counterpart to the bulbourethral gland in males, but it is located in the superficial perineal pouch.)
- Vagina (females)

# "Urogenital diaphragm"
Older texts have asserted the existence of an "urogenital diaphragm", which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of the urogenital diaphragm and superior fascia of the urogenital diaphragm.
While this term is used to refer to a layer of the pelvis that separates the deep perineal sac from the upper pelvis, such a discrete border of the sac probably does not exist. 
While it has no official entry in Terminologia Anatomica, the term is still used occasionally to describe the muscular components of the deep perineal pouch The urethra and the vagina, though part of the pouch, are usually said to be passing through the urogenital diaphragm, rather than part of the diaphragm itself. 
Some researchers still assert that such a diaphragm exists,  and the term is still used in the literature.
The term "urogenital diaphragm" is often confused with the pelvic floor, which is a true diaphragm supporting many of the pelvic organs.

# Additional images
- Male Anatomy
- Median sagittal section of pelvis, showing arrangement of fasci.
- The deeper branches of the internal pudendal artery.
Deletion (genetics)
In genetics, a deletion (also called gene deletion, deficiency, or deletion mutation) is a mutation (a genetic aberration) in which a part of a chromosome or a sequence of DNA is missing. Deletion is the loss of genetic material. Any number of nucleotides can be deleted, from a single base to an entire piece of chromosome.  Deletions can be caused by errors in chromosomal crossover during meiosis.  This causes several serious genetic diseases.

# Causes
Causes include the following:
- Losses from translocation
- Chromosomal crossovers within a chromosomal inversion
- Unequal crossing over
- Breaking without rejoining
For synapsis to occur between a chromosome with a large intercalary deficiency and a normal complete homolog, the unpaired region of the normal homolog must loop out of the linear structure into a deletion or compensation loop.

# Types
Types of deletion include the following:
- Terminal Deletion - a deletion that occurs towards the end of a chromosome.
- Intercalary Deletion - a deletion that occurs from the interior of a chromosome.

# Effects
Small deletions are less likely to be fatal; large deletions are usually fatal - there are always variations based on which genes are lost. Some medium-sized deletions lead to recognizable human disorders.
Deletion of a number of base pairs that is not evenly divisible by three will lead to a frameshift mutation, causing all of the codons occurring after the deletion to be read incorrectly during translation, producing a severely altered and potentially nonfunctional protein.
Deletions are responsible for an array of genetic disorders, including some cases of male infertility and two thirds of cases of Duchenne muscular dystrophy.  Deletion of part of the short arm of chromosome 5 results in a syndrome called Cri du chat, also known as "cry of the cat" syndrome. It is found in approximately 1 in 50,000 live births.  The surviving infants have a distinctive cry, severe mental retardation, and shortened life span. Deletion mutations are also responsible for the cat family's inability to taste sweetness.
Delusional jealousy

# Overview
Delusional jealousy, Morbid jealousy, or Othello syndrome is a psychiatric disorder in which a person holds a delusional belief that their spouse or sexual partner is being unfaithful.
The name Othello syndrome comes from the character in Shakespeare's play Othello, who murders his wife based on his false belief that she has been disloyal.
An affected person typically makes repeated accusations of infidelity based on insignificant or minimal evidence, often citing seemingly normal or everyday events or material to back up their claim. They may also take great pains to test their partner's fidelity and can go to considerable lengths to monitor their behavior and movements. This may be taken to extremes, such as "private-eye" type surveillance outside of the partner's residence or workplace, following them into the bathroom in case their partner has an illicit meeting or even hearing the voice of the perceived lover.
Delusional jealousy is more often found in males than females, and it can occur regardless of an individual's sexual orientation.
Unlike other delusional disorders, delusional jealousy has a strong association with violence and in some cases stalking behavior. At the very least affected individuals tend to be irritable and confrontational.
It can be found in the context of schizophrenia and delusional disorder, such as bipolar disorder, but is also associated with alcoholism and sexual dysfunction and has been reported after neurological illness.
Periodontal curette

# Overview
Periodontal curettes are dental instruments used primarily in the prophylactic and periodontal care of human teeth.  The working tips come in a variety of shapes and sizes, but they are rounded at the tip, so as to make subgingival cleansing less traumatic to the gingiva. Scalers possess a sharp tip to access supragingival calculus in tight embrasure spaces, thus making the curette the choice instrument for subgingival areas of calculus accumulation.
Curettes are best used when the terminal shank, namely, the last portion of the handle attached to the blade, is held parallel to the long axis of the tooth.  To facilitate proper usage, instruments often come with posterior analogs which possess angled terminal shanks.
Classically, there are two recognized groups of curettes.
- Universal curettes have blades that are situated perpendicular to their terminal shanks, and are thus able to cut against the tooth on both sides of their blades.  It is because of this position of the blades in relation to their shanks that allow the blades to be used against both the mesial and distal surfaces of teeth, thus earning them the name 'universal'.  Because they were developed at the Columbia University College of Dental Medicine, they are also commonly referred to as Columbia curettes.
- Gracey curettes have blades that are laterally offset by only 70 degrees in relation to the shank.  As a result of this, they have a lower cutting edge and an upper non-cutting edge.  Because only one of the sides of each blade can cut, Gracey curettes are site-specific, and a posterior instrument used to clean mesial surfaces of teeth won't work on distal surfaces, and vice versa.  Gracey blades used for mesial surfaces of anterior teeth from the facial are only suitable for the distal surfaces of the same teeth when access is performed from the lingual.
Dermatofibrosarcoma

# Overview
Dermatofibrosarcoma protuberans (DFSP) is a rare tumor. There is only about 1 case per million per year. DFSP is a sarcoma, more precisely a cutaneous soft tissue sarcoma.

# Presentation
About 90% of DFSPs are low grade sarcomas. About 10% are mixed; they contain a high-grade sarcomatous component (DFSP-FS); therefore, they are considered to be intermediate-grade sarcomas.  All DFSPs rarely lead to a metastasis (fewer than 5% do metastasise), but DFSPs can recur locally. DFSPs most often arise in patients who are in their thirties, but sometimes have been described in children or the elderly.

# Treatment
The standard of care for patients with DFSP is surgery. Usually, complete surgical resection with wide margins is performed. The addition of adjuvant radiotherapy (irradiation) improves local control in patients with close or positive margins during the surgery. A special surgical technique, the "Mohs micrographic surgery" (MMS), can be employed in patients with DFSP. MMS is technically possible if the DFSP is in an anatomically confined area. A high probability of cure of DFSP can be attained with MMS as long as the final margins are negative.  Patients who have a recurrent DFSP can have further surgery, but the probability of adverse effects of surgery and/or metastasis is increased in these patients.
Imatinib is a so-called "biologic", i.e. a newer medicinal drug. As all medicinal drugs which have a name that ends on -ib, imatinib is a small molecular pathway inhibitor; imatinib inhibits tyrosine kinase. It may be able to induce tumor regression in patients with recurrent DFSP, unresectable DFSP or metastatic DFSP.
Descemet's membrane

# Overview
Descemet's membrane is the basement membrane that lies between the corneal proper substance, also called stroma, and the endothelial layer of the cornea. The endothelial layer is located at the posterior of the cornea.  Descemet's membrane, as the basement membrane for the endothelial layer, is secreted by the single layer of cuboidal epithelial cells that compose the endothelial layer of the cornea.
Its thickness ranges from 3 m at birth to 8-10 m in adults. 
It is also known as the Posterior limiting lamina, posterior elastic lamina, lamina elastica posterior, and membrane of Demours. It was named after French physician Jean Descemet (1732-1810).