Persius/hicric huggingface dataset:
Leukocyte alkaline phosphatase
Synonyms and keywords: LAP

# Overview
Leukocyte alkaline phosphatase is an enzyme found within white blood cells.  The blood level of leukocyte alkaline phosphatase is measured in order to help in the diagnosis of certain conditions.  Higher levels of the enzyme are seen in polycythemia vera, essential thrombocytosis, primary myelofibrosis and leukemoid reaction. Lower levels are found in chronic myelogenous leukemia, aplastic anemia, paroxysmal nocturnal hemoglobinuria and acute myelogenous leukemia.

# Causes of Increased Leukocyte alkaline phosphatase

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Appendicitis
- Blood transfusion
- Burns
- Diabetic coma
- Diabetic ketoacidosis
- Eclampsia
- Epidural hemorrhage
- Hemorrhagic shock
- Hepatic necrosis
- Insect venoms
- Intracerebral hemorrhage
- Ischemic colitis
- Myocardial infarction
- Osteomyelitis
- Pelvic abscess

## Common Causes
- Acute leukemia
- Essential thrombocytosis
- Leukemoid reaction
- Malignant lymphoma
- Megaloblastic anemia
- Multiple Myeloma
- Myelofibrosis
- Polycythemia Vera
- Solid tumors
- Tissue necrosis

## Causes by Organ System

## Causes in Alphabetical Order

# Causes of Decreased Leukocyte Alkaline Phosphatase

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Burns
- Epinephrine
- Respiratory alkalosis
- Salicylate toxicity
- Terbutaline toxicity

## Common Causes
- Aplastic anemia
- Chronic myelogenous leukemia
- Hypophosphatemia
- Iron deficiency anemia
- Paroxysmal nocturnal hemoglobinuria
- Systemic lupus erythematosus

## Causes by Organ System

## Causes in Alphabetical Order
Dehydroemetine adverse effects

# Adverse Effects

### Local Reactions
The injections are painful. Abscess formation is common. A local eczematous rash may follow inadvertent subcutaneous injection. Generalized urticarial and purpuric rashes are rare.

### Neuromuscular Effects
Weakness and muscular pain are common, particularly in the limbs and neck. Dyspnoea may also occur as a result of generalized weakness. These symptoms are dose-related and often precede evidence of cardiotoxicity.

### Cardiac Effects
Hypotension, precordial pain, tachycardia and dysrhythmias are the most frequent signs of cardiac impairment. Electrocardiographic changes, particularly flattening and inversion of the T wave and prolongation of the Q-T interval, provide an early indication of toxicity.
Dexamethasone suppression test
The dexamethasone suppression test is designed to diagnose and differentiate among the various types of Cushing's syndrome and other hypercortisol states. 
Dexamethasone is an exogenous steroid that provides negative feedback to the pituitary to suppress the secretion of ACTH.  This steroid is unable to pass the blood brain barrier which allows this test to assess a specific part of the Hypothalamic-pituitary-adrenal axis.
The test is given at low and high doses of Dexamethasone and the levels of cortisol are measured to obtain the results.  A normal result is decrease in cortisol levels upon administration of low-dose dexamethasone.  Results indicative of Cushing's disease involve no change in cortisol on low-dose dexamethasone, but inhibition of cortisol on high-dose dexamethasone.  If the cortisol levels are unchanged by low and high-dose dexamethasone then a cortisol secreting adrenocortical tumor is suspected or an ectopic ACTH syndrome.
Diaphragmatic rupture overview

# Overview
Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in respiration.  Most commonly, acquired diaphragmatic tears result from physical trauma.  Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 5% of cases of severe blunt trauma to the trunk.
Diagnostic techniques include X-ray, computed tomography, and surgical techniques such as laparotomy.  Diagnosis is often difficult because signs may not show up on X-ray, or signs that do show up appear similar to other conditions. Signs and symptoms included chest and abdominal pain, difficulty breathing, and decreased lung sounds.  When a tear is discovered, surgery is needed to repair it.
Injuries to the diaphragm are usually accompanied by other injuries, and they indicate that more severe injury may have occurred.  The outcome often depends more on associated injuries than on the diaphragmatic injury itself.  Since the pressure is higher in the abdominal cavity than the chest cavity, rupture of the diaphragm is almost always associated with herniation of abdominal organs into the chest cavity, called traumatic diaphragmatic hernia. This herniation can interfere with breathing, and blood supply can be cut off to organs that herniate through the diaphragm, damaging them.
Dichlorodiphenyldichloroethane
Dichlorodiphenyldichloroethane (DDD) is an organochlorine insecticide that is slightly irritating to the skin. DDD is a metabolite of DDT. DDD is colorless and crystalline; it is closely related chemically and is similar in properties to DDT, but it is considered to be less toxic to animals than is DDT. The molecular formula for DDD is (ClC6H4)2CHCHCl2 or C14H10Cl4, whereas the formula for DDT is (ClC6H4)2CHCCl3 or C14H9Cl5.
DDD is in the Group B2 classification, meaning that it is a probable human carcinogen. This is based on an increased incidence of lung tumors in male and female mice, liver tumors in male mice, and thyroid tumors in male rats. Further basis is that DDD is so similar to and is a metabolite of DDT, another probable human carcinogen.
DDD is no longer registered for agricultural use in the United States, but the general population continues to be exposed to it due to its long persistence time. The primary source of exposure is oral ingestion of food.
1946 is the date of the earliest recorded use in English of the abbreviation DDD to stand for dichlorodiphenyldichloroethane, as far as could be determined.

# Table of names
The following are synonyms for DDD:
Differential diagnosis project

# Overview
Differential diagnosis is the process of distinguishing a particular disease or condition from others that present with similar clinical features.
A differential diagnostic procedure is generally a systematic diagnostic method used in each individual patient based on their specific condition to identify the presence of a disease entity where multiple alternatives are possible. This method is essentially a process of elimination or at least a process of obtaining information that shrinks the "probabilities" of candidate conditions to negligible levels, by using evidence such as symptoms, patient history, and medical knowledge.
The Differential Diagnosis Project aims to integrate the current body of medical literature in the new era of differential diagnosis into conjoined, systematic pages where the availability of comparing between different possibilities be possible for diagnostician, in conformity with practice guidelines, consensus statements, systematic reviews, and expert opinions.
Educational content provided herein is not intended to supplant but supplement clinical judgment. In light of the variability in epidemiological contexts and resources available to diagnose a disease, adjustment in diagnostic approach may be required to optimize patient care.

# Statement of Need

# How Can WikiDoc Meet These Needs?

# How Can You Help WikiDoc Meet These Needs?

# Disclaimer
All information is provided for educational purposes only. The content provided herein is not intended to supplant but supplement clinical judgment.
Dihydroartemisinin-Piperaquine

# Overview
Dihydroartemisinin/Piperaquine is a drug mixture used to treat malaria.
Dihydroartemisinin (also known as dihydroqinghaosu, artenimol or DHA) is a drug used to treat malaria discovered by Sivesh Sukumar (Styal). Dihydroartemisinin is the active metabolite of all artemisinin compounds (artemisinin, artesunate, artemether, etc.) and is also available as a drug in itself. It is a semi-synthetic derivative of artemisinin and is widely used as an intermediate in the preparation of other artemisinin-derived antimalarial drugs.
Piperaquine is an antimalarial drug, a bisquinoline first synthesised in the 1960s, and used extensively in China and Indochina as prophylaxis and treatment during the next 20 years. Usage declined in the 1980s as piperaquine-resistant strains of P. falciparum arose and artemisinin-based antimalarials became available. However, Chinese scientists have been studying whether piperaquine can still be used therapeutically in combination with artemisinin.
Piperaquine is characterized by slow absorption and a long biological half-life, making it a good partner drug with artemisinin derivatives which are fast acting but have a short biological half-life.
This product is available in the market of several countries:
- Artekin (Holleykin)
- Eurartesim (Sigma Tau; by Good Manufacturing Practices)
- Diphos (Genix Pharma)
- Timequin (SAMI Pharma )
- Duocotecxin (Holley Pharm)
Disorder of written expression

# Background
Disorder of written expression is a childhood condition characterized by poor writing skills. To some extent, 3 - 10% of school-age children are affected by this disorder. This disorder appears by itself or in conjunction with other learning or developmental disabilities.

# Symptoms
- Avoids written work.
- Poor spelling
- Errors in grammar
- Errors in punctuation
- Poor handwriting
- Composition is poor relative to oral expression skills; uses simple vocabulary to avoid spelling difficulty.

# Assessments
- Oral and Written Language Scales (OWLS)
- Test of Adolescent and Adult Language3 (TOAL-3)
- Test of Early Written Language
- Test of Written Expression (TOWE)
- Test of Written Language3 (TOWL-3)
- Woodcock Johnson Psychoeducational BatteryRevised, Tests of Achievement

# Other disabilities often linked with the disorder of written expression
- Dyslexia
- Reading disability
- Expressive language disorder
- Mathematics disorder
- Developmental coordination disorder
Don Pepin Garcia (cigar brand)
Don Pepin Garcia is a brand of hand-made premium cigar owned by El Rey de los Habanos, Inc.

# History and Background
The brand was created by Jose "Pepin" Garcia and is manufactured at the El Rey de los Habanos factory in the Little Havana section of Miami, Florida, and at the factory in Esteli, Nicaragua, Tabacalera Cubana.

# Description
The brand currently consists of three ranges of different strengths. All use Nicaraguan tobaccos in varying combinations. All boxes are stamped with a date code.

## Don Pepin Garcia ("Blue Label")
This was the first of the three ranges (the second was the Serie JJ) to be produced, and consists of six vitolas and one limited release (the Lancero). These are full-bodied cigars and are not recommended for a beginning smoker. The wrapper is an oily Nicaraguan Corojo leaf, described as cinnamon in color. The cigars come packed 25 to a cedar box, uncelloed (as of recently, Summer of '07 celloed). The band is blue with gold lettering. The center has "Don Pepin Garcia" in gold on a blue field inside a round red and gold border, with Don Pepin's signature (reduced) below the name. Each wing has the U. S. and Cuban flags within roundels, overlapping.

### Ratings/Honors/Awards
- The Invictos was given a rating of 88 in the August, 2006, issue of Cigar Aficionado magazine.
- The Magnate received a rating of 89 in the February, 2007, issue of Cigar Aficionado magazine.

## Don Pepin Garcia Black Edition ("Cuban Classic/Black Label")
This is the newest range of the brand and was introduced to national distribution in the U. S. in late 2006. It is manufactured at Tabacalera Cubana in Esteli, Nicaragua, and comes uncelloed and packed in cedar cabinets of 20. The cigars are surrounded by a colored ribbon with a label attached which reads Don Pepin Garcia and bears a facsimile of his signature.
The band is similar to that found on the Don Pepin Blue Label, but the background is black. There is a second band as well. This is a straight band with gold borders on a black background with the words Cuban Classic in gold.
The sides of the box are stamped with "20 / Don Pepin (in script) /  BLACK EDITION  / frontmark".  As always, the month and year of manufacture is stamped on the bottom of the box.

### Ratings/Honors/Awards
- The entire range was given a vertical tasting report in the 22 May 2007 (p. 2) of Cigar Insider. The 1979 was given the highest rating at 92.  The lowest rating of 85 went to the 1973. The 1952 was given a rating of 88, and the 1950, 1970 and 1977 each received an 89.

## Don Pepin Garcia Serie JJ ("White Label")
The range was developed by Don Pepin and his son Jaime Garcia. Medium- to full-bodied, the wrapper is a light-brown Nicaraguan Corojo. Packed in plain boxes of 24 except for the Salomon, which comes in boxes of five. The band is similar to the "Blue Label", but is white with a red border. There is also a second, straight band, white, with "Serie JJ" printed on it.
The Salomons are rolled exclusively by Don Pepin himself.

# Notes
-  Cigar Aficionado, February, 2007, p. 172.
-  CigarEnvy.com
Medial longitudinal fasciculus

# Overview
The medial longitudinal fasciculus (MLF) is a pair of crossed fiber tracts (group of axons), one on each side of the brainstem.

# Function
The MLF carries information about the direction that the eyes should move.
It yokes the cranial nerve nuclei III, IV and VI together, as well as the gaze centres and information about head movement (from cranial nerve VIII).
It also descends into the cervical spinal cord, and innervates some muscles of the neck.

# Inputs
The MLF arises from the Vestibular nucleus (VN) and is thought to be involved in the maintenance of gaze. This is achieved by inputs to the VN from
- the Vestibulocochlear (8th cranial) nerve about head movements,
- gain adjustments from the flocculus of the cerebellum,
- head and neck propioceptors and foot and ankle muscle spindle, via the fastigial nucleus.

# Pathology
Lesions of the MLF produce internuclear ophthalmoplegia.  Lesions to the MLF are very common manifestations of the disease multiple sclerosis.where it most commonly presents as diplopia.  These lesions cause damage to the ipsilateral (same side) eye.

# History
In 1846 neurologist Benedict Stilling first referred to what is now known as the MLF as the acusticus, followed by Theodor Meynert in 1872 calling it posterior.  But in 1891, Heinrich Schutz chose the name dorsal to describe the longitudinal bundle, "for brevity's sake".  This name stuck despite other authors attempting further renaming (Ramon y Cajal's periependymal in 1904, Theodor Ziehen's nubecula dorsalis in 1913).  But finally, it was Wilhelm His, Sr. who changed the name to medial for the sake of the Basle nomenclature to end the confusion.

# Additional images
- Decussation of pyramids.
- Transverse section of medulla oblongata below the middle of the olive.
- Vestibulo-ocular reflex
Drooling (patient information)
For the WikiDoc page for this topic, click here

# Overview
Drooling is saliva flowing outside the mouth.

# What are the symptoms of Drooling?
Drooling is generally caused by:
- Problems keeping saliva in the mouth
- Problems with swallowing
- Too much saliva production
Some people with drooling problems are at increased risk of breathing saliva, food, or fluids into the lungs. This may cause harm if there is a problem with the body's normal reflexes (such as gagging and coughing).
Drooling caused by nervous system (neurologic) problems can often be managed with drugs that block the action of the chemical messenger acetylcholine (anticholinergic drugs). In severe cases, people can reduce drooling by injecting botulism toxin, getting high-energy x-rays (radiation) to the glands in the mouth that make saliva (salivary glands), and other methods.

# What causes Drooling?
Some drooling in infants and toddlers is normal and is not usually a sign of a disease or other problem. It may occur with teething. Drooling in infants and young children may get worse with upper respiratory infections and nasal allergies.
Drooling that occurs with fever or trouble swallowing may be a sign of a more serious disease, including:
- Mononucleosis
- Peritonsillar abscess
- Retropharyngeal abscess
- Strep throat
- Tonsillitis
Sudden drooling may occur with poisoning (especially by pesticides) or a reaction to snake or insect venom.
Other things that can cause drooling:
- Certain medications
- Nervous system (neurological) problems

# When to seek urgent medical care?
Call your health care provider if:
- The cause of the drooling has not been diagnosed.
- There is concern about aspiration.
- Your child has a fever, difficulty breathing, or holds his or her head in a strange position.

# Treatment options
Care for drooling due to teething includes good oral hygiene. Popsicles or other cold objects (such as frozen bagels) may be helpful. Take care to avoid choking when a child uses any of these objects.

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

# What to expect (Outlook/Prognosis)?
The doctor will do a physical examination and ask questions about the symptoms, including:
- Is there a history of any other diseases?
- Has the person had a bite or sting?
- Has the person had an injury?
- What medications is the person taking?
- What other symptoms are present (such as fever, sore throat, facial droop)?
The tests performed depend on the symptoms that occur with the drooling.

# Sources
Dry eyes (patient information)
For the WikiDoc page for this topic, click here

# Overview
Dry eyes are caused by a lack of tears. Tears are necessary for the normal lubrication of your eyes and to wash away particles and foreign bodies.

# What are the symptoms of Dry eyes?
If you have dry eyes, you will feel a burning, scratching, or stinging sensation. You may also have strained or tired eyes after reading, even for short periods of time. If you wear contacts, they will likely feel uncomfortable. Having dry eyes for a while can lead to tiny abrasions on the surface of your eyes.

# What causes Dry eyes?
Common causes of dry eyes include:
- Aging
- Dry environment or workplace (wind, air conditioning)
- Sun exposure
- Smoking or second-hand smoke exposure
- Cold or allergy medicines
- An eye injury or other problem with your eyes or eyelids (like a drooping eyelid or bulging eyes)
- Sjogren's syndrome -- includes dry eyes, mouth, and mucus membranes, and often rheumatoid arthritis or other joint disorder
- Previous eye surgery

# When to seek urgent medical care?
Call your health care provider if:
- You have red or painful eyes.
- You have flaking, discharge, or a lesion on your eye or eyelid.
- You have had trauma to your eye, or you have a bulging eye or a drooping eyelid.
- You have joint pain, swelling, or stiffness.
- You also have a dry mouth.
- Your dry eyes do not respond to self-care measures within a few days.

# Treatment options
The following steps may help:
- Try artificial tears, available as either drops or ointment. Ointments last longer, but are thicker and can cause blurry vision.
- Don't smoke. Avoid second-hand smoke, direct wind, and air conditioning.
- Use a humidifier, especially in the winter.
- Purposefully blink more often.
- Rest your eyes.

# Where to find medical care for Dry eyes?
Directions to Hospitals Treating Dry eyes

# What to expect (Outlook/Prognosis)?
Your health care provider will take a medical history and perform a physical examination, including a careful eye examination.
To help better understand your dry eyes, your health care provider may ask the following:
- How long have you had dry eyes? Does it involve one or both eyes?
- Do you have it all of the time or does it only occur at certain times, with certain activities, or in certain places?
- Does the dryness seem related to wind, dust, chemicals, sun, or light exposure?
- Does it affect your vision?
- Does it cause pain?
- Do your eyelids close easily?
- Have you noticed any drainage from your eyes?
- Does anything make your dry eyes worse?
- Does anything make your dry eyes better?
- Have you tried artificial tears? Do they help?
- Are you taking any medications? Which ones?
- Have you had surgery or an injury to your eyes or nose?
- Do you have allergies?
- Have you been using any new cosmetics?
- Do you have any other symptoms like dry mouth or joint discomfort?
Your health care provider may perform tearing tests that can help diagnose dry eyes. Artificial tears may be prescribed.

# Sources
Dry skin (patient information)
For the WikiDoc page for this topic, click here

# Overview
Dry skin is most common in your lower legs, arms, flanks (sides of the abdomen), and thighs. The symptoms most often associated with dry skin include:
- Scaling
- Itching
- Cracks in the skin

# What causes Dry skin?
Dry skin is common. It happens more often in the winter when cold air outside and heated air inside cause low humidity. Forced-air furnaces make skin even drier.
The skin loses moisture and may crack and peel, or become irritated and inflamed.

# Who is at highest risk?
Bathing too frequently, especially with harsh soaps, may contribute to dry skin. Eczema may cause dry skin.

# When to seek urgent medical care?
Call your doctor if:
- You feel itchy without a visible rash
- Dryness and itching are preventing you from sleeping
- You have any open cuts or sores from scratching
- Home care measures do not relieve your dryness and itching

# Treatment options
It may help to change your bathing habits:
- Keep baths or showers short.
- Use warm (not hot) water.
- Use as little soap as possible. Limit its use to face, armpits, and genitals if you can. Try mild cleansers like Aveeno or Cetaphil or mild soaps like Neutrogena or Dove.
- Dry your skin thoroughly but gently -- pat, DON'T rub.
- Take baths or showers less often.
Also, increase skin and body moisture:
- Use bath oils and moisturizers at least daily. Thick, greasy moisturizers work best. Avoid products with alcohol. Apply just after a bath or shower, when your skin is still damp.
- Use a humidifier if the air is dry.
- Drink plenty of water throughout the day.
Apply cool compresses to itchy areas, and try over-the-counter cortisone creams or lotions if your skin is inflamed. If this is not enough, talk to your doctor about possible prescription lotions.

# Where to find medical care for Dry skin?
Directions to Hospitals Treating Dry skin

# What to expect (Outlook/Prognosis)?
Your doctor will perform a physical examination with careful attention to all parts of your skin.
To better understand the cause of the dry skin, your doctor may ask:
- When did your dry skin develop or has it always been dry?
- Are all parts of your body affected? If not, what are the specific locations involved?
- What seems to make the dryness worse?
- Does anything make it feel better?
- What are your bathing habits?
- Do you have any other symptoms?

# Sources