Persius/hicric huggingface dataset:
Animal heme-dependent peroxidases
Animal heme-dependent peroxidases is a family of peroxidases.
Peroxidases are found in bacteria, fungi, plants and animals. On the basis of sequence similarity, a number of animal haem peroxidases can be categorised as members of a superfamily: myeloperoxidase (MPO); eosinophil peroxidase (EPO); lactoperoxidase (LPO); thyroid peroxidase (TPO); prostaglandin H synthase (PGHS); and peroxidasin.

# Function
Myeloperoxidase (MPO) plays a major role in the oxygen-dependent microbicidal system of neutrophils. EPO from eosinophilic granulocytes participates in immunological reactions, and potentiates tumor necrosis factor (TNF) production and hydrogen peroxide release by human monocyte-derived macrophages. In
the main, MPO (and possibly EPO) utilises Cl-ions and H2O2 to form hypochlorous acid (HOCl), which can effectively kill bacteria or parasites. In secreted fluids, LPO catalyses the oxidation of thiocyanate ions (SCN-) by H2O2, producing the weak oxidising agent hypothiocyanite (OSCN-), which has bacteriostatic activity. TPO uses I- ions and H2O2 to generate iodine, and plays a central role in the biosynthesis of thyroid hormones T(3) and T(4).

# Structure
3D structures of MPO and PGHS have been reported. MPO is a homodimer: each monomer consists of a light (A or B) and a heavy (C or D) chain resulting from post-translational excision of 6 residues from the common precursor. Monomers are linked by a single inter-chain disulphide. Each monomer includes a bound calcium ion. PGHS exists as a symmetric dimer, each monomer of which consists of 3 domains: an N-terminal epidermal growth factor (EGF) like module; a membrane-binding domain; and a large C-terminal catalytic domain containing the cyclooxygenase and the peroxidase active sites. The catalytic domain shows striking structural similarity to MPO.

# Active site
The cyclooxygenase active site, which catalyses the formation of prostaglandin G2 (PGG2) from arachidonic acid, resides at the apex of a long hydrophobic channel, extending from the membrane-binding domain to the centre of the molecule. The peroxidase active site, which catalyses the reduction of PGG2 to PGH2, is located on the other side of the molecule, at the haem binding site. Both MPO and the catalytic domain of PGHS are mainly alpha-helical, 19 helices being identified as topologically and spatially equivalent; PGHS contains 5 additional N-terminal helices that have no equivalent in MPO. In both proteins, three Asn residues in each monomer are glycosylated.

# Human proteins containing this domain
DUOX1;     DUOX2;     EPX;       LPO;       MPO;       PTGS1;     PTGS2;     PXDNL;
TPO;
Antenatal detection and diagnosis

# Overview
Before birth, an obstetric ultrasound scan may be used to screen pregnant women for signs of CHD in their unborn babies. This screening scan is often performed around 20 weeks of pregnancy when the fast moving structures of the fetal heart are large enough to be more easily imaged.  
If CHD is suspected, a mother will be referred for a fetal echocardiograph, which is a more detailed, diagnostic ultrasound scan by a specialist cardiologist. 
It is increasingly possible for specialists to screen for CHD as early as 14 weeks, if CHD is suspected from other factors, such as a family history.
Anterior limb of internal capsule

# Overview
The anterior limb of internal capsule (or frontal part) contains:
- (1) fibers running from the thalamus to the frontal lobe;
- (2) fibers connecting the lentiform and caudate nuclei;
- (3) fibers connecting the cortex with the corpus striatum; and
- (4) fibers passing from the frontal lobe through the medial fifth of the base of the cerebral peduncle to the nuclei pontis.
Arrowhead Regional Medical Center
Arrowhead Regional Medical Center (ARMC) is a hospital located in Colton, California within Southern California's Inland Empire.  The director of the hospital is Dr. Dev Gnanadev.

# Reputation
Arrowhead Regional Medical Center is a well-known and highly respected medical research center in Southern California.

# Key Services
- General medical and surgical care
- Medical, Surgical , and Burn intensive care
- Cardiology department
- Neurology department
- Pediatric medical and surgical care
- Obstetrics
- Orthopedics department
- Emergency department
- Trauma Center
- Family medicine/Satellite clinics
- Interventive Radiology
- General Radiology

# Facility
Situated just nine miles from the San Andreas and two miles from the San Jacinto active fault lines, the new center is designed to remain self-sufficient for a minimum of three days after an 8.3 magnitude earthquake. The facility uses a combination of elastomeric base isolators and hydraulic viscous dampers (similar to those used in an MX missile silo) to absorb the energy generated during a seismic event and to protect the building's structural integrity.
The Arrowhead Regional Medical Center is the first facility in the U.S. to use film-less radiology hospital-wide. This system makes digital images, which are instantly available for viewing at multiple stations throughout the facility for faster and more accurate diagnosis.
Assessment of cardiovascular risk

# 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk

## Summary of Recommendations for Risk Assessment of Cardiovascular Risk

### Implementation of Risk Assessment Work Group Recommendations

### Assessment of 10-Year Risk of a First Hard ASCVD Event

### Use of Newer Risk Markers After Quantitative Risk Assessment

### Long-Term Risk Assessment
*Derived from the ARIC (Atherosclerosis Risk in Communities) study, Cardiovascular Health Study , CARDIA (Coronary Artery Risk Development in Young Adults) study , and Framingham original and offspring cohortsBased on new evidence reviewed during ACC/AHA update of evidenceAge, sex, total cholesterol, high-density lipoprotein cholesterol, systolic BP, use of antihypertensive therapy, diabetes, and current smoking.
ABI indicates ankle-brachial index; ACC, American College of Cardiology; AHA, American Heart Association; ApoB, apolipoprotein B; ASCVD, atherosclerotic cardiovascular disease; BP, blood pressure; CAC, coronary artery calcium; CIMT, carotid intima-media thickness; CKD, chronic kidney disease; COR, Class of Recommendation; CQ, critical question, ES, evidence statement; hs-CRP, high-sensitivity C-reactive protein; LOE, Level of Evidence; NHLBI, National Heart, Lung, and Blood Institute; and d, not applicable.
PCI: classification of the lesion

# Overview
According to the Abrupt Vessel Closure - AHA Task Force Definition, as modified by Ellis et al., coronary lesion complexity is typed as A, B1, B2, and C.

# Classification of the Lesion

## Type A
<10mm, discrete, concentric readily accessible, <45 degree angle smooth contour, little or no calcification, less than totally occluded, not ostial, no major side branch involvement, absence of thrombus.

## Type B1
One of the following characteristics:
10-20mm, eccentric, moderate tortuosity of proximal segment, irregular contour, presence of any thrombus grade, moderate or heavy calcification, total occlusion <3 months old, ostial lesion or bifurcation lesion requiring two guidewires.

## Type B2
Two or more of the following characteristics:
10-20mm, eccentric, moderate tortuosity or proximal segment, irregular contour, presence of any thrombus grade, moderate or heavy calcification, total occlusion <3 months old, ostial lesion or bifurcation lesion requiring two guidewires.

## Type C
20 mm diffuse, excessive tortuosity of proximal segment, total occlusion >3 months old and/or bridging collaterals inability to protect major side branches, degenerated vein graft with friable lesions.
Atovaquone proguanil how supplied

# How Supplied/Storage And Handling
MALARONE Tablets, containing 250 mg atovaquone and 100 mg proguanil hydrochloride.
-Bottle of 100 tablets with child-resistant closure (NDC 0173-0675-01).
-Unit Dose Pack of 24 (NDC 0173-0675-02).
MALARONE Pediatric Tablets, containing 62.5 mg atovaquone and 25 mg proguanil hydrochloride.
-Bottle of 100 tablets with child-resistant closure (NDC 0173-0676-01).

# Storage Conditions
Store at 25C (77F). Temperature excursions are permitted to 15 to 30C (59 to 86F) (see USP Controlled Room Temperature).
Bedaquiline indications and usage

# Indications and Usage
SIRTURO is a diarylquinoline antimycobacterial drug indicated as part of combination therapy in adults ( 18 years) with pulmonary multi-drug resistant tuberculosis (MDR-TB). Reserve SIRTURO for use when an effective treatment regimen cannot otherwise be provided. SIRTURO should be administered by directly observed therapy (DOT).
This indication is based on analysis of time to sputum culture conversion from two controlled Phase 2 trials in patients with pulmonary MDR-TB.

## Limitations of Use
The safety and efficacy of SIRTURO for the treatment of latent infection due to Mycobacterium tuberculosis have not been established. The safety and efficacy of SIRTURO for the treatment of drug-sensitive TB have not been established. In addition, there are no data on the treatment with SIRTURO of extra-pulmonary TB (e.g., central nervous system). The safety and efficacy of SIRTURO for the treatment of infections caused by non-tuberculous mycobacteria(NTM) have not been established. Therefore, use of SIRTURO in these settings is not recommended.
Beta adrenergic receptor kinase-2
Beta-adrenergic receptor kinase 2 (beta-ARK-2) also known as G-protein-coupled receptor kinase 3 (GRK3) is an enzyme that in humans is encoded by the ADRBK2 gene.

# Function
The beta-adrenergic receptor kinase specifically phosphorylates the agonist-occupied form of the beta-adrenergic and related G protein-coupled receptors. Overall, the beta adrenergic receptor kinase 2 has 85% amino acid similarity with beta adrenergic receptor kinase 1, with the protein kinase catalytic domain having 95% similarity. These data suggest the existence of a family of receptor kinases which may serve broadly to regulate receptor function.

# Discovery
The beta adrenergic receptor kinase-2  was cloned from mice and rats in 1991 and the human gene was cloned in 1993.

# Clinical significance
Gene linkage techniques were used to identify a mutation in the GRK3 gene as a possible cause of up to 10% of cases of bipolar disorder. Beta adrenergic receptor kinase-2 appears to affect dopamine metabolism.  Subsequent studies, while noting that chromosome 22q12 may harbor a risk gene for schizophrenia, did not find that the gene coding for beta adrenergic receptor kinase-2 was linked to schizophrenia.
It has been associated with WHIM syndrome.
Bezafibrate (patient information)

# USES
This medication is used along with a diet and an exercise program to treat high cholesterol levels.

# HOW TO USE
Take this medication by mouth exactly as prescribed with or just after meals. Do not take this more often or increase the dose without your doctor's approval. Your cholesterol level will not lower faster but the risk of side effects will be increased.

# SIDE EFFECTS
Stomach upset, stomach pain, gas, or nausea may occur the first several days as your body adjusts to the medication. Itchy skin, redness, headache, and dizziness have also been reported. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop: muscle aches/pains, muscle weakness, chest pain, unusual weakness, skin rash, vomiting. If you notice other effects not listed above, contact your doctor or pharmacist.

# PRECAUTIONS
Tell your doctor if you have: pre-existing kidney disease, liver disease, heart disease, any allergies. Limit intake of alcohol while taking this medication. This medication is not recommended for use during pregnancy or breast-feeding. Discuss the risks and benefits with your doctor.

# DRUG INTERACTIONS
Use caution if the following drugs are combined with bezafibrate because serious side effects such as muscle injury (myopathy) infrequently could occur: "statins" (e.g., lovastatin, atorvastatin), high-dose niacin (1 gram or more per day). Tell your doctor of any over-the-counter or prescription medication you may take including: blood thinners, cyclosporine, antidepressants, estrogen, birth control pills, cholestyramine anticholesterol. Do not start or stop any medicine without doctor or pharmacist approval.

# OVERDOSE
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

# NOTES
This medication is used only after diet therapy has been tried. This is not a substitute for diet. A low-fat, low cholesterol diet must be maintained while taking this medication. Lab tests will be done routinely while taking this medication to monitor its effects and prevent side effects.

# MISSED DOSE
If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not "double-up" the dose to catch up.

# STORAGE
Store this medication at room temperature between 59 and 86 degrees F (15 to 30 degrees C) away from heat and light. Do not store in the bathroom. Keep this and all medications out of the reach of children.

## The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist
Bicuspid aortic stenosis overview

# Overview
A normal aortic valve has three leafs (it is a tricuspid valve), but some patients are born with a congenital abnormality in which the aortic valve has two leaflets (a bicuspid aortic valve).

# Pathophysiology
A congenital bicuspid aortic valve may be associated with the development of either progressive clacific stenosis or regurgitation. What differentiates the pathophysiology of bicuspid aortic stenosis from other forms of aortic stenosis such as the degenerative aortic stenosis is the presence of concomitant valve disease, aortic root disease, and an increased incidence of coarctation of the aorta.

# Epidemiology and Demographics
In this condition, instead of three valve cusps, the aortic valve has two cusps which results from the fusing of one of the commissures. Bicuspid aortic stenosis is the most common congenital abnormality of the heart accounting for 5% of congenital heart defects and it occurs in 1-2% of the population. It can be manifested as a murmur and usually has no long term health consequences, but if it does, the manifestation of aortic stenosis occurs 10 years earlier.

# Risk Factors
Risk factors of bicuspid aortic valve to progress to stenosis are hypercholesterolaemia, hypertension and asymmetrical leaflets.

# Screening
First degree relatives of patients with bicuspid aortic valves should be screened using echocardiogram for its presence as there are evidence of familial clustering with autosomal dominant inheritance pattern.

# Natural History
Typically, aortic stenosis due to calcification of a bicuspid valve appears earlier, at 40 to 50 years of age, whereas that due to calcification and degeneration of a tricuspid aortic valve appears later, at 70 to 80 years of age.

# Videos
Below is the video of Dr. Lars Svensson, Cardiothoracic Surgeon and Director of the Aorta Center, at the Cleveland Clinic giving an overview of bicuspid aortic valve and its management.
Bonnemann-Meinecke-Reich syndrome
Synonyms and keywords: Encephalopathy; intracerebral calcification; retinal degeneration

# Overview
Bonnemann-Meinecke-Reich syndrome is a very rare syndrome characterized by calcium deposits in brain tissue, a deficiency of growth hormones, and degeneration of the retina.

# Pathophysiology

## Genetics
Bonnemann-Meinecke-Reich syndrome is a rare syndrome that has an autosomal recessive type of inheritance. 

# Differentiating Bonnemann-Meinecke-Reich syndrome from other Syndromes
Bonnemann-Meinecke-Reich syndrome has certain features which are similar to Cockayne syndrome. Cockayne syndrome presents with similar characteristics as Bonnemann-Meinecke-Reich such as dysmorphism and mental retardation, but it develops with more of a skeletal involvement.

# Epidemiology and Demography
Prevalence of this disease is less than 1 per 100,000.  This syndrome has been described in only two families, with each family containing two affected siblings. 

## Age
This syndrome affects children less than 1 year of age.

# Natural History, Complications and Prognosis
The onset of disease occurs in first year of life and leads to hepatic impairment and mental retardation.

## Complications
- Hepatic encephalopathy
- Mental retardation
- Vision loss

# Diagnosis

## Symptoms
- Confusion
- Loss of vision
- Incoordination
- Dysmorphism

## Physical Examination

### Appearance of the Patient
- Short stature
- Dysmorphism
- Craniosynostosis

### Eye
- Impaired vision
- Retinal degeneration

### Neurologic
- Muscle spasticity
- Motor incoordination

## Laboratory Findings

### Electrolyte and Biomarker Studies
- Growth hormone deficiency

### CT
- Cerebral images show calcification of the lenticular nuclei
- Ventriculomegaly

# Treament
- Treatment of encephalopathy with lactulose to decrease ammonia production.
- Diet regulation for protein intake.
Brilinta tablet/contraindications

# Contraindications
History of Intracranial Hemorrhage
BRILINTA is contraindicated in patients with a history of intracranial hemorrhage (ICH) because of a high risk of recurrent ICH in this population (see Clinical Studies).
Active Bleeding
BRILINTA is contraindicated in patients with active pathological bleeding such as peptic ulcer or intracranial hemorrhage (see Warnings and Adverse Reactions).
Severe Hepatic Impairment
BRILINTA is contraindicated in patients with severe hepatic impairment because of a probable increase in exposure, and it has not been studied in these patients. Severe hepatic impairment increases the risk of bleeding because of reduced synthesis of coagulation proteins (see
Pharmacology).
Hypersensivity
BRILINTA is contraindicated in patients with hypersensitivity (e.g. angioedema) to ticagrelor or any component of the product (see Adverse Reactions).
Buccal branch of the facial nerve
The Buccal Branches of the facial nerve (infraorbital branches), of larger size than the rest of the branches, pass horizontally forward to be distributed below the orbit and around the mouth.
The superficial branches run beneath the skin and above the superficial muscles of the face, which they supply: some are distributed to the Procerus, joining at the medial angle of the orbit with the infratrochlear and nasociliary branches of the ophthalmic.
The deep branches pass beneath the Zygomaticus and the Quadratus labii superioris, supplying them and forming an infraorbital plexus with the infraorbital branch of the maxillary nerve. These branches also supply the small muscles of the nose.
The lower deep branches supply the Buccinator and Orbicularis oris, and join with filaments of the buccinator branch of the mandibular nerve.
cAMP responsive element modulator
cAMP responsive element modulator is a protein that in humans is encoded by the CREM gene, and it belongs to the cAMP-responsive element binding protein family. It has multiple isoforms, which act either as repressors or activators. CREB family is important for in regulating transcription in response to various stresses, metabolic and developmental signals. CREM transcription factors also play an important role in many physiological systems, such as cardiac function, circadian rhythms, locomotion and spermatogenesis.

# Function
This gene encodes a bZIP transcription factor that binds to the cAMP responsive element found in many viral and cellular promoters. It is an important component of cAMP-mediated signal transduction during the spermatogenetic cycle, as well as other complex processes. Alternative promoter and translation initiation site usage allows this gene to exert spatial and temporal specificity to cAMP responsiveness. Multiple alternatively spliced transcript variants encoding several different isoforms have been found for this gene, with some of them functioning as activators and some as repressors of transcriptnhunion.

# Gene location
The chromosomal location of CREM gene is 10p11.21, and it starts at 35415769 and ends at 35501886 bp from pter ( according to hg19-Feb_2009)

# Interactions
CAMP responsive element modulator has been shown to interact with FHL5.

# Disease relevance of CREM

## Panic disorder
One study reported the DNA sequence variations in the gene for CREM in panic disorder patients. It showed a significant excess of the shorter eight-repeat allele and of genotypes containing the eight-repeat allele in panic disorder patients. The observed associations were limited to panic disorder without agoraphobia, and they were more prominent in females. But, the independent Italian and Spanish samples in this study did not support their results. Another family-based study showed little evidence of any susceptibility locus for panic disorder either within the CREM gene or in a nearby region on chromosome 10p11

## Spermiogenesis deficiency
Like Dr. Paolo Sassone-Corsi wrote in this article CREM is a master-switch regulator in testis. It plays an important role in the regulation of the expression of post-meiotic genes, and this has been supported by several studies using CREM-mutation mice. The results showed the first step in the process of sperm formation would be blocked if the germ cell development in mice CREM gene were disrupted. The cAMP response element sites can be found in the promoter region of some postmeiotic genes, so that the CREM can target and regulate these genes.
Two studies proved that treat the rats with Salvia hypoleuca and Alpina galanga can significantly increased the CREM gene expression.

## Systemic lupus erythematousus
Less IL-2 will be produced from T cells in humans or mice with systemic lupus erythematousus (SLE). Some studies showed that an increased level CREM was presented in the nucleus of T lymphocytes from SLE patients. The CREM bound to the -180 site of the IL-2 promoter to repress its transcription.
CLONIDINE patch drug interactions

# Interactions
Clonidine may potentiate the CNS-depressive effects of alcohol, barbiturates or other sedating drugs. If a patient receiving clonidine is also taking tricyclic antidepressants, the hypotensive effect of clonidine may be reduced, necessitating an increase in the clonidine dose. If a patient receiving clonidine is also taking neuroleptics, orthostatic regulation disturbances (e.g., orthostatic hypotension, dizziness, fatigue) may be induced or exacerbated.
Monitor heart rate in patients receiving clonidine concomitantly with agents known to affect sinus node function or AV nodal conduction, e.g., digitalis, calcium channel blockers and beta-blockers. Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concomitantly with diltiazem or verapamil.
Amitriptyline in combination with clonidine enhances the manifestation of corneal lesions in rats.