Persius/hicric huggingface dataset:
Marijuana intoxication (patient information)
Synonyms and Keywords: Cannabis intoxication; Pot; Mary Jane; Weed; Grass; Cannabis

# Overview
- Marijuana ("pot") intoxication is the euphoria, relaxation, and sometimes undesirable side effects that can occur when people use marijuana.
- Marijuana is the most commonly used illegal drug in the United States. The drug is usually smoked, but is sometimes eaten.
- Today, there are more than 12 million marijuana users in the United States and more than 300 million regular users worldwide.

# What are the symptoms of Marijuana intoxication?
- The intoxicating effects of marijuana include relaxation, sleepiness, and mild euphoria (getting high).
- Smoking marijuana leads to fast and predictable signs and symptoms. Eating marijuana can cause slower, and sometimes less predictable effects.
- Marijuana can cause undesirable side effects, which increase with higher doses. These side effects include:
- Decreased short-term memory
- Dry mouth
- Impaired perception and motor skills
- Red eyes
- More serious side effects include panic, paranoia, or acute psychosis, which may be more common with new users or in those who already have a psychiatric disease.
- The amount and effect of these side effects varies from person to person, as well as with the amount of marijuana used.
- Marijuana is often cut with hallucinogens and other, more dangerous drugs that have more serious side effects than marijuana. These side effects may include:
- Acute high blood pressure with headache
- Chest pain and heart rhythm disturbances
- Extreme hyperactivity and physical violence
- Heart attack
- Seizures
- Stroke
- Sudden collapse (cardiac arrest)

# When to seek urgent medical care?
- If someone who has been using marijuana develops any of the symptoms of intoxication, has trouble breathing, or cannot be awakened, call 911 or your local emergency number.
- If the person has stopped breathing or has no pulse, begin CPR and continue it until help arrives.

# Treatment options
- Caring for people with marijuana intoxication focuses on preventing injury and reassuring those who have panic reactions.
- Someone who is very agitated can be sedated with benzodiazepines (such as diazepam  or lorazepam ).
- Children who have more serious symptoms may need to be admitted to the hospital for treatment.
- People with more serious side effects may need to be hospitalized, have heart or brain monitoring, and take medication.

# Where to find medical care for Marijuana intoxication?
Directions to Hospitals Treating Marijuana intoxication

# What to expect (Outlook/Prognosis)?
People who have seizures, cardiac arrest, or a heart attack may not survive. However, these reactions are rare.

# Source
Mixed receptive-expressive language disorder

# Overview
Mixed receptive-expressive language disorder (DSM-IV 315.32) is a communication disorder in which both the receptive and expressive areas of communication may be affected in any degree, from mild to severe.
If someone is being assessed on the Wechsler Adult Intelligence Scale, for instance, this may show up in relatively low scores for Information, Vocabulary and Comprehension (perhaps below the 25th percentile). If the person has difficulty with spatial concepts, such as 'over', 'under', 'here' and 'there', he or she may have arithmetic difficulties,  have difficulty understanding word problems and instructions, or have difficulties using words.
They may also have a more general problem with words or sentences, both understanding and speaking them.
If someone is suspected to have mixed receptive-expressive language disorder, then they can go to a speech therapist or pathologist, and receive treatment. Most treatments are short term, and rely on accommodations made in the person's environment, so as to be minimally interfering with work and school functioning.
Mylohyoid branch of inferior alveolar artery
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# Overview
As the inferior alveolar artery enters the mandibular foramen, it gives off a mylohyoid branch which runs in the mylohyoid groove, and ramifies on the under surface of the Mylohyoideus.
Nearly neutral theory of molecular evolution
The nearly neutral theory of molecular evolution is a modification of the neutral theory of molecular evolution that accounts for slightly advantageous or deleterious mutations at the molecular level.  The nearly neutral theory was proposed by Tomoko Ohta in 1973 (including only deleterious mutations) and expanded in the early 1990s to include both advantageous and deleterious nearly neutral mutations.  Unlike in Motoo Kimura's original neutral theorywhich dealt only with mutations unaffected by natural selectionthe nearly neutral theory predicts a relationship between population size and the rate of molecular evolution: in larger populations, genetic drift, which can bring even slightly deleterious mutations to fixation, is a weaker force, so evolution happens more slowly than in smaller populations .

# Origins of the nearly neutral theory
In the early 1970s, evolutionary biologists found that rates of protein evolution (the "molecular clock") are fairly independent of generation time, while rates of noncoding DNA divergence are inversely proportional to generation time.  Noting that population size is generally inversely proportional to generation time, Tomoko Ohta proposed that most amino acid substitutions are slightly deleterious while noncoding DNA substitutions are more neutral.  In this case, the faster rate of neutral evolution in proteins expected in small populations (due to genetic drift) is offset by longer generation times (and vice versa), but in large populations with short generation times, noncoding DNA evolves faster while protein evolution is retarded by selection (which is more significant than drift for large populations).
In 1973, Ohta published a short letter in Nature suggesting that a wide variety of molecular evidence supported the theory that most mutation events at the molecular level are slightly deleterious rather than strictly neutral.  Between then and the early 1990s, many studies of molecular evolution used a "shift model" in which the negative effect on the fitness of a population due to deleterious mutations shifts back to an original value when a mutation reaches fixation.  In the early 1990s, Ohta developed a "fixed model" that included both beneficial and deleterious mutations, so that no artificial "shift" of overall population fitness was necessary.
Niacin/Simvastatin dosage and administration

# Dosage and Administration

## Recommended Dosing
SIMCOR should be taken as a single daily dose at bedtime, with a low fat snack. Patients not currently on niacin extended-release and patients currently on niacin products other than niacin extended-release should start SIMCOR at a single 500/20 mg tablet daily at bedtime. Patients already taking simvastatin 20 to 40 mg who need additional management of their lipid levels may be started on a SIMCOR dose of 500/40 mg once daily at bedtime . The dose of niacin extended-release should not be increased by more than 500 mg daily every 4 weeks - see Table 1.
The recommended maintenance dose for SIMCOR is 1000/20 mg to 2000/40 mg (two 1000/20 mg tablets) once daily depending on patient tolerability and lipid levels.The efficacy and safety of doses of SIMCOR greater than 2000/40 mg daily have not been studied and are therefore not recommended.
If SIMCOR therapy is discontinued for an extended period of time (> 7 days), re-titration as tolerated is recommended. SIMCOR tablets should be taken whole and should not be broken, crushed, or chewed before swallowing.
Due to the increased risk of hepatotoxicity with other modified-release (sustained-release or time-release) niacin preparations or immediate-release (crystalline) niacin, SIMCOR should only be substituted for equivalent doses of niacin extended-release (NIASPAN).
Flushing  may be reduced in frequency or severity by pretreatment with aspirin up to the recommended dose of 325 mg (taken approximately 30 minutes prior to SIMCOR dose). Flushing, pruritus, and gastrointestinal distress are also reduced by gradually increasing the dose of niacin (refer to Table 1) and avoiding administration on an empty stomach. Concomitant alcoholic, hot drinks or spicy foods may increase the side effects of flushing and pruritus and should be avoided around the time of SIMCOR ingestion.

## Coadministration with Other Drugs
Patients taking Amiodarone, Amlodipine or Ranolazine
The dose of SIMCOR should not exceed 1000/20 mg/day .

## Chinese Patients Taking SIMCOR
Because of an increased risk for myopathyin Chinese patients taking simvastatin 40 mg coadministered with lipid-modifying doses (1 g/day niacin) of niacin-containing products, caution should be used when prescribing SIMCOR in doses that exceed 1000/20 mg/day to Chinese patients. The cause of the increased risk of myopathyis not known. It is also unknown if the risk for myopathywith coadministration of simvastatin with lipid-modifying doses of niacin-containing products observed in Chinese patients applies to other Asian patients .
Niacin/lovastatin dosage forms and strengths

# Dosage Forms and Strengths
ADVICOR 500 mg/20 mg - Iron Oxide Yellow, Iron Oxide Red.
ADVICOR 750 mg/20 mg - FD&C Yellow #6/Sunset Yellow FCF Aluminum Lake.
ADVICOR 1000 mg/20 mg - Iron Oxide Red, Iron Oxide Yellow, Iron Oxide Black.
ADVICOR 1000 mg/40 mg - Iron Oxide Red.
PCI complications: access site complications

# Overview
Vascular access site complications are common during cardiac catheterization and PCI, and local bleeding (a local hematoma formation) is the most common one. A thoughtful and systematic approach to the catheterization procedure decreases problems of access.

# Access Site Complications
An old cathlab saying, Take time to evaluate and do it right the first time, should always be remembered.
Complications for vascular access can be divided into acute (during the insertion period or shortly after) or long term. Operators should have a thorough knowledge of the anatomy and of the potential complications from the procedure to identify and quickly treat any complications that may arise. Access through synthetic peripheral vascular grafts should be avoided if possible.
The femoral artery approach is the most frequent site of vascular access during invasive cardiac procedures. Possible vascular access routes are as follow:

### Arterial
- Axillary
- Brachial
- Femoral
- Radial (rarely used for cardiac catheterization, more common for diagnostic angiographies and percutaneous interventions)
- Subclavian (not used for cardiac catheterization)
- Translumbar (not used for cardiac catheterization)

### Venous
- Brachial
- Femoral
- Internal jugular
- Subclavian

## Patients at High Risk for Access Site Complications
- Obesity
- Patients with high blood pressure
- Elderly
- Female gender
- Patients with aortic insufficiency
- Patients who undergone prior puncture
- Patients with advanced peripheral arteriosclerosis
- Patients who suffer from coagulopathy or those taking anticoagulant or antiplatelet agents
- Patients with excessive edema

## Possible Complications
- Local tissue trauma or damage (e.g., bleeding into surrounding tissues, nerve injury)
- Vascular damage (e.g., perforation, dissection)
- AV fistula: If the femoral artery and the vein are both used, arterial sheath should be removed first and then the venous one to decrease risk of arteriovenous fistula formation.
- Infection and sepsis: After hemostasis is obtained the access area should be cleaned with antiseptic solution.
- Aberrant catheter placement
- Complication during subclavian vein cannulation. Copyleft image courtesy of C. Michael Gibson.
- Normal anatomic position of subclavian vein
- Complication during right femoral artery puncture. Copyleft image courtesy of C. Michael Gibson.
- Complication during right femoral artery puncture. Copyleft image courtesy of C. Michael Gibson.
- Complication of pulling out when there was resistance in a stent graft system. Part of right iliac and femoral arteries stripped with stent graft system from right femoral artery puncture site. Copyleft image courtesy of C. Michael Gibson.
- Higher Level puncture of femoral artery and cannula kinking. Copyleft image courtesy of C. Michael Gibson.
PCI complications: new or enlarging thrombus

# Overview
A new or enlarging thrombus is defined as: 
1. The appearance of thrombus grade 2 during a PCI procedure that was not present at baseline; 
2. A qualitative increase of baseline thrombus during a PCI procedure;
3. Presence of thrombus at baseline that improves during a PCI procedure only to worsen later:
For example, a thrombus of grade 5 is present at baseline.  During the PCI procedure, the thrombus grade improves to 2 however at the end of the procedure, the thrombus grade worsens to 4.  This example will qualify as a New or Enlarging Thrombus.
Paranoid Schizophrenia (patient information)

# Overview
Paranoid type schizophrenia is a mental illness that involves false beliefs of being persecuted or plotted against.

# What are the symptoms of Paranoid Schizophrenia?
- People with paranoid schizophrenia may have mistaken beliefs (delusions) that one or more people are plotting against them or their loved ones. It is difficult or impossible for others to convince them that they are not the target of a plot. People with this condition may spend a lot of time thinking about how to protect themselves from the person or people they believe are trying to harm them.
- Other symptoms include:
- Becoming socially isolated
- Feeling tense, suspicious, guarded, and reserved
- "Hearing things" (auditory hallucinations)
- Paranoid schizophrenia usually does not involve the disorganized speech and behavior that is seen in other types of schizophrenia.

# Where to find medical care for Paranoid Schizophrenia?
Directions to Hospitals Treating Paranoid Schizophrenia

# Source
Paromomycin sulfate warnings and precautions

# Precautions
The use of this antibiotic, as with other antibiotics, may result in an overgrowth of nonsusceptible organisms, including fungi. Constant observation of the patient is essential. If new infections caused by nonsusceptible organisms appear during therapy, appropriate measures should be taken.
The drug should be used with caution in individuals with ulcerative lesions of the bowel to avoid renal toxicity through inadvertent absorption.
This product contains FD&C Yellow No. 5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.
Penicillin V potassium clinical pharmacology

# Clinical Pharmacology
Penicillin V exerts a bactericidal action against penicillin-sensitive microorganisms during the stage of active multiplication. It acts through the inhibition of biosynthesis of cell-wall mucopeptide. It is not active against the penicillinase-producing bacteria, which include many strains of staphylococci. The drug exerts high in vitro activity against staphylococci (except penicillinase-producing strains), streptococci (groups A, C, G, H, L and M), and pneumococci. Other organisms sensitive in vitro to penicillin V are Corynebacterium diphtheriae, Bacillus anthracis, Clostridia, Actinomyces bovis, Streptobacillus moniliformis, Listeria monocytogenes, Leptospira, and Neisseria gonorrhoeae. Treponema pallidum is extremely sensitive.
The potassium salt of penicillin V has the distinct advantage over penicillin G in resistance to inactivation by gastric acid. It may be given with meals; however, blood levels are slightly higher when the drug is given on an empty stomach. Average blood levels are two to five times higher than the levels following the same dose of oral penicillin G and also show much less individual variation.
Once absorbed, penicillin V is about 80% bound to serum protein. Tissue levels are highest in the kidneys, with lesser amounts in the liver, skin, and intestines. Small amounts are found in all other body tissues and the cerebrospinal fluid. The drug is excreted as rapidly as it is absorbed in individuals with normal kidney function; however, recovery of the drug from the urine indicates that only about 25% of the dose given is absorbed. In neonates, young infants, and individuals with impaired kidney function, excretion is considerably delayed.
Photoreceptor cell-specific nuclear receptor
The photoreceptor cell-specific nuclear receptor (PNR), also known as NR2E3 (nuclear receptor subfamily 2, group E, member 3), is a protein that in humans is encoded by the NR2E3 gene. PNR is a member of the nuclear receptor super family of intracellular transcription factors.

# Function
PNR is exclusively expressed in the retina.  The main target genes of PNR are rhodopsin and several opsins which are essential for sight.

# Clinical significance
Mutations in the NR2E3 gene have been linked to several inherited retinal diseases, including enhanced S-cone syndrome (ESCS), a form of retinitis pigmentosa, and  Goldmann-Favre syndrome.
Posterior reversible encephalopathy syndrome
Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterised by headache, confusion, seizures and visual loss associated with imaging findings of bilateral cortical and subcortical brain edema. Common precipitating factors are abrupt elevations of blood pressure, renal decompensation, fluid retention, and immunosuppressive therapy. It was first described in 1996.
It is also known as reversible posterior Leukoencephalopathy syndrome .
it occurs due to elevation in Blood pressure. The condition is reversed by control of Blood pressure and withdrawal of the drug producing the symptoms.

# MRI Images with Axial Flare
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 1.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 2.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 3.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 4.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 5.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 6.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 7.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 8.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 9.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 10.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 11.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 12.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 13.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 14.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 15.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 16.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 17.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 18.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 19.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 20.jpg
- File:Posterior reversible encephalopathy syndrome - MRI Brain - Axial Flair - Image 21.jpg

## Life Threatening Causes

## Common Causes

## Causes by Organ System

## Causes in Alphabetical Order
Premarin pharmacokinetics and molecular data

# Pharmacokinetics
Absorption
Food-Effect
Distribution
Metabolism
Excretion

## Absorption
Conjugated estrogens are soluble in water and are well absorbed from the gastrointestinal
tract after release from the drug formulation. However, Premarin
contain a formulation of medroxyprogesterone acetate (MPA) that is immediately
released and conjugated estrogens that are slowly released over several hours. MPA is
well absorbed from the gastrointestinal tract. Table 1 summarizes the mean
pharmacokinetic parameters for unconjugated and conjugated estrogens, and
medroxyprogesterone acetate following administration of 2 Premarin 0.625 mg/2.5 mg
and 2 Premarin 0.625 mg/5 mg tablets to healthy postmenopausal women. Return to top

## Food-Effect
Single dose studies in healthy, postmenopausal women were conducted to
investigate any potential drug interaction when Premarin is
administered with a high fat breakfast. Administration with food decreased the Cmax of
total estrone by 18 to 34% and increased total equilin Cmax by 38% compared to the
fasting state, with no other effect on the rate or extent of absorption of other conjugated
-r unconjugated estrogens. Administration with food approximately doubles MPA Cmax
and increases MPA AUC by approximately 20 to 30%. Return to top

## Distribution
The distribution of exogenous estrogens is similar to that of endogenous estrogens.
Estrogens are widely distributed in the body and are generally found in higher
concentrations in the sex hormone target organs. Estrogens circulate in the blood largely
bound to sex hormone binding globulin (SHBG) and albumin. MPA is approximately
90% bound to plasma proteins but does not bind to SHBG. Return to top

## Metabolism
Exogenous estrogens are metabolized in the same manner as endogenous estrogens.
Circulating estrogens exist in a dynamic equilibrium of metabolic interconversions.
These transformations take place mainly in the liver. Estradiol is converted reversibly to
estrone, and both can be converted to estriol, which is the major urinary metabolite.
Estrogens also undergo enterohepatic recirculation via sulfate and glucuronide
conjugation in the liver, biliary secretion of conjugates into the intestine, and hydrolysis
in the gut followed by reabsorption. In postmenopausal women a significant proportion
-f the circulating estrogens exists as sulfate conjugates, especially estrone sulfate, which
serves as a circulating reservoir for the formation of more active estrogens. Metabolism
and elimination of MPA occurs primarily in the liver via hydroxylation, with subsequent
conjugation and elimination in the urine. Return to top

## Excretion
Estradiol, estrone, and estriol are excreted in the urine along with glucuronide and sulfate
conjugates. Most metabolites of MPA are excreted as glucuronide conjugates with only
minor amounts excreted as sulfates. Return to top
Adapted from the FDA Package Insert.
Rifampin isoniazid dosage and administration

# Dosage and Administration
In general, therapy should be continued until bacterial conversion and maximal improvement have occurred.

## Adults
Two RIFAMATE (rifampin and isoniazid capsules USP) capsules (600 mg rifampin, 300 mg isoniazid) once daily, administered one hour before or two hours after a meal.
Concomitant administration of pyridoxine (B6) is recommended in the malnourished, in those predisposed to neuropathy (e.g., diabetic), and in adolescents.