Persius/hicric huggingface dataset:
Hereditary coproporphyria
Hereditary coproporphyria (HCP) is a form of hepatic porphyria associated with a deficiency of the enzyme coproporphyrinogen III oxidase.
Hereditary coproporphyria (HCP) is an autosomal recessive genetic disease that causes purple urine, photosensitivity, and attacks of abdominal pain. Symptoms vary from mild to severe and can be regulated with diet and triggered with drug use.

# Symptoms
Symptoms include reddish-purple urine, acute neurological problems (typically episodic confusion and sensory changes), and attacks of acute abdominal/nerve pain. Around 30% suffer photosensitive skin eruptions with nail involvement; these can lead to permanent scarring.
Triggers vary, but infections, hormonal changes, dieting, and the use of alcohol and certain drugs such as barbiturates and birth control pills have all been implicated.

# Function
The coproporphinogen oxidase gene is an enzyme expressed in erythrocytes that converts coproporphyrinogen III to protoporphyrinogen IX.  Heme is made from porphyrin and when a mutation occurs, heme production is interrupted.  This leads to an overabundance of porphyrin in the body, which then exits through urine/feces.

# Pathophysiology
Hereditary coproporphyria is the result of a point mutation in the coproporphinogen oxidase (CPO) gene.  Documented changes in the DNA sequence that cause HCP include missense, nonsense, deletion and splicing of single nucleotides.  Documented changes in the protein sequence have been a replacement of ser208 to phe(s208f) and arg328 to cys(r328c).  Aside from varying intensity of symptoms there are no other known mutations, and it is not known at this time if mutations in other genes can trigger this same disease.  At this time it is not known if there are any specific groups of people that are especially susceptible to this disease, as patients have been documented all over the world.

# Molecular Biology
The CPO gene is located in chromosome 3 on the q12 locus.  The gene is 14,000 bases in length, has 6 introns, and 7 exons.  Once the introns are spliced out the actual coded mRNA is only 2675 bases in length. The protein contains 323 amino acids.

# Heredity
HCP is an autosomal disease, meaning it is carried in one of the autosomes, or non-sex chromosomes.  There have been documented cases of both heterozygous and homozygous inheritance, with similar symptoms in each patient.

# Treatment
While there is no cure for this condition, there are preventative measures people can take to regulate symptoms.  A diet high in carbohydrates, as well as avoidance of aggravating factors (such as alcohol and drug use) can prevent attacks.
Posterior cerebral artery
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In human anatomy, the posterior cerebral artery is the blood vessel that supplies oxygenated blood to the posterior aspect of the brain (occipital lobe).  It arises from the basilar artery and connects with the ipsilateral middle cerebral artery and internal carotid artery via the posterior communicating artery.

# Branches
The branches of the posterior cerebral artery are divided into two sets, ganglionic and cortical:

## Ganglionic branches
- The postero-medial ganglionic branches are a group of small arteries which arise at the commencement of the posterior cerebral artery: these, with similar branches from the posterior communicating, pierce the posterior perforated substance, and supply the medial surfaces of the thalami and the walls of the third ventricle.
- The posterior choroidal branches run forward beneath the splenium of the corpus callosum, and supply the tela chorioidea of the third ventricle and the choroid plexus.
- The postero-lateral ganglionic branches are small arteries which arise from the posterior cerebral artery after it has turned around the cerebral peduncle; they supply a considerable portion of the thalamus.

## Cortical branches
The cortical branches are:
- the anterior temporal, distributed to the uncus and the anterior part of the fusiform gyrus
- the posterior temporal, to the fusiform and the inferior temporal gyri
- the calcarine, to the cuneus and gyrus lingualis and the back part of the convex surface of the occipital lobe
- the parietooccipital, to the cuneus and the precuneus

# Pathology
Because the artery supplies much of the occipital lobe, occlusions can lead to deficiencies in visual perception.
Capnocytophaga canimorsus
Capnocytophaga canimorsus is a Gram-negative bacillus (rod-shaped) bacterium that causes a zoonotic disease in mostly asplenic patients. It is a member of the normal gingival flora of dogs and cats. It causes fulminant sepsis with disseminated intravascular coagulation (DIC), in typically asplenic patients.

# Treatment
Treatment is via antibiotics with the possible aid of activated protein C or plasmapheresis in severe cases.
Following animal bites, co-amoxiclav is often given to asplenic individuals to prevent disseminated infection; but in patients who are allergic to penicillins, the combination of doxycycline and metronidazole (to cover anaerobic organisms) may be used instead.
In patients with sepsis, treatment with imipenem, clindamycin, or a penicillin--lactamase inhibitor combination (e.g., co-amoxiclav or piperacillin-tazobactam) should be used.  Doxycycline is active in vitro but there is little experience in using it in treating sepsis, and in many countries there is no intravenous form available, which suggests that it should be reserved for when no other options are available.
Capnocytophaga canimorsus was AKA Dysgonic fermenter type 2 (DF2).

## Antimicrobial Regimen
- Capnocytophaga canimorsus
- 1. Severe cellulitis/sepsis or endocarditis
- Preferred regimen (1) (Beta-lactam/beta-lactamase inhibitor): Ampicillin/sulbactam 3 g IV q6h
- Preferred regimen (2) (Non-beta-lactamase producing): Penicillin G 2-4 MU IV q24h
- Alternative regimen (1): Ceftriaxone 1-2 g IV q24h
- Alternative regimen (2): Meropenem 1 g IV q8h
- Alternative regimen (3) (complicated infections or immunocompromise): Clindamycin 600 mg IV q8h may be combined with above agents
- Note (1): Resistance to aztreonam described, and variable susceptibility reported to TMP-SMX and aminoglycosides
- Note (2): For endocarditis, alternatives to penicillins not well established, treated for duration of 6 weeks
- Note (3): For non-endocarditis infections, duration not well established, but most authorities recommend at least 14-21 days of therapy
- 2. Mild cellulitis/dog or cat bites
- Preferred regimen (1): Amoxicillin/clavulanate 500 mg PO q8h or 875 mg PO bid
- Preferred regimen (2): Amoxicillin 500 mg PO q8h
- Alternative regimen (1): Clindamycin 300 mg PO q6h
- Alternative regimen (2): Doxycycline 100 mg PO bid
- Alternative regimen (3): Clarithromycin 500 mg PO bid
- Alternative regimen (4): Moxifloxacin 400 mg PO qd
- 3. Meningitis or brain abscess
- Preferred regimen (1): Ceftriaxone 2 g IV q12h AND Ampicillin 2 g IV q4h
- Preferred regimen (2) (if beta-lactamase producing or polymicrobial brain abscess): Imipenem/Cilastin 1000 mg q6-8h AND Clindamycin 600 mg IV q8h
- 4. Prevention
- Although no firm data supports this recommendation, many clinicians do give prophylaxis for dog and cat bites in asplenic patients with Amoxicillin/clavulanate for 7-10 days
Carbon dioxide equivalent
Carbon dioxide equivalent (CDE) and Equivalent carbon dioxide (or CO2e) are two related but distinct measures for describing how much global warming a given type and amount of greenhouse gas may cause, using the functionally equivalent amount or concentration of carbon dioxide (CO2) as the reference.

# Equivalent carbon dioxide
Equivalent CO2 (CO2e) is the concentration of CO2 that would cause the same level of radiative forcing as a given type and concentration of greenhouse gas. Examples of such greenhouse gases are methane, perfluorocarbons and nitrous oxide. CO2e is expressed as parts per million by volume, ppmv.
- The radiative forcing for pure CO2 is approximated by RF = \alpha ln(C/C_0) where C is the present concentration, \alpha is a constant, 5.35 and C_0 the pre-industrial concentration, 278 ppm. Hence the value of CO2e for an arbitrary gas mixture with a known radiative forcing is given by C_0 exp(RF/\alpha) in ppmv.
- To calculate the radiative forcing for a 1998 gas mixture, IPCC 2001 gives the radiative forcing (relative to 1750) of various gases as: CO2=1.46 (corresponding to a concentration of 365 ppmv), CH4=0.48, N2O=0.15 and other minor gases =0.01 W/m2. The sum of these is 2.10 W/m2. Inserting this to the above formula, we obtain CO2e = 412 ppmv.

# Carbon dioxide equivalent
Carbon dioxide equivalency is a quantity that describes, for a given mixture and amount of greenhouse gas, the amount of CO2 that would have the same global warming potential (GWP), when measured over a specified timescale (generally, 100 years). Carbon dioxide equivalency thus reflects the time-integrated radiative forcing, rather than the instantaneous value described by CO2e.
The carbon dioxide equivalency for a gas is obtained by multiplying the mass and the GWP of the gas. The following  units are commonly used:
- By the UN climate change panel IPCC: billion metric tonnes of CO2 equivalent (GtCO2eq).
- In industry: million metric tonnes of carbon dioxide equivalents (MMTCDE).
- For vehicles: g of carbon dioxide equivalents / km (gCDE/km).
For example, the GWP for methane is 21 and for nitrous oxide 310. This means that emissions of 1 million metric tonnes of methane and nitrous oxide respectively is equivalent to emissions of 21 and 310 million metric tonnes of carbon dioxide.
Caroli's disease overview

# Overview
Caroli disease is a rare inherited disorder characterized by dilatation of the intrahepatic bile ducts.  There are two types of Caroli disease, the most common being the simple, or isolated case where the bile ducts are widened by ectasia. The second, more complex, cause is commonly known as Caroli Syndrome. This complex form is also linked with portal hypertension and congenital hepatic fibrosis.
 The differences between the causes of the two cases have not yet been discovered. Caroli disease is also associated with liver failure and polycystic kidney disease.
Caroli disease also is known as communicating cavernous ectasia, or congenital cystic dilatation of the intrahepatic biliary tree. Caroli disease is distinct from other diseases that cause ductal dilatation caused by obstruction, in that it is not one of the many choledochal cyst derivatives.
Carotid-cavernous fistula
A carotid-cavernous fistula (CCF) results from an abnormal communication between the arterial and venous systems within the cavernous sinus in the skull. It is a type of arteriovenous fistula. As arterial blood under high pressure enters the cavernous sinus, the normal venous return to the cavernous sinus is impeded and this causes engorgement of the draining veins, manifesting most dramatically as a sudden engorgement and redness of the eye of the same side.

# Causes
Carotid cavernous fistulae may form following closed or penetrating head trauma, surgical damage,
rupture of an intracavernous aneurysm etc or in association with connective tissue disorders, vascular diseases and dural fistulas.

# Classification
Many types of classification have been proposed for CCF, based on the anatomy, pathophysiology and aetiology. They may be divided into low-flow or high-flow, traumatic or spontaneous and direct or indirect. One of the most popular classifications divides CCF into four varieties depending on the type of arterial supply.

# Symptoms and presentation
While CCF is not a lethal disease, its symptoms can be disabling and include bruit (a humming sound within the skull due to high blood flow through the arteriovenous fistula), progressive visual loss, and proptosis or progressive bulging of the eye due to dilatation of the veins draining the eye.
Patients usually present with sudden or insidious onset of redness in one eye, associated with proressive proptosis or bulging.
They may have a history of similar episodes in the past.

# Diagnosis
This is based on MRI scan with MRA/MRV, CT angiogram and a cerebral DSA.
Cefaclor clinical studies

# Clinical Studies

### Drug or Laboratory Test Interactions
Patients receiving cefaclor may show a false-positive reaction for glucose in the urine with tests that use Benedict's and Fehling's solutions and also with Clinitest tablets.
There have been reports of increased anticoagulant effect when cefaclor and oral anticoagulants were administered concomitantly.

## Carcinogenesis, Mutagenesis, Impairment of Fertility
Studies have not been performed to determine potential for carcinogenicity, mutagenicity, or impairment of fertility.

## Pregnancy Category: B
Teratogenic Effects
Reproduction studies have been performed in mice and rats at doses up to 12 times the human dose and in ferrets given 3 times the maximum human dose and have revealed no harm to the fetus due to cefaclor. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

## Labor and Delivery
The effect of cefaclor on labor and delivery is unknown.

## Nursing Mothers
Small amounts of cefaclor have been detected in mother's milk following administration of single
500-mg doses. Average levels were 0.18, 0.20, 0.21, and 0.16 g/mL at 2, 3, 4, and 5 hours respectively. Trace amounts were detected at 1 hour. The effect on nursing infants is not known. Caution should be exercised when cefaclor is administered to a nursing woman.

## Pediatric Use
Safety and effectiveness of this product for use in infants less than 1 month of age have not been established.

## Geriatric Use
Of the 3703 patients in clinical studies of cefaclor, 594 (16.0%) were 65 and older. No overall differences in safety of effectiveness were observed between these subjects and younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out.
This drug is known to be substantially excreted by the kidney (see CLINICAL PHARMACOLOGY), and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful in monitor renal function (see DOSAGE AND ADMINISTRATION).
Cefdinir clinical studies

# Clinical Studies

## Community-Acquired Bacterial Pneumonia
In a controlled, double-blind study in adults and adolescents conducted in the U.S., cefdinir BID was compared with cefaclor 500 mg TID. Using strict evaluability and microbiologic/clinical response criteria 6 to 14 days posttherapy, the following clinical cure rates, presumptive microbiologic eradication rates, and statistical outcomes were obtained:
In a second controlled, investigator-blind study in adults and adolescents conducted primarily in Europe, cefdinir BID was compared with amoxicillin/clavulanate 500/125 mg TID. Using strict evaluability and clinical response criteria 6 to 14 days posttherapy, the following clinical cure rates, presumptive microbiologic eradication rates, and statistical outcomes were obtained:

## Streptococcal Pharyngitis/Tonsillitis
In four controlled studies conducted in the U.S., cefdinir was compared with 10 days of penicillin in adult, adolescent, and pediatric patients. Two studies (one in adults and adolescents, the other in pediatric patients) compared 10 days of cefdinir QD or BID to penicillin 250 mg or 10 mg/kg QID. Using strict evaluability and microbiologic/clinical response criteria 5 to 10 days posttherapy, the following clinical cure rates, microbiologic eradication rates, and statistical outcomes were obtained:
Two studies (one in adults and adolescents, the other in pediatric patients) compared 5 days of cefdinir BID to 10 days of penicillin 250 mg or 10 mg/kg QID. Using strict evaluability and microbiologic/ clinical response criteria 4 to 10 days posttherapy, the following clinical cure rates, microbiologic eradication rates, and statistical outcomes were obtained:
Cefepime clinical studies

# Febrile Neutropenic Patients
The safety and efficacy of empiric cefepime monotherapy of febrile neutropenic patients have been assessed in two multicenter, randomized trials comparing cefepime monotherapy (at a dose of 2 g intravenously every 8 hours) to ceftazidime monotherapy (at a dose of 2 g intravenously every 8 hours). These studies comprised 317 evaluable patients.
ANC = absolute neutrophil count; SBP = systolic blood pressure
Table 9 describes the clinical response rates observed. For all outcome measures, cefepime was therapeutically equivalent to ceftazidime.
Insufficient data exist to support the efficacy of cefepime monotherapy in patients at high risk for severe infection (including patients with a history of recent bone marrow transplantation, with hypotension at presentation, with an underlying hematologic malignancy, or with severe or prolonged neutropenia). No data are available in patients with septic shock.

# Complicated Intra-Abdominal Infections
Patients hospitalized with complicated intra-abdominal infections participated in a randomized, double-blind, multicenter trial comparing the combination of cefepime (2 g every 12 hours) plus intravenous metronidazole (500 mg every 6 hours) versus imipenem/cilastatin (500 mg every 6 hours) for a maximum duration of 14 days of therapy. The study was designed to demonstrate equivalence of the two therapies. The primary analyses were conducted on the protocol-valid population, which consisted of those with a surgically confirmed complicated infection, at least one pathogen isolated pretreatment, at least 5 days of treatment, and a 4 to 6 week follow-up assessment for cured patients. Subjects in the imipenem/cilastatin arm had higher APACHE II scores at baseline. The treatment groups were otherwise generally comparable with regard to their pretreatment characteristics. The overall clinical cure rate among the protocol-valid patients was 81% (51 cured/63 evaluable patients) in the cefepime plus metronidazole group and 66% (62/94) in the imipenem/cilastatin group. The observed differences in efficacy may have been due to a greater proportion of patients with high APACHE II scores in the imipenem/cilastatin group.
Cefixime clinical studies

# Clinical Studies
Comparative clinical trials of otitis media were conducted in nearly 400 children between the ages of 6 months to 10 years. Streptococcus pneumoniae was isolated from 47% of the patients, Haemophilus influenzae from 34%, Moraxella catarrhalis from 15% and S. pyogenes from 4%.
The overall response rate of Streptococcus pneumoniae to cefixime was approximately 10% lower and that of Haemophilus influenzae or Moraxella  catarrhalis approximately 7% higher (12% when beta-lactamase positive isolates of H. influenzae are included) than the response rates of these organisms to the active control drugs.
In these studies, patients were randomized and treated with either cefixime at dose regimens of 4 mg/kg twice a day or 8 mg/kg once a day, or with a comparator. Sixty-nine to 70% of the patients in each group had resolution of signs and symptoms of otitis media when evaluated 2 to 4 weeks post-treatment, but persistent effusion was found in 15% of the patients. When evaluated at the completion of therapy, 17% of patients receiving cefixime and 14% of patients receiving effective comparative drugs (18% including those patients who had Haemophilus influenzae resistant to the control drug and who received the control antibiotic) were considered to be treatment failures. By the 2 to 4 week follow-up, a total of 30%-31% of patients had evidence of either treatment failure or recurrent disease.
Cephalanthus occidentalis
Cephalanthus occidentalis (Buttonbush, Button-bush, Button-willow or Honey-bells) is a species of Cephalanthus native to eastern and southern North America.
It is a deciduous shrub or small tree growing to 2-10 m (rarely 15 m) tall. The leaves are opposite or in whorls of three, elliptic to ovate, 7-20 cm long and 3-7 cm broad, with an entire margin and a short petiole. The flowers are produced in a dense globular inflorescence 2.5-3.5 cm diameter on a 2.55 cm peduncle. Each flower has a fused white to pale yellow four-lobed corolla forming a long slender tube connecting to the  calyx. The stigma is long, protruding from the corolla by about 4 mm.
There are two varieties, not considered distinct by all authorities:
- Cephalanthus occidentalis var. occidentalis (syn. var. pubescens)  Common Buttonbush. Eastern North America from Nova Scotia west to Minnesota and south to Florida and eastern Texas.
- Cephalanthus occidentalis var. californicus  California Button-willow. Southwestern North America, from western Texas west to California (Sierra Nevada foothills, San Joaquin Valley, Sacramento Valley, and the Inner North Coast Ranges) and south to Mexico and Central America.
Cerebral hypoxia overview
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# Overview
Cerebral hypoxia refers to deprivation of oxygen supply to brain tissue.  Mild or moderate cerebral hypoxia is sometimes known as diffuse cerebral hypoxia. It can cause confusion and fainting, but its effects are reversible. Total deprivation of oxygen to the brain is called cerebral anoxia. Extended periods of cerebral hypoxia can lead to brain death or permanent brain damage.
Most cases of cerebral hypoxia are caused by a sudden change in brain oxygen levels. The body can normally respond to mild gradual changes in blood oxygen with little or no noticeable effect on brain function. The acclimatization process used by high altitude climbers is an example of such adjustment.
The presence of cerebral hypoxia symptoms indicates that the brain has been overwhelmed by a change in its oxygen supply.  Consequently, even mild symptoms of cerebral hypoxia require immediate medical attention.