Persius/hicric huggingface dataset:
Stoma (medicine)

# Overview
In medicine, a stoma (Greek - plr. stomata) is an opening, usually unnatural or surgically created, which connects a portion of the body cavity to the outside environment. Surgical procedures in which stomata are created are ended in the suffix '-ostomy' and begin with a prefix denoting the organ or area being operated on.
One well-known form of a stoma is a colostomy, which is a surgically-created opening in the large intestine that allows the removal of feces out of the body, bypassing the rectum, to drain into a pouch or other collection device. The historical practice of trepanation was also a type of stoma.
Stoma (Anatomy), a stoma refers to a mouthlike part. In particular it relates to a procedure involving the gastrointestinal tract (GIT) or gastrointestinal system (GIS). The GIT begins at the mouth or oral cavity and continues until its termination, which is the anus. This surgical procedure is invoked usually as a result of and solution to disease in the GIT. The procedure involves bisecting this tube, usually between the later stage of the small intestine (Ileum) and the large intestine or colon, hence colostomy, and exiting it from the body in the abdominal region.
The point of exiting is what is known as the stoma. For greatest success and to minimise bad effects, it is preferable to perform this procedure as low down in the tract as possible, as this allows the optimal amount of natural digestion to occur before eliminating faecal matter from the body. The stoma is usually covered with a removable pouching system (adhesive or mechanical) that collects and contains the output for later disposal. Modern pouching systems enable most individuals to resume normal activities and lifestyles after surgery, often with no outward physical evidence of the stoma or its pouching system.

# Examples of stomas
- Dacryocystorhinostomy
- Enterostomy
Cecostomy
Colostomy
Duodenostomy
Ileostomy
Jejunostomy
- Cecostomy
- Colostomy
- Duodenostomy
- Ileostomy
- Jejunostomy
- Esophagostomy
- Gastrostomy (also see percutaneous endoscopic gastrostomy)
- Cholecystostomy
- Choledochostomy
- Sclerostomy
- Thoracostomy
- Tracheostomy
- Urostomy (also see Ileal conduit urinary diversion)
Nephrostomy
Ureterostomy
Vesicostomy (cystostomy)
- Nephrostomy
- Ureterostomy
- Vesicostomy (cystostomy)
Artificial tears
Artificial tears are lubricant eye drops used to treat the dryness and irritation associated with deficient tear production in keratoconjunctivitis sicca (dry eyes). They are also used to moisten contact lenses and in eye examinations.
Artificial tears are available over-the-counter. Artificial tears are supplemented with other treatments in moderate to severe forms of dry eyes.

# Chemistry
Preparations contain carboxymethyl cellulose, hydroxypropyl methylcellulose (a.k.a. HPMC or hypromellose), and hydroxypropyl cellulose. They contain water, salts and polymers but lack the proteins found in natural tears. Patients who use them more frequently than once every three hours should choose a brand without preservatives or one with special non-irritating preservatives.

# Effects
Application of artificial tears every few hours can provide temporary relief from the symptoms of dry eyes.
Hydroxypropyl cellulose stabilizes and thickens the precorneal tear film, and prolongs the tear film breakup time.

# Usage
Artificial tears usually are the first line of treatment for dry eyes. While mild cases require application of lubricant drops four times a day, severe cases require more aggressive treatment, such as ten to twelve times a day. Thicker artificial tears can be used in severe cases, although these may temporarily blur vision.
An artificial tear insert such as Lacrisert which contains hydroxypropyl cellulose can also be used every morning.

## Precautions
Drops for red eyes can make the eyes even drier. If wearing contact lenses, rewetting or lubricating drops specifically for contact lenses should be used. Other types of drops may contain ingredients that damage the lens.

# Adverse effects, interactions and contraindications
Possible adverse effects of carboxymethyl cellulose and other similar lubricants include eye pain, irritation, continued redness, or vision changes. Use should be discontinued if any of them occur. Those of hydroxypropyl cellulose include hyperaemia, photophobia, stickiness of eyelashes, discomfort, and irritation. Long term use of preservatives present in some artificial tears may harm the eye.
Artificial tears have no reported interactions. A documented contraindication of artificial tears is hypersensitivity.

# Veterinary uses
Artificial tears are a part of the topical therapy for keratoconjunctivitis sicca for animals such as dogs, cats and horses.
Assunta Hospital
Assunta Hospital (Chinese: (please provide Chinese Language); Malay: Hospital Assunta) is the famous and the first private hospital in Petaling Jaya, Selangor, Malaysia.

# History
Assunta Hospital was founded by Franciscan Missionaries of Mary (FMM) in 1957. The Hospital was built through the generosity of the public, Social Welfare Department, local and government grants. It was one of the first private hospitals in Petaling Jaya, Selangor Darul Ehsan. In 1961 the Hospital started the first private nursing school in the country.
The Assunta College of Nursing is well known for its nursing education. The Assunta Nursing Graduates pride themselves in their high professional nursing standards and caring service. Assunta Hospital is recognised as a charitable organisation. It is administered by a Board of Directors consisting of FMM Sisters, professionals and businessmen who give their service on an honorary basis.
With its rich historical background, Assunta Hospital has developed into a modern, specialist hospital with 350 beds and staff of 700. The Hospital prides itself on patient-centred care and is well-known for its nursing service.
Assunta Hospital has a tradition of offering pastoral care, administering to the physical, psychological, moral and spiritual needs of each patient. Equipped for many specialities, the hospital strives to keep abreast of the latest in medical knowledge and technology. Assunta Hospital's philosophy lends itself to a professional learning environment for the staff, stressing a commitment to continuing education in the care of patients.

# Famous patients
- Salmah Ismail (Saloma) - wife and widow of P. Ramlee (died 1982 at the Assunta Hospital)

# Controversy
The Hospital is currently under fire for refusing to treat a patient, who died a few hours later.
Atransferrinemia

# Overview
Atransferrinemia is a genetic disorder in which there is absence of transferrin, a plasma protein that transports iron through the blood.
Atransferrinemia is characterized by anemia and hemosiderosis in the heart and liver. The iron damage to the heart can lead to heart failure. The anemia is typically microcytic and hypochromic (the red blood cells are abnormally small and pale). Atransferrinemia is extremely rare, with eight cases documented worldwide.

# Pathophysiology

## Genetics
A case study was done in 1961 on a 7-year-old girl who passed away from heart failure with atransferrinemia. The half-normal levels of transferrin in her parents' bloodstream supported the notion that this disorder is transferred in an autosomal recessive pattern. Atransferrinemia was reported in only eight patients in six families as of the year 2000. A lack of scientific data and public outreach for children such as Violet (see picture above), however, have suggested that there is a higher number of current cases. Researchers used the first known case reported in the United States and identified mutations in the TF gene as a probable cause of the disorder.
File:Autorecessive.svg

# Diagnosis

## Symptoms
Severe microcytic hypochromic anemia, growth retardation and recurrent infections are the first clinical signs of the disease. Iron overload occurs mainly in the liver, heart, pancreas, thyroid, kidney and bone joints, leading to mild to severe symptoms of liver and heart failure, arthropathy and hypothyroidism. Death may occur due to heart failure or pneumonia.

# Treatment

## Medical Therapy
Treatment with infusions of plasma or purified apotransferrin may stabilise or correct the anemia and growth defects.
Bigeminal rhythm
Synonyms and keywords: Bigeminy, bigeminal beat

# Overview
Bigeminy is a type of cardiac arrhythmia in which abnormal heart beats occur every other concurrent beat.  The abnormal heart beat can originate from the atrium, AV node or the ventricle. A typical example is bigeminal rhythm resulting from premature ventricular contractions/complexes (PVC).  Following the PVC there is a pause and then the normal beat returns, only to be followed by another PVC.  The continuation of this pairing of beats is an example of bigeminy.  Other forms of abnormal beats include PAC, escape beats and parasystole.

# Classification
- Atrial bigeminy
- Junctional bigeminy
- Ventricular bigeminy
- Concealed bigeminy
- Escape capture bigeminy

# Pathophysiology
Several mechanisms can be involved in the creation of a bigeminal rhythm, such as:
- Ectopic firing of electrical impulses
- Abnormalities in electrical impulse generation
- Abnormalities in electrical impulse conduction

# Differential Diagnosis

## Trigeminal and Quadrigeminal Rhythms
If every other beat is abnormal, you can describe the rhythm as bigeminal.  If every third beat is abnormal, it is trigeminal; every fourth would be quadrigeminal.  Typically, if every fifth or more beat is abnormal, the abnormal beat would be termed occasional.

## Couplets and Triplets
Bigeminy is contrasted with couplets, which are paired abnormal beats.  If these concurrent beats number three, they are called triplets and are considered as a brief run of non-sustained Ventricular tachycardia or NS-VT.

# Diagnosis

## ECG
Shown below is an EKG depicting atrial bigeminy. The EKG shows a regularly irregular rhythm at a rate of about 75/minute. There are two different P wave morphologies best seen in lead V1.
Copyleft image obtained courtesy of ECGpedia,
Shown below is an EKG depicting bigeminy. The pacemaker is an atrial pacer set at 30/min. Note the marker channel documenting atrial pacing and then sensing of the QRS in the refractory period of the pacemaker. The paced atrial beats seem to stimulate a normal sinus beat and hence create the bigeminal rhythm.
Copyleft image obtained courtesy of ECGpedia,

# Treatment
- Asymptomatic atrial bigeminy is treated with digitalis or quinidine.
- Ventricular bigeminy is treated with suppressive drugs.
- Escape capture bigeminy that results from a bigeminal rhythm in the setting of SA node block or AV block requires an artificial pacemaker.
Attenuated virus
For the bacterial use of the term, see Attenuator (genetics)
The verb "attenuate" means "to become weak."
Attenuation in virology is reducing the virulence of a virus, whilst keeping it viable (or 'live'), for the purpose of creating a vaccine. It is the counterpart of the vaccines produced by 'killing' the virus (inactivated vaccine)
Viruses may be attenuated via passage of the virus through a foreign host, such as :
- tissue culture
- embryonated eggs
- live animals
The initial viral population is applied to the foreign host. In all likelihood one of these will possess a mutation that enables it to infect the new host. However this mutant will normally have a lower virulence in the original host, enabling it to infect them, but cause less damage, and so acts as a vaccine.

# Advantages of Attenuated Vaccines
- Activates all phases of the immune system (for instance IgA local antibodies are produced)
- Provides more durable immunity; boosters are not required
- Low cost
- Quick immunity
- Easy to transport/administer (for instance OPV for Polio can be taken orally, rather than requiring a sterile injection by a trained healthworker, as the inactivated form IPV does)

# Disadvantages
- Major Disadvantage -Secondary mutation can cause a reversion to virulence
- May still be able to cause disease in immunocompromised patients (e.g. those with AIDS)
- Sometimes may not work in tropical areas
Austrobaileyales
Austrobaileyales is the botanical name for an order of flowering plants, consisting of several dozen species of woody plants. It is only rarely recognised by systems of classification (an exception is the Reveal system).
The APG system, of 1998, did not recognize such an order. The APG II system, of 2003, does accept this order and places it among the basal angiosperms, that is: it does not belong to any further clade. APG II uses this circumscription:
- order Austrobaileyales
family Austrobaileyaceae, two species of woody vines from Australia
family Schisandraceae , several dozen species of woody plants, found in tropical to temperate regions of East and Southeast Asia and the Caribbean.
family Trimeniaceae, half-a-dozen species, of woody plants found in subtropical to tropical Southeast Asia, eastern Australia and the Pacific Islands
- family Austrobaileyaceae, two species of woody vines from Australia
- family Schisandraceae , several dozen species of woody plants, found in tropical to temperate regions of East and Southeast Asia and the Caribbean.
- family Trimeniaceae, half-a-dozen species, of woody plants found in subtropical to tropical Southeast Asia, eastern Australia and the Pacific Islands
Note: "+ ..." = optional seggregrate family, that may be split off from the preceding family. The Cronquist system, of 1981, also placed the  plants in families Illiciaceae and Schisandraceae together, but as separate families, united at the rank of order, in the order Illiciales.
ca:Austrobaileial
da:Austrobaileyales
de:Sternanisartige
ko:
hu:Austrobaileyales
nl:Austrobaileyales
sr:Austrobaileyales
sh:Austrobaileyales
fi:Austrobaileyales
sv:Austrobaileyales
Pendred syndrome
Pendred syndrome or Pendred disease is a genetic disorder leading to congenital bilateral (both sides) sensorineural hearing loss and goitre with occasional hypothyroidism (decreased thyroid gland function). There is no specific treatment, other than supportive measures for the hearing loss and thyroid hormone supplementation in case of hypothyroidism. It is named Dr Vaughan Pendred (1869-1946), the English doctor who first described the condition in an Irish family living in Durham in 1896. It accounts for 7.5% of all cases of congenital deafness.

# Signs and symptoms
The hearing loss of Pendred's syndrome is present from birth, and language acquisition may be a significant problem if this is severe in childhood. Hearing typically worsens over the years, and many proceed to deafness at a later age. In some cases, language development worsens after head injury, suggesting that the inner ear is sensitive to trauma in Pendred syndrome. A goitre is present in 75% of all cases.

# Diagnosis
Audiology (measuring ability to hear sounds of a particular pitch) is always abnormal, but the findings are not particularly specific and an audiogram is not sufficient to diagnose Pendred's syndrome. If the condition is suspected, a "perchlorate discharge test" is therefore sometimes performed. This test is highly sensitive, but may also be abnormal in other thyroid conditions. If a goitre is present, thyroid function tests are performed to identify mild cases of thyroid dysfunction even if they are not yet causing symptoms.
Some require CT scanning or MRI scanning of the middle ear. This is not always abnormal, but may show an abnormality of the inner ear known as Mondini dysplasia.

# Genetics
File:Autorecessive.svg
Pendred syndrome inherits in an autosomal recessive manner, meaning that one would need to inherit an abnormal gene from each parent to develop the condition. This also means that a sibling of a patient with Pendred's syndrome has a 25% chance of also having the condition.
It has been linked to mutations in the PDS gene, which codes for the pendrin protein (solute carrier family 26, member 4, SLC26A4). The gene is located on the long arm of chromosome 7 (7q31). Mutations in the same gene also cause enlarged vestibular aqueduct syndrome (EVA or EVAS), another congenital cause of deafness; specific mutations are more likely to cause EVAS, while others are more linked with Pendred syndrome.

# Pathophysiology
SLC26A4 can be found in the cochlea (part of the inner ear), thyroid and the kidney. In the kidney, it participates in the secretion of bicarbonate. However, Pendred's syndrome is not known to lead to kidney problems. It functions as an iodide/chloride transporter. In the thyroid, this leads to reduced organification of iodine (i.e. its incorporation into thyroid hormone).

# Treatment
No specific treatment exists for Pendred syndrome. Speech and language support, and cochlear implants, may improve language skills. If thyroid hormone levels are decreased, thyroxine may be required. Patients are advised to take precautions against head injury.
Borrelia mayonii
To learn more about Borrelia burgdorferi, the usual cause of Lyme disease, click here

# Overview
The first description of Lyme disease caused by B. mayonii among 6 patients from Minnesota, Wisconsin, and North Dakota in February 2016.

# Historical Perspective
- February 2016 - The first description of Lyme disease caused by B. mayonii among 6 patients from Minnesota, Wisconsin, and North Dakota. The discovery was made when 6 samples (5 blood and 1 synovial fluid) out of approximately 9,000 samples suspected to have Lyme disease between 2012 and 2014 were found to contain bacteria that were genetically distinct from B. burgdorferi.
- The term mayonii refers to the Mayo Clinic medical center in Minnesota, where genetic testing for the organism was first conducted.

# Associated Disease
- B. mayonii is thought to cause Lyme disease.

# Differentiating B. mayonii from B. burgdorferi
The following table demonstrates key clinical and epidemiological features  that distinguish B. mayonii from B. burgdorferi:
Adapted from Pritt BS et al. Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infectious Diseases. DOI: (15)00464-8  |  Centers for Disease Control and Prevention (CDC). New Lyme-disease-causing bacteria species discovered. URL: . Retrieved February 9th 2016.
BC Cancer Agency

# Overview
The BC Cancer Agency is part of the Provincial Health Services Authority in British Columbia, Canada.

# Mission
The Agency has a three part mission:
- To reduce the incidence of cancer.
- To reduce the mortality rate of people with cancer.
- To improve the quality of life of people living with cancer.

# Facilities
The Agency operates four regional cancer care centres and the BC Cancer Research Centre, with departments in Vancouver and in Victoria.
Essentially all radiotherapy services in British Columbia are provided by the BCCA, as well as a majority of chemotherapy services. The agency provides clinics in areas remote from the four main cancer centres, to provide cover for rural British Columbia and the Yukon. In addition, the agency provides prostate brachytherapy services to Saskatchewan province.

# Sources
- About BCCA
- About the BC Cancer Foundation, an independent charitable organization that supports research and care at BC Cancer Agency
Bare metal stent

# Overview
A bare-metal stent is a vascular stent without a coating (as used in drug-eluting stents).  BMS are mesh-like tubes of thin wire.

# Historical Perspective
The first stents licenced for use in cardiac arteries were bare metal - Often 316L stainless steel. More recent ('2nd generation') stents use cobalt chromium alloy. See drug-eluting stent#Design.

# Examples
Stainless steel : (J&J, Cordis) BxVelocity, (Medtronic) Express2, R Stent, Matrix Stent (Sahajanand Medical technologies)
Cobalt-chromium alloy : (Medtronic) Driver, (Guidant, Abbott) ML Vision, Coronnium (Sahajanand Medical technologies)
Bacillus (shape)
Although Bacillus, capitalized and italicized, specifically refers to the genus, the word bacillus may also be used to describe any rod-shaped bacterium, and in this sense, bacilli are found in many different taxonomic groups of bacteria.
It should be noted that the cell morphology term bacillus does not necessarily indicate Gram-positive staining, as E. coli is a Gram-negative, rod-shaped bacteria.
Enterobacteriaceae is also Gram-negative, and rod-shaped.
Bacillus are usually solitary, but can combine to form diplobacilli, streptobacilli, and palisades.
MacConkey agar can be used to distinguish among Gram negative bacilli.
Balantidium coli

# Overview
Balantidium coli is a species of ciliate protozoan. This parasite is the only member of this family known to be pathogenic to humans.  Hosts include pigs, wild boars, rats, primates (including humans), horses, cattle and guinea pigs. Infection is transmitted within or between these species by fecal-oral transmission.  Pigs are the most significant reservoir hosts, though they show few if any symptoms.
Cysts are the infective stage, responsible for transmission of balantidiasis.  The host usually acquires cysts through ingestion of contaminated food or water.  Following ingestion, excystation occurs in the small intestine, and the trophozoites colonize the large intestine.  Both cysts and trophozoites are identifiable by a large, "sausage shaped" macronucleus.
The trophozoites reside in the lumen of the large intestine, where they replicate by transverse binary fission, during which conjugation may occur.  Some trophozoites invade the wall of the colon using proteolytic enzymes and multiply; some of these return to the lumen. In the lumen Trophozoites may disintegrate or undergo encystation. Encystation is trigerred by dehydration of the intestinal contents and usually occurs in the distal large intestine, but may also occur outside of the host in feces.  Symptoms can be local due to involvement of the intestinal mucosa, or systemic in nature and include diarrhea.  Balantidiasis can be treated with carbarsone, tetracycline, or diiodohydroxyquin.

# Geographic distribution
B. coli can be found worldwide.  Pigs are a reservoir. Infection of people occurs more frequently in areas where pigs comingle with people, including the Philippines, Mexico, South America, and Papua New Guinea.
Less than 1% of the human population is infected worldwide.

# Life Cycle
Cysts are the parasite stage responsible for transmission of balantidiasis (1).  The host most often acquires the cyst through ingestion of contaminated food or water (2).  Following ingestion, excystation occurs in the small intestine, and the trophozoites colonize the large intestine (3).  The trophozoites reside in the lumen of the large intestine of humans and animals, where they replicate by binary fission, during which conjugation may occur (4).  Trophozoites undergo encystation to produce infective cysts (5).  Some trophozoites invade the wall of the colon and multiply.  Some return to the lumen and disintegrate.  Mature cysts are passed with feces (1).
- Life Cycle of Balatidium coli  Adapted from CDC

# Treatment

## Antimicrobial Regimen
- Balantidium coli treatment
- Adult dosage:
- Preferred regimen: Metronidazole 750 mg PO tid for 5 days, Tetracycline 500 mg PO qid for 10 days
- Alternative regimen: Iodoquinol 650 mg PO tid for a 20-days
- Pediatric dosage:
- Preferred regimen: Metronidazole 35-50 mg/kg/day PO in three doses (maximum dosage: 2 g) for 5 days, Tetracycline 40 mg/kg/dose PO in four doses for 10 days.
- Alternative regimen: Iodoquinol 40 mg/kg/dose PO in three doses for 20 days AND Doxycycline.
- Note: Nitazoxanide, a broad-spectrum antiparasitic and antihelminthic drug, may be another treatment for balantidiosis.