Persius/hicric huggingface dataset:
Buspirone overdose

# Overdosage topics
Signs and symptoms
- Mortality
Recommended overdose treatment

## Signs and symptoms
In clinical pharmacology trials, doses as high as 375 mg/day were administered to healthy male volunteers. As this dose was approached, the following symptoms were observed: nausea, vomiting, dizziness, drowsiness, miosis, and gastric distress. A few cases of overdosage have been reported, with complete recovery as the usual outcome. Return to top

### Mortality
No deaths have been reported following overdosage with BuSpar alone. Rare cases of intentional overdosage with a fatal outcome were invariably associated with ingestion of multiple drugs and/or alcohol, and a causal relationship to buspirone could not be determined. Toxicology studies of buspirone yielded the following LD50 values: mice, 655 mg/kg; rats, 196 mg/kg; dogs, 586 mg/kg; and monkeys, 356 mg/kg. These dosages are 160 to 550 times the recommended human daily dose. Return to top

## Recommended overdose treatment
General symptomatic and supportive measures should be used along with immediate gastric lavage. Respiration, pulse, and blood pressure should be monitored as in all cases of drug overdosage. No specific antidote is known to buspirone, and dialyzability of buspirone has not been determined. Return to top
Adapted from the FDA Package Insert.
Butterfly vertebra

# Overview
Butterfly vertebrae result from the failure of fusion of the lateral halves of the vertebral body because of persistent notochondal tissue between them. Anterior spina bifida, with on without anterior meninogocele, may be associated with a butterfly vertebra.

# Diagnosis

## X-ray
- The involved vertebral body is widened, and the bodies above and below the butterfly vertebra adapt to the altered intervertebral discs on either side by showing concavities along the adjacent endplates.
- Some bone bridging may occur across the defect which is usually seen in the thoracic on lumbar segments of the spine.
Buxus sempervirens
Buxus sempervirens (Common Box or European Box; also as Boxwood) is a flowering plant in the genus Buxus, native to western and southern Europe, northwest Africa, and southwest Asia, from southern England south to northern Morocco, and east through the northern Mediterranean region to Turkey.
It is an evergreen shrub or small tree growing to 1-9 m tall, with a trunk up to 20 cm diameter, exceptionally to 10 m tall and 45 cm diameter (Tree Register of the British Isles). The leaves are arranged in opposite pairs, green to yellow-green, oval, 15-30 mm long and 5-13 mm broad. The hermaphrodite flowers are inconspicuous, greenish-yellow, with no petals and are insect pollinated; the fruit is a three-lobed capsule containing 3-6 seeds.
The species typically grows on soils derived from chalk, limestone, usually as an understorey in forests of larger trees, most commonly associated with Fagus sylvatica forests, but also sometimes in open dry montane scrub, particularly in the Mediterranean region. Box Hill, Surrey is named after its notable box population, which comprises the largest area of native box woodland in England.

# Cultivation and uses
It is a very popular ornamental plant in gardens, being particularly valued for topiary and hedges because of its tolerance of close shearing, small leaves, and scented foliage. Several cultivars have been selected, including some with variegated foliage.
The wood ("boxwood") is very hard and heavy, used for engraving, marquetry, woodturning, and mallet heads. The noted English engraver Thomas Bewick pioneered the use of boxwood blocks for engraving.
The species is locally naturalised in parts of North America.
Burgi-Dunitz angle
The Burgi-Dunitz angle describes the angle of attack of a nucleophile at a carbonyl center.  The angle was named after H. B. Burgi and J.D. Dunitz, its principal investigators.
The Burgi-Dunitz angle depends not upon the nature of the nucleophile but, instead, is an intrinsic property of carbonyl centers.  Originally described vaguely as 105  5, the angle has come to be recognized as 107.  This result, the product of SCF-LCAO-MO calculations, is quite close to the tetrahedral angle (109.5) and supports the existence of a tetrahedral intermediate in such reactions.
The angle is a product of the overlap between the LUMO of the carbonyl function and HOMO of the nucleophile.  The orbital is perpendicular to the C=O bond, and optimally so, too, would be the angle of nucleophilic attack, which would produce the most energetically optimal overlap between its HOMO and the LUMO of the carbonyl center.  However, the lone pairs of oxygen and the atoms high electronegativity interact with that of the basic nucleophile force the angle of attack to 107.
While it may appear inconsequential, the Burgi-Dunitz angle was integral to the understanding the stereocontrol of hindered carbonyl centers and was an important factor in the perfection of the Cram-Felkin-Anh (Nguyen) model.
Carbon-oxygen bond
A carbon-oxygen bond is a covalent bond between carbon and oxygen and one of the most abundant in organic chemistry and biochemistry . Oxygen has 6 valence electrons and prefers to share two electrons in bonding with carbon, leaving the remaining 4 nonbonding in 2 lone pairs. The simplest representatives can be thought of organic derivatives of water: the alcohols.
A CO bond is strongly polarized towards oxygen (Electronegativity C vs O = 2.55:3.44) and many alcohols are water soluble. Bond lengths for paraffinic C-O bonds are in the range of 143 picometer shorter than that of C-N or C-C bonds. Shortened single bonds are found with carboxylic acids (136 pm) due to partial double bond character and elongated bonds are found in epoxides (147 pm) . The CO bond strength is also larger compared to CN or CC for example that in methanol 91 kcal/mol (298 K) (87 in methyl amine and 88 in ethane)
Carbon and oxygen form terminal double bonds in functional groups collectively known as carbonyl compounds to which belong such compounds as ketones, esters and carboxylic acids and many more. Internal CO double bonds are found in positively charged Oxonium ions but mainly as reactive intermediates.  In furans, the oxygen atom contributes to pi-electron delocalization via its filled p-orbital and hence furans are aromatic.  Bond lengths of CO double bonds are around 123 pm in carbonyl compounds. The CO bond in acyl halides have a partial triple bond and subsequently very short: 117 pm. Compounds with formal CO triple bonds do not exist. The CO triple bond has also very high bond energy, even higher than NN triple bond.

# Chemistry
Important carbon oxygen bond forming reactions are Williamson ether synthesis, nucleophilic acyl substitutions and electrophilic addition to alkenes. The Paterno-Buchi reaction is the carbonyl equivalent of of a metathesis reaction.

# Oxygen functional groups
Carbon-oxygen bonds are present in these functional groups:
C3 carbon fixation
This reaction occurs in all plants as the first step of the Calvin cycle. In ] plants, carbon dioxide is drawn out of malate and into this reaction rather than directly from the air.
Plants that survive solely on Template:C3 fixation (Template:C3 plants) tend to thrive in areas where sunlight intensity is moderate, temperatures are moderate, carbon dioxide concentrations are around 200 ppm or higher, and ground water is plentiful. The Template:C3 plants, originating during Mesozoic and Paleozoic era, predate the ] plants and still represent approximately 95% of Earth's plant biomass.  Template:C3 plants lose 97% of the water taken up through their roots to transpiration.
The isotopic signature of Template:C3 plants shows higher degree of 13C depletion than the Template:C4 plants.
CAGE questionnaire

# Overview
The CAGE questionnaire, among other methods, has been extensively validated for use in identifying alcoholism. CAGE is considered a validated screening technique, with one study determining that it CAGE test scores >=2 had a sensitivity of 93% and a specificity of 76% for the identification of problem drinkers. . It is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE are frequently implemented for such a purpose.

# CAGE questionnaire
The CAGE questionnaire, named for its four questions, is a method to screen for Alcoholism.
Two "yes" responses indicate that the respondent should be investigated further.
The questionnaire asks the following questions:
- Have you ever felt you needed to Cut down on your drinking?
- Have people Annoyed you by criticizing your drinking?
- Have you ever felt Guilty about drinking?
- Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?
CHA2DS2-VASc Score

# Overview
The CHA2DS2-VASc score  predicts clinical risk of stroke and thromboembolism in atrial fibrillation. The CHA2DS2-VASc score has been recommended in the 2010 European Society of Cardiology (ESC) guidelines, which promotes a risk factor based approach to stroke prevention, and de-emphasises the artificial stratification into low/moderate/high risk, given the poor predictive value of these 3 categories. 
Indeed, the CHA2DS2-VASc score is more inclusive of 'stroke risk modifier' risk factors and has been validated in several large independent cohorts. Of note, the most recent validation study used nationwide data on 73,538 hospitalized non-anticoagulated patients with AF, whereby in low risk subjects (score=0), the rate of thromboembolism per 100 person-years was 1.67 (95%CI 1.47 to 1.89) with CHADS2 and 0.78 (0.58 to 1.04) with the CHA2DS2-VASc score, at 1 year follow-up  . Thus, those categorised as low risk using the CHA2DS2-VASc score were truly low risk for thromboembolism, and the CHA2DS2-VASc score performed better than CHADS2 in identifying these 'low risk' patients. The c-statistics at 10 years follow-up were 0.812 (0.796 to 0.827) with CHADS2 and 0.888 (0.875 to 0.900) with the CHA2DS2-VASc score, respectively - thus, the CHA2DS2-VASc score also performed better than CHADS2 in predicting high risk patients.  

# CHA2DS2-VASc Risk Score Calculator

## Calculation of the CHA2DS2-VASc Score for Atrial Fibrillation Stroke Risk
function calcScore(){
var score = 0;
if(document.forms.checked == 1){score += 2;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 2;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
if(document.forms.checked == 1){score += 1;}
document.forms.value = score;
if(score == 0){document.forms.value = "Low risk; No antithrombotic therapy (or Aspirin 75-325mg daily)";}
if(score == 1){document.forms.value = "Moderate risk; Oral anticoagulation";}
if(score >= 2){document.forms.value = "High risk; Oral anticoagulation";}

## Anticoagulation based on the CHA2DS2-VASc score
Patients with a CHA2DS2-VASc of two or more may benefit from chronic anticoagulation according to American Heart Association clinical practice guidelines. The following table shows treatment strategies are recommended in the table below based on the European Society of Cardiology guidelines:

## Assessment of Bleeding Risk with Anticoagulation
The decision to anticoagulate a patient should also be based upon an assessment of the risk of bleeding using a score such as the HAS-BLED score.

# 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation (DO NOT EDIT)

## Prevention of Thromboembolism
Mineral ascorbates
Mineral ascorbates are salts of ascorbic acid (aka vitamin C).  They are powders manufactured by reacting ascorbic acid with mineral carbonates in aqueous solutions, venting the carbon dioxide, drying the reaction product, and then milling the dried product to the desired particle size.
The choice of the mineral carbonates can be calcium carbonate, potassium carbonate, sodium bicarbonate, magnesium carbonate, or many other mineral forms. Ascorbates are highly reactive antioxidants used as food preservatives.
Ascorbate salts may be better tolerated than the corresponding weakly acidic ascorbic acid.
Examples of mineral ascorbates are:
- Sodium ascorbate (E301)
- Calcium ascorbate (E302)
- Potassium ascorbate (E303)
- Magnesium ascorbate
Calculator project

# Overview
Calculators are assessment tools based on evidence-based practice for a specific group of patients with a clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced. The use of calculators in hospitals and primary care settings have been proven to improve the quality of care to patients, reduce the cost of care and reduce the length of hospital stay. WikiDoc is proud to engage in such a project.

# Statement of Need
Health care has undergone rapid changes over the years. The world of medicine is rapidly evolving and there is the need of a tool to improve the quality of health care administered to patients with the aim of reducing the cost of health care, standardizing health care processes, reducing the occurrence of medical errors and optimizing the treatment outcomes both in the acute and home care settings. Risk scores are intended to assist health care provider to optimize the patient care.

# How Can WikiDoc Meet These Needs?
The WikiDoc team has come up with the 'calculator project' intended to solve these problems. The calculator project is focused on creating calculators for the risk assessment tools. With the use of calculators, a health care provider can rapidly determine the prognosis and treatment goals of a specific medical condition and institute appropriate actions based on the interpretation. This project is intended for interns, residents, attending physicians, hospitalists, specialists, nurses, nurse practitioners, and physician assistants to contribute their knowledge and clinical experience. This project aims at improving the quality of making diagnoses and treating medical conditions, reducing the variability in treatment, and to improve the overall quality of patient care. WikiDoc welcomes your involvement in contributing to this project.

# How Can You Help WikiDoc Meet These Needs?
Your participation as an Assistant Editor-in-Chief in this project is very important to us at WikiDoc. You are welcome to apply if you are an intern, resident, attending physician, specialist, nurse or a nurse practitioner. It is required of you to have a strong grasp of medical knowledge, and preferably, a prior residency training and experience in order to apply.

# Disclaimer
All information is provided for educational purposes only. The content provided herein is not intended to supplant but supplement clinical judgment.
Calea zacatechichi
Calea zacatechichi, also known as Dream Herb, Cheech, and Bitter Grass, is a plant used by the indigenous Chontal of the Mexican state of Oaxaca for oneiromancy (a form of divination based on dreams.) It has been scientifically demonstrated that extracts of this plant increase reaction times and the frequency and/or recollection of dreams versus placebo and diazepam. It is also employed by the Chontal people as a medicinal herb against gastrointestinal disorders, and is used as an appetizer, cathartic anti-dysentery remedy, and as a fever-reducing agent.

# Use
The Chontal medicine men, who assert that this plant is capable of "clarifying the senses", call it thle-pela-kano, meaning "leaf of God". Whenever they desire to know the cause of an illness or the location of a distant or lost person, dry leaves of the plant are smoked, drunk in infusions, and put under the pillow before going to sleep. Reportedly, the answer to the question comes in a dream.

## Preparation & Dosage
Crushed dried leaves are steeped in hot water, and the resulting tea is drunk slowly, after which the user lies down in a quiet place and smokes a cigarette of the dried leaves of the same plant. The human dose for divinatory purposes reported by the Chontal people is a handful of the dried plant. The user knows that he or she has taken a large enough dose when a sense of tranquility and drowsiness is experienced and when he or she hears the beats of his or her own heart and pulse. Calea is a rather bitter herb. Many users prefer to smoke it rather than drinking the tea. There are no reports of hangover or other undesirable side effects.2

# Cultivation
Growing Calea from seeds is a difficult task, the most common way to grow it is propagation from cuttings.
The Calea plant likes full sun, good drained soils and a lot of irrigation.
A good soil mix for calea cultivation is:
1/3 of a rich substrate, 1/3 vermiculite and 1/3 of humus.
Propagation from seeds can be tried with the following method:
Sow the seeds in a pot with the soil mix indicated as above.
Don't cover the seeds, moisten the seeds with water and cover with a plastic bag.
This little greenhouse needs from 4 to 6 hours of light to germinate.
If the seeds dry out during this period, the plants will not germinate.

# Law
Calea zacatechichi is an unscheduled substance in the United States, meaning that it is completely legal to grow and sell. However, Louisiana State Act 159 makes the substance illegal to grow, cultivate, harvest or sell in that state if intended for ingestion. The act applies to more than 40 types of plants. 
Tennessee proposed a bill that would have made many "hallucinogenic" plants, including Calea zacatechichi, illegal when "intended for human consumption," but the law was changed to only ban Salvia divinorum.
Corpus callosotomy

# Overview
Corpus callosotomy (or less frequently, callotomy) is a surgical procedure that disconnects the cerebral hemispheres, resulting in a condition called split-brain.
Most modern callosotomies involve only the anterior portion of the corpus callosum, reflecting the fact that the frontal and temporal lobes are the most commonly involved in the genesis of seizures.  The deficits from this modified procedure are milder; side-effects have not been found in some patients (although it is very unlikely that none exist).
The corpus callosum is usually severed in order to stop epileptic seizures. Once the corpus callosum is cut, the brain has much more difficulty sending messages between the hemispheres. Although the corpus callosum is the largest white-matter tract connecting the hemispheres, some limited interhemispheric communication is still possible via the anterior commissure and posterior commissure. This does not have any major effect in everyday circumstances, but, when tested in particular situations, it is obvious that information transfer between the hemispheres is reduced.
MR images of a patient s/p corpus callostomy
Camillian Hospital
Camillian Hospital (called also "San Camillo Hospital") - small private hospital in Bangkok (Thailand), founded by catholic missionaries - camillians. Located in Watthana district. There are general practice and special care facilities.
The hospital is operated by Saint Camillus Foundation of Thailand and has charity programs to treat poor and low income patients.
Camillian hospital employees took active part in overcoming of the 2004 tsunami damage in Thailand setting up mobile clinics for the disaster survivors.
White sponge nevus

# Overview
White sponge nevus, also known as Cannon's disease or Hereditary leukokeratosis of mucosa, appears to follow a hereditary pattern as an autosomal dominant trait. Although it is congenital in most cases, it can occur in childhood or adolescence.

# Pathophysiology
It is caused by a mutation of the keratin 4 and keratin 13 genes.

# Presentation
It presents in the mouth, most frequently as a thick bilateral white plaque with a spongy texture, usually on the buccal mucosa, but sometimes on the labial mucosa, alveolar ridge or floor of the mouth.  The gingival margin and dorsum of the tongue are almost never affected.
Although this condition is perfectly benign, it is often mistaken for leukoplakia.  There is no treatment, but because there are no serious clinical complications, the prognosis is excellent.

# Notes
-  McGowan KA, Fuchs H, Hrabe de Angelis M, Barsh GS (2007). "Identification of a Keratin 4 mutation in a chemically induced mouse mutant that models white sponge nevus". J. Invest. Dermatol. 127 (1): 604. doi:10.1038/sj.jid.5700498. PMID 16858417. Unknown parameter |month= ignored (help)CS1 maint: Multiple names: authors list (link) .mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
-  Terrinoni A, Rugg EL, Lane EB;  et al. (2001). "A novel mutation in the keratin 13 gene causing oral white sponge nevus". J. Dent. Res. 80 (3): 91923. PMID 11379896. Unknown parameter |month= ignored (help)CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
Cannon-Bard theory

# Overview
The Cannon-Bard theory is a psychological theory developed by psychologists Walter Cannon and Philip Bard, which suggests that people feel emotions first and then act upon them. These actions include changes in muscular tension, perspiration, etc. The theory was formulated following the introduction of the James-Lange theory of Emotion in the late 1800s, which alternately suggested that emotion is the result of one's perception of their reaction, or "bodily change."
The Cannon-Bard theory sparked much controversy in cognitive circles due to its suggestion that there is no mechanism to emotion, and many theorists attempted to provide explanations of emotion that suggested a mechanism. One such theory was provided by Schachter & Singer's Two factor theory of emotion, in which they posited that emotion is the cognitive interpretation of a physiological response. For many, this remains the best formulation of emotion.

# Example
I see a man outside my window. I am afraid. I begin to perspire.
The Cannon-Bard Theory of Emotion is based on the premise that one reacts to a specific stimulus and experiences the corresponding emotion simultaneously. Therefore, if one is afraid of heights and is travelling to the top of a skyscraper, they are likely to experience the emotion of fear. Subsequently, the perception of this emotion (fear) influences the person's reaction to the stimulus (heights). Cannon and Bard posited that one is able to react to a stimulus only after experiencing the related emotion.

# Model
STIMULUS (Bear) -->  EMOTION (Fear) -->  REACTION/RESPONSE (Run Away)
de:Cannon-Bard-Theorie
nl:Cannon-Bard theorie