Persius/hicric huggingface dataset:
Myelophthisis
Synonyms and keywords: Myelophthisic anemia

# Overview
Myelophthisis refers to the displacement of hemopoietic bone-marrow tissue into the peripheral blood, either by fibrosis (myelofibrosis), tumors, or granulomas.  A myelophthisic blood smear is one which contains nucleated red blood cells, granulocyte precursors, and teardrop-shaped erythrocytes. This condition is also known as Myelophthisic anemia.  Myelophthisis can be observed in cancers that that involve the bone marrow such as leukemia, lymphoma, and myeloma or metastatic carcinoma. The commonest cause is metastatic cancer, most often carcinomas arising in breast, lung and prostate.However any infiltrative process (e.g.,granulomatous disease) involving the marrow can produce identical findings.It should be remembered that it is also a feature of spent phase of myeloproliferative disorders.They cause marrow distortion and fibrosis which act to displace normal marrow elements and disturb mechanisms that regulate the egress of red cells and granulocytes from the marrow.

# Historical Perspective

# Classification

# Pathophysiology
Myelophthisis is thought to be caused by damage to the normal hematopoietic stem cells, which leads to the release of cytokines, growth factors and other substance. Immature cells, stem cells and progenitor cells are thus released and relocate in the spleen and the liver .

# Causes
- Fibrosis (myelofibrosis)
- Metastatic carcinoma
- Lymphoma
- Granuloma
- Tuberculosis
- Gaucher disease

# Differentiating Myelophthisis from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

## Natural History

## Complications
The complications are related to pancytopenia including  anemia and its complications , infections and the bleeding tendency in addition to the hypersplenism which leads to refractory thrombocytopenia and portal hypertension.

## Prognosis
The prognosis of Myelophthisis depends on treating the etiology

# Diagnosis

## Diagnostic Criteria

## History and Symptoms
patients usually complain of symptoms of palpitations , fatigue , dyspnea and weakness .

## Physical Examination

## Laboratory Findings
Peripheral blood picture will show :
- normocytic normochromic anemia .
- Increased RBCs count.
- leukoerthroblasts
- Abnormally shaped RBCs.
- Bone marrow is often confirmatory ; will likely show dry tap due to the replacement of normal cells by fibrosis and abnormal cells which will aid in the diagnosis of the underlying etiology .

## Imaging Findings

## Other Diagnostic Studies

# Treatment
Treatment of Myelophthisis depends on treating the underlying cause.

## Medical Therapy

## Surgery

## Prevention
Myotendinosis
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# Overview

# Epidemiology and Demographics

# Risk Factors

# Screening

# Pathophysiology & Etiology

# Molecular Biology

# Genetics

# Natural History and Complications

# Diagnosis

## Common Causes

## Complete Differential Diagnosis of the Causes of ...
(In alphabetical order)
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Make sure that each diagnosis is linked to a page.

## Complete Differential Diagnosis of the Causes of ...
(By organ system)

## History and Symptoms

## Physical Examination

### Appearance of the Patient

### Vital Signs

### Skin

### Eyes

### Ear Nose and Throat

### Heart

### Lungs

### Abdomen

### Extremities

### Neurologic

### Other

## Laboratory Findings

### Electrolyte and Biomarker Studies

### Electrocardiogram

### Chest X Ray

### MRI and CT

### Echocardiography or Ultrasound

### Other Imaging Findings

## Pathology

### Gross Pathology

### Microscopic Pathology

## Other Diagnostic Studies

# Risk Stratification and Prognosis

# Treatment

## Pharmacotherapy

### Acute Pharmacotherapies

### Chronic Pharmacotherapies

## Surgery and Device Based Therapy

### Indications for Surgery

### Pre-Operative Assessment

### Post-Operative Management

### Transplantation

## Primary Prevention

## Secondary Prevention

## Cost-Effectiveness of Therapy

## Future or Investigational Therapies

# "The Way I Like To Do It ..." Tips and Tricks From Clinicians Around The World

## Suggested Revisions to the Current Guidelines
Naftidrofuryl

# Overview
Naftidrofuryl (INN, also known as nafronyl or as the oxalate salt naftidrofuryl oxalate or nafronyl oxalate) is a drug used in the management of peripheral and cerebral vascular disorders. It is claimed to enhance cellular oxidative capacity and to be a spasmolytic. It may also be a  5-HT2 receptor antagonist. It is also licenced for the treatment of intermittent claudication due to peripheral arterial disease.
It is sold under the brand name Dusodril (Merck) and cerebromap for multiapex in middle east. It is also sold as Praxilene in the United Kingdom.
Historically, it has been used to treat sudden idiopathic hearing loss and acute tinnitus.
Naftidrofuryl may be effective for relieving the pain of muscle cramps.
Native copper
Copper, as native copper, is one of the few metallic elements to occur in uncombined form as a natural mineral, although most commonly occurs in oxidized states and mixed with other elements. Native copper was an important ore of copper in historic times and was used by pre-historic peoples.
Native copper occurs as rarely isometric cubic and octahedral crystals, but more typically as irregular masses and fracture fillings. It is a copper-red color on fresh surfaces, but typically is weathered and coated with a green tarnish of copper(II) carbonate. Its specific gravity is 8.9 and the hardness is 2.5.
The mines of the Keweenaw native copper deposits of Upper Michigan were major copper producers in the 19th and early 20th centuries, and are the largest deposits of native copper in the world.  Native Americans mined copper on a small scale, and evidence exists of copper trading routes throughout North America among native peoples, proven by isotopic analysis.  The first commercial mines in the Keweenaw Peninsula (which is nicknamed the "Copper Country") opened in the 1840s.  Isle Royale in western Lake Superior, was also a site of many tons of native copper.  Some of it was extracted by native peoples, but only one of several commercial attempts at mining turned a profit there.
Another major native copper deposit is in Corocoro, Bolivia.
The name copper comes from the Greek kyprios, of Cyprus, the location of copper mines since pre-historic times.
Naxos disease

# Overview
Naxos disease is an autosomal recessive variant of ARVD, described initially on the Greek island of Naxos.  There, the penetrance is >90%.
It involves the gene that codes for plakoglobin (a protein that is involved in cellular adhesion), on chromosome 17p.
Naxos disease is described as a triad of ARVD, palmoplantar keratosis, and wooly hair.
The signs of Naxos disease are more severe than with autosomal dominant ARVD.
Nepetalactone
Nepetalactone is a lactone chemical compound first isolated in the plant catnip, Nepeta cataria (apparently named after the Italian town of Nepete).  It was first isolated in 1941 using steam distillation.
Nepetalactone's structure is two rings  a cyclopentane and a cyclic ester, making a terpenoid. Its empirical formula is C10H14O2. The structure and the effect of the compound is similar to valepotriates. There are a number of isomers of nepetalactone.
As 4a,7,7a-nepetalactone it is the active chemical in Nepeta cataria that causes its characteristic effect on cats. Around 75% of cats are affected; susceptibility is gene-linked. The chemical interacts as a vapour at the olfactory epithelium.
In humans, the compound has a number of very mild effects; it is a weak sedative, antispasmodic, febrifuge and antibacterial. In high doses it also has an emetic effect.
It also has an effect on some insects, repelling the cockroach and mosquito, poisonous to some common flies, but a sex pheromone to aphids.
S-100 protein
S-100 protein is a type of low molecular weight protein found in vertebrates characterized by two calcium binding sites of the helix-loop-helix ("EF-hand type") conformation. There are at least 21 different types of S100 proteins. The name is derived from the fact that the protein is 100% Soluble in ammonium sulfate at neutral pH.

# Structure
Most S100 proteins are homodimeric, consisting of two identical polypeptides held together by non-covalent bonds. Although S100 proteins are structurally similar to calmodulin, they differ in that they are cell-specific, expressed in particular cells at different levels depending on environmental factors. To contrast, calmodulin is a ubiquitous and universal intracellular Ca++ receptor widely expressed in many cells.

# Normal function
S-100 is normally present in cells derived from the neural crest (Schwann cells, melanocytes, and glial cells), chondrocytes, adipocytes, myoepithelial cells, macrophages, Langerhans cells, dendritic cells, and keratinocytes.  It may be present in some breast epithelial cells.
S100 proteins have been implicated in a variety of intracellular and extracellular functions. S100 proteins are involved in regulation of protein phosphorylation, transcription factors, Ca++ homeostasis, the dynamics of cytoskeleton constituents, enzyme activities, cell growth and differentiation, and the inflammatory response.

# Pathology
Several members of the S-100 protein family are useful as markers for certain tumors and epidermal differentiation.  It can be found in melanomas, 50% of malignant peripheral nerve sheath tumors, and clear cell sarcomas.
S100 proteins have been used in the lab as cell markers for anatomic pathology.
Neurotoxicity

# Overview
Neurotoxicity occurs when the exposure to natural or manmade toxic substances, which are called neurotoxins, alters the normal activity of the nervous system. This can eventually disrupt or even kill neurons, key cells that transmit and process signals in the brain and other parts of the nervous system. Neurotoxicity can result from exposure to substances used in chemotherapy, radiation treatment, drug therapies and organ transplants, as well as exposure to heavy metals such as lead and mercury, certain foods and food additives, pesticides, industrial and/or cleaning solvents, cosmetics, and some naturally occurring substances. Symptoms may appear immediately after exposure or be delayed. They may include limb weakness or numbness, loss of memory, vision, and/or intellect, headache, cognitive and behavioral problems and sexual dysfunction. Individuals with certain disorders may be especially vulnerable to neurotoxins.
The name implies the role of a neurotoxin although the term 'neurotoxic' may be used more loosely to describe states that are known to cause physical brain damage but where no obvious neurotoxin has been identified.
The term neurotoxic is used to describe a substance, condition or state that damages the nervous system and/or brain, usually by killing neurons. The term is generally used to describe a condition or substance that has been shown to result in observable physical damage. The presence of neurocognitive deficits alone is not usually considered sufficient evidence of neurotoxicity, as many substances exist which may impair neurocognitive performance without resulting in the death of neurons. This may be due to the direct action of the substance, with the impairment and neurocognitive deficits being temporary, and resolving when the substance is metabolised from the body. In some cases the level or exposure-time may be critical, with some substances only becoming neurotoxic in certain doses or time periods.

## Causes

## Drug Causes
- Amikacin sulfate
- Fludarabine
- Fluorouracil
- Cladribine
- Cytarabine
- Cytarabine liposome
- Isoniazid
- Nelarabine
- Procarbazine
- Sodium phenylbutyrate

# Prognosis
The prognosis depends upon the length and degree of exposure and the severity of neurological injury. In some instances, exposure to neurotoxins can be fatal. In others, patients may survive but not fully recover. In other situations, many individuals recover completely after treatment.
Neutral spine
A Neutral Spine or "good posture" refers to the "three natural curves  are present in a healthy spine."

# Posture
The word "posture" comes from the Latin verb "ponere" which is defined as "to put or place."  The general concept of human posture refers to "the carriage of the body as a whole, the attitude of the body, or the position of the limbs (the arms and legs)."   
Good posture is the stance which is attained, "when the joints are not bent and the spine is aligned and not twisted."In this position, a person is thus able to completely and optimally attain balance and proportion of the body mass and framework. Good posture optimizes breathing and affects the circulation of bodily fluids. Padmasana or the Lotus Position is a central stance in yoga which is used to enhance breathing through good posture. The word padmasana is a combination of the sanskrit words padma (lotus) and asana (posture). 

# Neutral spine
In medicine and occupations concerned with physical fitness, the concept of good posture is referred to as "Neutral Spine."  In this context, proper posture or "Neutral Spine,"
In contrast, a non-neutral spine leads to "improper posture,  especially when walking, puts increased stress on your back and causes discomfort and damage." A non-neutral spine develops as the result of a person's lifestyle. People who sit for long hours on the job are susceptible to a number of misalignments."
"Neutral Spine" is ideally maintained while sitting, standing, and sleeping.
Nitrenium ion
A nitrenium ion (also called: aminylium ion) in organic chemistry is a reactive intermediate based on nitrogen with both an electron lone pair and a positive charge and with two substituents (R2N+) . The compound can have both a singlet and a triplet state.
Aryl nitrenium ions are currently investigated because of their involvement in certain DNA damaging processes. These intermediates can have microsecond or longer lifetimes in water .
Nitrenium ions are also intermediates in organic reactions for instance the Bamberger rearrangement. They can also act as electrophiles in electrophilic aromatic substitution .
The term imidonium ion with the same meaning is now obsolete.
Nitrification
Nitrification is the biological oxidation of ammonia with oxygen into nitrite followed by the oxidation of these nitrites into nitrates. Nitrification is an important step in the nitrogen cycle in soil. This process was discovered by the Russian microbiologist, Sergei Winogradsky.
The oxidation of ammonia into nitrite, and the subsequent oxidation to nitrate is performed by two different bacteria (nitrifying bacteria). The first step is done by bacteria of (amongst others) the genus Nitrosomonas and Nitrosococcus. The second step (oxidation of nitrite into nitrate) is (mainly) done by bacteria of the genus Nitrobacter, with both steps producing energy to be coupled to ATP synthesis.  Nitrifying organisms are chemoautotrophs, and use carbon dioxide as their carbon source for growth.
Nitrification also plays an important role in the removal of nitrogen from municipal wastewater. The conventional removal is nitrification, followed by denitrification. The cost of this process resides mainly in aeration (bringing oxygen in the reactor) and the addition of an external carbon source (e.g. methanol) for the denitrification.
In most environments both organisms are found together, yielding nitrate as the final product. It is possible however to design systems in which selectively nitrite is formed (the Sharon process).
Together with ammonification, nitrification forms a mineralization process which refers to the complete decomposition of organic material, with the release of available nitrogen compounds. This replenishes the nitrogen cycle.

# Chemistry
Nitrification is a process of nitrogen compound oxidation (effectively, loss of electrons from the nitrogen atom to the oxygen atoms) :
- NH3 + O2  NO2 + 3H+ + 2e
- NO2 + H2O  NO3 + 2H+ + 2e
Nitrosylation
Nitrosylation is a protein modification, in which a nitrosyl group is post-translationally added to a protein.
There are a range of enzymes that produce nitric oxide, and the frequent consequence of this production is nitrosylation.
S-nitrosylation is a biologically important reaction of nitric oxide; it refers to the conversion of thiol groups, including cysteine residues in proteins, to form S-nitrosothiols (RSNOs). S-Nitrosylation is a mechanism for dynamic, post-translational regulation of most or all major classes of protein.
Norman Holter
Holter graduated from the University of California at Los Angeles in 1937. He then earned Master's degrees in chemistry and physics, and continued his education by completing postgraduate work at the University of Heidelberg (Germany), the University
-f Chicago, the Oak Ridge Institute of Nuclear Studies, and the University of Oregon Medical School. During World War II, Holter served as senior physicist in the U.S. Navy, studying the characteristics of waves. In 1946, he headed a government research team involved in
the atomic-bomb testing at Bikini Atoll. After the war, he continued work with the United States Atomic Energy Commission, and served as president of the Society of Nuclear Medicine from 1955-1956. In 1964, he became a full professor at the University of California in San Diego, coordinating activities at the Institute of Geophysics and Planetary Physics. In 1979, the Association for the Advancement of Medical Instrumentation (AAMI) awarded Holter with the AAMI Foundation Laufman-Greatbatch Prize for his contributions to medical technology.
Holter was the son and grandson, respectively, of Montana pioneers Norman B. Holter and Anton M. Holter. Numerous landmarks in and around Helena, Montana bear his family's name.
de:Norman J. Holter
Northern blot
The northern blot is a technique used in molecular biology research to study gene expression. It takes its name from the similarity of the procedure to the Southern blot procedure, named for biologist Edwin Southern, used to study DNA, with the key difference that, in the northern blot, RNA, rather than DNA, is the substance being analyzed by electrophoresis and detection with a hybridization probe. This technique was developed in 1977 by James Alwine, David Kemp, and George Stark at Stanford University.
The gels may be run on either agarose or denaturing polyacrylamide gels depending on the size of the RNA to be detected. A notable difference in the procedure in case of agarose gels, (as compared with the Southern blot) is the addition of formaldehyde  which acts as a denaturant. For smaller fragments denaturing polyacrylamide urea gels are employed.
As in the Southern blot, the hybridization probe may be made from DNA or RNA.
A variant of the procedure known as the reverse northern blot was occasionally (although, infrequently) used.  In this procedure, the substrate nucleic acid (that is affixed to the membrane) is a collection of isolated DNA fragments, and the probe is RNA extracted from a tissue and radioactively labelled.
The use of DNA microarrays that have come into widespread use in the late 1990s and early 2000s is more akin to the reverse procedure, in that they involve the use of isolated DNA fragments affixed to a substrate, and hybridization with a probe made from cellular RNA.  Thus the reverse procedure, though originally uncommon, enabled the one-at-a-time study of gene expression using northern analysis to evolve into gene expression profiling, in which many (possibly all) of the genes in an organism may have their expression monitored.
Nutrification
Enriching or fortifying foods with nutrients is called nutrification. Food enrichment is the restoration of the natural nutritive value of a food before it was processed, while fortification is the adding of vitamins or minerals to a food at levels higher than it originally possessed, though "fortification" is commonly used to refer to both processes.
Functional foods, designer foods, and techno-foods, are foods that are manufactured by food companies in collaboration with sellers of dietary supplements, in order to produce products that they can promote as healthy.  Techno-foods refer to foods and beverages that have been fortified in some way to confer health benefits beyond the original nutritional value of the foods themselves.
Initially, fortification was used as a public health strategy in the United States to eradicate vitamin and mineral deficiencies. For example, through the addition of iodine to table salt, goiter, a thyroid gland dysfunction, is now very uncommon.  Other examples include the addition of vitamin D to milk and fluoride to tap water.
As a public health measure, fortification has been very successful, though there are concerns that the consumer must consciously desire and be involved in nutritional change With fortification came the interweaving of science and commercial issues..  As with drugs, the benefits of nutrients are dose dependent, and eating too much of them can cause adverse effects .  Yet, fortification is used regularly as a marketing strategy, so that now most processed foods are fortified in some way.  Continued proliferation of this practice raises the concern that fortification will become too much of a good thing, where nutrient content in food in general may eventually increase to levels detrimental to the population.
Economic issues pertaining to food fortification have also emerged.  The wealthy, who may already eat enough nutrients, may be consuming more than they need when they purchase fortified products, while those in most need of the added nutrients may not be able to afford to buy enough fortified foods.
Oil of guaiac
Oil of guaiac is a fragrance used in soap. It comes from the palo santo tree (Bulnesia sarmientoi).
Oil of guaiac is produced through steam distillation of a mixture of wood and sawdust from palo santo.  It is sometimes incorrectly called guaiac wood concrete.  It is a yellow to greenish yellow semi-solid mass which melts around 40-50o C.  Once melted, it can be cooled back to room temperature yet remain liquid for a long time.  Oil of guaiac has a soft roselike odour, similar to the odour of Hybrid tea roses or violets.  Because of this similarity, it has sometimes been used as an adulterant for rose oil.
Oil of guaiac is primarily composed of 42-72% guaiol, bulnesol, d-bulnesene, b-bulnesene, a-guaiene, guaioxide and b-patchoulene. It is considered non-irritating, non-sensitizing, and non phototoxic to human skin.
Oil of guaiac was also a pre-Renaissance remedy to syphilis.
Olfactory pit
By the upgrowth of the surrounding parts the olfactory areas are converted into pits, the olfactory pits, which indent the fronto-nasal process and divide it into a medial and two lateral nasal processes.

# Additional images
- Head end of human embryo of about thirty to thirty-one days.
- Same embryo as shown in Fig. 45, with front wall of pharynx removed.
- The roof of the mouth of a human embryo, aged about two and a half months, showing the mode of formation of the palate.
- The head and neck of a human embryo thirty-two days old, seen from the ventral surface.