Persius/hicric huggingface dataset:
Sandbox: Maria12
Synonyms and keywords: Synonym 1; Synonym 2; Synonym 3

# Overview
Lymphadenopathy ( in Greek, adenas ("gland") and  patheia ("act of suffering" or "disease") ) refers to lymph nodes which are abnormal in size, number or consistency  and is often used as a synonym for swollen or enlarged lymph nodes.  Common causes of lymphadenopathy are infection, autoimmune disease, or malignancy.

# Classification
-  may be classified according to  into  subtypes/groups:
- Other variants of  include , , and .

# Pathophysiology
- The pathogenesis of  is characterized by , , and .
- The  gene/Mutation in  has been associated with the development of , involving the  pathway.
- On gross pathology, , , and  are characteristic findings of .
- On microscopic histopathological analysis, , , and  are characteristic findings of .

# Causes
-  may be caused by either , , or .
-  is caused by a mutation in the , , or  gene.
- There are no established causes for .

# Differentiating  from other Diseases
-  must be differentiated from other diseases that cause , , and , such as:

# Risk Factors
- Common risk factors in the development of  are , , , and .

# Diagnosis

## Diagnostic Criteria
- The diagnosis of  is made when at least  of the following  diagnostic criteria are met:

## Symptoms
-  is usually asymptomatic.
- Symptoms of  may include the following:

## Physical Examination
- Patients with  usually appear .
- Physical examination may be remarkable for:

## Laboratory Findings
- There are no specific laboratory findings associated with .
- A    is diagnostic of .
- An  concentration of   is diagnostic of .
- Other laboratory findings consistent with the diagnosis of  include , , and .

## Imaging Findings
- There are no  findings associated with .
-  is the imaging modality of choice for .
- On ,  is characterized by , , and .
-  may demonstrate , , and .

## Other Diagnostic Studies
-  may also be diagnosed using .
- Findings on  include , , and .

# Treatment

## Medical Therapy

## Surgery
Sandbox: mahda22

# Overview

# Epidemiology and Demographics

## Incidence
- The incidence/prevalence of  is approximately  per 100,000 individuals worldwide.
- In , the incidence/prevalence of  was estimated to be  cases per 100,000 individuals worldwide.

## Prevalence
- The incidence/prevalence of  is approximately  per 100,000 individuals worldwide.
- In , the incidence/prevalence of  was estimated to be  cases per 100,000 individuals worldwide.
- The prevalence of  is estimated to be  cases annually.

## Case-fatality rate/Mortality rate
- In , the incidence of  is approximately  per 100,000 individuals with a case-fatality rate/mortality rate of %.
- The case-fatality rate/mortality rate of  is approximately .

## Age
- Patients of all age groups may develop .
- The incidence of  increases with age; the median age at diagnosis is  years.
-  commonly affects individuals younger than/older than  years of age.
-  is usually first diagnosed among .
-  commonly affects .

## Race
- There is no racial predilection to .
-  usually affects individuals of the  race.  individuals are less likely to develop .

## Gender
-  affects men and women equally.
-  are more commonly affected by  than . The  to  ratio is approximately  to 1.

## Region
- The majority of  cases are reported in .
-  is a common/rare disease that tends to affect  and .

## Developed Countries

## Developing Countries

# References
Category:
- (name of the system)
Sandbox: staging

# Rai Staging System
According to the Rai Staging System, there are five stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, hemoglobin level, platelets level, the presence of splenomegaly, and the presence of lymphadenopathy.

# Binet Staging System
According to the Binet Staging System, there are three stages of chronic lymphocytic leukemia based on the degree of lymphocytosis, the presence of anemia or thrombocytopenia, and the involvement of three or more lymph node regions.
-  Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS (1975). "Clinical staging of chronic lymphocytic leukemia". Blood. 46 (2): 21934. PMID 1139039.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}
-  Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J;  et al. (1981). "A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis". Cancer. 48 (1): 198206. PMID 7237385.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
Sandbox:haytham1

# Immunochemotherapeutic regimens for the management of patients without chromosome 17p deletion or chromosome 11q deletion

## First line therapy
- Patients older than 70 years of age with poor performance status:
- Obinutuzumab AND chlorambucil
- Rituximab AND chlorambucil
- Bendamustine AND rituximab
- Cyclophosphamide AND predinisone  retixumab
- Retixumab
- Fludarabinec  retixumab
- Cladrabine
- Chlorambucil
- Fludarabine AND cyclophosphamide AND rituximab
- Fludarabine AND rituximab
- Bendamustine  rituximab
- Obinutuzumab AND chlorambucil
- Patients younger than 70 years of age with good status performance status:
- Fludarabine AND cyclophosphamide AND rituximab
- Fludarabine, rituximab
- pentostatin, cyclophosphamide, rituximab
- Bendamustine  rituximab
- Obinutuzumab + chlorambucil

## Refactory/recurrent therapy
Bendamustine + Rituximab
Chlorambucil
Chlorambucil + PredniSONE
Cladribine
Cyclophosphamide/PredniSONE
Cyclophosphamide/PredniSONE + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
Fludarabine
FR (Fludarabine + Rituximab)
MethylPREDNISolone (Pulse)
PCR (Pentostatin/Cyclophosphamide + Rituximab)
Rituximab

# Immunochemotherapeutic regimens for the management of patients with chromosome 17p deletion
Alemtuzumab + Rituximab
Bendamustine + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
FR (Fludarabine + Rituximab)
HDMP (High-Dose Methylprednisolone) + Rituximab

# Immunochemotherapeutic regimens for management of patients with chromosome 11q deletion
Bendamustine + Rituximab
Chlorambucil
Chlorambucil + PredniSONE
Cyclophosphamide/PredniSONE
Cyclophosphamide/PredniSONE + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
PCR (Pentostatin/Cyclophosphamide + Rituximab)
Reduced-dose FCR (Fludarabine/Cyclophosphamide + Rituximab)
Rituximab
Sandbox:surgery1
- Surgical intervention alone may be curative as a single therapeutic modality for the management of low risk neuroblastoma patients.
- Surgical intervention must be followed by chemotherapy for the management of intermediate risk neuroblastoma patients.
- The potential benefit of aggressive surgical approaches in high-risk patients with metastatic disease to achieve complete tumor resectionhas not been unequivocally demonstrated.
- Surgical complications following neuroblastoma resection may include:
- Intussusception
- Internal haemorrhage due to vessel injuries
-  Neuroblastoma treatmentfor health professionals. National Cancer Institute (2015) #section/_1 Accessed on October, 8 2015
-  Neuroblastomas. Patient (2015)  Accessed on October, 11 2015
Sandbox 1 mobile
For the desktop/tablet version, click here

# Overview
Wide complex tachycardia is characterized by a heart rate more than 100 beats per minute associated with a QRS interval of more than 120 ms.  When wide complex tachycardia is present, it is important to determine whether the tachycardia is of a supraventricular or a ventricular origin.

# Causes

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.  Wide complex tachycardia may be a life-threatening condition and must be treated as such irrespective of the causes.

## Common Causes
- Atrial fibrillation with aberrancy
- Atrial fibrillation with pre-excitation
- Supraventricular tachycardia (SVT) with aberrancy
- Ventricular tachycardia

# Diagnosis
Shown below is an algorithm depicting the diagnostic approach to wide complex tachycardia according to the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias and the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.

# Treatment
Shown below is an algorithm depicting the therapeutic approach of wide complex tachycardia according to the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias and the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.
ABC: Air, breathing and circulation; Afib: Atrial fibrillation; BBB: Bundle branch block; LV: Left ventricle; SVT: Supraventricular tachycardia; VT: Ventricular tachycardia; WPW: Wold Parkinson White

## Differentiating SVT from VT
Shown below is a table summarizing some clues that help differentiate SVT from VT.
For more details about differentiating VT from SVT, click here

## Antiarrhythmics
Shown below is a table summarizing the choices of the antiarrhythmic drugs for the different types of tachycardia according to the 2003 ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias.
BBB: Bundle branch block; LV: Left ventricle; SVT: Supraventricular tachycardia

# Do's
- Refer the patient to an arrhythmia specialist when the tachycardia causes syncope or dyspnea as well as when the wide complex tachycardia is of unknown cause.
- Place an ambulatory 24 hour Holter when the tachycardia is frequent and transient.
- Treat the patient as having a ventricular tachycardia when the diagnosis of supraventricular tachycardia can not be made.
- Suspect ventricular tachycardia in a patient with wide complex tachycardia and previous myocardial infarction or a history of structural heart disease.
- Use beta blockers with caution in pulmonary diseases or congestive heart failure.

# Dont's
- Don't rely on the hemodynamic status of the patient and the heart rate to differenciate SVT from VT.
Sandbox delirium

# Definition
According to National Institute of Health:
The Subtypes of Delirium:
- Hyperactive delirium: a subtype of delirium characterised by people who have high arousability and can be restless, agitated or aggressive.
- Hypoactive delirium: a subtype of delirium characterised by people who are withdrawn, quiet and sleepy.

# Causes

## Life Threatening Causes

## Common Causes

## Prognosis

# Management

# Do's
- Behavioral Pain Scale and the Critical Care Pain Observation Tool are currently the best available methods for assessing pain.

# Don'ts
Sartorius muscle

# Overview
The sartorius muscle is a long thin muscle that runs down the length of the thigh. It is the longest muscle in the human body. Its upper portion forms the lateral border of the femoral triangle.

# Origin and insertion
The sartorius muscle arises by tendinous fibres from the anterior superior iliac spine, running obliquely across the upper and anterior part of the thigh in an inferomedial direction.
It descends as far as the medial side of the knee, passing behind the medial condyle of the femur to end in a tendon.
This tendon curves anteriorly to join the tendons of the gracilis and semitendinous muscles which together form the pes anserinus, finally inserting into the proximal part of the tibia on the medial surface of its body.

# Etymology
The name sartorius is the Latin word for "sartorial" (i.e. "to do with tailoring", in turn from sartor i.e. "tailor", in turn from sartus i.e. "patched" or "repaired", in turn from sarcio i.e. "to patch", "to repair").
This name was chosen in reference to the cross-legged position in which tailors once sat.

# Actions
Assists in flexion, abduction and lateral rotation of hip, and flexion and medial rotation of knee.  Looking at the bottom of your foot, like you are checking to see if you stepped in dog poop, demonstrates all 5 actions of sartorius.

# Innervation
Situated in the anterior fascial compartment of the thigh, sartorius is innervated via branches of the femoral nerve.

# Variations
Slips of origin from the outer end of the inguinal ligament, the notch of the ilium, the ilio-pectineal line or the pubis occur.
The muscle may be split into two parts, and one part may be inserted into the fascia lata, the femur, the ligament of the patella or the tendon of the Semitendinosus.
The tendon of insertion may end in the fascia lata, the capsule of the knee-joint, or the fascia of the leg.
The muscle may be absent.

# Common Injuries of the Sartorius Muscle
Overextension of the hip may cause a strain of the muscle at its attachment point (the iliac crest).

# Additional images
- Bones of the right leg. Anterior surface.
- Structures surrounding right hip-joint.
- Muscles of the iliac and anterior femoral regions.
- Cross-section through the middle of the thigh.
- Muscles of the gluteal and posterior femoral regions.
- Femoral sheath laid open to show its three compartments.
- The left femoral triangle.
- The lumbar plexus and its branches.
- Front and medial aspect of right thigh.
Scalar (physics)
In physics, a scalar is a simple physical quantity that is not changed by coordinate system rotations or translations (in Newtonian mechanics), or by Lorentz transformations or space-time translations (in relativity). (Contrast to vector.)

# Examples
For example, the distance between two points in space is a scalar, as are the mass, charge, and kinetic energy of an object, or the temperature and electric potential at a point inside a medium. On the other hand, the electric field at a point is not a scalar in this sense, since to specify it one must give three real numbers that depend on the coordinate system chosen.  The speed of an object is a scalar (e.g. 180 km/h), while its velocity is not (i.e. 180 km/h north).  The gravitational force acting on a particle is not a scalar, but its magnitude is.
Examples of scalar quantities in Newtonian mechanics:
- electric charge and charge density
- mass and mass density
- speed, but not velocity or momentum
- temperature
- energy and energy density
- time
- pressure
- entropy
- negentropy
A physical quantity is expressed as the product  of a numerical value and a physical unit, not just a number. It does not depend on the unit distance (1 km is the same as 1000 m), although the number depends on the unit. Thus distance does not depend on the length of the base vectors of the coordinate system. Also, other changes of the coordinate system may affect the formula for computing the scalar (for example, the Euclidean formula for distance in terms of coordinates relies on the basis being orthonormal), but not the scalar itself. In this sense, physical distance deviates from the definition of metric in not being just a real number; however it satisfies all other properties. The same applies for other physical quantities which are not dimensionless.

# Scalars in relativity theory
In the theory of relativity, one considers changes of coordinate systems that trade space for time.  As a consequence, several physical quantities that are scalars in "classical" (non-relativistic) physics need to be combined with other quantities and treated as four-dimensional vectors or tensors.  For example, the charge density at a point in a medium, which is a scalar in classical physics, must be combined with the local current density (a 3-vector) to comprise a relativistic 4-vector.  Similarly, energy density must be combined with momentum density and pressure into the stress-energy tensor.
Examples of scalar quantities in relativity:
- electric charge
- spacetime interval (e.g., proper time and proper length)
- invariant mass
A related concept is a pseudoscalar, which is invariant under proper rotations but (like a pseudovector) flips sign under improper rotations. One example is the scalar triple product (see vector), and thus the signed volume. Another example is magnetic charge (as it is mathematically defined, regardless of whether it actually exists physically).
Schuffner's dots
Schuffner's dots refers to a hematological finding that is associated with malaria, specifically Plasmodium ovale and Plasmodium vivax.
Plasmodium vivax induces morphologic alterations in infected host erythrocytes that are visible by light microscopy in Romanovsky-stained blood smears as multiple brick-red dots. These morphologic changes, referred to as Schuffner's dots, are important in the identification of this species of malarial parasite and have been associated by electron microscopy with caveolavesicle complexes along the erythrocyte plasmalemma.
They are named for Wilhelm Schuffner, who described them in 1904.
Secondary palate

# Overview
The secondary palate is an anatomical structure that divides the nasal cavity from the oral cavity in many vertebrates.
In human embryology, it refers to that portion of the hard palate that is formed by the growth of the two palatine shelves medially and their mutual fusion in the midline. It forms the majority of the adult palate and meets the primary palate at the incisive foramen. Secondary palate development begins in the sixth week of pregnancy and can lead to cleft palate when it goes awry.
There are three major mechanisms known to cause this failure:
- Growth retardation - Palatal shelves do not grow enough to meet each other.
- Mechanical obstruction - Improper mouth size, or abnormal anatomical structures in the embryonic mouth prevent fully grown shelves from meeting each other.
- Midline epithelial dysfunction (MED) - The surface mucosa of embryonic shelves is impaired, which causes a failure of palatal fusion.
Senna acutifolia
Senna acutifolia (Alexandrian senna, AKA Egyptian Senna, Sene de la palthe, Tinnevelly Senna, East Indian Senna) is an ornamental  plant in the genus Senna.
Alexandrian senna is a shrubby plant reaches two meters in height with branched pale stems. it grows natively in upper Egypt, especially in the nuba region, and near Khartoum, Sudan, where it is cultivated for commercial purposes. It is also cultivated in India and Somalia.
It was named "Alexandrian senna" because Alexandria was the main trade port in past times. The fruits and leafs were transported from Nubia and Sudan and other places to Alexandria then from it and across the Mediterranean sea to Europe and adjacent Asia.
The leafs are complex feathery mutual pairs. the leaflets are varying from 4 to 6 pairs of mutual fully edged, with a sharp top. the midribs are equally divided at the base of the leaflets.
The flowers are in a raceme interior blossoms, big in size, yellow coloured that tends to brown. its fruit are horned compressed and flat.
Senna glycosides

# Overview
Senna glycosides or sennosides are medications which are used as laxatives. Senna derivatives act on the large intestine, or colon, to stimulate fluid secretion and contractions of the colonic wall known as peristalsis.
It is on the World Health Organization's List of Essential Medicines, the most important medications needed in a basic health system. They are named after plants of the genus Senna.

# Medical uses
Senna is used for the short-term treatment of symptomatic constipation.  It may also be used to aide in the evacuation of the bowel prior to surgery or invasive rectal or colonic examinations.

## Administration
It should be taken once daily at bedtime. Oral senna products typically produce a bowel movement in 6 to 12 hours. Rectal suppositories act within 2 hours.

# Contraindications
According to Commission E, the German equivalent of the U.S. Food and Drug Administration, senna is contraindicated in cases of intestinal obstruction, acute intestinal inflammation (e.g., Crohn's disease), ulcerative colitis, appendicitis, and abdominal pain of unknown origin.
Senna is considered contraindicated in patients with a documented allergy to anthraquinones. Such allergies are rare and typically limited to dermatological reactions of redness and itching.

# Adverse effects
Adverse effects are typically limited to gastrointestinal reactions and include abdominal pain or cramps, diarrhea, nausea, and vomiting.
Regular use of senna products can lead to a characteristic brown pigmentation of the internal colonic wall seen on colonoscopy.  This abnormal pigmentation is known as melanosis coli.

# Mechanism of action
The breakdown products of senna act directly as irritants on the colonic wall to induce fluid secretion and colonic contraction.

# Pharmacology
They are anthraquinone derivatives and dimeric glycosides.

# Formulations
Senna is an over-the-counter medication available in multiple formulations, including oral formations (liquid, tablet, granular) and rectal suppositories. Senna products are manufactured by multiple generic drug makers as various brand names.
Shapiro reaction
The Shapiro reaction or tosylhydrazone decomposition is an organic reaction in which a ketone or aldehyde is converted to an alkene through an intermediate hydrazone in the presence of 2 equivalents of strong base.

# Reaction mechanism
In a prelude to the actual Shapiro reaction a ketone or an aldehyde is reacted with p-toluenesulfonylhydrazide to a p-toluenesulfonylhydrazone (or tosyl hydrazone) which is an imine or hydrazone. Two equivalents of a strong base such as n-butyllithium then abstract first the hydrazone proton and then the less acidic  carbonyl proton leaving a carbanion. The carbanion proceeds in an elimination reaction creating the carbon to carbon double bond and converting the hydrazone group into a lithium diazonium group. This group expels nitrogen leaving a vinyllithium compound.

# Scope
Although many secondary reactions exist for this functional group, in the Shapiro reaction in particular water is added resulting in hydrolysis to the alkene. Other reactions of vinyllithium compounds include alkylation reactions with for instance alkyl halides. In general the least substituted alkene is the preferred reaction product.
The Bamford-Stevens reaction is also a tosylhydrazone decomposition but in this reaction a much weaker base can only abstract the hydrazone proton and not the  carbonyl proton and the reaction mechanism now involves a carbene or in a protic solvent a carbocation.
Sharpey's fibres
Sharpey's fibres (bone fibres, or perforating fibres) are a matrix of connective tissue consisting of bundles of strong collagenous fibres connecting periosteum to bone. They are part of the outer fibrous layer of periosteum, entering into the outer circumferential and interstitial lamellae of bone tissue.
In the teeth, Sharpey's fibres are the ends of principal fibres that insert into the cementum. A study on rats suggests that the three-dimensional structure of Sharpey's fibres intensifies the continuity between the periodontal ligament fibre and the alveolar bone (tooth socket), and acts as a buffer medium against stress.
In the skull the main function of Sharpey's fibres is to bind the cranial bones in a firm but moveable manner; they are most numerous in areas where the bones are subjected to the greatest forces of separation.
Each fibre is accompanied by an arteriole and one or more nerve fibres.
English anatomist William Sharpey described them in 1846.