Persius/hicric huggingface dataset:
Geranium maculatum
Geranium maculatum, the Spotted Geranium, Wood Geranium, or Wild Geranium is a woodland perennial plant native to eastern North America, from southern Manitoba and southwestern Quebec south to Alabama and west to Oklahoma and South Dakota. It grows in dry to moist woods and is normally abundant when found.
It is a perennial herbaceous plant growing to 60 cm tall, producing upright usually unbranched stems and flowers in spring to early summer. The leaves are palmately lobed with five or seven deeply cut lobes, 1012.5 cm broad, with a petiole up to 30 cm long arising from the rootstock. They are deeply parted into three or five divisions, each of which is again cleft and toothed. The flowers are 2.54 cm diameter, with five rose-purple, pale or violet-purple (rarely white) petals and ten stamens; they appear from April to June in loose clusters of two to five at the top of the stems. The fruit capsule, which springs open when ripe, consists of five cells each containing one seed joined to a long beak-like column 2-3 cm long (resembling  a crane's bill) produced from the center of the old flower. The rhizome is long, and 5 to 10 cm thick, with numerous branches. The rhizomes are covered with scars, showing the remains of stems of previous years growth. When dry it has a somewhat purplish color internally. Plants go dormant in early summer after seed is ripe and dispersed.
The plant has been used in herbal medicine, and is also grown as a garden plant.
Geschwind syndrome
Geschwind syndrome, also known as Waxman-Geschwind syndrome is a characteristic personality syndrome consisting of symptoms such as circumstantiality (excessive verbal output, stickiness, hypergraphia), altered sexuality (usually hyposexuality), and intensified mental life (deepened cognitive and emotional responses) is present in some epilepsy patients. There has also been recent suggestions to extend the list of symptoms to include things such as guilt and paranoia for example. This syndrome is particularly associated with temporal lobe epilepsy. For identification, the term "Geschwind syndrome" has been suggested as a name for this group of behavioral phenomena. There has currently been both support  and criticism  in suggestion of this syndrome. Currently the strongest support arises from many clinicians who describe and attempt to classify patients with seizures with these personality features. More studies are needed to confirm or deny that the Geschwind syndrome represents a specific epilepsy/psychiatric disorder. It was named after the two people who first characterized the syndrome: Norman Geschwind and Stephen Waxman.

# References and External Links
- J Neuropsychiatry Clin Neurosci 14:155-160, May 2002 Beyond Wernicke's A Lexicon of Eponyms in Psychiatry David Bresch, M.D.
- Waxman SG, Geschwind N: The interictal behavior syndrome of temporal lobe epilepsy. Arch Gen Psychiatry 1975; 32:1580-1586
Glenohumeral joint

# Overview
The glenohumeral joint, commonly known as the shoulder joint, is a synovial ball and socket joint and involves articulation between the glenoid fossa of the scapula (shoulder blade) and the head of the humerus (upper arm bone).

# Movements
The glenoid fossa is shallow and contains the glenoid labrum which deepens it and aids in stability. With 120 degrees of unassisted flexion, the glenohumeral joint is the most mobile joint in the body.
Scapulohumeral rhythm helps to achieve further range of movement.
The rotator cuff muscles of the shoulder produce a high tensile force, and help to pull the head of the humerus into the glenoid fossa.

# Capsule
The glenohumeral joint has a loose capsule that is lax inferiorly and therefore is at risk of dislocation inferiorly. The long head of the biceps brachii muscle travels inside the capsule to attach to the supraglenoid tubercle of the scapula.
Because the tendon is inside the capsule, it requires a synovial tendon sheath to minimize friction.
A number of bursae in the capsule aid mobility. Namely, they are the subdeltoid bursa (between the joint capsule and deltoid muscle), subcoracoid bursa (between joint capsule and coracoid process of scapula), coracobrachial bursa (between subscapularis muscle and tendon of coracobrachialis muscle), subacromial bursa (between joint capsule and acromion of scapula) and the subscapular bursa (between joint capsule and tendon of subscapularis muscle, also known as subtendinous bursa of subscapularis muscle). The bursa are formed by the synovial membrane of the joint capsule. An inferior pouching of the joint capsule between teres minor and subscapularis is known as the axillary recess.
It is important to note that the shoulder joint is a muscle dependent joint as it lacks strong ligaments.

# Ligaments
- Superior, middle and inferior glenohumeral ligaments
- Coracohumeral ligament
- Transverse humeral ligament

# Pathology
The capsule can become inflamed and stiff, with abnormal bands of tissue (adhesions) growing between the joint surfaces, causing pain and restricting movement of the shoulder, a condition known as frozen shoulder or adhesive capsulitis.
Glipizide overdose

# Overdose Information
General
Manifestatoins
Treatment

## General
There is no well-documented experience with Glipizide overdosage in humans. There
have been no known suicide attempts associated with purposeful overdosing with Glipizide. In nonclinical studies the acute oral toxicity of glipizide was extremely low in all species
tested (LD50 greater than 4 g/kg). Return to top

## Manifestatoins
Overdosage of sulfonylureas including glipizide can produce hypoglycemia. Return to top

## Treatment
If hypoglycemic coma is diagnosed or suspected, the patient should be given
rapid intravenous injection of concentrated (50%) glucose solution. This should be followed by a
continuous infusion of a more dilute (10%) glucose solution at a rate that will maintain the blood
glucose at a level above 100 mg/dL. Patients should be closely monitored for a minimum of 24 to
48 hours since hypoglycemia may recur after apparent clinical recovery. Clearance of glipizide
from plasma may be prolonged in persons with liver disease. Because of the extensive protein
binding of glipizide, dialysis is unlikely to be of benefit. Return to top
Adapted from the FDA Package Insert.
Hypermethioninemia

# Overview
Hypermethioninemia is an excess of the amino acid methionine, in the blood. This condition can occur when methionine is not broken down properly in the body.

# Diagnosis
People with hypermethioninemia often do not show any symptoms. Some individuals with hypermethioninemia exhibit learning disabilities, mental retardation, and other neurological problems; delays in motor skills such as standing or walking; sluggishness; muscle weakness; liver problems; unusual facial features; and their breath, sweat, or urine may have a smell resembling boiled cabbage.
Hypermethioninemia can occur with other metabolic disorders, such as homocystinuria, tyrosinemia and galactosemia, which also involve the faulty breakdown of particular molecules. It can also result from liver disease or excessive dietary intake of methionine from consuming large amounts of protein or a methionine-enriched infant formula.

# Pathophysiology
Inherited hypermethioninemia that is not associated with other metabolic disorders can be caused by shortages in the enzymes that break down methionine. These enzymes are produced from the MAT1A, GNMT and AHCY genes. The reactions involved in metabolizing methionine help supply some of the amino acids needed for protein production. These reactions are also involved in transferring methyl groups, consisting of a carbon atom and three hydrogen atoms, from one molecule to another (transmethylation), which is important in many cellular processes.
- The MAT1A gene provides instructions for producing the enzyme methionine adenosyltransferase. This enzyme converts methionine into a compound called S-adenosylmethionine.
- The GNMT gene provides instructions for making the enzyme glycine N-methyltransferase. This enzyme starts the next step in the process, converting S-adenosylmethionine to a compound called S-adenosyl homocysteine.
- The AHCY gene provides instructions for producing the enzyme S-adenosylhomocysteine hydrolase. This enzyme converts the S-adenosyl homocysteine into the compound homocysteine. Homocysteine may be converted back to methionine or into another amino acid, cysteine.
A deficiency of any of these enzymes results in a buildup of methionine in the body, and may cause signs and symptoms related to hypermethioninemia.

# Inheritance
Hypermethioninemia can have different inheritance patterns. This condition is usually inherited in an autosomal recessive pattern, which means two copies of the gene in each cell are altered. Most often, the parents of an individual with an autosomal recessive disorder each carry one copy of the altered gene but do not show signs and symptoms of the disorder.
Hypermethioninemia is occasionally inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In these cases, an affected person usually has one parent with the condition.
Goldenhar syndrome

# Overview
Goldenhar syndrome (also known as Oculo-Auriculo-Vertebral/OAV syndrome) is a congenital defect characterized by incomplete development of the ear, nose, soft palate, lip, and mandible. It is associated with anomalous development of the first branchial arch and second branchial arch.
The term is sometimes used interchangeably with Hemifacial Microsomia, although this definition is usually reserved for cases without internal organ/verterbrae disruption.
It affects between 1/3500 to 1/26000 live births in the UK.

# Eponym
The condition was documented in 1952 by .

# Symptoms
Chief markers of Goldenhar syndrome are incomplete development of the ear, nose, soft palate, lip, and mandible on usually one side of the body. Additionally, there are often issues with internal organs, especially heart, kidneys, and lungs. Typically, the organ will either not be present on one side or will be underdeveloped. Note that whilst it is more usual for there to be problems on only one side, it has been known for defects to occur bilaterally (approximate incidence 10% of confirmed GS cases).
Other problems can include scoliosis (twisting of the vertebrae), lipodermoids (fat in the eye), and hearing loss (see hearing loss with craniofacial syndromes).

# Causes
Causes of Goldenhar Syndrome are unknown, and is thought in most cases to be multifactorial, there have been recent accounts of familial patterns. It has been suggested that there is a brachial arch development issue late in the first trimester, also there is anecdotal evidence linking it to exposure to certain toxins (e.g. dioxin) before or during pregnancy.
There is circumstantial evidence suggesting the incidence of GS is higher in children of Gulf War veterans (see Gulf War Syndrome), though the small numbers involved make interpretation of the data difficult.

# Treatment
Treatment is usually confined to such surgical intervention as may be necessary to allow the child to develop normally e.g. jaw distraction/bone grafts, occular dermoid debulking, repairing cleft palate/lip, repairing heart malformations, spinal surgery.
Granulation tissue

# Overview
Granulation tissue is the perfused, fibrous connective tissue that replaces a fibrin clot in healing wounds.  Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size. The herb chamomile has been said to promote the growth of granulation tissue.

# Appearance
During the proliferative phase of wound healing, granulation tissue is:
- light red or dark pink in color, being perfused with new capillary loops or "buds";
- soft to the touch;
- moist; and
- bumpy (granular) in appearance.

# Structure
Granulation tissue is composed of tissue matrix supporting a variety of cell types, most of which can be associated with one of the following functions:
- extracellular matrix,
- immune system, or
- vascularisation.

## Extracellular Matrix
The extracellular matrix of granulation tissue is created and modified by fibroblasts.  Initially, it consists of a network of Type III collagen, a weaker form of the structural protein that can be produced rapidly.  This is later replaced by the stronger, long-stranded Type I collagen, as evidenced in scar tissue.

## Immunity
The main immune cells active in the tissue are macrophages and neutrophils, although other leukocytes are also present.  These work to phagocytize old or damaged tissue, and protect the healing tissue from pathogenic insult.  This is necessary both to aid the healing process and to protect against invading pathogens, as the wound often does not have an effective skin barrier to act as a first line of defence.

## Vascularization
It is necessary for a network of blood vessels to be established as soon as possible to provide the growing tissue with nutrients, to take away cellular wastes, and transport new leukocytes to the area.  Fibroblasts, the main cells that deposit granulation tissue, depend on oxygen to proliferate and lay down the new extracellular matrix. In vascularisation, also called angiogenesis, endothelial cells quickly grow into the tissue from older, intact blood vessels.  These branch out in a systematic way, forming anastomoses with other vessels.
Granuloma annulare
Granuloma annulare is a chronic skin disease consisting of a rash with reddish bumps arranged in a circle or ring. It most often affects children, young and older adults and it is slightly more common in females (60/40 ratio). The condition is usually seen in otherwise healthy people. Occasionally, it may be associated with diabetes or thyroid disease. Its cause is unknown.

# Presentation
Granuloma annulare is usually asymptomatic, but the rash may burn and be itchy. Patients usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands or feet, often centered around joints or knuckles. The bumps are caused by the clustering of T cells below the skin. Occasionally, multiple rings may be found. Rarely, granuloma annulare may appear as a firm nodule under the skin of the arms or legs.

# Prognosis
Because granuloma annulare is usually asymptomatic, treatment may not be necessary except for cosmetic reasons. Most lesions of granuloma annulare disappear in pre-puberity patients with no treatment within two years while older patients (50+) have rings for upwards of 20 years. The appearance of new rings years later is not uncommon.

## Gallery

### Extremities
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >
- url = >

### Head
- url = >
Gray baby syndrome
Gray baby syndrome (also termed Gray or Grey syndrome) is a rare but serious side effect that occurs in newborn infants (especially premature babies) following the intravenous administration of the antibiotic chloramphenicol.

# Pathophysiology
Newborn infants are predisposed to this condition because they do not yet have fully functional liver enzymes, nor do they have enough enzymes to handle the drug.

# Clinical features
Toxic levels of chloramphenicol after 29 days result in:
- Vomiting
- Ashen gray colour of the skin
- Limp body tone
- Hypotension (low blood pressure)
- Cyanosis blue discolouration of lips and skin.
- Hypothermia
- Cardiovascular collapse

# Treatment
Chloramphenicol therapy is discontinued immediately; exchange transfusion may be required to remove the drug.

# Prevention
The condition can be prevented by using chloramphenicol at the recommended doses and monitoring blood levels.

# Footnotes
-  McIntyre J, Choonara I (2004). "Drug toxicity in the neonate". Biol Neonate. 86 (4): 21821. PMID 15249753..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}
-  Pineiro-Carrero V, Pineiro E (2004). "Liver". Pediatrics. 113 (4 Suppl): 1097106. PMID 15060205.
-  Feder H (1986). "Chloramphenicol: what we have learned in the last decade". South Med J. 79 (9): 112934. PMID 3529436.
-  Mulhall A, de Louvois J, Hurley R (1983). "Chloramphenicol toxicity in neonates: its incidence and prevention" (Scanned copy & PDF). Br Med J (Clin Res Ed). 287 (6403): 14247. PMID 6416440.CS1 maint: Multiple names: authors list (link)
-  Forster J, Hufschmidt C, Niederhoff H, Kunzer W (1985). "". Monatsschr Kinderheilkd. 133 (4): 20913. PMID 4000136.CS1 maint: Multiple names: authors list (link)
Great cardiac vein
The Great Cardiac Vein (left coronary vein) begins at the apex of the heart and ascends along the anterior longitudinal sulcus to the base of the ventricles.
It then curves to the left in the coronary sulcus, and reaching the back of the heart, opens into the left extremity of the coronary sinus.
It receives tributaries from the left atrium and from both ventricles: one, the left marginal vein, is of considerable size, and ascends along the left margin of the heart.
Green prescription
A green prescription is a card given by a doctor or nurse to a patient, with exercise and lifestyle goals written on them.
The term, used by health practitioners in New Zealand draws parallel to the usual prescriptions given to patients for medications, and emphasises the importance of exercise in improving their condition, and not relying on drugs.
The green prescription is written after discussing the issues and goals in the consultation.
Studies have shown that an increase in exercise, better sense of well-being, and a decrease in blood pressure results from using the method. A decreased risk of coronary heart disease has not been shown. This was shown in two studies, one by Swinburn (1998), that surveyed patients in Auckland and Dunedin. The other was Elley (2003) and was done in 42 practices in the same region of New Zealand.
General practitioners like the idea as it formalises what they are telling the patient about lifestyle changes necessary (Swinburn 1997).
Grey Turner's sign

# Overview
Grey Turner's sign refers to bruising of the flanks, appearing as a blue discoloration.
This sign takes 2448 hours. It can predict a severe attack of acute pancreatitis, with mortality rising from 8-10% to 40%. It is a sign of retroperitoneal hemorrhage.
It may be accompanied by Cullen's sign, which may then be indicative of pancreatic necrosis with retroperitoneal or intraabdominal bleeding.
It is named after British surgeon  George Grey Turner.

# Causes
- Acute pancreatitis, whereby methemalbumin formed from digested blood tracks subcutaneously around the abdomen from the inflamed pancreas.
- Pancreatic hemorrhage
- Retroperitoneal hemorrhage
- Blunt abdominal trauma
- Ruptured abdominal aortic aneurysm
- Ruptured / hemorrhagic ectopic pregnancy
- Spontaneous bleeding secondary to coagulopathy (congenital or acquired)
Groom of the Stool

# Overview
The Groom of the Stool was a medieval English groom (i.e. a male servant) who, among other duties, had the task of cleaning the Monarch's rear after a bowel movement.
In the early years of Henry VIII's reign, the title was awarded to minions of the King, court companions who spent time with him in the Privy Chamber. These were the sons of noblemen or important members of the gentry. In time they came to act as virtual personal secretaries to the King, carrying out a variety of administrative tasks within his private rooms. The position was an especially prized one, as it allowed one unobstructed access to the King's attention. David Starkey writes: "The Groom of the Stool had (to our eyes) the most menial tasks; his standing, though, was the highest... Clearly then, the royal body service must have been seen as entirely honorable, without a trace of the demeaning or the humiliating." Further, "the mere word of the Gentleman of the Privy Chamber was sufficient evidence in itself of the king's will," and the Groom of the Stool bore "the indefinable charisma of the monarchy."
Sir Henry Norreys, a Groom of the Stool under Henry VIII, was executed for an alleged affair with Anne Boleyn.
A similar position, the Porte-coton existed at the French royal court.
The position existed in a less-scatological form, the Groom of the Stole, until 1901.
Guidelines project

# Overview
The purpose of the guidelines project is to provide an in-depth summary of the latest science and management recommendations to improve the quality of healthcare.  This project is intended for medical students, interns, residents, attending physicians, hospitalists, specialists, medical faculty, researchers, and allied health professionals to contribute expertise.  It implements the evidence-based approach that healthcare providers learn about medical advances and new treatment guidelines.  WikiDoc welcomes your involvement in contributing to this project.

# Goals of The Guidelines Project
- Improve the quality of healthcare by helping hospitals and healthcare providers treat patients according to proven guidelines.
- Implement the evidence-based approach that healthcare providers learn about medical advances and new treatment guidelines.
- Make our community healthier by advocating for key cardiology issues.

# Who can Contribute to The Guidelines Project
Guidelines project prefers input from medical professionals.  This project is intended for editors at an Assistant Editor-in-Chief level or higher.  This may be the right project for you if you are one of the followings:
- Medical student
- Intern
- Resident
- Attending physician
- Hospitalist
- Specialist
- Medical faculty
- Researcher
Guidewire prowater

# Overview
The performance characteristics of Asahi Prowater And Prowater Flex guidewires are as follows:

# Strcture
- This is a relatively safe guide wire with moderate support.
- Has a hybrid Coating: Soft hydrophobic tip & hydrophilic working coils. Hydrophilic coating maximizes lubricity to navigate anatomy and hydrophobic coating designed to enhance tactile feel.
- Uses  TruTorq technology - a design that fuses stainless steel to platinum spring coils via a single-joint. (claimed to afford the improved torque response and steerability seen with this wire.)
- Tip load: 0.8 g
- Radiopaque length: 3 cm
- Outside diameter: 0.014"
- Total length: 180 cm, 300 cm