Persius/hicric huggingface dataset:
Oliver's sign
Synonyms and keywords: Tracheal tug sign

# Overview
Oliver's sign is an abnormal downward movement of the trachea during systole that can indicate a dilation or aneurysm of the aortic arch.  Oliver's sign is elicited by gently grasping the cricoid cartilage and applying upward pressure while the patient stands with his or her chin extended upward.  Due to the anatomic position of the aortic arch, which overrides the left main bronchus, a downward tug of the trachea may be felt if an aneurysm is present.

# Historical Perspective
The sign was first described by English military surgeon William Silver Oliver in 1878.

# Causes

## Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- Aortic aneurysm
- Aortic dissection

## Common Causes
- Aortic aneurysm
- Aortic dissection
- Atherosclerosis
- Cystic medial necrosis
- Marfan's syndrome
- Trauma

## Causes by Organ System

## Causes in Alphabetical Order
Ootidogenesis
The succeeding ootidogenesis is the step in which the primary oocyte turns into an ootid. It is achieved by meiosis. The primary oocyte is even defined from its role to undergo meiosis.
However, although this process begins at prenatal age, it stops at prophase I. In late fetal life, all oocytes, still primary oocytes, have taken this halt in development, called dictyate. First after menarche they continue to develop, although only a few does so every menstrual cycle.

# Meiosis I
Meiosis I of ootidogenesis starts at embryonic age, but halts in diplotene of prophase I until puberty. For those primary oocytes continuing to develop in each menstrual cycle, however, synapsis occurs and tetrads form, enabling and crossing over. As a result of meiosis I, the primary oocyte becomes the secondary oocyte and the first polar body.

# Meiosis II
Immediately after meiosis I, the haploid secondary oocyte initiates meiosis II. However, this, too is halted in metaphase II. However, this only lasts until fertilization, if such occurs. When meiosis II is completed, an ootid and another polar body is created.
-  Biochem
Otic ganglion
The otic ganglion is a small, ovalshaped, flattened parasympathetic ganglion of a reddish-gray color, located immediately below the foramen ovale.

# Location and relations
It is related to the maxillary and internal pterygoid nerves, to the cartilaginous part of the Eustachian tube, to the origin of the tensor palati muscle, and to the middle meningeal artery.
It surrounds the origin of the nerve to the Pterygoideus internus.
It is in relation, laterally, with the trunk of the mandibular nerve at the point where the motor and sensory roots join; medially, with the cartilaginous part of the auditory tube, and the origin of the Tensor veli palatini; posteriorly, with the middle meningeal artery.

# Filaments
Functionally, it gives off filaments:
- posteriorly on the lateral surface of the Eustachian tube to the tensor tympani
- anteriorly to the tensor palati muscle
- to the inferior maxillary nerve, making up its motor root.
- to the auriculotemporal nerve, making up its sensory root.

## Branches of Communication
It is connected by two or three short filaments with the nerve to the Pterygoideus internus, from which it may obtain a motor, and possibly a sensory root.
It communicates with the glossopharyngeal and facial nerves, through the lesser superficial petrosal nerve continued from the tympanic plexus, and through this nerve it probably receives a root from the glossopharyngeal and a motor root from the facial; its sympathetic root consists of a filament from the plexus surrounding the middle meningeal artery.
The fibers from the glossopharyngeal which pass to the otic ganglion in the small superficial petrosal are supposed to be parasympathetic efferent (preganglionic) fibers from the dorsal nucleus or inferior salivatory nucleus of the medulla.
Fibers (postganglionic) from the otic ganglion with which these form synapses are supposed to pass with the auriculotemporal nerve to the parotid gland.
A slender filament (sphenoidal) ascends from it to the nerve of the Pterygoid canal, and a small branch connects it with the chorda tympani.

## Distribution
Its branches of distribution are: a filament to the Tensor tympani, and one to the Tensor veli palatini.
The former passes backward, lateral to the auditory tube; the latter arises from the ganglion, near the origin of the nerve to the Pterygoideus internus, and is directed forward.
The fibers of these nerves are, however, mainly derived from the nerve to the Pterygoideus internus.

# Additional images
- Plan of the facial and intermediate nerves and their communication with other nerves.
- Diagram of efferent sympathetic nervous system.
Oxpheneridine
Oxpheneridine (Carbamethidine) is a 4-phenylpiperidine derivative that is related to the opioid analgesic drug pethidine (meperidine).
Oxpheneridine is not currently used in medicine. Presumably it has similar effects to other opioid derivatives, such as analgesia, sedation, nausea and respiratory depression.
Unlike most opioid derivatives, oxpheneridine is not specifically listed as an illegal drug. In the UNODC narcotics report of 1958, they state that it was not possible to administer oxpheneridine in high doses as it is poorly soluble and highly irritating, and at the low doses administered it did not produce addiction in animals. This appears to be the only time oxpheneridine has been investigated, and so its pharmacological properties have not been well established.
Oxpheneridine would probably be regarded as a a controlled substance analogue of pethidine on the grounds of its related chemical structure in some jurisdictions such as the USA, Australia and New Zealand.
In Canada, Oxpheneridine is specifically excluded from the illegal drugs list on the Controlled Drugs and Substances Act schedules, presumably on the basis of the lack of addictive potential found by the UNODC. Canada also lists "Carbamethidine" as another excluded drug on its schedule, but this appears to be a double entry as the chemical name listed for carbamethidine is actually the chemical name of oxpheneridine, and the chemical name given for oxpheneridine on the Canadian drug schedules is chemically incorrect and does not correspond to a compound that could exist.
Oxybuprocaine

# Overview
Oxybuprocaine (INN), also known as benoxinate or BNX, is an ester-type local anesthetic, which is used especially in ophthalmology and otolaryngology. Oxybuprocaine is sold by Novartis under the brand names Novesine or Novesin.
Safety for use in pregnancy and lactation has not been established.

# Uses
- In ophthalmology in order to numb the surface of the eye (the outermost layers of the cornea and conjunctiva) for the following purposes:
in order to perform a contact/applanation tonometry,
for small operations,
in order to remove small foreign objects from the uppermost layer of the cornea or conjunctiva;
- in order to perform a contact/applanation tonometry,
- for small operations,
- in order to remove small foreign objects from the uppermost layer of the cornea or conjunctiva;
- in otolaryngology for numbing the mucous membranes of the nostrils and pharynx, for diagnostic purposes and small operations,
- for numbing the mucous membranes of bronchi, for example in bronchoscopy,
- and the oesophagus, for example in intubation.

# Pharmacokinetics
Anaesthesia starts with a latency of 30 to 50 seconds and lasts for about 10 to 30 minutes, depending on perfusion. The drug is metabolised by esterases in blood plasma and liver.

# Adverse effects
When used excessively, oxybuprocaine like any other topical anesthetic used in the eye and on mucous membranes (like for example tetracaine, proxymetacaine and proparacaine) can cause irritation, hypersensitivity, anaphylaxis, irreversible corneal damage and even complete destruction of the cornea. (Excessive use means several times a day during several days or even weeks.)

# Interactions
Oxybuprocaine is incompatible with silver and mercury salts, as well as basic substances. It also reduces the antimicrobial action of sulfonamides.
Oxyntomodulin
Oxyntomodulin is a naturally occurring 37 amino acid peptide hormone found in the colon, produced by the oxyntic (fundic) cells of the oxyntic (fundic) mucosa.  It has been found to suppress appetite.  A recent study has found that it can be used as a weight loss treatment.
The mechanism of action of oxyntomodulin is not well understood. It is known to bind both the GLP-1 receptor and the glucagon receptor but it is not known whether the effects of the hormone are mediated through these receptors or through an unidentified receptor.
Thiakis , a biotechnology company based in London and founded by Professor Steve Bloom and Dr John Burt, is developing a novel analogue of oxyntomodulin for the treatment of obesity.
P-type ATPase
P-type (or E1-E2-type) ATPases constitute a superfamily of cation transport enzymes, present both in prokaryota and eukaryota, whose members mediate membrane flux of all common biologically relevant cations. The ATPases, that form an aspartyl phosphate intermediate in the course of ATP hydrolysis, can be divided into 4 major groups:
- (1) Ca2+-transporting ATPases;
- (2) Na+/K+- and gastric H+/K+-transporting ATPases;
- (3) Plasma membrane H+-transporting ATPases (proton pumps) of plants, fungi and lower eukaryotes; and
- (4) all bacterial P-type ATPases, except the Mg2+-ATPase of Salmonella typhimurium, which is more similar to the eukaryotic sequences.

# Human proteins containing this domain
- Na+/K+ transporting: ATP1A1, ATP1A2, ATP1A3, ATP1A4, ATP1B1, ATP1B2, ATP1B3, ATP1B4
- Ca++ transporting: ATP2A1, ATP2A2, ATP2A3, ATP2B1, ATP2B2, ATP2B3, ATP2B4, ATP2C1
- Cu++ transporting: ATP7A, ATP7B
- Class I, type 8: ATP8A1, ATP8B1, ATP8B2, ATP8B3, ATP8B4
- Class II, type 9: ATP9A, ATP9B
- Class V, type 10: ATP10A, ATP10B, ATP10D
- Class VI, type 11: ATP11A, ATP11B, ATP11C
- H+/K+ transporting, nongastric: ATP12A
- type 13: ATP13A1, ATP13A2, ATP13A3, ATP13A4, ATP13A5
- ATP2C2;
- ATP4A;
- KIAA0195
PAH clearance

# Overview
Para aminohippurate clearance or PAH clearance is a method used in renal physiology to measure renal plasma flow, which, in turn, is a measure of renal function.
The concentration of para aminohippurate (PAH) is measured in one arterial blood sample (PPAH) and one urine sample(UPAH). The urine flow (V) as also measured. Renal perfusion flow is then calculated by:
What in fact is calculated is the effective renal plasma flow (eRPF). However, since the renal extraction ratio of PAH almost equals 1, then eRPF almost equals RPF.

# Precision
The renal extraction ratio of PAH is a normal individual is approximately 0.92, and thus not exactly 1.0. Thus, this method usually underestimates RPF by approximately 10%. This margin of error is generally acceptable considering the ease with which eRPF is measured.
PM20D1 (gene)
Peptidase M20 domain containing 1 is a circulating enzyme of the mammalian M20 peptidase family. It is encoded by the PM20D1 gene. PM20D1 catalyzes the synthesis of N-acyl amino acids from free fatty acids and free amino acids as well as the reverse hydrolytic reaction. PM20D1, along with FAAH, constitute the two dominant mammalian enzymes that physiologically regulate the fatty acid amide family of signaling metabolites.
In mice, PM20D1 is highly expressed in liver, kidney, small intestine, and brown fat. Its expression in adipose tissues is increased under hypermetabolic conditions. Genetic elevation of circulating PM20D1 in mice leads to accumulation of multiple circulating N-acyl amino acid species and a hypermetabolic phenotype. PM20D1-KO mice exhibit a bidirectional dysregulation of a distinct set of circulating N-acyl amino acids and range of phenotypes, including insulin resistance, altered body temperature in cold, and anti-nociceptive behaviors to inflammatory pain.

# Clinical significance
In humans, the PM20D1 locus has been associated with Alzheimer's disease. Elevation of brain PM20D1 is neuroprotective in rodent models of AD.
PROLONG Study

# Official Title
D-Dimer Test to Establish Duration of Anticoagulation After a First Idiopathic Episode of Venous Thromboembolism; the Prospective Randomized Prolong Study

# Objective
The optimal duration of oral anticoagulant treatment in patients with idiopathic venous thromboembolism is still uncertain.  The present study addresses the possible role of the D-dimer test in assessing the need for continuation of anticoagulation.  The study aims at assessing whether D-dimer assay may have a role in guiding the duration of anticoagulation in these patients.

# Sponsor
St. Orsola Hospital

# Timeline
The previous information was derived from ClinicalTrials.gov on 09/25/2013 using the identification number NCT00264277.

# Study Description
The previous information was derived from ClinicalTrials.gov on 09/25/2013 using the identification number NCT00264277.

# Eligibility Criteria

## Inclusion Criteria
- Age > 18 years
- After a first documented idiopathic proximal deep vein thrombosis and/or pulmonary embolism
- After at least 3 months of oral anticoagulation
- After written informed consent

## Exclusion Criteria
- If the Venous thromboembolism occurred:
During pregnancy or puerperium
After recent (i.e. within three months) fracture or plaster casting of a leg,
After immobilization with confinement to bed for three consecutive days
After surgery with general anesthesia lasting longer than 30 minutes
- During pregnancy or puerperium
- After recent (i.e. within three months) fracture or plaster casting of a leg,
- After immobilization with confinement to bed for three consecutive days
- After surgery with general anesthesia lasting longer than 30 minutes
- Patients with:
Active cancer
Antiphospholipid antibody syndrome
Antithrombin deficiency
Serious liver disease or renal insufficiency (creatininemia > 2 mg/dL),
Other indications for anticoagulation or contraindications for this treatment
Limited life expectation
- Active cancer
- Antiphospholipid antibody syndrome
- Antithrombin deficiency
- Serious liver disease or renal insufficiency (creatininemia > 2 mg/dL),
- Other indications for anticoagulation or contraindications for this treatment
- Limited life expectation
- Patients who live too far from the clinical center

# Outcomes

## Primary Outcomes
- Confirmed recurrent proximal deep vein thrombosis and/or pulmonary embolism at 18 months follow up
- Confirmed major bleeding events at 18 months follow up

## Secondary Outcomes
Not provided

# Publications

## Results

## Conclusion
Packaging gas
A packaging gas is a gas used to pack sensitive materials in a modified atmosphere. It is usually inert, or of a nature that protects the packaged goods, thus inhibiting reactions such as spoilage.  Some may also serve as propellant for aerosols like whipped cream.
For packaging food, various gases are approved. Their E numbers are in parenthesis:
- argon (E938), used for canned products
- helium (E939), used for canned products
- nitrogen (E941)
- oxygen (E948), used eg. for packaging of vegetables
- hydrogen (E949)
- carbon dioxide (E290, also propellant)
Specific kind of packaging gases are aerosol propellants:
- dichlorodifluoromethane known as CFC (E940), rarely used because of the damage that it does to the ozone layer
- nitrous oxide (E942), used for aerosol whipped cream canisters (see Nitrous oxide: Aerosol propellant)
- butane (E943a)
- isobutane (E943b)
- propane (E944)
Padilla Miami
Padilla Miami 8 &11 is a brand of hand-made premium cigar owned by Padilla Cigar Company.

# History and Background
The blend for this brand was created by Jose "Pepin" Garcia and the cigars are manufactured at the El Rey de los Habanos factory in the Little Havana section of Miami, Florida. The name refers to the location of the factory, which is near the corner of 8th Street & 11th Avenue in Miami.

# Description
A full-strength cigar, the Padilla Miami has a wrapper of Nicaraguan grown Cuban-seed Corojo surrounding a filler blend of Nicaraguan Criollo and Corojo and a binder of Nicaraguan Criollo.
The band is black with gold lettering, with a large monogram "P" surrounded by a gold border in the center, with "Miami" in gold on a red background below the monogram.  They are packed uncelloed in boxes of 20.

# Models/Vitolas

## Honors/Awards
The Padilla Miami 8 & 11 Robusto was named the thirteenth top-rated cigar of 2005 by Cigar Aficionado ("...a full-bodied masterpiece").

# Notes
1. One size is an exclusive to a single retailer, and is not given above (the Belicoso Fino, 5 x 52).
2. The Salomons are rolled exclusively by Don Pepin himself.
Paget Disease
Synonyms and keywords: PD; commonly known as Paget's disease or historically, osteitis deformans

# Overview

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Paget Disease from other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications and Prognosis

# Diagnosis
Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

# Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies | Stem cell

# Case Studies

# Related Chapters
- Back pain
- Chronic pain
- Osteoimmunology
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Pants Pankuro

# Overview
"Pants Pankuro" (Japanese: ) is the name of a series of animated shorts (each just over a minute in length) that air on Japanese public television.  The series is geared to toddlers and young children, and most episodes focus on the issues involved with toilet training.  It features a number of anthropomorphic characters, including talking toilets and washing machines, who instruct children about how to use the restroom and what to do in case of an accident.

# Characters
- Pants Pankuro, the protagonist, is about three years old. He has just started to wear underpants and use the toilet.
- Komingo is Pankuro's little sister.  She is not yet toilet trained.
- Koricchi is a boy the same age as Pankuro; the two are intensely competitive.
- Koin is a girl about the same age as Pankuro, who likes to spin and dance.
- Toire-sama is Pankuro's friendly household toilet.  Pankuro usually treats Toire-sama with great respect, as though he were an older relative.
- Kamiko-san is the toilet roll holder.
- Sentako Hacchan is Pankuro's eight-legged washing machine, who is very eager to do the laundry.  (The name is a combination of "sentaku," which means laundry, and "tako," which means octopus.)
- Koricchi's family also has an old-fashioned squat toilet (name unknown).
Parapsoriasis

# Overview
Parapsoriasis refers to one of a group of skin disorders that are characterized primarily by their resemblance to psoriasis (red, scaly lesions), rather than by their underlying etiology.
Neoplasms can devleop from parapsoriasis. For example, it can develop into cutaneous T-cell lymphoma.
The term "Parapsoriasis" was formed in 1902.

# Examples of parapsoriases
- Pityriasis lichenoides chronica
- Pityriasis lichenoides et varioliformis acuta

# Differentiating parapsoriasis from other dieases
Parapsoriasis should be differentiated from other diseases that cause papulosquamous or erythmatosquamous rash. The differentials include:
Paternal bond
The paternal bond is typically the relationship between a father and his child. In the U.S., legal paternity is presumed for the husband of the mother unless a separate action is taken; an unmarried man may establish paternity by signing a voluntary recognition of paternity or by taking court action. Paternity may also be established between a man and a younger person, commonly in adoption, without the two being related to each other.

# Fatherhood
The father of a child can develop the bond during the pregnancy of his partner, feeling attachment to the developing child. Research indicates that this may have some biological basis. Statistics show that fathers' levels of testosterone tend to decline several months before the birth of the child (due, perhaps, to an inverse pheromonal chemical produced by the mother during pregnancy). Since high testosterone levels seem to encourage more aggressive behaviour, low levels may enhance the ability to develop a new relationship bond (for example, with the child).
Fathers find many ways to bond with their children, such as soothing, consoling, feeding (expressed breast milk, infant formula or baby food), changing diapers, bathing, dressing, playing, and cuddling. Carrying the infant in a sling or backpack or pushing them in a baby transport can build the bond, as can participating in the baby's bedtime routine.
Pathergy test
Synonyms and keywords: Pathergy

# Overview
The pathergy test, is a non-specific skin or mucus membrane reaction to trauma that is observed in patients with Behcet disease. This reaction is classified as a hypersensitivity reaction. The positive pathergy test is one of the minor diagnostic criteria of Behcets disease.

# Historical Perspective
Skin pathergy test was first reported by Blobner in 1937.

# Procedure
Skin Pathergy test
There is no standardized method for performing the pathergy test. However, the method below is one of the suggested ways.
Procedure
The area of the skin should not be cleaned with disinfectant and the needle should be blunted against the inside surface of its sterile plastic sheath before using. The needle is inserted carefully at an angle of 30 to the skin into the dermis at a depth of 1.52 mm. The needle should not be observed beneath the epidermis and then it should be withdrawn with a twisting movement. The test is read between 24 to 48 hours after the procedure. One of the suggested scales for the degree of positivity is a three-point scale as follows:
- Negative Result: only needle mark (scored 0)
- Positive Result: the presence of papule or pustule
1+ papule only
2+ pustule
- 1+ papule only
- 2+ pustule
Another scale for the interpretation of the test, known as Dilsen pathergy test, is indicated in the table below:
To increase the sensitivity of the test:
- make at least two needle pricks on the glabrous skin of the forearm
- Use a large hypodermic needle (21 gauge or less)
- Use four needle pricks in total
- Use a blunt needle to prick
Oral pathergy test
To perform the test, a 20-gauge (0.9 mm) blunt disposable needle is used to prick the mucous membrane of the lower lip to the submucosa. The test is then read 48 hours later. The result is interpreted as below:
- Positive Result: Presence of pustule and/or ulcer
- Negative Result: Absence of aforementioned lesions
This method is more accessible than the traditional skin test, as there is no need to measure the size of the lesion and pustule or ulcer of any size turn the test positive. Additionally, it has similar sensitivity to Dilsen skin pathergy test.

# Associated Conditions
The following disorders are associated with positive pathergy test:
- Behcets disease (the skin pathergy test is a specific diagnostic tool for this disorder)
- Pyoderma gangrenosum
- Sweets syndrome
- Atypical eosinophilic pustular folliculitis
- Neonates with Down syndrome
- Myeloproliferative disorders
- Non-Hodgkins lymphoma
- Chronic myeloid leukemia treated with interferon 
- Inflammatory bowel disease
- spondyloarthropathies (rarely)
Pathogenicity
Pathogenicity is the ability of an organism to cause disease in another organism, thus called Pathogen.
It is often used interchangeably with the term "virulence", although some authors prefer to reserve the latter term for descriptions of the relative degree of damage done by a pathogen.  Pathogens are infectious agents that cause disease and include viruses, bacteria, fungi, protozoa and higher parasites.  The agents responsible for the CJD and BSE are also pathogenic.
The term used to describe the capacity of microbes to cause disease. 
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