Persius/hicric huggingface dataset:
Sanatorium
A sanatorium (also sanitorium, sanitarium) is a medical facility for long-term illness, typically tuberculosis. A distinction was sometimes made between a "sanitarium" (a kind of health resort, as in the Battle Creek Sanitarium) and "sanatorium" (a hospital).
According to the Saskatchewan Lung Association, when the National Anti-Tuberculosis Association was founded in 1904, it was felt that a distinction should be made between the health resorts with which people were familiar and the new tuberculosis treatment hospitals: "So they decided to use a new word which instead of being derived from the Latin noun sanitas, meaning health, would emphasize the need for scientific healing or treatment. Accordingly, they took the Latin verb root sano, meaning to heal, and adopted the new word sanatorium" .
The rationale for sanitoriums was that before antibiotic treatments existed, a regime of rest and good nutrition offered the best chance that the sufferer's immune system would "wall off" pockets of pulmonary tuberculosis infection.
In the early twentieth century, tuberculosis sanatoriums (or sanatoria) were common in the United States. The first tuberculosis sanatorium for blacks was Burkeville, Virginia's Piedmont Sanatorium. Waverly Hills Sanatorium, a Louisville, Kentucky tuberculosis sanatorium, was founded in 1911. It has become a mecca for curiosity-seekers who believe it is haunted .  A.G. Holley Hospital in Lantana, Florida is the last remaining freestanding tuberculosis sanatorium in the United States .
Switzerland had many sanatoriums, as it was believed that clean mountain air was the best treatment for lung diseases.  The ill of Europe were sent to recover there.  The Heliantia Sanatorium in Valadares, Portugal was used for the treatment of bone tuberculosis between the 1930s and 1960s.
After 1943, when Albert Schatz, a graduate student at Rutgers University, discovered Streptomycin, the first true cure for tuberculosis, sanatoriums began to close.  Around the 1950s, tuberculosis was no longer a major public health threat and so most of the sanatoriums had reached the end of their lives.  Most sanatoriums were demolished years ago.
Some, however, have assumed updated medical roles.  The Tambaram Sanatorium in south India is now a hospital of excellence for AIDS patients . The state hospital in Sanatorium, Mississippi is now a regional mental retardation center.

# Former Soviet Union
In the former Soviet Union the term has a slightly different meaning. It is mostly a combination of a resort/recreational facility and a medical facility intended to provide short-term complex rest and medical services.

# In literature
The Magic Mountain (Der Zauberberg), a novel by the German author Thomas Mann (18751955), is set in a sanatorium. Mann was familiar with this type of setting from 1912 when his wife was hospitalized with lung disease for several months in Dr. Friedrich Jessen's Waldsanatorium in Davos, Switzerland. Der Zauberberg, one of the most influential of all 20th-century novels, is a lengthy work and was first published in two volumes by S. Fischer Verlag in 1924.
Sandbox:DD
- The table below lists the risk factors for chronic lymphocytic leukmeia development:
-  What are the risk factors for chronic lymphocytic leukemia? American Cancer Society (2015)  Accessed on October, 12 2015
-   Chronic Lymphocytic Leukemia. Mayoclinic (2015)  Accessed on October, 12 2015
Sandbox:MP
Mehdi's sanbox

# Overview

# Historical Perspective
- Hippocrates (460 to 370 BC) was first to describe the phenomenon of sudden paralysis.
- Apoplexy, from the Greek word meaning "struck down with violence, first appeared in Hippocratic writings to describe this phenomenon.
- The word stroke was used as a synonym for apoplectic seizure as early as 1599, and is a fairly literal translation of the Greek term.
- In 1658, in his Apoplexia, Johann Jacob Wepfer (16201695) identified the cause of hemorrhagic stroke when he suggested that people who had died of apoplexy had bleeding in their brains.
- Wepfer also identified the main arteries supplying the brain, the vertebral and carotid arteries, and identified the cause of ischemic stroke when he suggested that apoplexy might be caused by a blockage to those vessels.

# Synopsis

# Imaging Studies

# Prevention

# Epidemiology and Demographics

## Stroke in USA
- Stroke is a leading cause of serious long-term disability
- In USA, the incidence and mortality rates of stroke has significantly decreased compared to previous years.
- From year 2003 to 2013, the mortality rates due to stroke declined by 18.5%.
- In 2013, stroke became the fifth leading cause of death.
- The case fatality rate of stroke is estimated to be 41.7 deaths per 100, 000 population
- The incidence of new (610, 000) or recurrent stroke (185, 000) is estimated to be 795000 people annually or 250 cases per 100, 000.
- It is estimated that one incidence of stroke happens every 4 sec with death occuring every 4 min.
- About 87% of all strokes are ischemic strokes
- Stroke costs the United States an estimated $34 billion each year

## Worldwide
- According to WHO, the incidence of stroke is estimated to be 15 million people annually, worldwide..
- Out of these, 5 million die and 5 million are left permanently disbaled..

## Age
- Stroke can occur in all age groups. However, the incidence of stroke is less among individuals age less than 40 years of age and the risk increases with increasing age. 
- According to WHO, stroke also occurs in about 8% of children with sickle cell disease..
- In 2009, 34% of people hospitalized for stroke were younger than 65 years
- The incidence of stroke in people aged 18 to 50 years is estimated to be approximately 10%. 
The rate of decline in mortality rates of stroke in different age groups is as follows:
- >65 years of age: from 534.1 to 245.2 per 100,000
- 45-65 years of age: from 43.5 to 20.2 per 100,000
- 18 to 44 years of age: from  from 3.7 to 2.0 per 100,000

## Gender
There is increased incidence of stroke in men as compared to women.

## Race
- The risk of incidence of first stroke is twice in african american population as compared to whites with increased mortality rates.
- Hispanics risk for stroke falls between that of whites and blacks 

## Geographical distribution
- There is increased incidence and mortality rates of stroke in developing countries as compared to developed countries due to low socio economic status and heath facilites.
- In USA, the highest death rates from stroke are in the southeastern United States.
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Synonyms and keywords: Acute lymphocytic leukemia, Acute myeloid leukemia, ALL, AML

# Overview
Acute Leukemia is a malignancy of bone marrow myeloid and lymphoblastic precursor cells, in which these poorly differentiated hematopoietic cells proliferate rapidly. Hence, their accumulation would disrupt the performance of bone marrow to produce normal blood cells

# Causes
AML and ALL are life-threatening diseases, which would result in death if left untreated. In the majority of cases, etiology is not apparent.

## Common Causes of AML
- Gene mutations:FLT3, IDHI, IDH2, KRAS, DNMT3A, NPM1
- Chromosomal translocations, deletions, and inversions
- Benzene or radiation exposure chronically 

## Common Causes of ALL
- Radiation exposure
- Genetic disorders; e.g., Down syndrome, ataxia-telangiectasia, Fanconi anemia
- Certain infections: e.g., HTLV-1 

# FIRE
A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention.
- Focused Initial Rapid Evaluation (FIRE) in AML :
- Focused Initial Rapid Evaluation (FIRE) in ALL:  

# Diagnosis
Diagnostic criteria of acute myeloid leukemia and acute lymphoblastic leukemia are similar to one another.
- According to the 2016 WHO criteria observing 20% blasts in the bone marrow biopsy or peripheral blood smear is diagnostic for AML. These genetic abnormalities in AML are diagnostic even with less than 20% marrow blasts: inv(16), t(16;16), t(8;21), and t(15;17).
- Presenting 20% of leukemic lymphoblasts in bone marrow aspirate and biopsy would prove ALL.

# Treatment
Treatment of acute lymphoblastic leukemia includes three phases:
- Induction therapy, i.e., prednisolone, vincristine, cytarabine
- Administrating Central Nervous System prophylaxis, i.e., methotrexate
- Chemotherapy as a maintenance treatment for two years
- Stem cell transplantation in adults who are eligible while there is a suitable donor

# Do's
- Before starting the therapy, taking a precise history and physical examination have to be done to diagnose any kind of comorbidities ,i.e. heart failure or renal diseases that affect the prognosis and treatment choices.
- HLA-typing evaluation have to be done for all of the AML cases In the pretreatment assessment.
- Seven days after the induction phase of chemotherapy ended, bone marrow biopsy must be done in order to assess the remission situation.
- In the induction chemotherapy process of AML for most of the cases, cytarabine IV infusion should be administrated for seven days consecutively + anthracycline on days one to three.(known as "7+3" regimens) 

# Don'ts
- If the patient with AML has a coagulopathy disorder and is susceptible to bleeding, do not have to undergo lumbar puncture in the workup process before correcting that.
- Without the assessment of cardiac symptoms and echocardiogram, chemotherapy medications which are cardiotoxic should not be administrated.
Sandbox CP
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Sandbox JA

# Test

# Parenchymal lesions
- Tuberculoma
- Single or multiple lesions of > 0.5 cm
- May occur in primary or secundary TB
- Main finding on Chest X-ray in 5% cases of secondary TB
- Results from the surrounding of M. tuberculosis with inflammatory or connective tissue.
- The center of the tuberculoma is often necrotic
- Satellite lesions (80%)
- Nodular or diffused calcifications in 20-30% cases
- Thin-walled cavity
- Present in active and inactive disease
- May regress after treatment
- Air-filled sect may persist
- May be misidentified as an emphysematous bulla or pneumatocelle.
- Cicatrization:
- Common in secondary TB
- Marked fibrosis in 40% of secondary TB cases, which may present as:
- Upper love atelectasis
- Compensatory hyperinflation of the lower lobe
- Hilar retraction
- Mediastinal shift
- Unspecific X-Ray findings:
- Parenchymal bands
- Fibrotic cavities
- Fibrotic nodules
- Traction bronchiectasis
- Lung Destruction:
- Common in end-stage of TB
- Involvement of the airways and parenchyma
- May follow primary TB or secondary TB
- Spreads across the lung with cavitation and fibrosis
- Concomitant infection with bacteria or bacteria may occur
- Complicates assessment of TB activity in the lung with the X-ray.
- Aspergilloma
- Mass of hyphae, cell debris and mucus, commonly located in a cavity or bronchus
- Previous history of chronic cavitary TB in 25-55% of cases presenting with aspergilloma
- Frequently courses with hemoptysis (50-90%)
- X-ray shows a mobile mass ringed by an air shadow
- CT shows a mobile mass, generally interspaced with air shadows
- May be calcified
- Bronchogenic carcinoma
- May be misinterpreted as TB progression
- Scar formation in TB may lead to carcinoma
- May cause reactivation of TB

# Airway Lesions

# Differential Diagnosis of Infectious Diarrhea
Acute inflammatory diarrhea may be caused by different pathogens. Bellow is a table describing some of these pathogens in terms of transmission and symptoms:
Sandbox gc

# Definition of Multivessel Disease
For AEGIS-II inclusion criteria #5, multivessel disease criteria can be met by findings on the cardiac catheterization for the index MI, a prior cardiac catheterization, or both:
- Index MI cardiac catheterization: 50% or greater stenosis of the left main or at least 2 coronary artery territories (LAD, LCX, RCA) (prior to any interventions performed)
- Prior cardiac catheterization: 50% or greater stenosis of left main or at least 2 coronary artery territories (LAD, LCx, RCA) (prior to any interventions performed)
- Both: Index MI cardiac catheterization with 1 vessel with 50% or greater stenosis (prior to any interventions performed) AND prior PCI of at least 1 vessel different from index MI vessel
- Prior multivessel CABG
Multivessel disease requires a 50% or greater stenosis in at least 2 of the 3 major epicardial artery territories (LAD, LCx, RCA) or the left main vessel. Branch vessel disease may qualify as part of the territory of that branch vessel (for example, a diagonal vessel is considered part of the LAD territory). For the purpose of this study, the ramus is considered part of the Left Circumflex artery territory. If a branch vessel is used as a qualifying vessel, that branch should be of large enough size to potentially undergo revascularization if clinically indicated, e.g. >2mm vessel size.

# MVD Tool
Sandbox mk

# Overview
Peptic ulcer disease patient appears in severe stress due to abdominal pain. Common physical examination findings of peptic ulcer disease include epigastric tenderness, tachycardia.Perforated peptic ulcer disease patient presents with  classic triad of severe epigastric tenderness, tachycardia, and abdominal rigidity. Clinical signs of perforated peptic ulcer occurs in 3 stages: In the initial stage within first 2 hours, the patient presents with tachycardia, epigastric pain and cool extremities.In next 2 to 12 hours, the patient presents with lower right quadrant tenderness and abdominal rigidity. In more than 12 hours, the patient presents with abdominal distension, hypotension, and pyrexia with acute circulatory collapse.

# Physical Examination

## Appearance of the Patient
- Patient usually appear in severe distress due to severe abdominal pain.

## Vital Signs
- Patient has normal vital signs in initial stages of peptic ulcer.
- In peptic ulcer perforations vital signs may include :
Tachycardia with regular pulse
Weak pulse
low blood pressure with normal pulse pressure
High-grade fever is present at later stage of peptic ulcer perforation
- Tachycardia with regular pulse
- Weak pulse
- low blood pressure with normal pulse pressure
- High-grade fever is present at later stage of peptic ulcer perforation

## Skin
- Pallor is present in patients presents with hematemesis and melena.
- Source- Dr Graham Beards (Own work) 
- The hand of a person with severe anemia (on the left) compared to one without (on the right) Source -James Heilman, MD - Own work

## HEENT
- Pallor on the lower conjunctiva can be seen.

## Lungs
- Normal  B/L vesicular breath sounds.

## Heart
- S1 and S2 normal ,no murmur/rubs/gallops.

## Abdomen
- Abdominal tenderness at the epigastrium
- Perforated peptic ulcer presents with
Rebound tenderness
Decreased bowel sounds
Lower right quadrant tenderness
Abdominal rigdity
Abdominal distension 
- Rebound tenderness
- Decreased bowel sounds
- Lower right quadrant tenderness
- Abdominal rigdity
- Abdominal distension
Saquinavir

# Overview
Saquinavir is an antiretroviral drug used in HIV therapy. It falls in the protease inhibitor class. Two formulations have been marketed:
- a hard-gel capsule formulation of the mesylate, with trade name Invirase, which requires combination with ritonavir to increase the saquinavir bioavailability;
- a soft-gel capsule formulation of saquinavir (microemulsion, orally-administered formulation), with trade name Fortovase.
Both formulations are generally used as a component of highly active antiretroviral therapy (HAART).
Saquinavir was developed by the pharmaceutical company Roche. Saquinavir was the first protease inhibitor (and sixth antiretroviral) approved by the Food and Drug Administration (FDA). Within 2 years of its approval, and that of ritonavir 4 months later, annual deaths from AIDS in the United States fell from over 50,000 to approximately 18,000 
. It was approved on December 6, 1995, as Invirase, a poorly-absorbed hard gel capsule which quickly led to viral resistance in many of the pioneer patients. The manufacturer, Roche, requested and received approval of Invirase via the FDA's "Accelerated Approval" program, a process designed to speed drugs to market for the treatment of serious diseases. This decision was controversial, amid disagreement between AIDS activists over the benefits of thorough testing versus early access to new drugs.
It was approved again on Nov 7, 1997 as Fortovase, a soft gel capsule reformulated for improved bioavailability. Roche announced in May 2005 that, owing to reduction in demand, Fortovase would cease being marketed early in 2006 in favour of Invirase boosted with ritonavir.

# Category
Protease inhibitor

# US Brand Names
INVIRASE

# FDA Package Insert
Description

# Mechanism of Action
Saquinavir is a protease inhibitor. Proteases are enzymes that cleave protein molecules into smaller fragments. HIV protease is vital for both viral replication within the cell and release of mature viral particles from an infected cell. Saquinavir binds to the active site of the viral protease and prevents cleavage of viral polyproteins, preventing maturation of the virus. Saquinavir inhibits both HIV-1 and HIV-2 proteases.
Sarcolipin
Sarcolipin is a micropeptide protein that in humans is encoded by the SLN gene.

# Function
Sarcoplasmic reticulum Ca2+-ATPases are transmembrane proteins that catalyze the ATP-dependent transport of Ca2+ from the cytosol into the lumen of the sarcoplasmic reticulum in muscle cells. The SLN gene encodes a small transmembrane proteolipid that regulates several sarcoplasmic reticulum Ca2+-ATPases by reducing the accumulation of Ca2+ in the sarcoplasmic reticulum without affecting the rate of ATP hydrolysis.
Ablation of sarcolipin increases atrial Ca2+ transient amplitudes and enhanced atrial contractility. Furthermore, atria from sarcolipin-null mice have blunted response to isoproterenol stimulation, implicating sarcolipin as a mediator of beta-adrenergic responses in atria.
Recently it has been shown that SLN is an important mediator of muscle based thermogenesis and loss of sarcolipin predisposes mice to diet-induced obesity thus suggesting its role in energy metabolism and regulation of weight gain 

# Interactions
SLN (gene) has been shown to interact with PLN and ATP2A1.
Saturation
In chemistry, saturation has five different meanings:
- In physical chemistry, saturation is the point at which a solution of a substance can dissolve no more of that substance and additional amounts of that substance will appear as a precipitate. This point of maximum concentration, the saturation point, depends on the temperature of the liquid as well as the chemical nature of the substances involved. This can be used in the process of recrystallisation to purify a chemical: it is dissolved to the point of saturation in hot solvent, then as the solvent cools and the solubility decreases, excess solute precipitates. Impurities, being present in much lower concentration, do not saturate the solvent and so remain dissolved in the liquid. If a change in conditions (e.g. cooling) means that the concentration is actually higher than the saturation point, the solution has become supersaturated.
- In physical chemistry, when referring to surface processes, saturation denotes the degree of which a binding site is fully occupied.  For example, base saturation refers to the fraction of exchangeable cations that are base cations. Similarly, in environmental soil science, nitrogen saturation means that an ecosystem, such as a soil, can not store any more nitrogen.
- In organic chemistry, a saturated compound has no double or triple bonds.  In saturated linear hydrocarbons, every carbon atom is attached to two hydrogen atoms, except those at the ends of the chain, which bear three hydrogen atoms.  In the case of saturated methane, four hydrogen atoms are attached to the single, central carbon atom. Of simple hydrocarbons, alkanes are saturated, and alkenes are unsaturated.  The degree of unsaturation specifies the amount of hydrogen that a compound can bind. The term is applied similarly to the fatty acid constituents of lipids, where the fat is described as saturated or unsaturated, depending on whether the constituent fatty acids contain carbon-carbon double bonds. Unsaturated is used when any carbon structure contains double or occasionally triple bonds. Many vegetable oils contain fatty acids with one (monounsaturated) or more (polyunsaturated) double bonds in them.  The bromine number is an index of unsaturation.
- In organometallic chemistry, an unsaturated complex has fewer than 18 valence electrons and thus is susceptible to oxidative addition or coordination of an additional ligand.  Unsaturation is characteristic of many catalysts because it is usually a requirement for substrate activation.
- In biochemistry, the term saturation refers to the fraction of total protein binding sites that are occupied at any given time.
School run
The School Run is a modern phenomenon associated with parents taking their children to school by car.  Outside most British schools parents park cars near the school gates and drop off and pick up their children at the appropriate times.
In the past it was not unusual for most children to walk to school, either on their own, with friends, or accompanied by an adult. Walking to school has fallen from 61% of primary school pupils in 1992/4 to 50% in 2004. 
Walking to school is being replaced by parents using cars, sometimes in a rota with other parents.
The reasons for this are manyfold.  Firstly, in many cases both parents work and do not have time to walk their children to school, and do not know any other parents who have the time either.  Secondly, even if the children are old enough to walk on their own (or cycle), most parents are worried that something may happen to them, e.g. abduction, car accidents etc. Some schools do not offer bus service and can be too far to walk to school anyway, forcing the school run.
Ironically, the risk of children being run over near their schools is much higher than in the past due to all the parents driving their own children to school and parking in unsafe places near the school gates. It is not unusual to see cars parking in bus stops, on pedestrian crossings or facing the wrong way, with children getting in or out of the car.
The fear that something may happen to the children has perhaps more to do with media coverage of isolated (but tragic) cases than any real threat.
Some schools now have a 20 mph (~30 km/h) speed limit operating when the children are about, though traffic congestion often necessitates a lower speed.
A further problem in recent times has been an increasing level of choice by parents as to which school their children go to. Obviously the inevitable result is that kids may have further to travel and are more likely to require a bus or a lift in the car.
It is claimed that the school run is responsible for a large amount of the traffic problems in the morning rush hour. However, the often dramatic reduction in congestion at the start of school holidays, is also because many parents have to go on holiday at this time.
The decreasing amount of exercise and associated increase in obesity are also partly blamed on the school run.
In the United Kingdom, the school run has become a popular target for some politicians and campaigners against the use of cars for journeys which could be better walked or cycled. One of the campaigns promoting this alternative is the walk to school campaign.