Persius/hicric huggingface dataset:
Toothache
Irritation at the nerve root of a tooth is characterized as toothache. Dental pain is caused primarily by injury, decay, infection or tooth loss. Pain that is believed to be in the tooth could actually be from the temporomandibular joint, cardiac or ear problems.

# Diagnosis

# Physical Examination
- Tooth mobility
- using the back ends of two mouth mirrors, test the tooths mobility

## Other (Teeth)
- mobility tests
- percussion
- electric pulp tests
- thermal tests

## Chest X Ray
- test for sinusitis

## Other Imaging Findings
- Transillumination can be used to show fractures in tooth structure
- Dental radiographs

# Differential Diagnosis of Causes of Toothache
In alphabetical order.  
- Angina Pectoris
- Barodontalgia from high altitudes
- "Dental Migrane"
- Dry Socket (osteitis)
- Headache
- Otitis Media and /or mastoiditis
- Periradicular or periapical pain
- Pulpaglia
- Salivary gland disorders
- Sinusitis
- Temporomadibular Joint Syndrome pain (TMJ)
- Traumatic occlusion
- Traumatic tooth injury
- Trigeminal neuralgia

# Treatment

## Acute Pharmacotherapies
- Penicillin for infections
- other oral antibiotics for sinusitis
- Pain relief for migranes/migrane specific medications

# Surgery and Device Based Therapy

## Abscess
- incision and drainage will relieve pain immediately

## Irreversible pulpitis
- root canal/tooth extraction

## Reversible pulpitis
- filling or crown

# Primary Prevention

## TMJ
- avoid to gum disorders and bruxing use a bite blocker

## Brush and floss teeth
Deaf-mute

# Overview
Deaf-mute was a term historically used by hearing people to identify a person who was deaf and could not speak. In the past "deaf-mute" was socially acceptable, usually to describe deaf people who use a signed language, but is now considered offensive (similar to the way that "colored" was once used to describe African Americans but is now looked upon as derogatory). The preferred term today is simply "deaf".  The term "deaf-mute" first appears in the Code of Hammurabi, an ancient set of laws from the near east, in 1700 BC.   It is also referenced in ancient Greek writing of the 7th century BC.  It continues to be used to refer to deaf people, mainly within a historical context, to indicate deaf people who cannot  speak, or have some degree of speaking ability, but choose not to speak because of the negative or unwanted attention atypical voices sometimes attract.
Additionally, it is sometimes used to refer to other hearing people in jest, to chide, or to invoke an image of someone who refuses to employ common sense or who is unreliable.  "Deaf and dumb," "semi-deaf" and "semi-mute" are other historic references to deaf people. Of these latter examples, only "deaf and dumb" prevails as a reference.
There are connotations of insensitivity to deaf people concerning these terms of reference and for this reason the prevailing terms are generally looked upon as insulting, inaccurate or socially and politically incorrect.  From antiquity (as noted in the Code of Hammurabi) until recent (and less enlightened) times , the terms "deaf-mute" and "deaf and dumb" were even considered analogous to "idiot" by some hearing people.
In Europe and western society, most deaf people are taught to speak with varying outcomes of ability or degrees of fluency. The simple identity of "deaf" has been embraced by the community of signing deaf people since the foundations of public deaf education in the 18th century and remains the preferred term of reference or identity for many years.

# Deaf-muteness in art and literature
The phrase is used in the Catcher in the Rye to indicate someone who does not speak their mind, and hears nothing, in effect becoming isolated from the world.
Chief Bromden, in One Flew Over the Cuckoo's Nest, is believed by all to be deaf-mute, but in fact he can hear and speak; he does not let anyone know this because, as he grew up, he was not spoken to (making him "deaf") and ignored (making him "mute").
In the film Babel, the character Chieko Wataya, played by Rinko Kikuchi, is a deaf teenaged girl who is referred to several times in the English subtitles as being a deaf-mute (although it is unclear how accurately the subtitles translate the Japanese reference to the deaf character).
The character Singer in the novel The Heart Is a Lonely Hunter, written in 1940, is referred to as a deaf-mute multiple times.
de:Taubstummheit
it:Sordomuto
Dean Burk
Dean Burk (March 21, 1904 - Oct. 6 1988) was a co-discoverer of biotin, medical researcher, and a cancer researcher at the Kaiser Wilhelm Institute and the National Cancer Institute .
He entered the University of California at Davis at the age of 15. A year later, he transferred to the University of California at Berkeley, where he received his B.S. in Entomology in 1923. Four years later he earned a Ph.D. in biochemistry.  Burk joined the Department of Agriculture in 1929 working in the Fixed Nitrogen Research Laboratory.
In 1939, he joined the cancer institute as a senior chemist. He was head of the cytochemistry laboratory when he retired in 1974. He also taught biochemistry at the Cornell University medical school from 1939 to 1941. From  he was a research master at George Washington University.  Burk was a close friend and co-author of papers with Otto Heinrich Warburg.
For his work on photosynthesis, Burk received the Hillebrand Prize in 1952  and the Gerhard Domagk Prize in 1965 for his techniques to distinguish between a normal cell and one damaged by cancer. He was a co-developer of the prototype of the  Magnetic Resonance Scanner and a co-discoverer of biotin.
After retiring form the NCI in 1974 he devoted himself to the study and discussion of fluoridation and alternative cancer treatments.  A friend of Dean Burk has written that Dean Burk was responsible for convincing the government of the Netherlands to cease adding fluoride to its drinking water. 
He published more than 250 scientific articles in his lifetime.

# Publications
- D Burk, H Lineweaver (1930) "The Influence of Fixed Nitrogen on Azobacter," Journal of Bacteriology, Apr;27(4):325-40.
- I Weisman, L. Bennett, L. Maxwell Sr., M. Woods, and D. Burk (1972)"Recognition of Cancer in vivo by Nuclear Magnetic Resonance", Science 178, 1288 - 1290
- J Yiamouyiannis, D Burk "Fluoridation and cancer, age-dependence of cancer mortality related to artificial fluoridation" Fluoride 1977
- Burk D, Schade AL. On respiratory impairment in cancer cells. Science. 1956 Aug 10;124(3215):270-2.
Debulking

# Overview
In interventional cardiology, the term debulking refers to the removal of plaque and thrombus from a blockage or lesion. Devices such as directional and rotational atherectomy are debulking devices.
Debulking is the surgical removal of part of a malignant tumour which cannot be completely excised, so as to enhance the effectiveness of radiation or chemotherapy. It is used only in specific malignancies, as generally partial removal of a tumor is not considered a worthwhile intervention. Ovarian carcinoma and some types of brain tumor are debulked prior to commencing radio- or chemotherapy.  It is usually a long and often complicated procedure taking several hours or more to perform, depending on internal involvement and location.
Debulking is also known as cytoreduction surgery; "cytoreduction" refers to reducing the number of cancer cells.
Decametre
A decametre also dekametre (American spelling: dekameter, earlier decameter  symbol dam) is a very rarely used unit of length in the metric system, equal to ten metres, the SI base unit of length. It can be written in scientific notation as 1 E+1 m (exponential notation)  meaning 10  1 m.
This measure is included mostly for completeness. One practical use of the decameter is for altitude of geopotential heights (circumscribing equal pressure) in meteorology. Interestingly, meteorologists also use another seldom encountered SI prefix: hecto- in hectopascal (hPa).  The volumetric form (see below) cubic decametre is convenient for describing large volumes of water such as in rivers and lakes.
- For surface the square decametre (dam2) is a common unit, be it by the name are (a). The are is a measurement of area the size of 1 decametre by 1 decametre  the square decametre  10 metres by 10 metres, equalling 100 square metres (100 m2).
- For volumes the cubic decametre (dam3) is also used, 10 m by 10 m by 10 m equalling 1,000 cubic metres (1,000 m3).
Decoction
A decoction is a method of extraction of herbal or plant material, which includes, but is not limited to: Stems, roots, bark, and rhizomes.
Some teas are decoctions.  Likewise, the term is used colloquially in South India to refer to black coffee prepared by the traditional method.  Decoctions, however,  differ from most teas, infusions, or tisanes, in that decoctions are usually boiled.
Decoction mashing is the traditional method used in many German breweries. It was used out of necessity before the invention of thermometers allowed simpler step mashing. But the practice continues for many traditional beers because of the unique malty flavor it lends to the beer. This is the result of Maillard reactions while boiling part of the grain.

# Process
Decoction involves first mashing, and then boiled in water to extract oils, volatile organic compounds, and other chemical substances.

## In herbalism
In herbalism, decoctions are usually made to extract fluids from hard plant materials such as roots and bark. To achieve this, the plant material is is usually boiled for 8-10 minutes in water. It is then sifted.
Deep vein

# Overview
Deep vein is a term used to describe a vein that is deep in the body.  It is used to differentiate deep veins from veins which are close to the surface, also known as superficial veins.
Deep veins are almost always beside an artery with the same name (e.g. the femoral vein is beside the femoral artery).  Collectively, they carry the vast majority of the blood.  Occlusion of a deep vein can be life threatening and is most often caused by thrombosis.  Occlusion of a deep vein by thrombosis is called deep vein thrombosis.

# Some named deep veins
- internal jugular vein

### Upper limb
- brachial vein
- radial vein
- ulnar vein

### Lower limb
- femoral vein, sometimes called the superficial femoral vein, which is a source of confusion.
- profunda femoris vein
- popliteal vein
- peroneal vein
- anterior tibial vein
- posterior tibial vein
Deformity
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of the body a body part, or a body organ (internal or external) compared to the average shape for the part in question.
Deformity may arise from numerous causes:
- A genetic mutation
- Damage to the fetus or uterus
- Complications at birth
- A growth or hormone disorder
- Reconstructive surgery following a severe injury e.g. burn injury.
- Arthritis and other rheumatoid disorders
Irish Mythology includes the Fomorians, who are almost without exception described as being deformed, possessing only one of what most have two of (eyes, arms, legs, etc.) or having larger than normal limbs. Other mythological creatures may have been created due to a deformative syndrome also, for instance, descriptions of  mermaids may be related to the symptoms of sirenomelia.
Deformity can occur in non-humans, as well.  Frogs can be mutated due to Ribeiroia (Trematoda) infection.
It is important to note that in many cases, deformed individuals do not survive. For example, in many cases in which a major deformity is present at birth, it is the result of an underlying condition severe enough that the baby does not survive very long. Or, in cases in which an individual becomes deformed due to an event, the event may kill the individual.  In some societies, defective babies are abandoned at birth: some are saved by the "kindness of strangers"(See John Boswell).
Degloving
Degloving is a type of injury wherein an extensive section of skin is completely torn off the underlying tissue, severing its blood supply. It is named by analogy to the process of removing a glove.
Typically, degloving injuries affect the extremities and limbs; this is because any injury which would induce degloving of the head or torso is likely to be lethal. However, controlled facial degloving is often featured in plastic surgery.
Alexandros Kyriakidis established that degloved skin is effectively dead, and should be treated as a skin graft.
Many small mammals are able to induce degloving of their tails to escape capture ; this is comparable to tail autotomy in reptiles.
Delamanid

# Overview
Delamanid (USAN, codenamed OPC-67683) is an experimental drug for the treatment of multi-drug-resistant tuberculosis. It works by blocking the synthesis of mycolic acids in Mycobacterium tuberculosis, the organism which causes tuberculosis, thus destabilising its cell wall.
In phase II clinical trials, the drug was used in combination with standard treatments, such as four or five of the drugs ethambutol, isoniazid, pyrazinamide, rifampicin, aminoglycoside antibiotics, and quinolones. Healing rates (measured as sputum culture conversion) were significantly better in patients who additionally took delamanid.
The European Medicines Agency (EMA) recommended conditional marketing authorization for delamanid in adults with multidrug-resistant pulmonary tuberculosis without other treatment options because of resistance or tolerability.  The EMA considered the data show that the benefits of delamanid outweigh the risks, but that additional studies were needed on the long-term effectiveness.
Deliriant
The deliriants (or anticholinergics) are a special class of acetylcholine-inhibitor dissociatives. The name comes from their primary effect of inducing a medical state of frank delirium, characterized by stupor, utter confusion, confabulation, and regression to "phantom" behaviors such as disrobing and plucking. Other commonly reported behaviors include holding full and lifelike conversations with imagined people, finishing a complex, multi-stage action (such as getting dressed) and then suddenly discovering you had not even begun yet, and being unable to recognize one's own reflection in a mirror (and thus becoming angry with the "stranger's" acts of mimicry). The effects have been likened to sleepwalking, a fugue state or a psychotic episode (particularly in that the subject has minimal control over their actions and little to no recall of the experience). This is a notable departure from typical hallucinogens.
Included in this group are such Solanaceae plants as deadly nightshade, mandrake, henbane and datura (containing tropane alkaloids sometimes referred to as the Belladonna alkaloids), as well as a number of pharmaceutical drugs such as the antihistamine diphenhydramine (Benadryl) and the antiemetics dimenhydrinate (Dramamine or Gravol) and scopolamine. The chemical warfare agent BZ (3-Quinuclidinyl benzilate) is a highly-potent anticholinergic military incapacitating agent.
Despite the fully-legal status of several common deliriant plants, deliriants are largely unpopular as recreational drugs due to the severe and unpleasant nature of their disassociative effects. User reports of recreational deleriant usage on Erowid generally indicate a firm unwillingness to repeat the experience. In addition to their potentially-dangerous mental effects, many tropane alkaloids (such as scopolamine and atropine) are highly poisonous and can cause death due to tachycardia-induced heart failure and hyperthermia even in small doses. Other physical effects include intense and painful drying of the eyes and mucous membranes, as well as a pronounced dilation of the pupils which can last for several days resulting in sensitivity to light, blurry vision and inability to read.
Deliriants are common to European mythology, including the plants mandrake, deadly nightshade, and various datura species.

# Pharmacological classes of deliriants, and their general subjective effects
Entries marked with a # are naturally occurring

## Anticholinergics

### Tropanes
- Atropine (racemic Hyoscyamine) #
- Scopolamine #
- Hyoscyamine #

### Disubstituted glycolic acid esters
- 3-quinuclidinyl benzylate
- Ditran
- Benactyzine (Amisyl)

## Antihistaminics
- diphenhydramine (Benadryl or Unisom)
- dimenhydrinate (Dramamine)
- cyclizine (Marezine or Marzine)
Delta ray
A delta ray is sometimes used to describe any recoil particle that causes secondary ionization. The term was coined by J.J. Thomson. It is entirely unrelated to the family of subatomic particles named delta baryon.  The term is rarely used today.

# Characteristics
A delta ray is characterized by very fast electrons produced in quantity by alpha particles or other fast energetic charged particles knocking orbiting electrons out of atoms. Collectively, these electrons are defined as delta radiation when they have sufficient energy to ionize further atoms through subsequent interactions on their own. Delta rays appear as branches in the main track of a cloud chamber. These branches will appear nearer the start of the track of a heavy charged particle, where more energy is imparted to the ionized electrons.

# Delta rays in particle accelerators
Otherwise called a knock-on electron, the term "delta ray" is also used in high energy physics to describe single electrons in particle accelerators that are exhibiting characteristic deceleration.  In a bubble chamber, electrons will lose their energy more quickly than other particles through Bremsstrahlung and will create a spiral track due to their small mass and the magnetic field.  The Bremsstrahlung rate is proportional to the square of the acceleration of the electron.

# References in popular culture
In science fiction, a "delta ray" is often used to describe an undefined, fictional type of ray or radiation, sometimes as a hazard, sometimes used in energy weapons.
Vomitoxin
Vomitoxin, also known as deoxynivalenol (DON), is a type B trichothecene, an epoxy-sesquiterpeneoid. This mycotoxin occurs predominantly in grains such as wheat, barley, oats, rye, and maize, and less often in rice, sorghum, and triticale. The occurrence of deoxynivalenol is associated primarily with Fusarium graminearum (Gibberella zeae) and F. culmorum, both of which are important plant pathogens which cause Fusarium head blight in wheat and Gibberella ear rot in maize. A direct relationship between the incidence of Fusarium head blight and contamination of wheat with deoxynivalenol has been established. The incidence of Fusarium head blight is strongly associated with moisture at the time of flowering (anthesis), and the timing of rainfall, rather than the amount, is the most critical factor.
F. graminearum grows optimally at a temperature of 25 C and at a water activity above 0.88. F. culmorum grows optimally at 21 C and at a water activity above 0.87. The geographical distribution of the two species appears to be related to temperature, F. graminearum being the commoner species and occurring in warmer climates. Deoxynivalenol has been implicated in incidents of mycotoxicoses in both humans and farm animals.
Vomitoxin is rather a mild toxin compared to other toxins which can form in grains and forages. Reduced feed intake, and the accompanying decrease in performance, are the only symptoms of vomitoxin toxicity livestock producers will likely encounter. This response to vomitoxin appears to occur through the central nervous system. Vomitoxin belongs to a class of mycotoxins (tricothecenes) which are strong protein inhibitors. Inhibition of protein synthesis following exposure to vomitoxin causes the brain to increase its uptake of the amino acid tryptophan and, in turn, its synthesis of serotonin. Increased levels of serotonin are believed to be responsible for the anorexic effects of DON and other tricothecenes. Irritation of the gastrointestinal tract may also play a role in reducing feed intake... This fact may also partially explain the high incidence of pars esaughageal stomach ulcers observed in sows off feed during feed refusal.
- Human foods: Vomitoxin is not a known carcinogen as with aflatoxin. Large amounts of grain with vomitoxin would have to be consumed to pose a health risk to humans. The FDA has established a level of 1 ppm (parts per million) restriction of vomitoxin.
- Companion animals: Dogs and cats are restricted to 5 ppm and of grains and grain byproducts and that the grains not exceed 40% percent of the diet.
- Livestock and farm animals: In animals and livestock, vomitoxin causes a refusal to feed and lack of weight gain when fed above advised levels. Restrictions are set at 10 ppm for poultry and ruminating beef and feedlot cattle older than 4 months. Ingredients may not exceed 50% of the animal's diet. Dairy cow limits are set at 2 ppm.
Deracoxib
Deracoxib is a non-steroidal, anti-inflammatory drug of the coxib class.

# Indications and use
Deracoxib is commonly indicated for the control of pain and inflammation associated with osteoarthritis in dogs.  It is not approved or recommended for use of pain control in cats.

# Dosage
Postoperative Pain Relief:
3 to 4 mg/kg/day as needed, not to exceed 7 days.
Osteroarthitis Pain Relief:
1 to 2 mg/kg/day adjusted to minimum effective dose that has good clinical results
This could mean anywhere from 1/4 of a pill every other day to 1 pill every day.
High doses can cause Cox-1 inhibition even though this drug is selective to Cox-2, which in turn can cause the side effects associated with NSAIDs.

# Contraindications
Use of deracoxib should be avoided in dogs who are hypersensitive to deracoxib or other NSAID; it should only be used in such dogs with extreme caution.
It also shouldn't be administered to dogs with gastro-intestinal ulcers, renal disease, hepatic disorders, hypoproteinemia, dehydration, or cardiac disease without extreme caution.
Dogs with renal disease may need dose adjustment (if the benefits of the medience outweigh the risks) while those on concurrent diuretic therapy are at increased risk for NSAID toxicity and should not be given this medication.
Concurrent use with steriods or other NSAIDs should be avoided.
Safety has not been established in pregnant or nursing dogs, so deracoxib should not be administered to such dogs.
Safetly also hasn't been established in dogs younger than 4 months of age, but young dogs may be given this drug so long as they are monitored closely for side effects.
Dogs weighing less than 6.3 kg (under 4 lbs) should not be given this medience for osteoarthitis pain and inflammation, and those weighing less than 3.1 kg should not be given this medience for post-operative pain relief.
Deracoxib is not approved for use in cats, so it shouldn't be given to them for pain relief.

# Side Effects
As with all NSAIDs, this medication may cause gastric ulercations, evidenced by diarrhea, vomiting, and other GI problems, particularly during long-term use or in sensitive individuals.  The medication should be discontinued immediately if such side effects occur and owners should contact their veterinain.  Such side effects are more likely to occur if this drug is used in combination with other NSAIDs or with steroids; therefore is not recommended to give it with other NSAIDs or steriods.
Other side effects include depression, lethargy, increase in drinking or urination, jaundice, vomiting, bloody or black stools, pale gums, hot spots, lethargy, increased respiration (fast or heavy breathing), incoordination, and behavior changes.
Because the medication is a Cox-2 inhibitor and less likely to inhibit protective mechanisms of prostaglandins, side effects are not as common as in other NSAIDs such as aspirin.  Hence it is considered relatively safe in dogs.

# Brand names
- Novartis: Deramaxx

# External references
- American Clinical insert, Deramaxx
- Canadian Clinical insert, Deramaxx
- Novartis Deramaxx site