Persius/hicric huggingface dataset:
Rho(D) Immune Globulin

# Overview
Rho(D) Immune Globulin is a medicine given by intermuscular injection which is used  to prevent the immunological condition known as Rhesus disease (or hemolytic disease of newborn). It can prevent maternal sensitization by Rh D antigens on the surface of blood cells from a Rhesus positive fetus in a Rhesus negative mother.  The medicine is a solution of IgG anti-D (anti-RhD) antibodies which binds and destroys fetal Rh D positive red blood cells that have passed through the placenta from the fetus to the maternal circulation.  This prevents maternal B-cell activation and memory cell formation. With the widespread use Rho(D) Immune Globulin Rh disease of the fetus and newborn has almost disappeared. It can also be used in the treatment of ITP in Rh+ patients.

# History
RhoGAM was introduced by Ortho-Clinical Diagnostics, a subsidiary holding of Johnson and Johnson, and first administered on May 29, 1968. It has been estimated that with its use a perinatal mortality of about 10,000 cases per year in the US alone has been largely eliminated.

# Human blood product
Rho(D) Immune Globulin is a derivative of human plasma. In the manufacturing process steps are taken to eliminate bacterial and viral contamination. In some patients it may trigger an allergic reaction. However, the possibility of transmission of Creutzfeldt-Jakob disease remains as a residual risk. The technique of Plasma Fractionation was founded by James F. Crispen, M.D.

# Use
The medication has a Food and Drug Administration (FDA) Pregnancy Category C. It is given by intramuscular injection as part of modern antenatal care and within 72 hours after childbirth.

# Brand names
RhoGAM and MICRhoGam are brand names of Johnson and Johnson. Other brand names are: BayRHo-D, Gamulin Rh, HypRho-D Mini-Dose, Mini-Gamulin Rh, Rhophylac, and WinRho SDF.
Ribavirin how supplied

# How Supplied
REBETOL 200 mg Capsules are white, opaque capsules with REBETOL, 200 mg, and the Schering Corporation logo imprinted on the capsule shell; the capsules are packaged in a bottle containing 56 capsules (NDC 0085-1351-05), 70 capsules (NDC 0085-1385-07), and 84 capsules (NDC 0085-1194-03).
REBETOL Oral Solution 40 mg per mL is a clear, colorless to pale or light yellow bubble gum-flavored liquid and it is packaged in 4-oz amber glass bottles (100 mL/bottle) with child-resistant closures (NDC 0085-1318-01).
The bottle of REBETOL Capsules should be stored at 25C (77F); excursions permitted to 15-30C (59-86F) .
REBETOL Oral Solution should be stored between 2-8C (36-46F) or at 25C (77F); excursions permitted to 15-30C (59-86F) .
Rifabutin how supplied

# How Supplied
MYCOBUTIN Capsules (rifabutin capsules, USP) are supplied as hard gelatin capsules having an opaque red-brown cap and body, imprinted with MYCOBUTIN/PHARMACIA & UPJOHN in white ink, each containing 150 mg of rifabutin, USP.
MYCOBUTIN is available as follows:
NDC 0013-5301-17                Bottles of 100 capsules
Keep tightly closed and dispense in a tight container as defined in the USP. Store at 25C (77F); excursions permitted to 1530C (5986F) .
Rifapentine overdosage

# Overdosage
There is no experience with the treatment of acute overdose with rifapentine at doses exceeding 1200 mg per dose.
In a pharmacokinetic study involving healthy volunteers (n=9), single oral doses up to 1200 mg have been administered without serious adverse events. The only adverse events reported with the 1200 mg dose were heartburn (3/8), headache (2/8) and increased urinary frequency (1/8). In clinical trials, tuberculosis patients ranging in age from 20 to 74 years accidentally received continuous daily doses of rifapentine 600 mg. Some patients received continuous daily dosing for up to 20 days without evidence of serious adverse effects. One patient experienced a transient elevation in SGPT and glucose (the latter attributed to pre-existing diabetes); a second patient experienced slight pruritus. While there is no experience with the treatment of acute overdose with rifapentine, clinical experience with rifamycins suggests that gastric lavage to evacuate gastric contents (within a few hours of overdose), followed by instillation of an activated charcoal slurry into the stomach, may help adsorb any remaining drug from the gastrointestinal tract.
Rifapentine and 25-desacetyl rifapentine are 97.7% and 93.2% plasma protein bound, respectively. Rifapentine and related compounds excreted in urine account for only 17% of the administered dose, therefore, neither hemodialysis nor forced diuresis is expected to enhance the systemic elimination of unchanged rifapentine from the body of a patient with Rifapentine overdose.
Rifaximin how supplied

# How Supplied/Storage And Handling
200 mg tablet is a pink-colored, round, biconvex tablet with Sx debossed on one side.  It is available in the following presentations:
- NDC 65649-301-03, bottles of 30 tablets
- NDC 65649-301-41, bottles of 100 tablets
- NDC 65649-301-05, carton of 100 tablets, unit dose
The 550 mg tablet is a pink-colored, oval, biconvex tablet with rfx debossed on one side.  It is available in the following presentations:
- NDC 65649-303-02, bottles of 60 tablets
- NDC 65649-303-03, carton of 60 tablets, unit dose

# Storage
Store XIFAXAN Tablets at 2025C (6877F); excursions permitted to 1530C (59-86F). See USP Controlled Room Temperature.
Rifaximin microbiology

# Microbiology

## Mechanism of Action
Rifaximin is a non-aminoglycoside semi-synthetic antibacterial derived from rifamycin SV.  Rifaximin acts by binding to the beta-subunit of bacterial DNA-dependent RNA polymerase resulting in inhibition of bacterial RNA synthesis.
Escherichia coli has been shown to develop resistance to rifaximin in vitro.  However, the clinical significance of such an effect has not been studied.
Rifaximin is a structural analog of rifampin. Organisms with high rifaximin minimum inhibitory concentration (MIC) values also have elevated MIC values against rifampin. Cross-resistance between rifaximin and other classes of antimicrobials has not been studied.
Rifaximin has been shown to be active against the following pathogen in clinical studies of infectious diarrhea as described in the Indications and Usage  section: Escherichia coli (enterotoxigenic and enteroaggregative strains).
For HE, rifaximin is thought to have an effect on the gastrointestinal flora.

## Susceptibility Tests
In vitro susceptibility testing was performed according to the National Committee for Clinical Laboratory Standards (NCCLS) agar dilution method M7-A6 . However, the correlation between susceptibility testing and clinical outcome has not been determined.
Rio Tabac Alpha Series
Rio Tabac Alpha Series is a brand of hand-made premium cigar owned by Rocky's Cigars, Inc..

# History
The Rio Tabac Alpha Series was created in 2006 by Jose "Pepin" Garcia and is manufactured in  Nicaragua. It was originally made at El Rey de los Habanos factory in Miami, Florida, but is no longer made by Don Pepin.

# R
This range is the first in the Alpha Series. The 'R' stands for Robust. 

## Description
This is a full-bodied cigar. The wrapper is a Criollo '98 Oscuro, dark, but not jet-black. The filler, as always with Don Pepin's blends, is an all-Nicaraguan blend known as Blend No. 7.  The specific binder is unknown, although most likely a Nicaraguan leaf.

## Models/Vitolas

# Notes
-  Jump up to: 1.0 1.1 Catalogue blurb.
Rizatriptan overdosage

# Overdosage
No overdoses of MAXALT were reported during clinical trials in adults.
Some adult patients who received 40 mg of MAXALT either a single dose or as two doses with a 2-hour interdose interval had dizziness and somnolence.
In a clinical pharmacology study in which 12 adult subjects received MAXALT, at total cumulative doses of 80 mg (given within four hours), two of the subjects experienced syncope, dizziness, bradycardia including third degree AV block, vomiting, and/or incontinence.
In the long-term, open label study, involving 606 treated pediatric migraineurs 12 to 17 years of age (of which 432 were treated for at least 12 months), 151 patients (25%) took two 10-mg doses of MAXALT-MLT within a 24-hour period. Adverse reactions for 3 of these patients included abdominal discomfort, fatigue, and dyspnea.
In addition, based on the pharmacology of MAXALT, hypertension or myocardial ischemia could occur after overdosage. Gastrointestinal decontamination, (i.e., gastric lavage followed by activated charcoal) should be considered in patients suspected of an overdose with MAXALT. Clinical and electrocardiographic monitoring should be continued for at least 12 hours, even if clinical symptoms are not observed.
The effects of hemo- or peritoneal dialysis on serum concentrations of rizatriptan are unknown.
Rosiglitazone overdose

# Overdose
Limited data are available with regard to overdosage in humans. In clinical studies in
volunteers, AVANDIA has been administered at single oral doses of up to 20 mg and was
well-tolerated. In the event of an overdose, appropriate supportive treatment should be initiated
as dictated by the patients clinical status.
Adapted from the FDA Package Insert.
Salicylate sensitivity
Salicylate sensitivity, also known as salicylate intolerance, is a chemical reaction that occurs when too much salicylate (salicylic acid) is introduced into a person's system. Salicylates are chemicals that occur naturally in plants and serve as a natural immune hormone and preservative, protecting the plants against diseases, insects, fungi, and harmful bacteria. Salicylate can also be found synthetically in many medicines, perfumes and preservatives. This chemical can cause health problems in anyone when consumed in large doses. But, for those who are salicylate intolerant even small doses of salicylate can cause reactions. This reaction is different than a true allergy as it is a pharmacological reaction (like the side effects of a drug) and not an immunological reaction. People with salicylate sensitivity are unable to handle more than a certain amount of salicylates at a time without symptoms occurring.

# Symptoms
The most common symptoms of salicylate sensitivity are:
- Itchy skin, hives or rashes
- Stomach pain/upset stomach
- Asthma and other breathing difficulties
- Headaches
- Swelling of hands, feet, eyelids, face and/or lips
- Bed wetting or urgency to pass water
- Mouth ulcers or raw hot red rash around the mouth
- Persistent cough
- Changes in skin color/skin discoloration
- Fatigue
- Sore, itchy, puffy or burning eyes
- Sinusitis/Nasal polyps
- Diarrhea
- Nausea
- Hyperactivity
- Memory loss and poor concentration
- Depression
- ADD/ADHD
- Pseudo-anaphylaxis

# Treatment
Because salicylate intolerance is not a true allergy there is currently no scientific method that will accurately determine if a person is sensitive to salicylates or not. This is because salicylate sensitivity is a dose-related reaction and symptoms only occur when the tolerance level of the individual has been exceeded. One method currently available to determine food intolerance is an elimination diet. Completely eliminating salicylate from ones diet and environment for 4 to 6 weeks can decrease or possibly eliminate all symptoms involved with salicylate intolerance. After this time period, most salicylate intolerant people can consume or come into contact with occasional small doses of salicylate without symptoms re-occurring. Alternately, those who are extremely sensitive to salicylates should avoid salicylates as much as possible.
Contraindicated medicines
- Tromethamine
Salter-Harris fracture

# Overview
Injuries leading to the bone fracture affecting the epiphyseal plate, or physis, are important and common in orthopedic medicine and the cause diagnostic and treatment challenges for orthopaedic surgeons. The related incidence rate of these fracture among pedicatric population is 15-20%.

# Historical Perspective 
In 1863, Foucher JT was the first person who described the injuries affecting the epiphyseal plate.
In 1895, Poland J, classified the injuries affecting the epiphyseal plat into the four types.
In 1936 , Aitken AP, defined the specific differences of different types of physes based on their differences in: structure, location, weightbearing status, and susceptibility to injury.
In 1963, two Canadian orthopaedic surgeons, Robert B. Salter (19242010) and W. Robert Harris (19222005), introduced a physeal fracture classification system according to the anatomy, fracture pattern, and prognosis of bone fracture.
Then, various researchers and physicians tried to expanded the original work of Salter and Harris in order to make it to be to be more comprehensive:
In 1968, Rang M, added a different sixth type of physeal injuries describing the caused damage to the perichondral ring due to the direct open injuries to the affected bone.
In 1981, Ogden JA, described nine types of injuries such as injuries affecting the developing bones other growth mechanisms.

# Salter-Harris classification
Sandbox/intraabdominal

# Overview

# Definitions
From a clinical view, intra-abdominal infections can be classified in:
- Uncomplicated, in which the infectious process involves only a single organ and there is no anatomical disruption
- Complicated, in which the infectious process extends beyond the hollow viscus into the peritoneal space and is associated with abscess formation or peritonitits.
Patients with uncomplicated intra-abdominal infections usually do not need antimicrobial therapy besides perioperative prophylaxis and can be managed with surgery alone (i.e. appendicitis).
A health care-associated infection is a new term that describe patients that have a close contact with health systems, they include community-onset infection and hospital-onset infection. The following table describes the two types of health care-associated infection that would guide the therapeutic regimen. 

# Principles of Therapy for Complicated Intra-abdominal Infection
The following table describes the factors that define a high risk infection, due to an increase chance of treatment failure and a more severe infection.
- All patients should undergo a source control procedure to clear infected foci.
- Patients should undergo fluid resuscitation to restore cardiovascular homeostasis. For patients with septic shock, follow The Surviving Sepsis Campaign guidelines for managing septic shock.
- If the diagnosis of intra-abdominal infection is confirmed or is considered highly likely, antibiotics should be initiated immediately.
- Patients without septic shock should receive the proper ] in the emergency department.
- Only cultures from the site of infection should be obtained from higher-risk patients, for patients with lower-risk community-acquired infection, cultures are optional.
- Sensibility testing for Pseudomonas, Proteus, Acinetobacter, Staphylococcus aureus, and Enterobacteriaceae should be done, as this organisms have shown higher resistance rates in recent years.
- Lower-risk patients with community-acquired intra-abdominal infection which show favorable clinical progress do not require modification of therapy.
- If microorganisms with high pathogenic potential are found, susceptibility results should be used to determine antibiotic therapy in high-severity community-acquired or health care-associated infection.
- The recommended duration of therapy is 4-7 days.
- Completion of the antibiotic course with oral presentations can be considered if the patient evolves favorably, is  able to tolerate an oral diet and if his susceptibility studies do not show resistant microorganisms.

# Extra-biliary Complicated Intra-abdominal Infection

## Community-Acquired
 Click on the following categories to expand treatment regimens.

## Health Care-Associated
 Click on the following categories to expand treatment regimens.

# Biliary Infection

## Community-acquired Acute Cholecystitis
 Click on the following categories to expand treatment regimens.

## Health Care-Associated Biliary Infection
Sandbox: DDx pancrease
- Done:
- Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Solid-pseudopapillary tumour of pancreas, Insulinoma, Gastrinoma, Glucagonoma, VIPoma, Somatostatinoma
- Zollinger-Ellison syndrome, Adenocarcinoma of pancreas, Solid-pseudopapillary tumour of pancreas, Insulinoma, Gastrinoma, Glucagonoma, VIPoma, Somatostatinoma
, , Intraductal papillary mucinous neoplasm, Mucinous cystic neoplasm, Pancreatic intraepithelial neoplasia, Pancreatoblastoma, Serous cystadenoma, carcinoma,Intraductal papillary mucinous neoplasm (IPMN), Serous cystadenoma, Mucinous cystic neoplasm, ,  ,,  Pancreatic ductal adenocarcinoma Solid-pseudopapillary neoplasm
- Rare
- Colloid carcinoma
- Hepatoid carcinoma
- Signet ring cell
- Pancreatic teratoma
- Pancreatic lymphoma
- Pancreatic Sarcoma
- Undifferentiated carcinoma/Undifferentiated carcinoma with osteoclast-like giant cell
- Neurofibroma
- Elderly
- Positive history of other cancer
- Present with abdominal pain, malabsorption symptoms, gastric outlet obstruction symptoms, and gastrointestinal bleeding symptoms
Sandbox: cysticercosis
Presenting symptoms vary with accorfing to the site of infestation:
Neurocysticercosis:
Parenchymal:
Many cases (up to 80%) can remain asymptomatic and discovered either in autopsies or accidentallt during routine imaging. 19
Seizures: Most common manifestation of parenchymal neuroccysticercosis.20Seizers can be focal, generalized or focal with secondary generalization.  
Headache
Nausea and vomiting
Psychiatric disorders: has a wide variatoin from abnormal dysfunction and up to dementia (20)
Extraparenchymal:
Ocular cysticercosis:
Symptoms depend on the exact site of infestation in the eye. Retinal and subretinal infestaion have the worst prognosis and are the most difficult to treat.
Extraneural in the brain ventricles and subarachnoid space:
Cysticerci obstruct of the flow of the CSF and cause hydrocephalus. Symptoms usually result from increased intracranial pressure.
Headache
Nausea and vomiting
Decreased visual acuity
Seizures
Spinal cord cysticercosis:
very rare (1.5-3%) of all the cases. (21)
Presentaion depends on the site of the lesion.
Paraesthesia
radicular pain
Muscular weakness due to LMN lesions
Extraneural cysticercosis:
Cutanuous:
May be asymtomatic
Irritation and disfigurement by the nodules
Muscular:
Asymptoamtic
Muscle aches and weakness
- Cysticerci in the muscles: Cysticerci in the muscles generally do not cause symptoms. However, you may be able to feel lumps under your skin.
- Cysticerci in the eyes: Although rare, cysticerci may float in the eye and cause Blurred Vision. Infection in the eyes may cause Swelling or detachment of the retina.
- Neurocysticercosis (cysticerci in the brain, spinal cord): Symptoms of neurocysticercosis depend upon where and how many cysticerci (often called lesions) are found in the brain. Seizures, and Headache are the most common symptoms. However, confusion, lack of attention to people and surroundings, difficulty with balance, swelling of the brain (called hydrocephalus) may also occur. Death can occur suddenly with heavy infections.
Symptoms can occur months to years after infection, usually when the cysts are in the process of dying. When this happens, the brain can swell. The pressure caused by swelling is what causes most of the symptoms of neurocysticercosis. Most people with cysticerci in muscles wont have symptoms of infection.
Sandbox:classification

# Overview

# Classification
- There is no established system for the classification of .
OR
-  may be classified according to  into  subtypes/groups: , , , and .
OR
-  may be classified into  subtypes based on , , and .
-  may be classified into several subtypes based on , , and .
OR
- Based on the duration of symptoms,  may be classified as either acute or chronic.
OR
- If the staging system involves specific and characteristic findings and features:
- According to the , there are  stages of  based on the , , and . Each stage is assigned a  and a  that designate the  and .
OR
- The staging of  is based on the .
OR
- There is no established system for the staging of .
Sandbox adenoid cystic

# Overview
Adenoid cystic cancer (AdCC) is a very rare type of cancer that can exist in many different body sites.  It most often occurs in the areas of the head and neck, in particular the salivary glands; but has also been reported in the breast, lacrimal gland of the eye, lung, brain, bartholin gland, and the trachea.  It is  sometimes referred to as adenocyst, malignant cylindroma, adenocystic, adenoidcystic, ACC, AdCC.

# Pathophysiology
- Adenoid cystic carcinoma (sometimes referred to as adenocyst, malignant cylindroma, adenocystic, adenoidcystic, ACC or AdCC.) is a rare type of cancer that can exist in many different body sites.  Despite this tumor most often occurs in the salivary glands, it can also be found in many anatomic sites, including the breast, lacrimal gland, lung, brain, bartholin gland, trachea, and the paranasal sinuses.
- It is the third most common malignant salivary gland tumor overall (after mucoepidermoid carcinoma and polymorphous low grade adenocarcinoma). It represents 28% of malignant submandibular gland tumors, making it the single most common malignant salivary gland tumor in this region.  Patients may survive for years with metastases because this tumor is generally well-differentiated and slow growing. - In a 1999 study of a cohort of 160 ACC patients, disease specific survival was 89% at 5 years but only 40% at 15 years, reflecting deaths from late-occurring metastatic disease.

## Microscopic Pathology

### Video
Shown below is a video describing the microscopic features of Adenoid cystic carcinoma

# Treatment

## Surgery
- Primary treatment for this cancer, regardless of body site, is surgical removal with clean margins. This can be challenging in the head and neck region due to this tumour's tendency spread along nerve tracts.

## Medical Therapy
- Adjuvant or palliative radiotherapy is commonly given following surgery. Chemotherapy is used for metastatic disease. Chemotherapy is considered on a case by case basis, as there is little data on the positive effects of chemotherapy.  Clinical studies are ongoing, however.
- Recently, one of the women with a patient journal was treated with radiofrequency ablation for metastatic tumors in the lung.
- Radiofrequency ablation is a relatively new technique in the treatment of cancers, generally soft-tissue areas such as the liver and lungs, especially ones that make normal surgery not an option.

# Case Study

## Case #1
In this patient's case, she had 6 small (largest had grown to 2 cm when she went in for surgery) metastatic tumors in both of her lungs. Since surgical removal of both lungs is (obviously) not an option, pinpoint targeting of tumors with a microwave to "cook" the cancerous tumor was a much better option.  As far as her doctor could tell, this is the first attempt at using this procedure on AdCC.  There has also been some work in the lungs, albeit with other forms of cancer, with cryoablation which freezes rather than cooks the tumor.