Persius/hicric huggingface dataset:
El Rey de los Habanos (cigar brand)
El Rey de los Habanos is  a brand of premium hand-rolled cigars created and owned by Jose "Pepin" Garcia.

# History
The El Rey de los Habanos is the first brand of premium cigars to be created by Jose "Pepin" Garcia after his arrival in the United States and is manufactured at the El Rey de los Habanos factory in Little Havana, Miami, Florida. It was released to national distribution in 2005.

# Description
It is medium to full-bodied, with a creamy, rich taste. It is a Nicagraguan puro, being constructed entirely of tobacco from Nicaragua. The wrapper is a colorado maduro in color.
The current range consists of four vitolas. It was originally offered in bundles of 25 uncellophaned cigars, but in early 2007, the packaging was changed to semi-varnished slide-top boxes of 23.
Its red band has led to it being called the "Don Pepin Red Label."

# Models/Vitolas

# See Also
- Perelman, Richard B., comp. Perelman's Pocket Cyclopedia of Cigars, 2006 edn. Los Angeles: Perelman, Pioneer & Co., (2005). p. 215.
Emtricitabine indications and usage

# Indications and Usage
EMTRIVA is indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection.
Additional important information regarding the use of EMTRIVA for the treatment of HIV-1 Infection.
EMTRIVA should not be coadministered with ATRIPLA, COMPLERA, STRIBILDTM, TRUVADA, or lamivudine-containing products.
In treatment-experienced patients, the use of EMTRIVA should be guided by laboratory testing and treatment history.
Emtricitabine rilpivirine tenofovir

# Overview
Emtricitabine/rilpivirine/tenofovir (trade name Complera, Eviplera) is a fixed dose combination of antiretroviral drugs for the treatment of HIV.  The drug was co-developed by Gilead Sciences and Johnson & Johnson's Tibotec division and was approved by the Food and Drug Administration in August 2011, and by the European Medicines Agency in November 2011 (Eviplera), for patients who have not previously been treated for HIV.  It is available as a once-a-day single tablet.

# Category
Antiretroviral

# US Brand Names
COMPLERA

# FDA Package Insert
Description

# Mechanism of Action
COMPLERA is a fixed-dose combination of the antiretroviral drugs emtricitabine, rilpivirine and tenofovir disoproxil fumarate.
- Emtricitabine: Emtricitabine, a synthetic nucleoside analog of cytidine, is phosphorylated by cellular enzymes to form emtricitabine 5'-triphosphate. Emtricitabine 5'-triphosphate inhibits the activity of the HIV-1 RT by competing with the natural substrate deoxycytidine 5'-triphosphate and by being incorporated into nascent viral DNA which results in chain termination. Emtricitabine 5-triphosphate is a weak inhibitor of mammalian DNA polymerase , , , and mitochondrial DNA polymerase .
- Rilpivirine: Rilpivirine is a diarylpyrimidine non-nucleoside reverse transcriptase inhibitor of HIV-1 and inhibits HIV-1 replication by non-competitive inhibition of HIV-1 RT. Rilpivirine does not inhibit the human cellular DNA polymerases , , and mitochondrial DNA polymerase .
- Tenofovir Disoproxil Fumarate: Tenofovir DF is an acyclic nucleoside phosphonate diester analog of adenosine monophosphate. Tenofovir DF requires initial diester hydrolysis for conversion to tenofovir and subsequent phosphorylations by cellular enzymes to form tenofovir diphosphate. Tenofovir diphosphate inhibits the activity of HIV-1 RT by competing with the natural substrate deoxyadenosine 5-triphosphate and, after incorporation into DNA, by DNA chain termination. Tenofovir diphosphate is a weak inhibitor of mammalian DNA polymerases , , and mitochondrial DNA polymerase .
Entecavir dosage and administration

# Dosage And Administration
BARACLUDE should be administered on an empty stomach (at least 2 hours after a meal and 2 hours before the next meal).

## Recommended Dosage
Compensated Liver Disease
The recommended dose of BARACLUDE for chronic hepatitis B virus infection in nucleoside-treatment-naive adults and adolescents 16 years of age and older is 0.5 mg once daily.
The recommended dose of BARACLUDE in adults and adolescents (at least 16 years of age) with a history of hepatitis B viremia while receiving lamivudine or known lamivudine or telbivudine resistance mutations rtM204I/V with or without rtL180M, rtL80I/V, or rtV173L is 1 mg once daily.
Decompensated Liver Disease
The recommended dose of BARACLUDE for chronic hepatitis B virus infection in adults with decompensated liver disease is 1 mg once daily.
Oral Solution
BARACLUDE (entecavir) Oral Solution contains 0.05 mg of entecavir per milliliter. Therefore, 10 mL of the oral solution provides a 0.5 mg dose and 20 mL provides a 1 mg dose of entecavir.

## Renal Impairment
In subjects with renal impairment, the apparent oral clearance of entecavir decreased as creatinine clearance decreased . Dosage adjustment is recommended for patients with creatinine clearance less than 50 mL/min, including patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD), as shown in Table 1. The once-daily dosing regimens are preferred.

## Hepatic Impairment
No dosage adjustment is necessary for patients with hepatic impairment.

## Duration of Therapy
The optimal duration of treatment with BARACLUDE for patients with chronic hepatitis B virus infection and the relationship between treatment and long-term outcomes such as cirrhosis and hepatocellular carcinoma are unknown.
Etravirine warnings and precautions

# Warnings and Precautions

## Severe Skin and Hypersensitivity Reactions
Severe, potentially life-threatening, and fatal skin reactions have been reported. These include cases of Stevens-Johnson syndrome, toxic epidermal necrolysis and erythema multiforme. Hypersensitivity reactions including Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) have also been reported and were characterized by rash, constitutional findings, and sometimes organ dysfunction, including hepatic failure. In Phase 3 clinical trials, Grade 3 and 4 rashes were reported in 1.3% of subjects receiving INTELENCE compared to 0.2% of placebo subjects. A total of 2.2% of HIV-1-infected subjects receiving INTELENCE discontinued from Phase 3 trials due to rash . Rash occurred most commonly during the first 6 weeks of therapy. The incidence of rash was higher in females 
Discontinue INTELENCE immediately if signs or symptoms of severe skin reactions or hypersensitivity reactions develop (including, but not limited to, severe rash or rash accompanied by fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, facial edema, hepatitis, eosinophilia, angioedema). Clinical status including liver transaminases should be monitored and appropriate therapy initiated. Delay in stopping INTELENCE treatment after the onset of severe rash may result in a life-threatening reaction.

## Fat Redistribution
Redistribution/accumulation of body fat, including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and "cushingoid appearance" have been observed in patients receiving antiretroviral therapy. The mechanism and long-term consequences of these events are currently unknown. A causal relationship has not been established.

## Immune Reconstitution Syndrome
Immune reconstitution inflammatory syndrome has been reported in patients treated with combination antiretroviral therapy, including INTELENCE. During the initial phase of combination antiretroviral treatment, patients whose immune system responds may develop an inflammatory response to indolent or residual opportunistic infections (such as Mycobacterium avium infection, cytomegalovirus, Pneumocystis jiroveci pneumonia (PCP) or tuberculosis), which may necessitate further evaluation and treatment.
Autoimmune disorders (such as Graves' disease, polymyositis, and Guillain-Barre syndrome) have also been reported to occur in the setting of immune reconstitution; however, the time to onset is more variable, and can occur many months after initiation of treatment.
Fluid attenuated inversion recovery

# Overview
Fluid Attenuated Inversion Recovery (FLAIR) is a pulse sequence used in Magnetic Resonance Imaging.
The pulse sequence is an inversion recovery technique that nulls fluids. For example, it can be used in brain imaging to suppress Cerebrospinal fluid (CSF) so as to bring out the periventricular hypertintense lesions, such as multiple sclerosis (MS) plaques.
By carefully choosing the TI, the signal from any particular tissue can be nulled. The appropriate TI depends on the tissue via the formula:
One should typically yield a TI of 70% of T1. In the case of CSF suppression, one aims for T2 weighted images.
Fibroblast growth factor receptor 4
Fibroblast growth factor receptor 4 is a protein that in humans is encoded by the FGFR4 gene. FGFR4 has also been designated as CD334 (cluster of differentiation 334).
The protein encoded by this gene is a member of the fibroblast growth factor receptor family, where amino acid sequence is highly conserved between members and throughout evolution. FGFR family members differ from one another in their ligand affinities and tissue distribution. A full-length representative protein would consist of an extracellular region, composed of three immunoglobulin-like domains, a single hydrophobic membrane-spanning segment and a cytoplasmic tyrosine kinase domain. The extracellular portion of the protein interacts with fibroblast growth factors, setting in motion a cascade of downstream signals, ultimately influencing mitogenesis and differentiation. The genomic organization of this gene, compared to members 1-3, encompasses 18 exons rather than 19 or 20. Although alternative splicing has been observed, there is no evidence that the C-terminal half of the IgIII domain of this protein varies between three alternate forms, as indicated for members 1-3. This particular family member preferentially binds acidic fibroblast growth factor and, although its specific function is unknown, it is overexpressed in gynecological tumor samples, suggesting a role in breast and ovarian tumorigenesis.

# Interactions
Fibroblast growth factor receptor 4 has been shown to interact with FGF1.
Flowing afterglow mass spectrometry
Flowing afterglow mass spectrometry, FA-MS, is a sensitive and quantitative mass spectrometry analytical approach that offers a route to on-line, real-time deuterium abundance measurements in water vapour in breath and above aqueous liquids, including urine and serum. This method involves the production and flow of thermalised hydrated hydronium cluster ions in inert helium or argon carrier gas along a flow tube following the introduction of a humid air sample. These ions react in multiple collisions with water molecules, their isotopic compositions reach equilibrium and the relative magnitudes of their isotopomers are measured by a quadrupole mass spectrometer located downstream.

# Trace Gas Analysis
One of the first papers reporting the use of the flowing afterglow was reported in Planet Space Sci in 1966 by Norton, Ferguson, Fehsenfeld, and Schmeltekopf.  They studied ion-molecule reactions pertinent to the Martian atmosphere.  This flowing afterglow technique replaced the then standard stationary afterglow.  Flowing afterglow has many attractive aspects: well-understood laminar behavior, viscous gas flow,  a large density of carrier gas which allows the study of thermalized reactions, and the capability to make new reactant ions in situ.  The ambipolar plasma is sampled using a nosecone and detected using conventional quadrupole or tandem mass spectrometry, depending on the application.  One of the drawbacks of the flowing afterglow technique is the possibility of generating 
multiple reactant ions.  This problem is cicumvented by implementing the selected ion flow tube (SIFT).
The flowing afterglow technique can be used to identify and quantify the volatile organic compounds (VOCs) of a sample as long as the fundamental ion chemistry is known.  The commonly used ions are H3O+, O2+*, and NO+.  All ions have drawbacks and advantages.  Strategies that have been employed to unequivacally identify the VOCs include using gas chromatography coupled with flowing afterglow and   using a complement of reagent ions.  Detection limits are typically in the parts per billion range if there is limited sample or parts per trillion if there is an unlimited sample size.
Fosamprenavir indications and usage

# Indications and Usage
LEXIVA is indicated in combination with other antiretroviral agents for the treatment of human immunodeficiency virus (HIV-1) infection.
The following points should be considered when initiating therapy with LEXIVA plus ritonavir in protease inhibitor-experienced patients:
The protease inhibitor-experienced patient trial was not large enough to reach a definitive conclusion that LEXIVA plus ritonavir and lopinavir plus ritonavir are clinically equivalent.
Once-daily administration of LEXIVA plus ritonavir is not recommended for adult protease inhibitor-experienced patients or any pediatric patients.
Dosing of LEXIVA plus ritonavir is not recommended for protease inhibitor-experienced pediatric patients younger than 6 months.
Getting the wind knocked out of you
Getting the wind knocked out of you is a kind of diaphragm spasm that occurs when sudden force is applied to the abdomen which puts pressure on the solar plexus. It results in a temporary paralysis of the diaphragm that makes it difficult to breathe for a short period of time.  It can also occur from a strong blow to the back.
When the abdomen is struck, a large difference in pressure occurs across the diaphragm. The diaphragm then stretches, which also stretches the diaphragm's nerves. The resulting mechanical force puts the diaphragm into a muscle spasm, comparable to having a charley horse in the leg. It takes a few seconds for the diaphragm to relax again before breathing can resume normally. Martial artists are often taught to breathe out heavily when struck in the stomach, to minimize this effect.
Often the laryngial muscles contract during diaphragm spasm producing an inspiratory sound known as stridor which can be heard for several cycles as breathing resumes. Singultus, commonly known as the hiccups, is also a form of diaphragm spasm, although much milder.  A singultus episode impairs voluntary breathing control for brief moments (measured in milliseconds) rather than for several seconds.
Glycogen phosphorylase isoenzyme BB
Glycogen phosphorylase isoenzyme BB (abbreviation: GPBB) is an isoenzyme of glycogen phosphorylase. This isoform of the enzyme exists in cardiac (heart) and brain tissue.
The enzyme is one of the "new cardiac markers" which are discussed to improve early diagnosis in acute coronary syndrome. A rapid rise in blood levels can be seen in myocardial infarction and unstable angina.
Other enzymes related to glycogen phosphorylase are abbreviated as GPLL (liver) and GPMM (muscle).
H.pylori infection diagnostic tests

# Overview
In developed countries, the use of test and treat strategy is declining for younger patients presenting with dyspepsia. In developing countries, as the rates of ulcer or gastric cancer are high, the more appropriate initial approach in the diagnosis of H. pylori infection in developing countries are an empirical test-and-treat approach or initial endoscopy.

# Developed countries
- The use of a test-and-treat strategy is declining for younger patients presenting with dyspepsia.
- The preferred first-line treatment when the H. pylori prevalence is <20% is the immediate use of an antisecretory drug (proton-pump inhibitor).
- For those aged 50 and older, endoscopy to exclude an upper gastrointestinal malignancy and testing for H. pylori infection if no malignancy is found remains a logical approach.
- Testing for H. pylori infection should be carried out in younger patients in countries with a high risk of gastric cancer.

# Developing countries
AS the rates of ulcer or gastric cancer are high, the more appropriate initial approach in diagnosis of H. pylori infection in developing countries are:
- An empirical test-and-treat approach
-r
- Initial endoscopy
Hypothalamic-pituitary-gonadal axis
The hypothalamic-pituitary-gonadal axis (also HPTA) is a way of referring to the combined effects of the hypothalamus, pituitary gland, and gonads as if these individual endocrine glands were a single entity.  Because these glands often behave in cooperation, physiologists and endocrinologists find it convenient and descriptive to speak of them as a single system.
The hypothalamic-pituitary-gonadal axis is a critical part in the development and regulation of a number of the body's systems, such as the reproductive and immune systems.
The pathway is often described as beginning with GnRH (Gonadotropin Releasing Hormone) secretion from parvicellular neurons in the arcuate nucleus into the median eminence. GnRH then enters the hypophyseal portal system, traveling in the long vein until reaching the anterior pituitary, where it acts on gonadotropes to release LH (luetenizing hormone) and FSH (follicle stimulating hormone) back into the blood stream. LH and FSH both act on the gonads to produce varying effects, including release of sex hormones and keeping the gonadal integrity. Hormone release in the hypothalamic-pituitary-gonadal axis is regulated typically by a negative feedback mechanism, driven through negative feedback on gonadotropes in the anterior pituitary or by more indirect inhibition of MPH neurons from positively stimulating parvicellular neurons in the arcuate nucleus. Stimulation and regulation complete the pathway between hypothalamus, pituitary and gonads.

# Regulation
The hypothalamic-pituitary-gonadal pathway is regulated normally through negative feedback by hydrophobic and hydrophilic hormones. LH from gonadotropes stimulate the gonads to secrete gonad steroids such as testosterone or estrogen, while FSH stimulates release of inhibin from the gonads. Both estrogen and (testosterone?) inhibit directly on adenohypophyseal gonadotropes. The steroids are hydrophobic and thus differ from inhibin in that testosterone and estrogen can cross the blood brain barrier and inhibit MPH neurons, which normally stimulate arcuate nucleus neurons that release GnRH.
Haemorrhagic disease of the newborn
Synonyms and keywords: Vitamin K deficiency of newborn; hemorrhagic disease of newborn (Vitamin K deficiency)

# Overview
Haemorrhagic disease of the newborn is a coagulation disturbance in newborns due to vitamin K deficiency. As a consequence of vitamin K deficiency there is an impaired production of coagulation factors II, VII, IX, X, C and S by the liver.

# Pathophysiology
Newborns are relatively vitamin K deficient for a variety of reasons. They have low vitamin K stores at birth, vitamin K passes the placenta poorly, the  levels of vitamin K in breast milk are low and the gut flora has not yet been developed (vitamin K is normally produced by bacteria in the intestines).

# Diagnosis

## Symptoms
The disease causes an increased risk of bleeding. The most common sites of bleeding are
- Umbilicus
- Mucous membrane
- Gastrointestinal tract
- Circumcision
- Venipunctures.

# Treatment
Treatment consists of vitamin K supplementation. This is often given prophylactically newborns shortly after birth.
Hallucination (patient information)
For the WikiDoc page for this topic, click here

# Overview
Hallucinations involve sensing things while awake that appear to be real, but instead have been created by the mind.

# Considerations
- Common hallucinations include:
- Feeling bodily sensations, such as a crawling feeling on the skin or the movement of internal organs
- Hearing sounds, such as music, footsteps, windows or doors banging
- Hearing voices when no one has spoken (the most common type of hallucination). These voices may be critical, complimentary, neutral, or may command someone to do something that may cause harm to themselves or to others.
- Seeing patterns, lights, beings, or objects that aren't there
- Smelling a foul or pleasant odor
- In some cases, hallucinations may be normal. For example, hearing the voice of, or briefly seeing, a loved one who has recently died can be a part of the grieving process.

# What causes Hallucination?
There are many causes of hallucinations, including:
- Being drunk or high, or coming down from such drugs as marijuana, LSD, cocaine (including crack), PCP, amphetamines, heroin, ketamine, and alcohol.
- Delirium or dementia (visual hallucinations are most common)
- Epilepsy that involves a part of the brain called the temporal lobe (odor hallucinations are most common)
- Fever, especially in children and the elderly
- Narcolepsy
- Psychiatric disorders, such as schizophrenia and psychotic depression
- Sensory problem, such as blindness or deafness
- Severe illness, including liver failure, kidney failure, AIDS, and brain cancer

# When to seek urgent medical care?
- A person who begins to hallucinate and is detached from reality should get checked by a health care professional right away. Many medical and psychiatric conditions that can cause hallucinations may quickly become emergencies.
- A person who begins to hallucinate may become nervous, paranoid, and frightened, and should not be left alone.
- Call your health care provider, go to the emergency room, or call the local emergency number (such as 911) if someone appears to be hallucinating and is unable to tell hallucinations from reality.

# Diagnosis
- Your health care provider will do a physical examination and take a medical history. Blood may be drawn for testing.
- Medical history questions may include the following:
- How long have the hallucinations been occurring?
- Do the hallucinations occur just before or just after sleep?
- Has there been a recent death or other emotional event?
- What medications are being taken?
- Has alcohol been used?
- Are illegal drugs being used?
- Is there agitation?
- Is there confusion?
- Is there a fever?
- Is there a headache?
- Is there vomiting?

# Source
Hund's rule of maximum multiplicity

# Overview
Hund's rule of maximum multiplicity is an observational rule of atomic chemistry discovered by Friedrich Hund, which is one of a set of rules referred to collectively as Hund's rules. They are important for spectroscopy and quantum chemistry.
Hund's rule of maximum multiplicity is a principle (1925) of atomic chemistry which states that a greater total spin state usually makes the resulting atom more stable, most commonly manifested in a lower energy state, because it forces the unpaired electrons to reside in different spatial orbitals. A commonly given reason for the increased stability of high multiplicity states is that the different occupied spatial orbitals create a larger average distance between electrons, reducing electron-electron repulsion energy. In reality, it has been shown that the actual reason behind the increased stability is a decrease in the screening of electron-nuclear attractions. Total spin state is calculated as the total number of unpaired electrons + 1, or twice the total spin + 1 written as 2s+1.
As a result of Hund's rule, constraints are placed on the way atomic orbitals are filled using the Aufbau principle. Before any two electrons occupy an orbital in a subshell, other orbitals in the same subshell must first each contain one electron.  Also, the electrons filling a subshell will have parallel spin before the shell starts filling up with the opposite spin electrons (after the first orbital gains a second electron). As a result, when filling up atomic orbitals, the maximum number of unpaired electrons (and hence maximum total spin state) is assured.
In 2004, researchers reported the synthesis of 5-dehydro-m-xylylene (DMX), the first organic molecule known to violate Hund's rule.