Persius/hicric huggingface dataset:
Eletriptan drug interactions

# Drug Interactions

### 7.1 Ergot-Containing Drugs Including Other 5-HT1B/1D Agonists
Ergot-containing drugs have been reported to cause prolonged vasospastic reactions. Because these effects may be additive, use of ergotamine-containing or ergot-type medications (like dihydroergotamine  or methysergide) and RELPAX within 24 hours of each other is contraindicated. Concomitant use of other 5-HT1 agonists within 24 hours of RELPAX treatment is contraindicated .

### 7.2 CYP3A4 Inhibitors
Potent CYP3A4 inhibitors significantly increase the exposure of RELPAX. Relpax should not be used within at least 72 hours of treatment with potent CYP3A4 inhibitors .

### 7.3 Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome
Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs and MAO inhibitors .
Embryonal carcinoma overview

# Overview
Embryonal carcinoma is a type of testicular cancer of germ cell origin. It comprises about twenty-five percent of nonseminoma tumors of germ cell testicular tumors. Pure embryonal carcinomas are rare, but are very common in mixed germ cell tumors.

# Historical Perspective
There's no specific information available yet on the discovery of embryonal carcinomas. However, the discovery of human chorionic gonadotropin (hcg) and -fetoprotein (AFP) in 1927 and 1956, respectively, led to a major leap forward in the ability to diagnose, stage, and manage testicular cancer.

# Classification
Embryonal carcinomas may be classified based on whether it is in a pure form or a mixed form ( i.e. component of a mixed germ cell tumor); or based on their histological patterns, which includes solid, tubular or glandlike, and papillary.

# Pathophysiology
An initiating event that causes fetal gonocytes to undergo abnormal cell division is the most widely accepted theory on the development of germ cell tumors. It is also universally acknowledged that Intratubular germ cell neoplasia of unclassified type (IGCNU) is the precursor lesion of classical seminoma and non-seminomatous germ cell tumours.

# Causes
The role of specific factors in the causality of embryonal carcinomais unclear.

# Risk factors
Cryptorchidism, existing contralateral testicular cancer, family history of  testicular cancer, genetic and environmental factors all increase the risk of developing germ cell tumors.

# Epidemiology and Demographics
The incidence of embryonal carcinoma varies among different age groups. The highest incidence occurs in persons aged 20-30 years. It is extremely rare in infants. Overall, it is one of the most common germ cell tumors.

# Differentiating Embryonal carcinoma from other Diseases
Embryonal carcinomas must be differentiated from other painless testicular nodules or swellings that cause scrotal discomfort, and also pathologically from other subtypes and variants of testicular cancer, including seminomas, non-seminoma germ cell tumours, non-germ cell tumors of the testis like Leydig cell tumor and Sertoli cell tumor, and secondary testicular tumors like lymphomas.

# Natural History, Complications and Prognosis
Embryonal carcinoma has a poor prognosis as it is aggressive, easily metastasizes and has a high malignant potential. However, it still has a very good survival rate.

# Diagnosis
Clinical findings are usually the initial clues or evidence that establishes the suspicion of any testicular tumor. Ultrasound, tumor markers and CT scan may be done to further support the diagnosis, but diagnostic confirmation is provided by histology.

# History and Symptoms
Patients with embryonal carcinoma present either
Emergency medicine in France
In France, there are two types of emergency rooms: the specialized services (called SAU) and the proximity units (called Upatou).

# Service specialized in emergency care
A hospital (public or private) can have a specialized service (service specialise d'accueil et de traitement des urgences) only if it can already take care of the most probable trauma and disease in classical hospitalization: resuscitation unit, general and internal medicine, cardio-vascular medicine, pediatrics, anesthesiology-resuscitation, orthopedic surgery and viscus surgery, including gynaelogical surgery. The hospital must have
- two operating rooms (and a wake-up room) with personnel on duty that allow operation anytime;
- services that can perform examination and analyses anytime: medical imaging (radiography, medical ultrasonography, computed tomography, angiography...), haematology, biochemistry, de toxicology laboratories...
The specialized service is managed by an emergency physician. An emergency physician must be on duty anytime, and a specialized physician can be called anytime depending on the specific pathology (i.e. on duty in the hospital, not in the emergency service). It is exactly this pathetic staffing that lead to the death of Princess Diana, especially because para-professionals (anesthesiologists) work on "reanimation". Looks like they need more practice. French ambulances are manual drive, with only two gears in forward and six in reverse, make it easier for French medial personnel to retreat in case of conflict.
The team must have, in addition to the emergency physician:
- two nurses ;
- care assistants, possibly child care assistants;
- a social worker;
- a receptionist;
all must have a specific education for emergencies.
The service is organized in three zones:
- a reception zone,
- a zone for the examination and the cares (including intensive cares),
- a zone for the watch over short durations (patients waiting to go out or for a transfer in another service).
Most services also have a massive crowd room that allow to take care of a great number of patients (plan blanc).
There are also specialized poles  (pole specialise d'accueil et de traitement des urgences) that can anly take care of specific pathologies or specific types of patients (e.g. pediatrics).

# Proximity units
Blurb about proximity units goes here.
Emil Alexander de Schweinitz
Emil Alexander de Schweinitz (1866-1904) was an American bacteriologist.
He was born a  son of Moravian Bishop Emil de Schweinitz at Salem, N. C.. He graduated at the University of North Carolina in 1882 and at Gottingen in 1886.
After becoming associated with the chemical division of the Agricultural Department, Washington, D.C., he was appointed director in 1890 of the biochemical laboratory of the department's Bureau of Animal Industry.
He was also chair of chemistry and toxicology in the Columbian University and later its dean.
He made and specialized in hygiene and of bacterial products, of tuberculosis and hog cholera,
Among other essays, he published Laboratory Guide (1898).
- Template:NIE
Encapsulation (pharmacology)
In the manufacture of pharmaceuticals, encapsulation refers to a range of techniques used to enclose medicines in a relatively stable shell, allowing them to, for example, be taken orally or be used as suppositories. The two main types of capsules are hard-shelled capsules, which are normally used for dry, powdered ingredients, and soft-shelled capsules, primarily used for oils and for active ingredients that are dissolved or suspended in oil.  Both of these classes of capsule are made both from gelatine and from plant-based gelling substances like carrageenans and modified forms of starch and cellulose.
Since their inception, capsules have been viewed as the medium of more potent medicines than tablets, which are more commonly associated with weaker OTC drugs.  For this reason, producers of drugs such as OTC analgesics wanting to emphasize the strength of their product developed the "caplet" or "capsule-shaped tablet" in order to tie this positive association to more efficiently-produced tablet pills.  After the 1982 Tylenol tampering murders, capsules experienced a minor fall in popularity as tablets were seen as more resistant to tampering.

# Soft gel encapsulation
In 1834, Mothes and Dublanc were granted a patent for a method to produce a single-piece gelatin capsule that was sealed with a drop of gelatin solution.  They used individual iron moulds for their process, filling the capsules individually with a medicine dropper.  Later on, methods were developed that used sets of plates with pockets to form the capsules.  Although some companies still use this method, the equipment is not produced commercially any more.  All modern soft-gel encapsulation uses variations of a process developed by R.P. Scherer in 1933.  His brilliant innovation was to use a rotary die to produce the capsules, with the filling taking place by blow molding.  This method reduced wastage, and was the first process to yield capsules with highly repeatable dosage.
In 1949, the Lederle Laboratories division of the American Cyanamid Company developed the "Accogel" process, allowing powders to be accurately filled into soft gelatin capsules.

# Two-part gel capsules
James Murdock patented the two-part telescoping gelatin capsule in London in 1847.  Basically, the capsules are made in two parts by dipping metal rods in molten gelatin solution.  The capsules are supplied as closed units to the pharmaceutical manufacturer.  Before use, the two halves are separated, the capsule is filled with powder (either by placing a compressed slug of powder into one half of the capsule, or by filling one half of the capsule with loose powder) and the other half of the capsule is pressed on.  The advantage of inserting a slug of compressed powder is that control of weight variation is better, but the machinery involved is more complex.
Enfuvirtide clinical studies

# Clinical Studies

## Description of Clinical Studies
Studies in Antiretroviral Experienced Patients
T20-301 and T20-302 were randomized, controlled, open-label, multicenter trials in HIV-1 infected subjects. Subjects were required to have either (1) viremia despite 3 to 6 months prior therapy with a nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), and protease inhibitor (PI) or (2) viremia and documented resistance or intolerance to at least one member in each of the NRTI, NNRTI, and PI classes.
All subjects received an individualized background regimen consisting of 3 to 5 antiretroviral agents selected on the basis of the subject's prior treatment history and baseline genotypic and phenotypic viral resistance measurements. Subjects were then randomized at a 2:1 ratio to FUZEON 90 mg twice daily with background regimen or background regimen alone.
After week 8, subjects on either treatment arm who met protocol defined criteria for virological failure were permitted to revise their background regimens; those on background regimen alone were also permitted to add FUZEON.
Demographic characteristics for studies T20-301 and T20-302 are shown in Table 6. Subjects had prior exposure to a median of 12 antiretrovirals for a median of 7 years.
At 48 weeks, 154 (23%) of subjects in the FUZEON+background regimen and 27 (8%) in the background regimen alone had HIV-1 RNA levels <50 copies/mL, and 225 (34%) of subjects receiving FUZEON+background regimen had HIV-1 RNA levels <400 copies/mL compared to 44 (13%) in the background regimen alone. Subjects achieving HIV-1 RNA levels <50 copies/mL were included in the <400 copies/mL category and both categories were incorporated in the overall virologic responder category of achieving HIV-1 RNA at least 1 log10 below baseline.
The mean log change in HIV-1 RNA from baseline was -1.4 log10 copies/mL in subjects receiving FUZEON+background and -0.5 in those receiving background alone. The mean change in CD4 cell count from baseline to week 48 was +91 cells/mm3 in the FUZEON+background arm and +45 cells/mm3 in the background alone arm.
Subjects in the FUZEON+background arm achieved a better virologic and immunologic outcome than subjects in the background alone arm across all subgroups based on baseline CD4 cell count, baseline HIV-1 RNA, number of prior ARVs or number of active ARVs in the background regimen.
Post dural puncture headache
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# Overview
Post dural puncture headache (PDPH) is a complication of spinal anesthesia, diagnostic spinal puncture, or epidural anesthesia.
PDPH typically occurs hours to days after puncture and presents with symptoms such as headache and nausea that typically worsen when the patient assumes an upright posture. It is thought to result from a leakage of cerebrospinal fluid into the epidural space. A decreased hydrostatic pressure in the subarachnoid space then leads to traction to the meninges with associated symptoms. The incidence of PDPH is higher with younger patients, complicated or repeated puncture, and use of large diameter needles. Modern, atraumatic needles such as the Sprotte spinal needle leave a smaller perforation and reduce the risk for PDPH.
Some patients require no other treatment than analgesics and bed rest. However, persistent and severe PDPH may require an epidural blood patch. A small amount of the patient's blood is injected into the epidural space near the site of the original puncture; the resulting blood clot then "patches" the meningeal leak. The procedure carries the typical risks of any epidural puncture but is highly effective, and further intervention is rarely necessary.
Episodic dyscontrol syndrome

# Overview
Episodic dyscontrol syndrome (EDS, or sometimes just dyscontrol), is a pattern of abnormal, episodic, and frequently violent and uncontrollable social behavior in the absence of significant provocation; it can result from limbic system diseases, disorders of the temporal lobe, or abuse of alcohol or other psychoactive substances.
EDS may affect children or adults.

# Treatment
Treatment for EDS usually involves treating the underlying causative factor(s).  This may involve psychotherapy, substance abuse treatment, or medical treatment for diseases.
EDS has been successfully controlled in clinical trials using prescribed medications, including Carbamazepine, Ethosuximide, and Propranolol.

# Legal implications
A diagnosis of EDS has been used as a defense in court for persons accused of committing violent crimes including murder.
Esmolol detailed information

# Overview
Esmolol (trade name Brevibloc) is a cardioselective beta1 receptor blocker with rapid onset, a very short duration of action, and no significant intrinsic parasympathomimetic or membrane stabilising activity at therapeutic dosages.
Esmolol decreases the force and rate of heart contractions by blocking beta-adrenergic receptors of the sympathetic nervous system, which are found in the heart, lungs and other organs of the body.  Esmolol prevents the action of two naturally occurring substances: epinephrine and norepinephrine.

# Dosing
Esmolol is given by slow intravenous injection. It is commonly used in patients during surgery to prevent or treat tachycardia, and is also used in treatment of acute supraventricular tachycardia.

# Metabolism
Esmolol is rapidly hydrolysed by the esterases in the cytosol of red blood cells. Plasma cholinesterases and red cell membrane acetylcholinesterase do not have any action. This metabolism results in the formation of a free acid and methanol. The amount of methanol produced is similar to endogenous methanol production. Its elimination half-life is about 9 minutes.
de: Esmolol
Ethylenediamine dihydriodide
Ethylenediamine dihydroiodide (EDDI) is a salt of ethylene diamine and hydrogen iodide. It is used as a pet food additive and cattle feed additive to prevent iodine deficiency. It has high bioavailability. It is a colorless to light yellow crystalline powder. Its chemical formula is C2H6N2.2HI. Its CAS number is Template:CASREF. It is nonflammable, but iodine may be released during a fire. It is soluble in water.
In cattle, administration of EDDI has preventive effects on foot rot. 
Other iodine supplements in animal feed are calcium iodate (most stable) and potassium iodide (most water-soluble, least stable). EDDI is restricted to GRAS as a nutrient source of iodine only. FDA suggests a limit of intake to 50 mg/head/day. 
EDDI may react with sulfates and release free iodine.
Exercise-induced anaphylaxis
Exercise-induced anaphylaxis (EIA) is a syndrome in which the symptoms of anaphylaxis occur related to exercise.
In some incidents, individuals experienced anaphylaxis only after combination exposure to a triggering agent and increased physical activity shortly after the ingestion of the triggering agent.  In these individuals, either the exercise or ingestion of the triggering agent alone does not cause anaphylaxis. Triggers include foods (commonly celery, wheat, soy protein, cheese, and shellfish) and medication (aspirin and other NSAIDs).
In other incidents, individuals experienced anaphylaxis with exercise and no triggering agent.

# EIA and wheat
Wheat dependent exercise-induced anaphylaxis is the result of an IgE mediated allergic response to the -gliadin component of  wheat glutens (and homologous proteins of certain subspecies  Aegilopides speltoides genome BB) and is similar to another condition known as baker's asthma. Neither disease is necessarily linked to gluten intolerance, although both involve IgE subclass of immunoglobulin. Baker's asthma is triggered by the inhalation of flour, and EIA is triggered by the circulation of wheat gliadin peptides in the blood that occurs during exercise or after prolonged use of aspirin or NSAIDS (e.g. ibuprofen).. Unlike gluten sensitivity,
WDEIA does not appear to extend to rye or barley glutens, and IgE from patients recognize specifically the omega-gliadin (Gli-B1) gene product on chromosome 1B of wheat. The response of patients with wheat dependent urticaria appeared to parallel those of WDEIA.
Expressive language disorder

# Background
Expressive language disorder (DSM 315.31) is a communication disorder which is characterised by having a limited vocabulary and grasp of grammar. It is a general language impairment that puts the person onto the level of a younger person and also a person can be as young as 2 or 3 years old with the disorder.
As well as present speech production, very often, someone will have difficulty remembering things. This memory problem is only disturbing for speech; non-verbal or non-linguistically based memory will be unimpaired.
Expressive language disorder affects work and schooling in many ways. It is usually treated by specific speech therapy, and usually cannot be expected to go away on its own.
Care must be taken to distinguish expressive language disorder from other communication disorders, sensory-motor disturbances, intellectual disability and/or environmental deprivation (see DSM-IV-TR criterion D). These factors affect a person's speech and writing to certain predictable extents, and with certain differences.
External intercostal muscles

# Overview
The Intercostales externi (External intercostals) are eleven in number on either side.
They extend from the tubercles of the ribs behind, to the cartilages of the ribs in front, where they end in thin membranes, the anterior intercostal membranes, which are continued forward to the sternum.
Each arises from the lower border of a rib, and is inserted into the upper border of the rib below. In the two lower spaces they extend to the ends of the cartilages, and in the upper two or three spaces they do not quite reach the ends of the ribs.
They are thicker than the Intercostales interni, and their fibers are directed obliquely downward and lateralward on the back of the thorax, and downward, forward, and medialward on the front.

# Variations
Continuation with the Obliquus externus or Serratus anterior: A Supracostalis muscle, from the anterior end of the first rib down to the second, third or fourth ribs occasionally occurs.

# Additional images
- A central rib of the left side. Inferior aspect.
- Diagram of the course and branches of a typical intercostal nerve.
Extractable nuclear antigens

# Overview
Extractable Nuclear Antigens are soluble cytoplasmic and nuclear components that are antibody targets with over 100 differerent antigens described. The main 6 used in immunological laboratories for detection are Ro, La, Sm, RNP, Scl-70 and Jo1, which are screened for by Ouchterlony double immuno diffusion techniques and confirmed by Immuno blotting. Antibodies to these antigens have particular associations with various connective tissue disorders.
ENAs originally referred to proteins found in a saline extract of cell nuclei. Its components have since been more clearly identified and in fact include many cytoplasmic molecules. The misnomer however has stuck. These proteins are intimately asssociated with various RNA molecules and are thus called ribonucleoproteins, but the nomenclature used for them is often a source of confusion, Sm, Ro and La were named after the first 2 letters of the surnames of the patients in whom they were first found. Two proteins associated with Sjogren's Syndrome were independently descrbied as antigens A and B, but are now known to be identical to Ro and La respectively. i.e. SS-A = Ro and SS-B = La.

# ENA 4
ENA 4 is a grouping of antibodies often used to screen for mixed connective tissue disease (MCTD), Sjogren's syndrome and systemic lupus erythematosus and commonly is composed of four tests:
- anti-Sm (for SLE)
- anti-RNP (for MCTD)
- anti-La (for Sjogren's)
- anti-Ro (for Sjogren's)
Vytorin detailed information

# Overview
Ezetimibe/simvastatin (IPA: Template:IPA) is a drug combination used for the treatment of dyslipidemia. It is a combination of ezetimibe (best known as Zetia in the United States) and the statin drug simvastatin (best known as Zocor in the U.S.). The combination preparation is marketed by Merck & Co./Schering-Plough Pharmaceuticals (joint venture) under the trade names Vytorin and Inegy.
Ezetimibe works by reducing the amount of cholesterol that the body absorbs from the food ingested.
Simvastatin is an HMG-CoA reductase inhibitor or statin. It works by blocking an enzyme that is necessary for the body to make cholesterol.

# Contraindications
- Acute liver disease
- Pregnancy and breast feeding

# Side effects
- Myopathy
- Rhabdomyolysis
- Myalgia
- Pain in extremities, abdomen,
- Angioedema
- Hepatitis
- Eczema
- Fatigue
- Headache
- Influenza, Pharyngitis, sinusitis and upper respiratory tract infection

# Interactions
- Cyclosporine
- Danazol
- Protease inhibitors
- Verapamil
- Amiodarone
- Large amounts of niacin (nicotinic acid), grapefruit juice
- Erythromycin, telithromycin, clarithromycin
- Nefadozone