Persius/hicric huggingface dataset:
Albendazole adverse reactions

# Adverse Reactions
The adverse event profile of albendazole differs between hydatid disease and neurocysticercosis. Adverse events occurring with a frequency of 1% in either disease are described in the table below.
These symptoms were usually mild and resolved without treatment. Treatment discontinuations were predominantly due to leukopenia (0.7%) or hepatic abnormalities (3.8% in hydatid disease). The following incidence reflects events that were reported by investigators to be at least possibly or probably related to albendazole.
The following adverse events were observed at an incidence of <1%:

### Blood and Lymphatic System Disorders
Leukopenia. There have been rare reports of granulocytopenia, pancytopenia, agranulocytosis, or thrombocytopenia (see WARNINGS). Patients with liver disease, including hepatic echinococcosis, appear to be more at risk of bone marrow suppression (see WARNINGS and PRECAUTIONS).

### Immune System Disorders
Hypersensitivity reactions, including rash and urticaria.

### Postmarketing Adverse Reactions
In addition to adverse events reported from clinical trials, the following events have been identified during world-wide post-approval use of ALBENZA. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to ALBENZA.

### Blood and Lymphatic System Disorders
Aplastic anemia, bone marrow suppression, neutropenia.

### Hepatobiliary Disorders
Elevations of hepatic enzymes, hepatitis, acute liver failure.

### Skin and Subcutaneous Tissue Disorders
Erythema multiforme, Stevens-Johnson syndrome.

### Renal and Urinary Disorders
Acute renal failure.
Albendazole drug interactions

# Drug Interactions

### Dexamethasone
Steady-state trough concentrations of albendazole sulfoxide were about 56% higher when 8 mg dexamethasone was coadministered with each dose of albendazole (15 mg/kg/day) in 8 neurocysticercosis patients.

### Praziquantel
In the fed state, praziquantel (40 mg/kg) increased mean maximum plasma concentration and area under the curve of albendazole sulfoxide by about 50% in healthy subjects (n = 10) compared with a separate group of subjects (n = 6) given albendazole alone. Mean Tmax and mean plasma elimination half-life of albendazole sulfoxide were unchanged. The pharmacokinetics of praziquantel were unchanged following coadministration with albendazole (400 mg).

### Cimetidine
Albendazole sulfoxide concentrations in bile and cystic fluid were increased (about 2-fold) in hydatid cyst patients treated with cimetidine (10 mg/kg/day) (n = 7) compared with albendazole (20 mg/kg/day) alone (n = 12). Albendazole sulfoxide plasma concentrations were unchanged 4 hours after dosing.

### Theophylline
The pharmacokinetics of theophylline (aminophylline 5.8 mg/kg infused over 20 minutes) were unchanged following a single oral dose of albendazole (400 mg) in 6 healthy subjects.
Almotriptan contraindications

# Contraindications
- Ischemic heart disease, coronary artery vasospasm, or other significant underlying cardiovascular disease
- Cerebrovascular syndromes (e.g., history of stroke or TIA)
- Peripheral vascular disease (including ischemic bowel disease)
- Uncontrolled hypertension
- Do not use Almotriptan within 24 hours of an ergotamine-containing, or ergot-type medication, or of another 5-HT1 agonist, e.g., another triptan
- Hemiplegic or basilar migraine
- Known hypersensitivity to Almotriptan

## Ischemic or Vasospastic Coronary Artery Disease, or Other Significant Underlying Cardiovascular Disease
Do not use Almotriptan (almotriptan malate) in patients with ischemic heart disease (angina pectoris, history of myocardial infarction, or documented silent ischemia), or in patients who have symptoms or findings consistent with ischemic heart disease, coronary artery vasospasm, including Prinzmetal's variant angina, or other significant underlying cardiovascular disease [see Warnings and Precautions

## Cerebrovascular Syndromes
Do not use Almotriptan in patients with cerebrovascular syndromes including (but not limited to) stroke of any type as well as transient ischemic attacks .

## Peripheral Vascular Disease
Do not use Almotriptan in patients with peripheral vascular disease including (but not limited to) ischemic bowel disease .

## Uncontrolled Hypertension
Because Almotriptan may increase blood pressure, do not use Almotriptan in patients with uncontrolled hypertension .

## Ergotamine-Containing and Ergot-Type Medications
Do not use Almotriptan and ergotamine-containing or ergot-derived medications like dihydroergotamine, ergotamine tartrate, or methysergide within 24 hours of each other [seeDrug Interactions .

## Concomitant Use With 5-HT1 Agonists (e.g., Triptans)
Almotriptan and other 5-HT1 agonists (e.g., triptans) should not be administered within 24 hours of each other .

## Hemiplegic or Basilar Migraine
Do not use Almotriptan in patients with hemiplegic or basilar migraine.

## Hypersensitivity
Almotriptan is contraindicated in patients with known hypersensitivity to almotriptan or any of its inactive ingredients.
Almotriptan drug interactions

# Drug Interactions
- Do not use Almotriptan and ergotamine-containing or ergot-type medications within 24 hours of each other
- Do not use Almotriptan and other 5-HT1 agonists (e.g., triptans) within 24 hours of each other
- SSRI or SNRI: life-threatening serotonin syndrome reported during combined use with triptans
- Ketoconazole: use single dose of Almotriptan 6.25 mg; maximum Almotriptan daily dose 12.5 mg
For additional detailed information on drug interactions, see Clinical Pharmacology, Pharmacokinetics (12.3).

## Ergot-Containing Drugs
These drugs have been reported to cause prolonged vasospastic reactions. Because, in theory, vasospastic effects may be additive, ergotamine-containing or ergot-type medications (like dihydroergotamine, ergotamine tartrate, or methysergide) and Almotriptan (almotriptan malate) should not be used within 24 hours of each other .

## 5-HT1 Agonists (e.g., Triptans)
Concomitant use of other 5-HT1 agonists (e.g., triptans) within 24 hours of treatment with Almotriptan is contraindicated .

## Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors
Cases of life-threatening serotonin syndrome have been reported during combined use of triptans and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) .

## Ketoconazole and Other Potent CYP3A4 Inhibitors
Co-administration of almotriptan and oral ketoconazole, a potent CYP3A4 inhibitor, resulted in an approximately 60% increase in exposure of almotriptan. Increased exposures to almotriptan may be expected when almotriptan is used concomitantly with other potent CYP3A4 inhibitors.
In patients concomitantly using potent CYP3A4 inhibitors, the recommended starting dose of Almotriptan is 6.25 mg. The maximum daily dose should not exceed 12.5 mg within a 24-hour period. Concomitant use of Almotriptan and potent CYP3A4 inhibitors should be avoided in patients with renal or hepatic impairment.
Anatomy of the heart overview

# Overview
The mediastinum occupies the center of the thoracic cavity between the pulmonary viscera. It spans superiorly at the level of the thoracic aperture, inferiorly at the diaphragm, and from the sternum to the costal cartilages and bodies of vertebrae T1 to T12 antero-posteriosly.  With the exception of the lungs, the mediastinum involves all thoracic viscera.  For the purpose of description, the mediastinum is divided into superior, middle and inferior sections.  The heart, its roots of the great vessels (ascending aorta, pulmonary trunk, superior vena cava), and the pericardium occupy the middle mediastinum.

# The Pericardium
The pericardium is a double-walled sac containing the heart and the roots of the great vessels.

# Right Atrium
Right atrium is one of the four chambers of the heart located above the right ventricle and receives deoxygenated blood from inferior vena cava, superior vena cava and coronary sinus. This deoxygenated blood from the right atrium then passes through the tricuspid valve into the right ventricle.

# Left Atrium
Left atrium is located at the base of the heart above the left ventricle. It receives oxygenated blood through pulmonay veins and pumps the blood to the left ventricle through the mitral valve.

# Right Ventricle
Right ventricle is a triangular chamber extending from the right atrium to the cardiac apex and receives deoxygenated blood from the right atrium.  It pumps this blood into the lungs through the pulmonary artery for oxygenation.

# Left Ventricle
Left ventricle comprises the bulk of the myocardium and receives oxygenated blood from the left atrium through the mitral valve and pumps the same blood into the aorta via the aortic valve.
Anterior communicating artery
In human anatomy, the anterior communicating artery is a blood vessel of the brain that connects the left and right anterior cerebral arteries.
The anterior communicating artery connects the two anterior cerebral arteries across the commencement of the longitudinal fissure. Sometimes this vessel is wanting, the two arteries joining together to form a single trunk, which afterward divides; or it may be wholly, or partially, divided into two. Its length averages about 4 mm, but varies greatly. It gives off some of the anteromedial ganglionic vessels, but these are principally derived from the anterior cerebral artery.
It is part of the cerebral arterial circle, also known as the circle of Willis.

# Pathology
Aneurysms of the anterior communicating artery are the most common circle of Willis aneurysm and can cause visual field defects such as bitemporal hemianopsia, psychopathology and frontal lobe pathology.
Ventral ramus of spinal nerve

# Overview
The ventral ramus (anterior ramus, anterior branch, anterior divisions of the spinal nerves) supply the antero-lateral parts of the trunk, and the limbs; they are for the most part larger than the posterior divisions.
In the thoracic region they run independently of one another, but in the cervical, lumbar, and sacral regions they unite near their origins to form plexuses.
The Ventral rami, including the sinuvertebral nerve branches, supply structures anterior to the facet joint, including the vertebral bodies, the discs and their ligaments and joints other spinal nerves to form the lumbo-sacral plexus.
Anti inflammatory medications

# Overview
Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation. Anti-inflammatory drugs make up one half of analgesics, remedying pain by reducing inflammation as opposed to opioids which affect the brain.

# Steroidal anti-inflammatory drugs
Many steroids, specifically glucocorticoids, reduce inflammation by binding to cortisol receptors. These drugs are often referred to as corticosteroids, though that is a larger category.

# Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (NSAIDs), alleviate pain by counteracting the cyclooxygenase (COX) enzyme. On its own COX enzyme synthesizes prostaglandins, creating inflammation. In whole the NSAIDs prevent the prostaglandins from ever being synthesized, reducing or eliminating the pain.
In addition to medical drugs, many herbs have anti-inflammatory qualities, including hyssop, ginger, Turmeric, Arnica montana which contains helenalin, a sesquiterpene lactone, and willow bark, which contains salicylic acid, a substance related to the active ingredient in aspirin.
On the other hand, there are analgesics like paracetamol, called acetaminophen in the U.S. and sold under the brand name of Tylenol, which are commonly associated with anti-inflammatory drugs but which have no anti-inflammatory effects.
Some are concerned about the long term usage of NSAIDs as they cause gastric erosions which can become stomach ulcers and in extreme cases result in death. The risk of death as a result of use of NSAIDs is 1 in 10,000 for young adults aged 16-45. The risk increases tenfold for those over 75.

# Ice treatment
Applying ice to a tissue injury has an anti-inflammatory effect and is often suggested as an injury treatment and pain management technique for athletes.
Practitioners of Chinese medicine, on the other hand, contend that ice is only useful for 24 hours or so after acute trauma. After which time ice becomes counterproductive to healing, as cold inhibits local blood circulation.

# Anti-inflammatory Foods
Due to concerns over the gastric problems caused by NSAIDs researchers are turning to more natural solutions to dealing with the problem of inflammation. One ingredient with a great future potential is capsaicin, a naturally occurring ingredient in chili peppers. Studies have shown some success in the control of pain and inflammation when capsaicin is applied topically.
Others advocate the consumption of anti-inflammatory foods as a means of controlling inflammation. Anti-inflammatory foods include most colorful fruits and vegetables, oily fish and certain nuts, seeds, herbs and spices such as ginger. Those following an anti-inflammatory diet will avoid refined oils and sugars, and show a preference for anti-inflammatory foods in their meal choices.  Tobacco may have some anti-inflammatory effects, see Smokers Paradox. In some conditions, dietary omega-3 fatty acids  lower inflammation, see Essential fatty acid interactions.
Anti-topoisomerase antibodies
Anti-topoisomerase antibodies (ATA) are directed against topoisomerase and found in several diseases, most importantly scleroderma. Diseases with ATA are autoimmune disease because they react with self-proteins. They are also referred to as anti-DNA topoisomerase I antibody (anti-topo I).

# Epitopes and subtypes
Anti Scl-70 is recognized as one of two major classes of autoantibodies in sclerosis (systemic or scleroderma). The antigen of Anti Scl-70 was recognized as topoisomerase I in 1986 with anti-centromere antibodies constituting the other class. ATA is associated with more severe disease.
Anti-topoisomerase antibodies can be classified according to their immunoglobulin class (IgM, IgG or IgA). IgG-ATA is found most frequently in scleroderma, with IgA being quite common but IgM very infrequent.

# Pathology
Topoisomerase I is an enzyme that relaxes the strain on DNA by nicking and ligating the DNA. ATA inhibits the activity of this enzyme. Since this activity occurs in the nucleus of the cell ATA is a form of anti-nuclear antibody. Scleroderma results from the overproduction of collagen in affected tissues, one study claims that there is an increased density of Topoisomerase I sites in the collagen genes, and that the antibodies may be altering transcription at these loci.
ATA correlates with rapid progression of disease.
In systemic lupus erythematosus  ATA are associated with nephritis.
Increases in ATA+ in scleroderma and SLE are associated with increases in serum CTLA4.

# Genetics
HLA-DR2 (DR15 and DR16) are associated with Scleroderma and systemic sclerosis. It has been found that patients with ATA that recognize the ET4 domain of topoisomerase were frequently HLA-DR2,, and in another population study it was found that DR-15 is associated with ATA in systemic sclerosis.  In addition to HLA-DR, the protein tyrosine phosphatase, non-receptor type 22 (lymphoid) (1p13.2 - PTPN22), "CT/TT" genotype showed significant association with anti-topo I. The TAP1gene(6p21.3, HLA complex) has also been found in association with ATA+ sclerosis.
Are Chiropractors Physicians?
Physician is a term which generally means a doctor trained to diagnose and treat human diseases and not anatomically limited. Thus by this definition a Medical doctor, Osteopath (in the US) and a Chiropractor are all physicians.  However, effective July 1, 2009, the Joint Commission which is the basis of all HOSPITAL  policy throughout the US, 
has changed its statutes to specify that Doctors of Medicine ( Allopaths), Osteopathy, Podiatry, OD's  Optometry and Chiropractic  are physicians.
The term is a word regulated by Federal and individual State laws,  thus legislation, not by professional associations, or by State medical licensing boards; in the same way that "bank" or "university" are regulated terms. Pursuant to US Federal Law, any doctor receiving medicare benefits is defined as a "physician".  Infamous exceptions to this rule include California and New York.
Of course, when it must be remembered that e.g. New York was the 49th State to grant licensing to Chiropractors, (only lagging behind Louisiana) and at that time, fully one third of the membership of the AMA was in New York.
Artificial urethral sphincter

# Overview
Artificial urinary sphincters replace the function of the natural urinary sphincter in patients with sphincter damage or neurologic disease. Most commonly used to treat patients with urinary incontinence following surgery for prostate cancer. They are sometimes used in combination with a bladder neck stent.

# Design
A typical design includes:
- Urethral cuff at the bladder neck or proximal urethra.
- Cuff is attached to a pump and fluid balloon reservoir.
- Pump can be manually used to inflate or deflate the urethral cuff by redistributing the fluid in the balloon reservoir.
- Inflation of the cuff constricts the sphincter, and deflation of the cuff allows urine to leave the bladder and flow through the urethra.
Images of an artificial urethral sphincter
Aseptic meningitis prevention

# Primary Prevention
People with certain viral infections can sometimes develop meningitis. There are no vaccines for the most common causes of viral meningitis. Thus, the best way to prevent it is to prevent viral infections. However, that can be difficult since sometimes people can be infected with a virus and spread the virus even though they do not appear sick. Following are some steps you can take to help lower your chances of becoming infected with viruses or of passing one on to someone else:
- Wash hands thoroughly and often, especially after changing diapers, using the toilet, or coughing or blowing your nose.
- Clean contaminated surfaces, such as doorknobs or the TV remote control, with soap and water and then disinfect them with a dilute solution of chlorine-containing bleach.
- Avoid kissing or sharing a drinking glass, eating utensils, lipstick, or other such items with sick people or with others when you are sick.
- Make sure you and your child are vaccinated. Vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (MMR vaccine) and chickenpox (varicella-zoster vaccine).
- Avoid bites from mosquitoes and other insects that carry diseases that can infect humans.
- Control mice and rats. If you have a rodent infestation in and/or around your home, follow the cleaning and control precautions listed on CDCs website about LCMV (Lymphocytic choriomeningitis virus).

## Vaccines
Vaccines are available for some organisms that cause aseptic meningitis. Good infection control in the hospital is recommended. If the causative organism is contagious, steps may need to be taken to isolate the individual and protect the community.
Azithromycin clinical studies

# Clinical Studies

## Community-Acquired Pneumonia
In a controlled study of community-acquired pneumonia performed in the U.S., azithromycin (500 mg as a single daily dose by the intravenous route for 25 days, followed by 500 mg/day by the oral route to complete 710 days therapy) was compared to cefuroxime (2250 mg/day in three divided doses by the intravenous route for 25 days followed by 1000 mg/day in two divided doses by the oral route to complete 710 days therapy), with or without erythromycin. For the 291 patients who were evaluable for clinical efficacy, the clinical outcome rates, i.e., cure, improved, and success (cure + improved) among the 277 patients seen at 1014 days post-therapy were as follows:
In a separate, uncontrolled clinical and microbiological trial performed in the U.S., 94 patients with community-acquired pneumonia who received azithromycin in the same regimen were evaluable for clinical efficacy. The clinical outcome rates, i.e., cure, improved, and success (cure + improved) among the 84 patients seen at 1014 days post-therapy were as follows:
Microbiological determinations in both trials were made at the pre-treatment visit and, where applicable, were reassessed at later visits. Serological testing was done on baseline and final visit specimens. The following combined presumptive bacteriological eradication rates were obtained from the evaluable groups:
Combined Bacteriological Eradication Rates for Azithromycin:
The presumed bacteriological outcomes at 1014 days post-therapy for patients treated with azithromycin with evidence (serology and/or culture) of atypical pathogens for both trials were as follows:
Bone morphogenetic protein 15
Bone morphogenetic protein 15 is a protein that in humans is encoded by the BMP15 gene. It's mainly involved in folliculogenesis.

# Structure and expression
The protein encoded by this gene is a member of the TGF- superfamily. It is a paracrine signaling molecule involved in oocyte and follicular development. Using Northern blot analysis, BMP15 has been shown to be exclusively expressed in the ovaries. It is thought that this protein may be involved in oocyte maturation and follicular development as a homodimer or by forming heterodimers with a related protein, Gdf9.

# Functions
The functions of BMP15 include:
- Promotion of growth and maturation of ovarian follicles, starting from the primary gonadotrophin-independent phases of folliculogenesis.
- Regulation of the sensitivity of granulosa cells to follicle-stimulating hormone (FSH) action, contributing to the determination of the number of eggs that are ovulated.
- Prevention of granulosa cell apoptosis.
- Promotion of developmental competence of oocytes.
Defects in BMP15 are associated with primary ovarian insufficiency. BMP15may represent a biomarker of ovarian response to ovarian stimulation or oocyte quality.