Persius/hicric huggingface dataset:
NINCDS-ADRDA Alzheimer's Criteria

# Overview
The NINCDS-ADRDA Alzheimer's Criteria were proposed in 1984 by the (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association) and are among the most used in the diagnosis of Alzheimer's disease (AD). These criteria require that the presence of cognitive impairment and a suspected dementia syndrome be confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD; while they need histopathologic confirmation (microscopic examination of brain tissue) for the definitive diagnosis.  They specify as well eight cognitive domains that may be impaired in AD. These criteria have shown good reliability and validity.

# Criteria
- Definite Alzheimer's disease: The patient meets the criteria for probable Alzheimer's disease and has histopathologic evidence of AD via autopsy or biopsy.
- Probable Alzheimer's disease: Dementia has been established by clinical and neuropsychological examination. Cognitive impairments also have to be progressive and be present in in two or more areas of cognition. The onset of the deficits has been between the ages of 40 and 90 years and finally there must be an absence of other diseases capable of producing a dementia syndrome.
- Possible Alzheimer's disease: There is a dementia syndrome with an atypical onset, presentation or progression; and without a known etiology; but no co-morbid diseases capable of producing dementia are believed to be in the origin of it.
- Unlikely Alzheimer's disease: The patient presents a dementia syndrome with a sudden onset, focal neurologic signs, or seizures or gait disturbance early in the course of the illness.

# Cognitive domains
The NINCDS-ADRDA Alzheimer's Criteria specify eight cognitive domains that may be impaired in AD: memory, language, perceptual skills, attention, constructive abilities, orientation, problem solving and functional abilities).

# Other criteria
Similar to the NINCDS-ADRDA Alzheimer's Criteria are the DSM-IV-TR criteria published by the American Psychiatric Association. At the same time the advances in functional neuroimaging techniques such as PET or SPECT that have already proven their utility to differentiate Alzheimer's disease from other possible causes, have led to proposals of revision of the NINCDS-ADRDA criteria that take into account these techniques.
Naratriptan clinical pharmacology

# Clinical Pharmacology

### Mechanism of Action
Naratriptan binds with high affinity to 5-HT1D and 5-HT1B receptors and has no significant affinity or pharmacological activity at 5-HT2-4 receptor subtypes or at adrenergic 1, 2, or ; dopaminergic D1 or D2; muscarinic; or benzodiazepine receptors.
The therapeutic activity of naratriptan in migraine is generally attributed to its agonist activity at 5-HT1D/1B receptors. Two current theories have been proposed to explain the efficacy of 5-HT1D/1B receptor agonists in migraine. One theory suggests that activation of 5-HT1D/1B receptors located on intracranial blood vessels, including those on the arteriovenous anastomoses, leads to vasoconstriction, which is correlated with the relief of migraine headache. The other hypothesis suggests that activation of 5-HT1D/1B receptors on sensory nerve endings in the trigeminal system results in the inhibition of pro-inflammatory neuropeptide release.
In the anesthetized dog, naratriptan has been shown to reduce the carotid arterial blood flow with little or no effect on arterial blood pressure or total peripheral resistance. While the effect on blood flow was selective for the carotid arterial bed, increases in vascular resistance of up to 30% were seen in the coronary arterial bed. Naratriptan has also been shown to inhibit trigeminal nerve activity in rat and cat. In 10 human subjects with suspected coronary artery disease (CAD) undergoing coronary artery catheterization, there was a 1% to 10% reduction in coronary artery diameter following subcutaneous injection of 1.5 mg of naratriptan.

### Pharmacokinetics
Naratriptan tablets are well absorbed, with about 70% oral bioavailability. Following administration of a 2.5 mg tablet orally, the peak concentrations are obtained in 2 to 3 hours. After administration of 1- or 2.5-mg tablets, the Cmax is somewhat (about 50%) higher in women (not corrected for milligram-per-kilogram dose) than in men. During a migraine attack, absorption was slower, with a Tmax of 3 to 4 hours. Food does not affect the pharmacokinetics of naratriptan. Naratriptan displays linear kinetics over the therapeutic dose range.
The steady-state volume of distribution of naratriptan is 170 L. Plasma protein binding is 28% to 31% over the concentration range of 50 to 1,000 ng/mL.
Naratriptan is predominantly eliminated in urine, with 50% of the dose recovered unchanged and 30% as metabolites in urine. In vitro, naratriptan is metabolized by a wide range of cytochrome P450 isoenzymes into a number of inactive metabolites.
The mean elimination half-life of naratriptan is 6 hours. The systemic clearance of naratriptan is 6.6 mL/min/kg. The renal clearance (220 mL/min) exceeds glomerular filtration rate, indicating active tubular secretion. Repeat administration of naratriptan tablets does not result in drug accumulation.
Nipah virus encephalitis overview

# Overview
Nipah virus was identified in 1999 when it caused an outbreak of neurological and respiratory disease on pig farms in peninsular Malaysia, resulting in 105 human deaths and the culling of one million pigs. In Singapore, 11 cases including one death occurred in abattoir workers exposed to pigs imported from the affected Malaysian farms. The Nipah virus has been classified by the CDC as a Category C agent ().
Symptoms of infection from the Malaysian outbreak were primarily encephalitic in humans and respiratory in pigs. Later outbreaks have caused respiratory illness in humans, increasing the likelihood of human-to-human transmission and indicating the existence of more dangerous strains of the virus.
Based on seroprevalence data and virus isolations, the primary reservoir for Nipah virus was identified as Pteropid fruit bats including Pteropus vampyrus (Malayan flying fox) and Pteropus hypomelanus (Island flying fox), both of which occur in Malaysia.
The transmission of Nipah virus from flying foxes to pigs is thought to be due to an increasing overlap between bat habitats and piggeries in peninsular Malaysia. At the index farm, fruit orchards were in close proximity to the piggery, allowing the spillage of urine, faeces and partially eaten fruit onto the pigs. Retrospective studies demonstrate that viral spillover into pigs may have been occurring in Malaysia since 1996 without detection. During 1998, viral spread was aided by the transfer of infected pigs to other farms where new outbreaks occurred.

# Historical Perspective
Hendra virus was first isolated in 1994 from specimens obtained during an outbreak of respiratory and neurologic disease in horses and humans in Hendra, a suburb of Brisbane, Australia. Nipah virus was initially isolated in 1999 upon examining samples from an outbreak of encephalitis and respiratory illness among adult men in Malaysia and Singapore.

# Risk Factors
People who have contact with body fluids or excretions of horses infected with Hendra virus are at risk for Hendra virus disease. Nipah virus infection is associated with close contact with Nipah virus-infected pigs. Neither disease has spread from human to human.

# Primary Prevention
These diseases can be prevented by avoiding animals that are known to be infected and using appropriate personal protective equipment devices when it is necessary to come into contact with potentially infected animals.
Nonflammable alcohol vapor in CO2
Nonflammable alcohol vapor in CO2 (NAV-CO2) systems use carbon dioxide (CO2) as a propellant to dispense a 56% isopropyl alcohol solution in a stream of CO2 gas. The use of CO2 as a propellant serves to displace ambient oxygen and eliminate the risk of explosion.

# Application
Alcohol is a wide spectrum disinfectant that kills bacteria and viruses through denaturation. NAV-CO2 allow alcohol to be used safely in an atomized vapor, capable of reaching nooks, crannies and crevices that would be beyond the reach of other disinfecting methods. NAV-CO2 systems have been used to fight nosocomial infections including methicillin-resistant Staphylococcus aureus and other pathogens such as HIV, norovirus, hepatitis, tuburculosis, and listeria.

# Advantages
Alcohol and CO2 are both gases at room temperature. Both substances evaporate off of contact surfaces within minutes after application. Surfaces do not require wiping, reducing the spreading of pathogens on cloths. Alcohol and CO2 are inexpensive and readily available.
Environmental advantages include a viable alternative to oxidizing sanitizers such as bleach.

# Precautions
Operators of NAV-CO2 systems are advised to use the system in ventilated areas, as the continuous use in an airtight area may deprive the operator of oxygen.
Norfloxacin indications and usage

# Indications And Usage
NOROXIN is indicated for the treatment of adults with the following infections caused by susceptible strains of the designated microorganisms:

## Urinary tract infections
Uncomplicated urinary tract infections (including cystitis) due to Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus epidermidis, Staphylococcus saprophyticus, Citrobacter freundii, Enterobacter aerogenes, Enterobacter cloacae, Proteus vulgaris, Staphylococcus aureus, or Streptococcus agalactiae.
Complicated urinary tract infections due to Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, or Serratia marcescens.
Efficacy for this organism in this organ system was studied in fewer than 0 infections.

## Sexually transmitted diseases
(see WARNINGS)
Uncomplicated urethral and cervical gonorrhea due to Neisseria gonorrhoeae.

## Prostatitis
Prostatitis due to ].
(See DOSAGE AND ADMINISTRATION for appropriate dosing instructions.)
Penicillinase production should have no effect on norfloxacin activity.
Appropriate culture and susceptibility tests should be performed before treatment in order to isolate and identify organisms causing the infection and to determine their susceptibility to norfloxacin. Therapy with norfloxacin may be initiated before results of these tests are known; once results become available, appropriate therapy should be given. Repeat culture and susceptibility testing performed periodically during therapy will provide information not only on the therapeutic effect of the antimicrobial agents but also on the possible emergence of bacterial resistance.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of NOROXIN and other antibacterial drugs, NOROXIN should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Nystatin warnings and precautions

# Precautions

## General
This medication is not to be used for the treatment of systemic mycoses. Discontinue treatment if sensitization or irritation is reported during use.

## Carcinogenesis, Mutagenesis, Impairment of Fertility
No long-term animal studies have been performed to evaluate carcinogenic potential. There also have been no studies to determine mutagenicity or whether this medication affects fertility in males or females.

## Pregnancy
Teratogenic Effects: Category C
Animal reproduction studies have not been conducted with nystatin. It is also not known whether nystatin can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Nystatin should be given to a pregnant woman only if clearly needed.

## Nursing Mothers
It is not known whether nystatin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nystatin is administered to a nursing woman.
Oseltamivir indications and usage

# Indications And Usage

## Treatment of Influenza
TAMIFLU is indicated for the treatment of acute, uncomplicated illness due to influenza infection in patients 2 weeks of age and older who have been symptomatic for no more than 2 days.

## Prophylaxis of Influenza
TAMIFLU is indicated for the prophylaxis of influenza in patients 1 year and older.

## Limitations of Use
The following points should be considered before initiating treatment or prophylaxis with TAMIFLU:
- Efficacy of TAMIFLU in patients who begin treatment after 48 hours of symptoms has not been established.
- TAMIFLU is not a substitute for early influenza vaccination on an annual basis as recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.
- There is no evidence for efficacy of TAMIFLU in any illness caused by agents other than influenza viruses types A and B.
- Influenza viruses change over time. Emergence of resistance mutations could decrease drug effectiveness. Other factors (for example, changes in viral virulence) might also diminish clinical benefit of antiviral drugs. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use TAMIFLU.
Osteopathic manipulative medicine

# Overview
Osteopathic Manipulative Medicine (abbreviated as OMM) is an approach to manual therapy used to improve the impaired or altered function of the musculo-skeletal system (somatic dysfunction). With roots in ancient Greek "frictions," manual manipulation has long been a part of health care.  Today's OMM was first practiced by Andrew Taylor Still, M.D., the founder of modern osteopathic medicine. In the United States, its country of origin, OMM is used by Doctors of Osteopathic Medicine (D.O.s) along with surgery and medication in treatment of patients. Outside the United States, practitioners of osteopathy (who may have the qualification of D.O. as a Diploma of Osteopathy, but do not necessarily have the same medical training as American-trained D.O.s) generally limit their scope to manual manipulation.
There are different techniques applied to the musculoskeletal system as OMM. These techniques can be applied to the joints, their surrounding soft tissues, muscles and fasciae.
Also, OMM is a treatment that is intended to be used in conjunction with mainstream treatments where it is deemed appropriate.  It is rarely used as a primary treatment regimen unless the D.O. is absolutely certain that the patient's problems are a result of a musculoskeletal somatic dysfunction.  Furthermore, as with other medical treatment methodologies, there are certain situations where use of OMM is strictly contraindicated (for example, cervical spine HVLA techniques may never be used on patients with Down Syndrome).
While this OMM practice is traditionally ascribed to D.O.'s, it should also be noted that there are M.D. practitioners of OMM since many Osteopathic medical schools have created training programs for their M.D. counterparts.  Recently OMM training programs have likewise been extended to other medical professionals including, but not limited to:  Physician Assistants, Nurse Practitioners, Nurses, etc.
Some techniques used in OMM are:
- Balanced ligamentous tension (BLT)
- Counterstrain
- Cranial osteopathy
- High Velocity Low Amplitude Thrust (HVLAT)
- Joint mobilization - articulatory techniques
- Lymphatic Pump
- Muscle Energy Technique (MET)
- Myofascial Release
- Neuromuscular therapy, trigger point therapy or myodysneuric point therapy
- Soft Tissue Technique
- Visceral manipulation
When combined as Osteopathic Manual Medicine, these forms of treatment allow the osteopathic physician to restore the normal contact within the joint and with other structures. This eliminates muscular spasms and tensions in the ligaments, thereby restoring complete mobility to the joint. It is probably the comprehensive and eclectic style of OMM that distinguishes it most from that employed by most other manual therapists. The immediate goal of musculoskeletal manipulation is to restore maximal, pain-free movement of the musculoskeletal system in postural balance.
Oxiconazole (patient information)

# Why is this medication prescribed
Oxiconazole, an antifungal agent, is used to treat skin infections such as athlete's foot, jock itch, and ringworm.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

# How should this medicine be used
Oxiconazole comes in a cream or lotion to be applied to your skin. Oxiconazole usually is applied once a day (in the evening) or twice a day (in the morning and evening). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use oxiconazole exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Thoroughly clean the infected area, allow it to dry, and then gently rub the medication in until most of it disappears. Use just enough medication to cover the affected area. You should wash your hands after applying the medication.

# What special precautions should I follow
Before using oxiconazole
- tell your doctor and pharmacist if you are allergic to oxiconazole or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, including vitamins.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using oxiconazole, call your doctor.

# What should I do if I forget a dose
Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

# Side effects

## Mild side effects
Oxiconazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- itching
- burning
- redness
- dry or flaky skin
- tingling

## Severe side effects
If you experience any of the following symptoms, call your doctor immediately:
- pain
- swelling
- open sores
- skin rash
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# What other information should I know
Keep all appointments with your doctor. Oxiconazole is for external use only. Do not let oxiconazole get into your eyes, nose, or mouth, and do not swallow it. Do not apply dressings, bandages, cosmetics, lotions, or other skin medications to the area being treated unless your doctor tells you.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
If you still have symptoms of infection after you finish the oxiconazole, call your doctor.

# Brand names
- Oxistat
Oxiconazole indications and usage

# Indications And Usage
OXISTAT Cream and Lotion are indicated for the topical treatment of the following dermal infections: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, Trichophyton mentagrophytes, or Epidermophyton floccosum.
OXISTAT Cream is indicated for the topical treatment of tinea versicolor (pityriasis) due to Malassezia furfur.
OXISTAT Cream may be used in pediatric patients for tinea corporis, tinea cruris, tinea pedis, and tinea (pityriasis) versicolor; however, these indications for which OXISTAT Cream has been shown to be effective rarely occur in children below the age of 12.
PCI Complications: Pseudoaneurysm

# Definition
Coronary artery aneurysm is considered a vessel wall expansion > 20% following PCI.

# Etiology
Coronary artery aneurysms or pseudoaneurysms, are rare findings after balloon angioplasty, atheroablation, and coronary stenting.  Coronary artery aneurysms likely arise from tears or dissection and incomplete healing that compromises the vessel wall integrity and result in vessel wall expansion.
Coronary artery aneurysms are also rarely (<1%) seen after drug eluting stent placement, although the pathologic etiology of aneurysms in this setting may relate to expansion of all three layers of the arterial wall due to inflammation and effects from the cytostatic or cytotoxic drugs and malapposition of the stent struts (1, 2).  Under rare circumstances, coronary artery aneurysms can become infected requiring surgical intervention (3, 4).
Pediatric end-stage liver disease

# Overview
Pediatric end-stage liver disease (PELD) is a disease severity scoring system for children under 12 years of age. It is calculated from the patient's albumin, bilirubin, and international normalized ratio (INR) together with the patient's age and degree of growth failure. This score is also used by the United Network for Organ Sharing (UNOS) for prioritizing allocation of liver transplants.

# PELD Formula
The PELD score is calculated using the following formula:
PELD Score =  0.480 x Loge(bilirubin mg/dL) 
- 1.857 x Loge(INR)
- 0.687 x Loge(albumin g/dL) 
if the patient is less than 1 year old (scores for patients listed for liver 
transplantation  before the patients first birthday continue to include the value assigned
for age (< 1 Year) until the patient reached the age of 24 months)
- 0.667 if the patient has growth failure (<-2 Standard deviation)
Multiply the score by 10 and round to the nearest whole number.
Laboratory values less than 1.0 are set to 1.0 for the purposes of the PELD score calculation.
The laboratory values needed to calculate the PELD scores may be entered to the hundredths 
decimal place (two places after the decimal, e.g., 0.01), so that coordinators can enter the value(s) exactly 
as reported by the laboratory. Waitlist programming will then round values to the tenths decimal place 
(e.g., 0.1) prior to calculating the PELD score. For example, if a center enters an INR value of 1.82, 
a value of 1.8 will be used for the calculation of the PELD score.