Persius/hicric huggingface dataset:
Bioelectrical impedance analysis
Bioelectrical impedance analysis (BIA) is a commonly used method for estimating body composition. Since the advent of the first commercially available devices in the mid-1980s the method has become popular owing to its ease of use, portability of the equipment and its relatively low cost compared to some of the other methods of body composition analysis. It is familiar in the consumer market as a simple instrument for estimating body fat. BIA actually determines the electrical impedance, or opposition to the flow of an electric current through body tissues which can then be used to calculate an estimate of total body water (TBW). TBW can be used to estimate fat-free body mass and, by difference with body weight, body fat.
Many of the early research studies showed that BIA was quite variable and it was not regarded by many as providing an accurate measure of body composition. In recent years technological improvements have made BIA a more reliable and therefore more acceptable way of measuring body composition. Nevertheless it is not a "gold standard" or reference method. Like all assessment tools, the result is only as good as the test done. Although the instruments are straightforward to use, careful attention to the method of use (as described by the manufacturer) should be given.  Simple devices to estimate body fat, often using BIA, are available to consumers as body fat meters. These instruments are generally regarded as being less accurate than those used clinically or in nutritional and medical practice.
In recent years, more accurate methods of Bioelectrical Impedance Analysis have been developed.

# Direct-Segmental Bioelectrical Impedance Analysis
A new technology, called Direct-Segmental Bioelectrical Impedance Analysis (DSM-BIA), is much more accurate than traditional BIA. This technology utilizes eight points of tactile electrodes while conveying multiple frequencies of currents through the body. Frequencies higher than 100 kHz allow for the measurement of both intracellular and extracellular water. Single frequency BIA can only detect extracellular water. Validation studies have proven that the DSM-BIA machines manufactured by this company are 96-98% accurate when compared with the gold standards of body composition, hydrostatic weighing and DEXA testing.
Bishop Auckland General Hospital
Bishop Aukland General Hospital is a small but very modern NHS district general. Much of its catchment area is rural. It was opened in 2002 and then had around 286 beds but its bed number varies all the time. There has been much controversy over the recent 'decline of services' in this hospital . The hospital is part of the County Durham and Darlington Foundation Trust.
The issue which made much controversy was the loss of the special care baby unit(SCBU) 
Special care babies are now cared for at Darlington Memorial Hospital. 
Ward 3 (Haematology) was also closed down, and surgical beds were greatly cut and now only relatively minor surgical procedures are carried out at this hospital, many of which are day cases.
Despite all this the overall quality and use of services in the trust (County Durham and Darlington foundation trust) was rated as 'good' by the  HealthCare Commission Ratings. The other two main sites in the trust are Darlington Memorial Hospital and University Hospital of North Durham.

# Services provided
Bishop Auckland General Hospital still provides an A&E department, performs elective surgery and day surgery, and has a range of acute medical specialities including diabetics, endocrinology, cardiology and respiratory medicine. It has a Critical Care unit containing ITU and CCU beds. It provides general rehabilitation care to inpatients. The hospital also has a stroke unit and a rehabilitation daycare centre and a chemotherapy day unit.
Bloating resident survival guide
Synonyms and keywords:Approach to abdominal bloating, Approach to abdominal belching, Approach to flatulence, Use of FODMAPs.

# Overview
Bloating is one of the most common gastrointestinal complaints that is attributed by the patient as the subjective sensation of incorrectly perceived excess gas. There are multiple non-functional etiologies of abdominal bloating and distension. Primary functional abdominal distension (FABD) should be diagnosed as a single entity and doesn't overlap with other functional gastrointestinal disorders. Rome IV diagnostic criteria mentions the co-existence of mild abdominal pain and/or minor bowel movements. FABD can be treated with antispasmodic along with peppermint oil in randomized controlled trials. A stepwise approach is usually needed that includes the dietary interventions, microbiome modulation, and medical therapy in the management of FABD.

# Causes
- The causes of abdominal bloating are numerous and are managed according to the underlying etiology:

# Complete Diagnostic Approach
- Shown below is an algorithm summarizing the diagnosis of abdominal bloating according to the American College of Gastroenterology Guidelines:

# Treatment
- Shown below is an algorithm summarizing the treatment of abdominal bloating according the the American College of Gastroenterology Guidelines:

# Dos
- Use of probiotics can help reduce bloating.
- Antidepressants can help to reduce the symptoms of IBS but the data is unclear over the reduction of bloating.
- Hypnotherapy has been reported to be useful in reducing the symptoms of bloating.
- Bowel training and diaphragmatic breathing have been useful in the management of bloating, however the data is unclear.

# Don'ts
- Artificial sweeteners containing sorbitol, mannitol, and xylitol should be avoided.
- Medications such as anticholinergics, opiates, calcium channel blockers, and antidepressants should also be avoided as they have an effect on bloating.
- 20% of carbohydrates in baked beans, 710% in wheat, oats, potatoes, and corn, and 1% in white rice are not absorbed well in the intestine and they can predispose to bloating, hence it is advisable to avoid them in the patients with increased complaints of bloating.
Reference ranges for blood tests
A reference range is a set of values used by a health professional to interpret a set of medical test results. The range is usually defined as the set of values 95% of the normal population falls within.
The reference range will vary, depending on the age, sex and  race of a population, and even the instruments the laboratory uses to perform the tests. Furthermore, by definition, 5% of the normal population will fall outside the reference range.

# Clinical biochemistry
- Items marked with a  are part of "CHEM-7" and CHEM-20
- Items marked with a - are part of "CHEM-20", but not CHEM-7
- Not listed: - uric acid,

# Hematology

# Immunology
Boceprevir indications and usage

# Indications And Usage
VICTRELIS (boceprevir) is indicated for the treatment of chronic hepatitis C genotype 1 infection, in combination with peginterferon alfa and ribavirin, in adult patients (18 years and older) with compensated liver disease, including cirrhosis, who are previously untreated or who have failed previous interferon and ribavirin therapy, including prior null responders, partial responders, and relapsers .
The following points should be considered when initiating VICTRELIS for treatment of chronic hepatitis C infection:
- VICTRELIS must not be used as monotherapy and should only be used in combination with peginterferon alfa and ribavirin.
- The efficacy of VICTRELIS has not been studied in patients who have previously failed therapy with a treatment regimen that includes VICTRELIS or other HCV NS3/4A protease inhibitors.
- Poorly interferon responsive patients who were treated with VICTRELIS in combination with peginterferon alfa and ribavirin have a lower likelihood of achieving a sustained virologic response (SVR), and a higher rate of detection of resistance-associated substitutions upon treatment failure, compared to patients with a greater response to peginterferon alfa and ribavirin .
Bromodomain-containing protein 3
Bromodomain-containing protein 3 (BRD3) also known as RING3-like protein (RING3L) is a protein that in humans is encoded by the BRD3 gene. This gene was identified based on its homology to the gene encoding the RING3 (BRD2) protein, a serine/threonine kinase. The gene localizes to 9q34, a region which contains several major histocompatibility complex (MHC) genes.

# Structure
BRD3 is a member of the Bromodomain and Extra-Terminal motif (BET) protein family. Like other BET family members it contains two tandem homologous bromodomains and an "Extra-Terminal" motif.
BRD3, similar to BRD2, does not have a long C-terminal domain as BET family proteins BRD4 and BRDT do.

# Function
Like other BET protein family members, BRD3 associates with acetylated lysine residues on histones and transcription factors.
BRD3 has been implicated in nucleosome remodeling in the context of transcription.
BRD2 and BRD3 perform overlapping cellular functions.

# Clinical significance
Chromosomal translocation of BRD3 with the NUT gene has been implicated in NUT midline carcinoma. BRD3-NUT driven cancers are histopathologically indistinguishable from BRD4-NUT driven cancers, likely because these translocations involve the N-terminal portion bromodomain-containing portion of these proteins which are highly conserved.
Depletion of BRD3 slows growth in cancer models including prostate cancer and medulloblastoma. The effect of BRD3 depletion is milder than that of other BET proteins BRD2 and BRD4 when each is tested in isolation. BET inhibitors target highly conserved BET bromodomains and displace BRD2, BRD3, and BRD4 from chromatin simultaneously. Functional redundancy between BRD2 and BRD3 suggests that their simultaneous disruption of these proteins may be more important than is appreciated by depletion of these proteins individually.
Cadherin related family member 3
Cadherin related family member 3 (CDHR3), also known as CDH28 or its abbreviation CDHR3, is a protein that in humans is encoded by the CDHR3 gene.
 The protein is predominately expressed in respiratory epithelium and the first notion of its clinical implications was from the discovery that genetic variation of CDHR3 is strongly associated to early severe asthma exacerbations in children. Subsequent studies have suggested that CDHR3 is a receptor for a subtype of rhinovirus.

# Function and cellular location
The exact physiological role of CDHR3 is not known, but as the CDHR3 protein is expressed in epithelial tissues and has six extracellular cadherin domains plus a short transmembrane segment, it is believed to be related to the function of similar cadherins which function in cell adhesion and cell-to-cell signaling.
Two single-cell RNA expression studies furthermore found CDHR3 to be highly selectively expressed in ciliated epithelial cells, compared to other cell types in the respiratory epithelium, and thereby to be a marker for ciliated cells in respiratory airway tissue.

# Clinical significance
A nonsynonymous mutation in CDHR3 at rs6967330 (C529Y) was at first found to be associated with severe asthma exacerbations in early childhood, with genome-wide significance. Functional experiments further indicated that this gene polymorphism leads to increased surface expression of the CDHR3 protein. A subsequent study found that CDHR3 is a probable receptor for rhinovirus type C, a common form of rhinovirus.
Recent studies furthermore found that CDHR3 gene variation is not associated with childhood bronchiolitis from respiratory syncytial virus (RSV) infection, which resemble early asthma exacerbations as a phenotype. However, childhood bronchiolitis not caused by RSV infection, of which rhinovirus is often implicated, was associated with the CDHR3 gene variation. This is line with the results from a study on chronic rhinosinusitis, which often is associated rhinovirus infection, where CDHR3 gene variation also was found to be a strong risk factor. Therefore, CDHR3 seems to causally linked to increased propensity for rhinovirus C infection.
Capreomycin sulfate microbiology

# Microbiology
Capreomycin is active against strains of Mycobacterium tuberculosis found in humans.

## Susceptibility Tests
The in vitro susceptibility of strains of M. tuberculosis to capreomycin varies with the media and techniques employed. In general, the minimum inhibitory concentrations for M. tuberculosis are lowest in liquid media that are free of egg protein (7H10 or Dubos) and range from 1 to 5 g/mL when the indirect method is used. Comparable inhibitory concentrations are obtained when 7H10 agar is used for direct susceptibility testing. When indirect susceptibility tests are performed on standard tube slants with 7H10 media, susceptible strains are inhibited by 10 to 25 g/mL capreomycin. Egg-containing media, such as Lowenstein-Jensen or ATS, require concentrations of 25 to 50 g/mL to inhibit susceptible strains.

## Cross-Resistance
Frequent cross-resistance occurs between capreomycin and viomycin. Varying degrees of cross-resistance between capreomycin and kanamycin and neomycin have been reported. No cross-resistance has been observed between capreomycin and isoniazid, aminosalicylic acid, cycloserine, streptomycin, ethionamide, or ethambutol.
Cardiac catheterization overview

# Overview
Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Coronary catheterization is a subset of this technique, involving the catheterization of the coronary arteries.
A small puncture is made in a vessel in the groin, the inner bend of the elbow, or neck area (the femoral vessels or the carotid/jugular vessels), then a guidewire is inserted into the incision and threaded through the vessel into the area of the heart that requires treatment, visualized by fluoroscopy or echocardiogram, and a catheter is then threaded over the guidewire. If X-ray fluoroscopy is used, a radiocontrast agent will be administered to the patient during the procedure. When the necessary procedures are complete, the catheter is removed. Firm pressure is applied to the site to prevent bleeding.  This may be done by hand or with a mechanical device.  Other closure techniques include an internal suture.  If the femoral artery was used, the patient will probably be asked to lie flat for several hours to prevent bleeding or the development of a hematoma. Cardiac interventions such as the insertion of a stent prolong both the procedure itself as well as the post-catheterization time spent in allowing the wound to clot.
A cardiac catheterization is a general term for a group of procedures that are performed using this method, such as coronary angiography. Once the catheter is in place, it can be used to perform a number of procedures including angioplasty, angiography, and balloon septostomy.
Cardiopulmonary exercise testing
Cardiopulmonary exercise testing (CPET) is a relatively noninvasive method of testing that measures respiratory gas exchange (e.g., oxygen uptake (VO2), carbon dioxide output (VCO2), minute ventilation (VE), and anaerobic threshold), in addition to monitoring electrocardiography, blood pressure, and pulse oximetry during a maximal progressive exercise tolerance test.   
When appropriate, arterial sampling is also performed to provide more detailed information about pulmonary gas exchange.
Performing this test may required in following situations:  
- Assistance in the differentiation of cardiac versus pulmonary limitations as a cause of exercise-induced dyspnea or impaired exercise capacity when the cause is uncertain
- Identification of high-risk patients presenting with heart failure who are candidates for cardiac transplantation or other advanced treatment
- Evaluation of exercise capacity when indicated for medical reasons in patients with cardiac pathology for whom the estimates of exercise capacity from exercise test time or work rate are unreliable
- Evaluation of patients presenting with heart failure to help determine whether heart failure is the cause of exercise limitations when the contribution of heart failure is uncertain
- Adjunct to preoperative assessment for patients being considered for lung cancer resectional surgery, when cardiovascular evaluation or pulmonary function testing indicates patient is at increased risk for perioperative complications.
Catamenial pneumothorax overview

# Overview
Catamenial pneumothorax is a condition of collapsed lung occurring in conjunction with menstrual periods (catamenial refers to menstruation), believed to be caused primarily by  endometriosis of the pleura (the membrane surrounding the lung).

# Classification
Catamenial Pneumothorax is the most common form of thoracic endometriosis syndrome, which also includes catamenial hemothorax, catamenial hemoptysis, catamenial hemopneumothorax and endometriosis lung nodules, as well as some exceptional presentations.

# Pathophysiology
Endometriosis can attach to the lung, forming chocolate-like cysts. Generally the parietal pleura is involved, but the lung itself, the visceral layer, the diaphragm, and more rarely the tracheobronchial tree may also be afflicted. How this endometrial tissue reaches the thorax remains enigmatic, although defects in the diaphragm can often be found.
The cysts can release blood; the endometrial cyst "menstruates" in the lung. Air can move in by an unknown mechanism. The blood and air cause the lung to collapse (i.e. catamenial hemopneumothorax).

# Epidemiology and Demographics
Some sources claim this entity represents 3-6% of pneumothorax in women. In regard of the low incidence of (primary spontaneous, i.e. not due to surgical trauma etc.) pneumothorax in women (about 1/100,000/year), this is a very rare condition. Hence, many basic textbooks don't mention it, and many doctors have never heard of it. However, catamenial pneumothorax is probably under-recognized.

# Diagnosis

## History and Symptoms
Onset of lung collapse is less than 72 hours after menstruation. Typically, it occurs in women aged 30-40 years, but has been diagnosed in young girls as early as 10 years of age and post menopausal women (exclusively in women of menstrual age) most with a history of pelvic endometriosis.

## Laboratory Findings
Diagnosis can be hinted by high recurrence rates of lung collapse in a woman of reproductive age with endometriosis.  CA-125 is elevated.

# Treatment

## Surgery
Pneumothorax is a medical emergency because it comes with severe pain and decreased lung function. A chest tube should be inserted after clinical assessment. This releases the air and menstrual blood, and the lung can re-expand.
Surgery, hormonal treatments and combined approaches have all been proposed, with variable results in terms of short and long term outcome. Surgical removal of the endometrial tissue should be endeavoured during menstruation for optimal visualisation of the cyst. Pleurodesis may also be helpful. Menstruation and accompanying lung collapse can be suppressed with hormone therapy, like with Lupron Depot, danazol or extended cycle combined oral contraceptive pills.
Cefadroxil indications and usage

# Indications and Usage
DURICEF is indicated for the treatment of patients with infection caused by susceptible strains of the designated organisms in the following diseases:
Urinary tract infections caused byE. coli,P. mirabilis, and Klebsiella species.
Skin and skin structure infections caused by staphylococci and/or streptococci.
Pharyngitis and/or tonsillitis caused by Streptococcus pyogenes (Group A beta-hemolytic streptococci).
Note: Only penicillin by the intramuscular route of administration has been shown to be effective in the prophylaxis of rheumatic fever. DURICEF is generally effective in the eradication of streptococci from the oropharynx. However, data establishing the efficacy of DURICEF for the prophylaxis of subsequent rheumatic fever are not available.
Note: Culture and susceptibility tests should be initiated prior to and during therapy. Renal function studies should be performed when indicated.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of DURICEF and other antibacterial drugs, DURICEF 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.
Cefditoren indications and usage

# Indications and Usage
SPECTRACEF (cefditoren pivoxil) is indicated for the treatment of mild to moderate infections in adults and adolescents (12 years of age or older) which are caused by susceptible strains of the designated microorganisms in the conditions listed below.
- Acute Bacterial Exacerbation of Chronic Bronchitis caused by Haemophilus influenzae (including -lactamase-producing strains), Haemophilus parainfluenzae (including -lactamase producing strains), Streptococcus pneumoniae (penicillin susceptible strains only), or Moraxella catarrhalis (including -lactamase-producing strains).
- Community-Acquired Pneumonia caused by Haemophilus influenzae (including -lactamase-producing strains), Haemophilus parainfluenzae (including -lactamase-producing strains), Streptococcus pneumoniae (penicillin-susceptible strains only), or Moraxella catarrhalis (including -lactamase producing strains).
- Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
- Uncomplicated Skin and Skin-Structure Infections caused by Staphylococcus aureus (including -lactamase-producing strains) or Streptococcus pyogenes.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of SPECTRACEF and other antibacterial drugs, SPECTRACEF should be used only to treat 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.
Ceftibuten indications and usage
CEDAX (ceftibuten) is indicated for the treatment of individuals with mild-to-moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below (see DOSAGE AND ADMINISTRATION and CLINICAL STUDIES sections).
Acute Bacterial Exacerbations of Chronic Bronchitis due to Haemophilus influenzae (including -lactamase-producing strains), Moraxella catarrhalis(including -lactamase-producing strains), or Streptococcus pneumoniae (penicillin-susceptible strains only).
NOTE: In acute bacterial exacerbations of chronic bronchitis clinical trials where Moraxella catarrhalis was isolated from infected sputum at baseline, ceftibuten clinical efficacy was 22% less than control.
Acute Bacterial Otitis Media due to Haemophilus influenzae (including -lactamase-producing strains), Moraxella catarrhalis (including -lactamase-producing strains), or Streptococcus pyogenes.
NOTE: Although ceftibuten used empirically was equivalent to comparators in the treatment of clinically and/or microbiologically documented acute otitis media, the efficacy against Streptococcus pneumoniae was 23% less than control. Therefore, ceftibuten should be given empirically only when adequate antimicrobial coverage against Streptococcus pneumoniae has been previously administered.
Pharyngitis and Tonsillitis due to Streptococcus pyogenes.
NOTE: Only penicillin by the intramuscular route of administration has been shown to be effective in the prophylaxis of rheumatic fever. Ceftibuten is generally effective in the eradication of Streptococcus pyogenes from the oropharynx; however, data establishing the efficacy of the CEDAX product for the prophylaxis of subsequent rheumatic fever are not available.