Persius/hicric huggingface dataset:
Rimantadine adverse reactions

# Adverse Reactions
In 1,027 patients treated with Flumadine in controlled clinical trials at the recommended dose of 200 mg daily, the most frequently reported adverse events involved the gastrointestinal and nervous systems.
Incidence >1%: Adverse events reported most frequently (1-3%) at the recommended dose in controlled clinical trials are shown in the table below.
Less frequent adverse events (0.3 to 1%) at the recommended dose in controlled clinical trials were: Gastrointestinal System: diarrhea, dyspepsia; Nervous System:impairment of concentration, ataxia, somnolence, agitation, depression; Skin and Appendages: rash; Hearing and Vestibular: tinnitus; Respiratory: dyspnea.
Additional adverse events (less than 0.3%) reported at recommended doses in controlled clinical trials were: Nervous System: gait abnormality, euphoria, hyperkinesia, tremor, hallucination, confusion, convulsions; Respiratory: bronchospasm, cough; Cardiovascular: pallor, palpitation, hypertension, cerebrovascular disorder, cardiac failure, pedal edema, heart block, tachycardia, syncope; Reproduction: non-puerperal lactation; Special Senses: taste loss/change, parosmia.
Rates of adverse events, particularly those involving the gastrointestinal and nervous systems, increased significantly in controlled studies using higher than recommended doses of Flumadine. In most cases, symptoms resolved rapidly with discontinuation of treatment. In addition to the adverse events reported above, the following were also reported at higher than recommended doses: increased lacrimation, increased micturition frequency, fever, rigors, agitation, constipation, diaphoresis, dysphagia, stomatitis, hypesthesia and eye pain.
Adverse Reactions in Trials of Rimantadine and Amantadine: In a six-week prophylaxis study of 436 healthy adults comparing rimantadine with amantadine and placebo, the following adverse reactions were reported with an incidence >1 %.
GERIATRIC USE: Approximately 200 patients over the age of 64 were evaluated for safety in controlled clinical trials with Flumadine (rimantadine hydrochloride). Geriatric subjects who received either 200 mg or 400 mg of rimantadine daily for 1 to 50 days experienced considerably more central nervous system and gastrointestinal adverse events than comparable geriatric subjects receiving placebo. Central nervous system events including dizziness, headache, anxiety, asthenia, and fatigue, occurred up to two times more often in subjects treated with rimantadine than in those treated with placebo. Gastrointestinal symptoms, particularly nausea, vomiting, and abdominal pain occurred at least twice as frequently in subjects receiving rimantadine than in those receiving placebo. The gastrointestinal symptoms appeared to be dose related. In patients over 64, the recommended dose is 100 mg, daily (see Clinical Pharmacology and Dosage and Administration).
Rimantadine drug interactions

# Drug Interactions
Cimetidine: The effects of chronic cimetidine use on the metabolism of rimantadine are not known. When a single 100 mg dose of Flumadine was administered one hour after the initiation of cimetidine (300 mg four times a day), the apparent total rimantadine clearance of this single dose in normal healthy adults was reduced by 18% (compared to the apparent total rimantadine clearance in the same subjects in the absence of cimetidine).
acetaminophen: Flumadine, 100 mg, was given twice daily for 13 days to 12 healthy volunteers. On day 11, acetaminophen (650 mg four times daily) was started and continued for 8 days. The pharmacokinetics of rimantadine were assessed on days 11 and 13. Coadministration with acetaminophen reduced the peak concentration and AUC values for rimantadine by approximately 11%.
aspirin: Flumadine, 100 mg, was given twice daily for 13 days to 12 healthy volunteers. On day 11, aspirin (650 mg, four times daily) was started and continued for 8 days. The pharmacokinetics of rimantadine were assessed on days 11 and 13. Peak plasma concentrations and AUC of rimantadine were reduced approximately 10% in the presence of aspirin.
Live Attenuated influenza Vaccine (LAIV): The concurrent use of Flumadine with live attenuated influenza vaccine has not been evaluated. However, because of potential interference between these products, the live attenuated intranasal influenza vaccine should not be administered until 48 hours after cessation of Flumadine and Flumadine should not be administered until two weeks after the administration of live attenuated intranasal influenza vaccine unless medically indicated. The concern about potential interference arises principally from the potential for antiviral drugs to inhibit replication of live vaccine virus.
Ritonavir labels and packages

# Labels And Packages
NORVIR 100 mg soft gelatin capsules are manufactured for:
AbbVie Inc.
North Chicago, IL 60064 USA
- The brands listed are trademarks of their respective owners and are not trademarks of AbbVie Inc. The makers of these brands are not affiliated with and do not endorse AbbVie Inc. or its products.
03-A843 November 2013
NDC 0074663330
Norvir
Ritonavir Capsules
Soft Gelatin
100 mg
30 Capsules
ALERT: Find out about medicines that should NOT be taken with NORVIR.
Note to Pharmacist: Do not cover ALERT box with pharmacy label.
Package insert is provided with tear-off patient information.
Rx only abbvie
Rizatriptan contraindications

# Contraindications
MAXALT is contraindicated in patients with:
- Ischemic coronary artery disease (angina pectoris, history of myocardial infarction, or documented silent ischemia), or other significant underlying cardiovascular disease .
- Coronary artery vasospasm including Prinzmetal's angina .
- History of stroke or transient ischemic attack (TIA) .
- Peripheral vascular disease (PVD) .
- Ischemic bowel disease .
- Uncontrolled hypertension .
- Recent use (i.e., within 24 hours) of another 5-HT1 agonist, ergotamine-containing medication, or ergot-type medication (such as dihydroergotamine or methysergide) .
- Hemiplegic or basilar migraine .
- Concurrent administration or recent discontinuation (i.e., within 2 weeks) of a MAO-A inhibitor .
- Hypersensitivity to MAXALT or MAXALT-MLT (angioedema and anaphylaxis seen) .
Rizatriptan drug interactions

# Drug Interactions

### 7.1	Propranolol
The dose of MAXALT should be adjusted in propranolol-treated patients, as propranolol has been shown to increase the plasma AUC of rizatriptan by 70% .

### 7.2 Ergot-Containing Drugs
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 MAXALT within 24 hours is contraindicated.

### 7.3 Other 5-HT1 Agonists
Because their vasospastic effects may be additive, co-administration of MAXALT and other 5-HT1 agonists within 24 hours of each other is contraindicated .

### 7.4 SSRIs/SNRIs and Serotonin Syndrome
Cases of serotonin syndrome have been reported during co-administration of triptans and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) .

### 7.5 Monoamine Oxidase Inhibitors
MAXALT is contraindicated in patients taking MAO-A inhibitors and non-selective MAO inhibitors. A specific MAO-A inhibitor increased the systemic exposure of rizatriptan and its metabolite .
Rosacea (patient information)
For the WikiDoc page for this topic, click here

# Overview
Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids. It may appear as redness, prominent spider-like blood vessels, swelling, or skin eruptions similar to Acne.

# What are the symptoms of Rosacea?
- Redness of the face in discrete areas or covering the entire face
- A tendency to flush or blush easily
- Increased number of spider-like blood vessels (telangiectasia) of the face
- A red, bulbous nose
- Acne-like skin eruptions (may ooze or crust)
- A burning or stinging sensation of the face
- Irritated, bloodshot, watery eyes

# What causes Rosacea?
Rosacea involves swelling of the blood vessels just under the skin. It may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).

# Who is at highest risk?
Although the cause of rosacea is unknown, you are more likely to develop this harmless skin condition if:
- You are fair-skinned
- You blush easily
- You are a woman (however, men with the condition are usually more severely affected)
- You are between the ages of 30 and 50

# Diagnosis
Your physician can usually diagnose rosacea with a thorough medical history and physical exam.

# Treatment options
There is no known cure for rosacea. The goal is to identify and avoid possible triggers, and thus reduce flare-ups. By keeping a symptom diary to identify the specific triggers you may have, you may be able to see a pattern of what makes your rosacea worse. Use this information to avoid future flare-ups.
Here are some steps that may help:
- Avoid sun exposure. Use sunscreen every day.
- Avoid prolonged exertion in hot weather.
- Try to reduce stress. Try deep breathing, yoga, or other relaxation techniques.
- Limit spicy foods, alcohol, and hot beverages.
Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.
Antibiotics taken by mouth (such as tetracycline, minocycline, or doxycycline) or applied to the skin (such as metronidazole) may control skin eruptions. Other medications (isoretinol or Accutane), which are similar to vitamin A, are stronger alternatives that your doctor or dermatologist might consider. Rosacea is not acne and will not improve with over-the-counter acne treatment.
In severe cases, laser surgery may help reduce the redness. Surgical reduction of enlarged nose tissue may also improve your appearance, if you so choose.

# Where to find medical care for Rosacea?
Directions to Hospitals Treating Rosacea

# What to expect (Outlook/Prognosis)?
Rosacea is not medically dangerous. It is not curable, but can usually be controlled with treatment. It may be persistent and chronic.

# Possible complications
- Permanent changes in appearance (for example, a bulbous nose)
- Psychological damage, loss of self esteem

# Sources
Royal College of Pathologists
The Royal College of Pathologists, was founded in 1962, and is a medical organisation that promotes and sets standards for the study and practice of pathology.
The College has oversight of the following main disciplines
- Histopathology
Neuropathology
Cytopathology
Paediatric pathology
- Neuropathology
- Cytopathology
- Paediatric pathology
- Chemical Pathology
- Haematology (with the Royal College of Physicians)
- Immunology (with the Royal College of Physicians)
- Microbiology & Virology

# Training and Examinations
The College is responsible for oversight of postgraduate education and training in all branches of pathology in the UK.
The College has an active educational programme and sponsors workshops, lectures and courses.

# Continued Professional Development
The College  runs a national scheme for oversight of continued education of pathologists in clinical practice.

# Membership
Membership in the College can be obtained by several routes, the most usual being via a postgraduate examination, indicated with the designation Member of the Royal College of Pathologists (MRCPath). The designation Fellow of the Royal College of Pathologists (FRCPath) is bestowed upon members who are in good standing, as an indication of seniority.

# Presidents
Professor Sir James Underwood 2004-2006
Royal College of Radiologists

# Overview
The Royal College of Radiologists is the professional body responsible for the specialty of clinical oncology and clinical radiology throughout the United Kingdom. Its role is to advance the science and practice of radiology and oncology, further public education and set appropriate professional standards of practice. The College also sets and monitors the educational curriculum for those training to enter the profession. It is a registered charity in the United Kingdom (no. 211540). 
The College publishes two journals, the Clinical Oncology Journal and the Clinical Radiology Journal, as well as awarding various prizes and scholarships.

# History
A series of bodies has represented practitioners of radiological medicine in the UK, starting in 1897 with the foundation of the Roentgen Society (named for the physicist Wilhelm Conrad Rontgen). Subsequently founded societies included the British Association of Radiologists (1934), the Society of Radiotherapists of Great Britain and Northern Ireland (1935) and the Faculty of Radiologists (1939).
In 1950 the first issue of the Clinical Radiology Journal was published by the Faculty of Radiologists, who were then granted a Royal Charter of incorporation in 1953. A supplemental charter was given in 1975 to rename the Faculty as The Royal College of Radiologists. The College then published the first issue of the Clinical Oncology Journal in September 1989.

# Official Website
Royal College of Radiologists
Sacral insufficiency fracture

# Causes
- Postmenopausal osteoporosis (most common)
- Senile osteoporosis
- Pelvic irradiation
- Corticosteroid therapy
- Rheumatoid arthritis

# Diagnosis

## History and Symptoms
- Typically, patients present with groin, low back, or buttock pain.
- Patients present with either no history of trauma or a history of low impact trauma.

# Diagnostic Findings

## Plain Film
- The most common finding is a sclerotic band or line.
- Lytic fracture line or cortical break rarely is observed.

## CT
- Sacral fractures typically are oriented vertically and located parallel to the sacroiliac joints.
- Linear fracture line with surrounding sclerosis is observed.

## MRI
- Decreased signal on T1-weighted images and increased signal on T2-weighted images.
- Signal changes are seen as linear bands within the sacral ala and body and are parallel to the sacroiliac joints.
- On T2-weighted images, the fracture line may be seen if it is surrounded by adjacent marrow edema.

## Nuclear Medicine
- H or "Honda sign" which indicated horizontal involvement of the sacrum and vertical involvement of the sacral ala
- The "dot and dash" pattern is another common appearance.

# Images
Images courtesy of RadsWiki
Sadistic personality disorder

# Overview
Sadistic personality disorder is a diagnosis which only appeared in the revised third edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The current version of the DSM (DSM-IV-TR) does not include it, so it is no longer considered a valid diagnostic category.  There appears to be a genetic component to the disorder.

# DSM III-R criteria
Sadistic personality disorder is a pervasive pattern of cruel, demeaning, and aggressive behavior, beginning by early adulthood, as indicated by the repeated occurrence of at least four of the following:
- Has used physical cruelty or violence for the purpose of establishing dominance in a relationship (not merely to achieve some noninterpersonal goal, such as striking someone in order to rob him/her).
- Humiliates or demeans people in the presence of others.
- Has treated or disciplined someone under his/her control unusually harshly.
- Is amused by, or takes pleasure in, the psychological or physical suffering of others (including animals).
- Has lied for the purpose of harming or inflicting pain on others (not merely to achieve some other goal).
- Gets other people to do what he/she wants by frightening them (through intimidation or even terror).
- Restricts the autonomy of people with whom he or she has a close relationship, e.g., will not let spouse leave the house unaccompanied or permit teenage daughter to attend social functions.
- Is fascinated by violence, weapons, injury, or torture.
The behavior has not been directed toward only one person (e.g., spouse, one child) and has not been solely for the purpose of sexual arousal (as in sexual sadism).
Sancti Spiritus (cigar brand)
Sancti Spiritus is a brand of hand-made premium cigar owned by Cigar King, Inc..

# History and Background
The brand was created by Jose "Pepin" Garcia and is manufactured at the El Rey de los Habanos factory in the Little Havana section of Miami, Florida.
The brand takes its name from the Sancti Spiritus province of Cuba, within which Don Pepin's home town of Cabaiguan is situated.

# Description
The brand consists of a single range of four vitolas. The cigar is a medium-bodied cigar. The filler and binder are Nicaraguan tobaccos and the wrapper is a Nicaraguan Corojo.  The band is based on the Cuban flag, and shows a scene from the Plaza Mayor in the city of Trinidad in which the statue of Terpsichore, the Greek Muse of dance and dramatic chorus, is prominent. The cigars come packed 25 to a box.

# Models/Vitolas

# Notes
-  Photo of the Plaza Mayor, Trinidad, Cuba
-  Description of Trinidad, with photo of statue.
Sandbox/Rate Control Strategy

# Rate Control Strategy
Shown below is an algorithm depicting the management of ventricular rate in patients with atrial fibrillation based on the 2014 ACCF/AHA/HRS Guideline for the Management of Patients With Atrial Fibrillation.
Abbreviations: AF: Atrial fibrillation; COPD: Chronic obstructive pulmonary disease; CVD: Cardiovascular disease; EF:  Ejection fraction; HF: Heart failure; HFpEF:  Heart failure with preserved ejection fraction; HFrEF: Heart failure with reduced ejection fraction; HR: Heart rate; LV: Left ventricle

## Rate Control Drugs & Dosages
Shown below is a table summarizing the list of recommended agents for control of heart rate and their dosages.
Sandbox:Croup medical therapy

# Overview
The treatment for croup depends on the severity of symptoms.  The main stem for the treatment is the use of corticosteroids, especially dexamethasone or budesonide, given orally for mild cases and parenteral for more severe cases.   Nebulized epinephrine is administered for moderate to severe cases, and it is effective in alleviating the intensity of symptoms related to upper airway obstruction, improvement is seen within 10-20 minutes since administration and last for approximately for 2 hours.   There is no significant difference between using racemic and L-epinephrine, being the latter less expensive and available in most countries.  Oxygen may be needed if hypoxia develops.  Children with moderate or severe croup are typically hospitalized for observation, usually for less than a day. Intubation is rarely needed (less than 1% of hospitalized patients).

# Medical Therapy Based on the MedicationAdapted from Lancet. 2008;371(9609):329339. 
 Click on the following categories to expand treatment regimens.

# Medical Therapy Based on the Severity Adapted from Pediatric Pulmonology 49:421429 (2014) 
 Click on the following categories to expand treatment regimens.
Sandbox:Otitis externa causes

# Overview
The primary cause of otitis externa is bacterial; the majority of cases result from Pseudomonas aeruginosa or Staphylococcus aureus infections. Otomycosis can cause otitis externa, with primary infectious fungi including Candida albicans and Aspergillus niger. Allergy-caused dermatitis can cause non-infectious otitis externa if they spread to the ear canal, including inflammatory dermatoses such as eczema, seborrhea, and psoriasis. Contact dermatitis can cause otitis externa from allergic reactions to cosmetic chemicals and metals. Rarely, psoriasis therapy secukinumab can cause otitis externa as an adverse reaction.

# Causes
Causes of otitis externa include all sources ofinflammation of the external ear canal.

## Bacterial
- The primary bacterial infectious causes of otitis externa are the following:
Pseudomonas aeruginosa
Staphylococcus aureus
- Pseudomonas aeruginosa
- Staphylococcus aureus
- Additional bacterial causes include the following:
Staphylococcus epidermidis
Microbacterium otitidis
Microbacterium alconae
Staphylococcus caprae
Staphylococcus auricularis
Enterococcus faecalis
Enterobacter cloacae
Staphylococcus capitis
Staphylococcus haemolyticus
- Staphylococcus epidermidis
- Microbacterium otitidis
- Microbacterium alconae
- Staphylococcus caprae
- Staphylococcus auricularis
- Enterococcus faecalis
- Enterobacter cloacae
- Staphylococcus capitis
- Staphylococcus haemolyticus
- Infectious bacteria that thrive in water can cause otitis externa due to facilitated transport to the ear canal.

## Fungal
- Otomycosis can cause otitis externa, with primary infectious fungi including the following:
Candida albicans
Aspergillus niger
- Candida albicans
- Aspergillus niger
- Otomycosis-caused otitis externa is common after prolonged antibiotic therapy.

## Allergic Reactions
- Allergy-caused dermatitis can cause non-infectious otitis externa if they spread to the ear canal and include the following:
Eczema
Seborrhea
Psoriasis
Contact dermatitis as a reaction to the following:
Metals, especially nickel or silver
Hearing aids
Chemical irritants, including shampoos, soaps, cosmetics etc.
- Eczema
- Seborrhea
- Psoriasis
- Contact dermatitis as a reaction to the following:
Metals, especially nickel or silver
Hearing aids
Chemical irritants, including shampoos, soaps, cosmetics etc.
- Metals, especially nickel or silver
- Hearing aids
- Chemical irritants, including shampoos, soaps, cosmetics etc.

## Drug interaction
- Rarely, psoriasis therapy secukinumab can cause otitis externa as an adverse reaction.
Sandbox: Kawasaki - ACC -2017

# AHA Scientific Statement - 2017

# Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease (KD)

## Recommendations for Cardiovascular Assessment for Diagnosis and Monitoring During the Acute Illness

## Recommendations for Initial Treatment With Intravenous Immunoglobulin (IVIG) and Asetil Salisilat Acid (ASA)

## Recommendations for Adjunctive Therapies for Primary Treatment

## Recommendations for Additional Therapy in the IVIG-Resistant Patient

## Recommendations for Prevention of Thrombosis During the Acute Illness

## Recommendations for Treatment of Coronary Artery Thrombosis

## Recommendations for Risk Stratification of Coronary Artery Abnormalities

## Risk-Stratified Recommendations for Long-Term Evaluation and Management

## No Involvement (Z Score Always <2)

## Dilation Only (Z Score 2 but <2.5, or a Decrease in Z Score During Follow-up 1)

## Regression to Normal Z Score or Dilation Only

## Medium Aneurysms (Z Score 5 to <10, With an Absolute Luminal Dimension <8 mm)

## Current or Persistent Medium Aneurysms

## Regression to Small Aneurysms

## Regression to Normal Z Score or Dilation Only

## Large and Giant Aneurysms (Z Score 10 or Absolute Dimension 8 mm)

## Regression to Medium Aneurysms

## Regression to Small Aneurysms

## Regression to Normal Z Score or Dilation Only

## Recommendations for Testing for Inducible Ischemia

## Recommendation for Assessment of Patients With Inducible Myocardial Ischemia

## Recommendations for Indications for Mechanical Revascularization

## Recommendations for Modes of Revascularization

## Recommendation for Cardiac Transplantation
Sandbox: diaphragmatic hernia
Synonyms and keywords: Congenital diaphragm hernia, Diaphragm hernia, Hernia through the diaphragm.

# Overview

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

# Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Chest X Ray| CT | MRI | Other Imaging Findings | Other Diagnostic Studies

# Treatment
Medical Therapy |  Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

# Case Studies
Case #1