Persius/hicric huggingface dataset:
Cardiac allograft vasculopathy screening

# Overview
Cardiac allograft vasculopathy (CAV) is the leading cause of morbidity and mortality beyond the first year after heart transplantation. In most cardiac transplant centers coronary angiography currently remains the screening tool of choice for CAV. Early diagnosis is important as it may allow for alterations in medical therapy before the disease progresses to the stage where revascularization is required.

# Screening
The 2010 International Society of Heart and Lung Transplant Guidelines for the care of heart transplant recipients recommend annual invasive coronary angiography as the screening tool of choice for CAV. In most centers screening of graft coronary arteries for signs of CAV is usually performed six weeks after cardiac transplantation and then annually thereafter. In a retrospective study by Haddad et al it was reported that angiographic evidence of CAV increases by approximately 10% with every 2-year period after cardiac transplantation. The principal advantages of coronary angiography are its wide acceptability, low cost compared with other novel imaging techniques, and ease of performance. Studies have shown that coronary angiography is 80% sensitive and 96% specific in detecting CAV.
Although coronary angiography is the preferred screening modality in many centers it lacks sensitivity in detecting early-CAV associated arterial wall changes. In early CAV due to positive arterial remodeling coronary vascular lumen is relatively preserved until negative remodeling occurs resulting in narrowing of the arterial lumen. This positive remodeling is not detected by coronary angiography leading to an under-estimation of the extent of CAV. Novel intracoronary imaging techniques such as intravascular ultrasound and optical coherence tomography have shown promising results in detecting these early-CAV associated coronary arterial wall changes. Therefore supplementing these techniques to annual coronary angiography, especially in the initial years of heart transplantation may aid in identifying high-risk subjects and appropriately risk stratifying them. However, currently studies do not exist to support this strategy.
Cefoperazone Compatibility and Stability
The following solutions may be used for the initial reconstitution of CEFOBID (sterile cefoperazone).

# General Reconstitution Procedures
CEFOBID (sterile cefoperazone) for intravenous or intramuscular use may be initially reconstituted with any compatible solution mentioned above in Table 1. Solutions should be allowed to stand after reconstitution to allow any foaming to dissipate to permit visual inspection for complete solubilization. Vigorous and prolonged agitation may be necessary to solubilize CEFOBID in higher concentrations (above 333 mg cefoperazone/mL). The maximum solubility of CEFOBID (sterile cefoperazone) is approximately 475 mg cefoperazone/mL of compatible diluent.

# Preparation for Intravenous Use
General
CEFOBID (sterile cefoperazone) concentrations between 2 mg/mL and 50 mg/mL are recommended for intravenous administration.
Preparation of Vials
Vials of CEFOBID (sterile cefoperazone) may be initially reconstituted with a minimum of 2.8 mL per gram of cefoperazone of any compatible reconstituting solution appropriate for intravenous administration listed above in Table 1. For ease of reconstitution the use of 5 mL of compatible solution per gram of CEFOBID is recommended. The entire quantity of the resulting solution should then be withdrawn for further dilution and administration using any of the following vehicles for intravenous infusion:
The resulting intravenous solution should be administered in one of the following manners:
Intermittent Infusion
Solutions of CEFOBID should be administered over a 1530 minute time period.
Continuous Infusion
CEFOBID can be used for continuous infusion after dilution to a final concentration of between 2 and 25 mg cefoperazone per mL.
Preparation for Intramuscular Injection
Any suitable solution listed above may be used to prepare CEFOBID (sterile cefoperazone) for intramuscular injection. When concentrations of 250 mg/mL or more are to be administered, a lidocaine solution should be used. These solutions should be prepared using a combination of Sterile Water for Injection and 2% Lidocaine Hydrochloride Injection (USP) that approximates a 0.5% Lidocaine Hydrochloride Solution. A two-step dilution process as follows is recommended: First, add the required amount of Sterile Water for Injection and agitate until CEFOBID powder is completely dissolved. Second, add the required amount of 2% lidocaine and mix.
When a diluent other than Lidocaine HCl Injection (USP) is used reconstitute as follows:

# STORAGE AND STABILITY
CEFOBID (sterile cefoperazone) is to be stored at or below 25C (77F) and protected from light prior to reconstitution. After reconstitution, protection from light is not necessary.
The following parenteral diluents and approximate concentrations of CEFOBID provide stable solutions under the following conditions for the indicated time periods. (After the indicated time periods, unused portions of solutions should be discarded.)
Cervical part of internal carotid artery
The Cervical portion (or cervical segment) of the internal carotid begins at the bifurcation of the common carotid, opposite the upper border of the thyroid cartilage, and runs perpendicularly upward, in front of the transverse processes of the upper three cervical vertebr, to the carotid canal in the petrous portion of the temporal bone.
It is comparatively superficial at its commencement, where it is contained in the carotid triangle, and lies behind and lateral to the external carotid, overlapped by the Sternocleidomastoideus, and covered by the deep fascia, Platysma, and integument: it then passes beneath the parotid gland, being crossed by the hypoglossal nerve, the Digastricus and Stylohyoideus, and the occipital and posterior auricular arteries.
Higher up, it is separated from the external carotid by the Styloglossus and Stylopharyngeus, the tip of the styloid process and the stylohyoid ligament, the glossopharyngeal nerve and the pharyngeal branch of the vagus.
It is in relation, behind, with the Longus capitis, the superior cervical ganglion of the sympathetic trunk, and the superior laryngeal nerve; laterally, with the internal jugular vein and vagus nerve, the nerve lying on a plane posterior to the artery; medially, with the pharynx, superior laryngeal nerve, and ascending pharyngeal artery.
At the base of the skull the glossopharyngeal, vagus, accessory, and hypoglossal nerves lie between the artery and the internal jugular vein.
Chief Veterinary Officer, United Kingdom
The Chief Veterinary Officer (or CVO) is an official in the British government, who is head of veterinary services in the United Kingdom.  Wales, Scotland and Northern Ireland also each have a Chief Veterinary Officer.

# List of post holders for the United Kingdom
The following people have held the post of Chief Veterinary Officer for the United Kingdom:
- Alexander Curtis Cope (1893 - 1905)
- Sir Stewart Stockman (1905 - 1926)
- Sir James Joseph Ralph Jackson (1926 - 1932)
- Sir Percy John Luxton Kelland (1932 - 1938)
- Sir Daniel Alfred Edmond Cabot (1938 - 1948)
- Sir Thomas Dalling (1948 - 1952)
- Sir John Neish Ritchie (1952 - 1965)
- Mr John Reid (1965 - 1970)
- Mr A G Beynon (1970 - 1973)
- Mr A C L Brown (1973 - 1980)
- Mr William Howard Rees, August 1980 - May 1988
- Keith Meldrum, June 1988 to April 1997
- James Scudamore, April 1997 - March 2004
- Dr Debby Reynolds, March 2004 - present

# List of post holders for Wales
- Dr Christianne Glossop

# List of post holders for Scotland
The Scottish post was created in October 2002, and the following people have held the post:
- Leslie Gardner, October 2002 - March 2003.
- Charles Milne, March 2003 - present

# List of post holders for Northern Ireland
- Mr Robert (Bob) Milligan McCracken, 1998 - 2002
- Mr R M Houston
Chloramphenicol warnings and precautions
IMPORTANT CONSIDERATIONS IN PRESCRIBING CHLORAMPHENICOL SODIUM SUCCINATE FOR INJECTION
Chloramphenicol sodium succinate for injection is intended for IV use only.  It has been demonstrated to be ineffective when given intramuscularly.
- Chloramphenicol sodium succinate for injection must be hydrolyzed to its microbiologically active form and there is a big lag in achieving adequate blood levels compared with the base given IV.
- The oral form of chloramphenicol is readily absorbed and adequate blood levels are achieved and maintained on the recommended dosage.
- Patients started on IV chloramphenicol sodium succinate for injection should be changed to the oral form as soon as practicable

# PRECAUTIONS
Baseline blood studies should be followed by periodic blood studies approximately every two days during therapy.  The drug should be discontinued upon appearance of reticulocytopenia, leukopenia, thrombocytopenia, anemia or any other blood study findings attributable to chloramphenicol.  However, it should be noted that such studies do not exclude the possible later appearance of the irreversible type of bone marrow depression.
Repeated courses of the drug should be avoided if at all possible.  Treatment should not be continued longer than required to produce a cure with little or no risk or relapse of the disease.
Concurrent therapy with other drugs that may cause bone marrow depression should be avoided.
Excessive blood levels may result from administration of the recommended dose to patients with impaired liver or kidney function, including that due to immature metabolic processes in the infant.  The dosage should be adjusted accordingly or, preferably, the blood concentration should be determined at appropriate intervals.
There are no studies to establish the safety of this drug in pregnancy.
- In the treatment of typhoid fever some authorities recommended that chloramphenicol be administered at therapeutic levels for 8 to 10 days after the patient has become afebrile to lessen the possibility of relapse.
Since chloramphenicol readily crosses the placental barrier, caution in use of the drug is particularly important during pregnancy at term or during labor because of potential toxic effects on the fetus (gray syndrome).
Precaution should be used in therapy of premature and full-term infants to avoid gray syndrome toxicity (see ADVERSE REACTIONS).  Serum drug levels should be carefully followed during therapy of the newborn infant.
Precaution should be used in therapy during lactation because of the possibility of toxic effects on the nursing infant.
The use of this antibiotic, as with other antibiotics, may result in an overgrowth of nonsusceptible organisms, including fungi.  If infections caused by nonsusceptible organisms appear during therapy, appropriate measures should be taken
Clioquinol Topical (patient information)

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

# How this medication should be used
Clioquinol comes as a cream, lotion, and ointment to apply to the skin. Clioquinol is usually used two to four times a day for 4 weeks (2 weeks for jock itch). Follow the directions on the label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use clioquinol exactly as directed. Do not use more or less of it or use it more often than indicated on the product label.
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.

# Special precautions
Before using clioquinol:
- tell your doctor and pharmacist if you are allergic to clioquinol or any other drugs.
- tell your doctor and pharmacist what prescription and nonprescription drugs you are taking, including vitamins.
- tell your doctor and pharmacist if you are about to take a thyroid function test.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using clioquinol, call your doctor.

# What to do if you 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
Clioquinol may cause side effects. If you experience any of the following symptoms, call your doctor immediately:
- itching
- burning
- irritation or stinging
- redness
- swelling
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 .

# Storage conditions needed for this medication
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). Do not freeze. Protect it from light. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# Other information
Keep all appointments with your doctor. Clioquinol is for external use only and may stain your clothes, hair, skin, and nails yellow. Do not let clioquinol get into your eyes or mouth, and do not swallow it. Do not apply cosmetics, lotions, or other skin products to the area being treated unless your doctor tells you.
Do not let anyone else use your medication. If you still have the symptoms of infection after you finish the clioquinol, call your doctor.

# Brand names
- Vioform
Cloxacillin Sodium clinical pharmacology

# Clinical Pharmacology
Dicloxacillin sodium, USP is resistant to destruction by acid. Absorption of dicloxacillin sodium after oral administration is rapid but incomplete. Food in the gastrointestinal tract decreases the absorption of dicloxacillin. Studies with an oral dose of 125 mg gave average serum levels at 60 minutes of 4.74 mcg/mL. At four hours, average levels were 0.62 mcg/mL. In one study, single oral doses of dicloxacillin sodium 500 mg produced peak serum concentrations of 10 to 17 mcg/mL at 1 to 1.5 hours.
Once absorbed, dicloxacillin sodium is 95% to 99% bound to serum proteins, mainly albumin.
Dicloxacillin sodium, with normal doses, has insignificant concentrations in the cerebrospinal and ascitic fluids. It is found in therapeutic concentrations in the pleural, bile, and amniotic fluids. Dicloxacillin sodium is rapidly excreted as unchanged drug in the urine by glomerular filtration and active tubular secretion. The elimination half-life for dicloxacillin sodium is about 0.7 hours.
Dicloxacillin is not dialyzable. Only minimal amounts are removed by hemodialysis or peritoneal dialysis.
Cloxacillin Sodium indications and usage

# Indications and Usage
The penicillinase-resistant penicillins are indicated in the treatment of infections caused by penicillinase-producing staphylococci which have demonstrated susceptibility to the drugs. Cultures and susceptibility tests should be performed initially to determine the causative organism and their sensitivity to the drug (see CLINICAL PHARMACOLOGY  Susceptibility Testing).
The penicillinase-resistant penicillins may be used to initiate therapy in suspected cases of resistant staphylococcal infections prior to the availability of laboratory test results. The penicillinase-resistant penicillins should not be used in infections caused by organisms susceptible to penicillin G. If the susceptibility tests indicate that the infection is due to an organism other than a resistant staphylococcus, therapy should not be continued with a penicillinase-resistant penicillins.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of dicloxacillin sodium capsules and other antibacterial drugs, dicloxacillin sodium capsules 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.
Cutaneous innervation of the upper limbs
Cutaneous innervation refers to the area of the skin which is supplied by a specific nerve.
Modern texts are in agreement about which areas of the skin are served by which nerves, but there are minor variations in some of the details. The borders designated by the diagrams in the 1918 edition of Gray's Anatomy, provided below, are similar but not identical to those generally accepted today.

# Arm and shoulder
- Supraclavicular nerves (yellow)
- Axillary nerve (blue). Also Superior lateral cutaneous nerve of arm.
- Inferior lateral cutaneous nerve of arm - Near blue "axillary" area, but actually branches from radial nerve. Most modern sources distinguish the superior and inferior, but some still include a single "lateral brachial cutaneous nerve". )
- Intercostobrachial nerve (purple)
- Medial cutaneous nerve of arm (yellow) - labeled as "medial brachial cutaneous".
- Posterior cutaneous nerve of arm (pink) - not explicitly distinguished from that of Posterior cutaneous nerve of forearm on diagram, but is often distinguished in modern terminology

# Forearm
- Lateral cutaneous nerve of forearm (purple) - labeled as "lat. antibrach. cut.". Branch of musculocutaneous nerve.
- Medial cutaneous nerve of forearm (green) - labeled as "medial antibrach. cutaneous". Branch of medial cord.
- Posterior cutaneous nerve of forearm (pink) - labeled as "dorsal antibrach. cut." Branch of radial nerve.

# Hand
- Superficial branch of the radial nerve (yellow)
- Median nerve (pink)
- Superficial branch of ulnar nerve (blue)
Dehydroemetine dosage and administration

# Dosage and Administration
Injections should always be given intramuscularly. Intravenous injection is unacceptably dangerous and holds no advantage. At least 6 weeks should elapse before a second course is administered.
In amebic dysentery, supplementary treatment with tetracycline reduces the risk of bacterial superinfection.
In hepatic abscess, supplementary treatment with chloroquine, which is selectively concentrated in the liver, may be given orally, either concurrently or immediately afterwards.
All patients should subsequently receive diloxanide by mouth to eliminate surviving organisms in the colon.

### Adults
1 mg/kg daily, to a maximum of 60 mg, for up to 4-6 days. This dosage should be reduced by up to 50% in elderly and severely ill patients.

### Children
1 mg/kg daily for no more than 5 days.
Demeclocycline hydrochloride description

# Description
Demeclocycline hydrochloride is an antibiotic isolated from a mutant strain of Streptomyces aureofaciens. Chemically it is 7-Chloro-4-(dimethylamino)-1,4,4a,5,5a,6,11,12a-octahydro-3,6,10,12, 12a-pentahydroxy-1,11-dioxo-2-naphthacenecarboxamide monohydrochloride. The structural formula is:
The molecular weight is 501.32 and the empirical formula is C21H21CIN2O8HCI.
Each film-coated tablet contains demeclocycline hydrochloride 150 mg or 300 mg. In addition, each tablet contains the following inactive ingredients: alginic acid, colloidal silicon dioxide, crosscarmellose sodium, lactose monohydrate, microcrystalline cellulose, magnesium stearate, and povidone. The film coating material, contains FD&C Red #40, hypromellose 3cP, hypromellose 6cP, hypromellose 50cP, macrogol, polydextrose, titanium dioxide and triacetin.
Diffuse idiopathic skeletal hyperostosis

# Overview
Diffuse idiopathic skeletal hyperostosis is a common condition characterized by bone proliferation at sites of tendinous and ligamentous insertion. The cervical and thoracic spine in particular are affected. There is an association with hyperglycemia and approximately one-third of patients test positive for human leukocyte antigenB27.

# Diagnosis
The imaging findings are
- Florid, flowing ossification is noted along the anterior or right anterolateral aspects of at least four contiguous vertebrae.
- Disk spaces are usually well preserved.
- Enthesopathy of the iliac crest, ischial tuberosities, and greater trochanters and spur formation in the appendicular skeleton (olecranon, calcaneum) are frequently present.
Divalproex sodium nonclinical toxicology

# Nonclinical Toxicology

### 13.1 Carcinogenesis, Mutagenesis, and Impairment of Fertility
Valproate was administered orally to rats and mice at doses of 80 and 170 mg/kg/day (less than the maximum recommended human dose on a mg/m2 basis) for two years. The primary findings were an increase in the incidence of subcutaneous fibrosarcomas in high dose male rats receiving valproate and a dose-related trend for benign pulmonary adenomas in male mice receiving valproate. The significance of these findings for humans is unknown.
Valproate was not mutagenic in an in vitro bacterial assay (Ames test), did not produce dominant lethal effects in mice, and did not increase chromosome aberration frequency in an in vivo cytogenetic study in rats. Increased frequencies of sister chromatid exchange (SCE) have been reported in a study of epileptic children taking valproate, but this association was not observed in another study conducted in adults. There is some evidence that increased SCE frequencies may be associated with epilepsy. The biological significance of an increase in SCE frequency is not known.
Chronic toxicity studies of valproate in juvenile and adult rats and dogs demonstrated reduced spermatogenesis and testicular atrophy at oral doses of 400 mg/kg/day or greater in rats (approximately equivalent to or greater than the maximum recommended human dose (MRHD) on a mg/m2 basis) and 150 mg/kg/day or greater in dogs (approximately 1.4 times the MRHD or greater on a mg/m2 basis). Fertility studies in rats have shown no effect on fertility at oral doses of valproate up to 350 mg/kg/day (approximately equal to the MRHD on a mg/m2 basis) for 60 days. The effect of valproate on testicular development and on sperm production and fertility in humans is unknown.
Ebstein's anomaly of the tricuspid valve

# Overview

# Anatomy

# Historical Perspective

# Pathophysiology

# Causes

# Differentiating Ebsteins anomaly of the tricuspid valve from other Disorders

# Epidemiology and demographics

# Risk Factors

# Natural history, Complications, and Prognosis

# Diagnosis
History and Symptoms | Physical Examination |  Electrocardiogram | Chest X Ray | MRI | CT | Echocardiography or Ultrasound | Cardiac Catheterization | Electrophysiological Testings | ACC/AHA Guidelines for Diagnostic Tests  | ACC/AHA Guidelines for Evaluation of Patients

# Treatment
Medical Therapy | Surgery | Prevention | ACC/AHA Guidelines for Reproduction
Econazole patient counseling information

# PATIENT COUNSELING INFORMATION
See FDA-approved patient labeling (Patient Information)
The patient should be instructed as follows:
Inform patients that Ecoza (econazole nitrate) topical foam, 1% is for topical use only. Ecoza (econazole nitrate) topical foam, 1% is not intended for oral, intravaginal, or ophthalmic use.
Ecoza topical foam, 1% is flammable; avoid heat, flame, and smoking during and immediately following application.
If a reaction suggesting sensitivity or chemical irritation develops with the use of Ecoza topical foam, 1%, use of the medication should be discontinued.
Manufactured in the USA for
Quinnova Pharmaceuticals, LLC
Jamison, PA 18929