Persius/hicric huggingface dataset:
Congenital protein C or S deficiency (patient information)
For the WikiDoc page on Protein C deficiency, click here
For the WikiDoc page on Protein S deficiency, click here

# Overview
Congenital protein C or S deficiency is a lack of proteins C or S in the fluid part of the blood. The proteins are natural substances that help prevent blood clots.

# What are the symptoms of Protein C or S deficiency?
- If you have this condition, you are more likely to develop blood clots.
- The symptoms are the same as for deep venous thrombosis, and include:
- Pain or tenderness in the affected area
- Redness or swelling in the affected area

# What causes Protein C or S deficiency?
- Congenital protein C or S deficiency is an inherited disorder, which means it is passed down through families. Congenital means it is present at birth.
- The disorder causes abnormal blood clotting.
- About 1 out of every 300 people has one normal gene and one faulty gene for protein C deficiency.
- Protein S deficiency occurs in about 1 in 20,000 people.

# When to seek urgent medical care?
Call your health care provider if you have symptoms of clotting in a vein (such as swelling and redness of the leg).

# Diagnosis
- Laboratory tests will be done to check for proteins C and S. If you have this disorder, you will have a lack of protein C or S.
- Other tests that may be done include:
- Bleeding time
- Partial thromboplastin time
- Prothrombin time
- Thrombin time

# Treatment options
Blood thinners (heparin and warfarin) are used to treat and prevent blood clots.

# Where to find medical care for Protein C or S deficiency?
Medical care for Protein C or S deficiency can be found here.

# Prevention
If your health care provider diagnoses you with this disorder, you should be careful to prevent clots from forming. This can occur when the blood moves slowly in the veins, such as from prolonged bed rest during an illness, surgery, hospital stay, or prolonged reduced activity such as long airplane or car trips.

# What to expect (Outlook/Prognosis)?
The outcome is usually good with treatment, but symptoms may return.

# Possible complications
- Childhood stroke
- More than one pregnancy loss (recurrent miscarriage)
- Recurrent clots in the veins
- Pulmonary embolism
- In rare cases, using warfarin to thin the blood and prevent clots can cause brief increased clotting and severe skin wounds. Patients are at risk if they are not treated with the blood-thinning drug heparin before taking warfarin.

# Source
Differentiating Churg-Strauss syndrome from other diseases

# Overview
Eosinophilic granulomatosis with polyangiitis must be differentiated from other diseases that can cause eosinophilia, purpura, alveolar hemorrhage, necrotizing extra-capillary glomerulonephritis, such as granulomatosis with polyangiitis and microscopic polyangiitis.

# Differentiating Eosinophilic granulomatosis with polyangiitis from other Diseases
Eosinophilic granulomatosis with polyangiitis must be differentiated from other diseases that cause purpura, alveolar hemorrhage, necrotizing extra-capillary glomerulonephritis, such as granulomatosis with polyangiitis and Microscopic polyangiitis.

## Differentiating Eosinophilic granulomatosis with polyangiitis from other Diseases
Eosinophilic granulomatosis with polyangiitis must be differentiated from other diseases that cause pulmonary eosinophilia and perinuclear anti-neutrophil cytoplasmic antibodies (ANCA) such as:

## Pulmonary eosinophilia
- Parasitic infections
- Drugs
- Allergic bronchopulmonary aspergillosis

## Perinuclear ANCA
- Cystic Fibrosis
- Bronchogenic carcinoma
- Inflammatory bowel disease
- Sclerosing cholangitis
- Myeloproliferative disorders
- Systemic lupus erythematosis
- Rheumatoid arthritis
Abbreviations:
ABG= Arterial blood gas, ANA= Antinuclear antibody, ANP= Atrial natriuretic peptide, ASO= Antistreptolysin O antibody, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure, PCR= Polymerase chain reaction, PFT= Pulmonary function test.

# Diagnosis of Eosinophilic granulomatosis with polyangiitis
In order to make a diagnosis of Eosinophilic granulomatosis with polyangiitis the following criteria must be present:
According to the American College of Rheumatology classification criteria 
According to Lanham diagnostic criteria
Differentiating Polymyalgia rheumatica from other diseases

# Overview
Polymyalgia rheumatica (PMR) must be differentiated from other conditions such as late onset rheumatoid arthritis, polymyositis, dermatomyositis, fibromyalgia, and remitting seronegative symmetrical synovitis with pitting edema.

# Differentiating Polymyalgia Rheumatica from other Diseases
Polymyalgia rheumatica (PMR) must be differentiated from other conditions such as late onset rheumatoid arthritis, polymyositis, dermatomyositis, fibromyalgia, and remitting seronegative symmetrical synovitis with pitting edema.

## Differentiating polymyalgia rheumatica on the basis of fatigue and chronic pain

## Differentiating polymyalgia rheumatica from other causes of inflammatory myopathy
Differentiating autoimmune retinopathy from other diseases

# Overview
Autoimmune retinopathy should be differentiated from retinal vascular diseases such as Behcet and systemic lupus erythematosus, white-dot syndrome spectrum disorders (particularly acute zonal occult outer retinopathy (AZOOR)), retinal degenerative disorders (such as retinitis pigmentosa (RP) and cone-rod dystrophy), and non-infectious and infectious uveitis syndromes.

# Differentiating Autoimmune Retinopathy from other Diseases
In early stages of autoimmune retinopathy (AIR), the visual acuity is preserved, but it progressively gets worse.  Patients report of transient dimming of the vision, which may be mistaken for other retinal vascular diseases such as Behcet and systemic lupus erythematosus. 
Other differential diagnosis of AIR include: white-dot syndrome spectrum disorders (particularly acute zonal occult outer retinopathy (AZOOR)), retinal degenerative disorders (such as retinitis pigmentosa (RP) and cone-rod dystrophy), and non-infectious and infectious uveitis syndromes.
Due to the presence of anti-retinal antibodies, and overlapping findings and symptoms, it is difficult to differentiate between retinitis pigmentosa and autoimmune retinopathy.
Electrocardiographic findings in biventricular hypertrophy

# Electrocardiographic Findings in Biventricular Hypertrophy
Biventricular hypertrophy is suggested if:
- There are voltage criteria for left ventricular hypertrophy (LVH) in the chest leads as well as right axis deviation in the limb leads.
- There are voltage criteria for LVH in the chest leads combined with prominent R waves in the right chest leads.
- There is a shallow S wave in lead V1 associated with a deeper S wave in V2, the so called shallow S wave syndrome.
- One of the best criteria according to Marriott is left atrial enlargement (LAE) as the sole representative of left ventricular enlargement, combined with any of the following clues to right ventricular hypertrophy (RVH):
S/R ratio of 1.0 or more in V5 or V6
An S wave in V5 or V6 of 7 mm or more
Right axis deviation
- S/R ratio of 1.0 or more in V5 or V6
- An S wave in V5 or V6 of 7 mm or more
- Right axis deviation
Elvitegravir cobicistat emtricitabine tenofovir overdosage
_NOTOC__

# Overdosage
No data are available on overdose of STRIBILD in patients. If overdose occurs the patient must be monitored for evidence of toxicity. Treatment of overdose with STRIBILD consists of general supportive measures including monitoring of vital signs as well as observation of the clinical status of the patient.
Elvitegravir: Limited clinical experience is available at doses higher than the therapeutic dose of elvitegravir. In one study, boosted elvitegravir equivalent to 2 times the therapeutic dose of 150 mg once daily for 10 days was administered to 42 healthy subjects. No severe adverse reactions were reported. The effects of higher doses are not known. As elvitegravir is highly bound to plasma proteins, it is unlikely that it will be significantly removed by hemodialysis or peritoneal dialysis.
Cobicistat: Limited clinical experience is available at doses higher than the therapeutic dose of cobicistat. In two studies, a single dose of cobicistat 400 mg (2.7 times the dose in STRIBILD) was administered to a total of 60 healthy subjects. No severe adverse reactions were reported. The effects of higher doses are not known. As cobicistat is highly bound to plasma proteins, it is unlikely that it will be significantly removed by hemodialysis or peritoneal dialysis.
Emtricitabine: Limited clinical experience is available at doses higher than the therapeutic dose of EMTRIVA. In one clinical pharmacology study, single doses of emtricitabine 1200 mg (6 times the dose in STRIBILD) were administered to 11 subjects. No severe adverse reactions were reported. The effects of higher doses are not known.
Hemodialysis treatment removes approximately 30% of the emtricitabine dose over a 3 hour dialysis period starting within 1.5 hours of emtricitabine dosing (blood flow rate of 400 mL per minute and a dialysate flow rate of 600 mL per minute). It is not known whether emtricitabine can be removed by peritoneal dialysis.
Tenofovir DF: Limited clinical experience at doses higher than the therapeutic dose of VIREAD 300 mg is available. In one study, 600 mg tenofovir DF (2 times the dosage in STRIBILD) was administered to 8 subjects orally for 28 days, and no severe adverse reactions were reported. The effects of higher doses are not known. Tenofovir is efficiently removed by hemodialysis with an extraction coefficient of approximately 54%. Following a single 300 mg dose of VIREAD, a 4-hour hemodialysis session removed approximately 10% of the administered tenofovir dose.
Sandbox:Zika virus infection epidemiology and demographics

# Overview
In 2015, there were 1248 reported cases of Zika virus infection in Brazil as measured by the manifestation of microcephaly in infants born to mothers with Zika virus infection, an incidence of 99.7/100,000 infants. The majority of Zika virus infection cases are reported in South Africa and Tropical Asia. As of 2014, Zika Virus infection outbreaks have become prevalent in South America as well, particularly Brazil. Cases reported in other regions of the world have come from infected travelers from areas experiencing outbreaks. Zika virus infection affects all age groups, with newborn infants particularly vulnerable due to risk of transmission from the mothers upon birth.

# Epidemiology and Demographics

## Incidence
- The incidence of Zika virus infection can be estimated as 99.7/100,000 live births of infants displaying microcephaly as of November 30th, 2015, attributed to the mothers testing positive for the Zika virus genome. This is a twentyfold increase from 2010's report of 5.7/100,000 cases of microcephaly in newborns.

## Age
- The prevalence of Zika virus infection is seen across all age groups, with cases reported in infants, adolescents, and adults.
- Newborn infants are prone to infection due to transmission from the mother during birth.

## Gender
- Men and women are equally affected by Zika virus infection.

## Developed Countries
- While Zika virus infection outbreaks have not been reported in developed countries, cases have been reported in travelers returning from affected countries.

## Developing Countries
- Before 2007, Zika virus infection outbreaks reports were limited to Tropical Africa and Southeast Asia. However, an outbreak on Yap Island in the Federated States of Micronesia in 2007 was the first of several cases reported on Pacific islands and archipelagos outside of Africa and Asia.
- Zika virus infection outbreaks have been reported in Mexico and South America. The first South American outbreak was reported originating in Easter Island, Chile, in 2014. Additional Countries in the South America with outbreaks include:
Brazil
Colombia
Ecuador
Guatemala
El Salvador
Paraguay
Suriname
Venezuela
- Brazil
- Colombia
- Ecuador
- Guatemala
- El Salvador
- Paraguay
- Suriname
- Venezuela
- Brazil has reported 1,248 cases of Zika virus infection, including 3 deaths, as of December 2015.
State Research Center of Virology and Biotechnology VECTOR
The State Research Center of Virology and Biotechnology VECTOR, also known as the Vector Institute, is a highly sophisticated biological research center in Koltsovo, Novosibirsk Oblast, Russia. It is roughly analogous to both the Centers for Disease Control and Prevention and the US Army Chemical and Biological Defense Command. It has research facilities and capabilities for all levels of Biological Hazard, CDC Levels 1-4. It is one of two official repositories for the now-eradicated smallpox virus, and is part of the system of laboratories known as the Biopreparat.
Recently the facility has been upgraded and secured using the most modern cameras, motion sensors, fences, and biohazard containment systems.  Its relative seclusion make security an easier task.  Since its inception there has been an elite army regiment guarding the facility.
The facility has, at least until Soviet times, been a nexus for biological warfare research, though the nature of any ongoing research in this area is uncertain.  Many of the researchers at the institution are courted by other research institutions around the globe.
Sudden infant death syndrome epidemiology and demographics

# Overview
Sudden infant death syndrome (SIDS) is one of the major cause of death in infants especially whose age range between one month to one year in United States of America. The incidence of SIDS is low but it is higher in some ethnic groups in America.

# Epidemiology and Demographics

## Incidence
- The incidence of Sudden infant death syndrome (SIDS) is approximately is less than <1 per 1000 live births in United States.

## Prevalence
- The prevalence of Sudden infant death syndrome (SIDS) in association with smoking during pregnancy increased from 50% to 80%.

## Mortality rate
- The infant mortality rate of SIDS is approximately 3.2 per 1,000 live births for Chinese mothers.
- The infant mortality rate of SIDS is approximately 2.2 and 2.8 per 1,000 live births for American Indian mothers.
- The infant mortality rate of SIDS is approximately 13.3 per 1,000 live births for black mothers.
- The infant mortality rate of SIDS is approximately 4.2 per 1,000 live births for Hispanics.
- .The infant mortality rate of SIDS is approximately 8.5 per 1,000 live births for Puerto Rican mothers.

## Age
- Sudden infant death syndrome (SIDS) commonly affects individuals younger than twelve months of age.

## Race
- Sudden infant death syndrome (SIDS) usually affects individuals of the American Indian, Alaskan native, and African American race more than the general population.

## Gender
- According to the European case-control study Sudden infant death syndrome (SIDS) affects boys more than girls.
- Cases of developing Sudden infant death syndrome (SIDS)  in twins is extremely rare.

## Developed Countries and Developing Countries
- Countries like Europe, Australia, New Zealand, and United States who implemented Back to Sleep program which means encouraging non-prone sleeping positions decreased the incidence of SIDS.
- In United States the incidence of SIDS decreased dramatically after the implementation of American Academy of Pediatrics (AAP) strategy of placing the infant in in a supine position for sleep.
T-cell lymphoma invasion and metastasis-inducing protein 1
T-cell lymphoma invasion and metastasis-inducing protein 1, also known as TIAM1, is a human protein gene.
It modulates the activity of Rho GTP-binding proteins and connects extracellular signals to cytoskeletal activities. Acts as a GDP-dissociation stimulator protein that stimulates the GDP-GTP exchange activity of Rho-like GTPases and activates them. Activates RAC1, CDC42, and to a lesser extent RHOA. 
It is tightly associate with BAIAP2 as a subunit.
It was found in virtually all analyzed tumor cell lines including B- and T-lymphomas, neuroblastomas, melanomas and carcinomas.
It contains one DH (DBL-homology) domain, one PDZ domain, two PH domains and one Ras-binding RBD domain.
Transposition of the great arteries differential diagnosis

# Overview
Patients with transposition of the great vessels should be differentiated from other cardiac and non-cardiac causes of cyanosis.

# Differentiating Transposition of the great vessels from other Diseases
Patients with transposition of the great vessels should be differentiated from other cardiac and non-cardiac causes of cyanosis-
Cardiac causes (starts with 't')-
- Tetralogy of Fallot
- Truncus arteriosus
- Total anomalous pulmonary venous connection
- Tricuspid valve abnormalities
Other less common causes are- pulmonary atresia, hypoplastic left heart syndrome, anomalous systemic venous connection.
Non-cardiac causes
- Pulmonary diseases - Structural abnormalities of the lung, V/P (ventilation-perfusion mismatch), airway obstruction, pneumothorax, and hypoventilation.
- Abnormal hemoglobin like methemoglobin, polycythemia
- Peripheral cyanosis for e.g. sepsis, hypoglycemia, dehydration, and hypoadrenalism.
Transposition of the great arteries should be differentiated from other cyanotic congenital heart diseases found in the pediatrics population. These disorders described in the table below:
Vascular Imaging in Patients With Vertebral Artery Disease

# Management of Atherosclerotic Risk Factors in Patients With Vertebral Artery Disease

## 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)

### Vascular Imaging in Patients with Vertebral Artery Disease (DO NOT EDIT)
Acute abdominal pain resident survival guide (pediatrics)
Synonyms and keywords:

# Overview
This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

# Causes

## Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
- Life threatening cause 1
- Life threatening cause 2
- Life threatening cause 3

## Common Causes
- Common cause 1
- Common cause 2
- Common cause 3
- Common cause 4
- Common cause 5

# FIRE: Focused Initial Rapid Evaluation

# Complete Diagnostic Approach
Shown below is an algorithm summarizing the diagnosis of ] according the the  guidelines.

# Treatment
Shown below is an algorithm summarizing the treatment of ] according the the  guidelines.

# Do's
- The content in this section is in bullet points.

# Don'ts
- The content in this section is in bullet points.
Anterior intercostal branches of internal thoracic artery
The Anterior intercostal branches of internal thoracic artery supply the upper five or six intercostal spaces.
Two in number in each space, these small vessels pass lateralward, one lying near the lower margin of the rib above, and the other near the upper margin of the rib below, and anastomose with the intercostal arteries from the aorta.
They are at first situated between the pleura and the Intercostales interni, and then between the Intercostales interni and externi.
They supply the intercostal muscles and, by branches which perforate the Intercostales externi, the Pectoral muscles and the mamma.
Clindamycin palmitate hydrochloride clinical pharmacology

# CLINICAL PHARMACOLOGY
Blood level studies comparing clindamycin palmitate HCl with clindamycin hydrochloride show that both drugs reach their peak active serum levels at the same time, indicating a rapid hydrolysis of the palmitate to the clindamycin.
Clindamycin is widely distributed in body fluids and tissues (including bones). Approximately 10% of the biological activity is excreted in the urine. The average serum half-life after doses of clindamycin palmitate hydrochloride for oral solution (Pediatric) is approximately two hours in pediatric patients.
Serum half-life of clindamycin is increased slightly in patients with markedly reduced renal function. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.
Serum level studies with clindamycin palmitate HCl in normal pediatric patients weighing 50 to 100 lbs given 2, 3 or 4 mg/kg every 6 hours (8, 12 or 16 mg/kg/day) demonstrated mean peak clindamycin serum levels of 1.24, 2.25 and 2.44 mcg/mL respectively, one hour after the first dose. By the fifth dose, the 6-hour serum concentration had reached equilibrium. Peak serum concentrations after this time would be about 2.46, 2.98 and 3.79 mcg/mL with doses of 8, 12 and 16 mg/kg/day, respectively.
Serum levels have been uniform and predictable from person to person and dose to dose. Multiple-dose studies in neonates and infants up to 6 months of age show that the drug does not accumulate in the serum and is excreted rapidly. Serum levels exceed the MICs for most indicated organisms for at least six hours following administration of the usually recommended doses of clindamycin palmitate hydrochloride for oral solution (Pediatric) in adults and pediatric patients.
No significant levels of clindamycin are attained in the cerebrospinal fluid, even in the presence of inflamed meninges.
Pharmacokinetic studies in elderly volunteers (61 to 79 years) and younger adults (18 to 39 years) indicate that age alone does not alter clindamycin pharmacokinetics (clearance, elimination half-life, volume of distribution, and area under the serum concentration-time curve) after IV administration of clindamycin phosphate.
After oral administration of clindamycin hydrochloride, elimination half-life is increased to approximately 4.0 hours (range 3.4 to 5.1 h) in the elderly compared to 3.2 hours (range 2.1 to 4.2 h) in younger adults; administration of clindamycin palmitate HCl resulted in a similar elimination half-life value of about 4.5 hours in elderly subjects. However, the extent of absorption is not different between age groups and no dosage alteration is necessary for the elderly with normal hepatic function and normal (age-adjusted) renal function