Persius/hicric huggingface dataset:
Sexual violence resident survival guide
Synonyms and keywords:Approach to Sexual Violence; Approach to Physical Violence; Approach to Sexual Assault; Approach to Rape

# Overview
Sexual violence is a public health concern as well as violation of human rights. It has many forms which include rape, sexual assault, sexual coercion, sexual harassment, sexual exploitation, and sexual battery. It occurs without the consent of the victim or when the victim refuses or is unable to give a consent due to age, intoxication, illness or any other reasons. It is a common problem that may be seen in primary care. It is important for physicians to identify if a person has suffered from any type of sexual violence and take care of their safety. The evaluation and treatment of sexual assault victims are mostly limited to female and pediatric patients but a few of the guidelines are applicable to male victims as well. Though most of the post-examination follow-up guidelines focus on the factors affecting female victims, there are a few studies that focus on male and homosexual victims and factors affecting their treatment and follow-up.

# Causes

## Common Causes
While it is hard to pinpoint medical causes for sexual violence, many risk factors have been associated with the aggressor:
- Aggressive nature, including hostility against women
- Rape-supportive attitudes
- Alcohol use
- Nonsexual delinquency
- Lack of parental monitoring
- Poor emotional bond between caregiver and child is also associated with sexually aggressive behavior
- Peer pressure to engage in sexual activity
- Pornography use
- Substance abuse

# Diagnosis
Shown below is an algorithm summarizing the diagnosis of sexual violence.

# Treatment
Shown below is an algorithm summarizing the treatment of sexual violence.
Non-pharmacological treatment of Sexual violence:
Treatments for sexual assault victims include treatment of PTSD, fear, and anxiety, and/or depression
Pharmacological treatment:
Empiric prophylaxis for STDs consists of

# Dos
- Make sure the victim is not left alone.
- Provide emotional support and reassure the victim that they are not at fault for what happened.
- If the victim has been raped, a doctor will use a rape kit to collect hair, semen, clothing fibers, and other evidence of the attacker's identity.
- Even if the victim is not sure they want to report about the violence, it is important to collect and preserve evidence so it can be accessed at a later date if required.
- If the victim wishes to report about the violence, the staff of the hospital will call the police from the emergency room.
- Victims should be treated for sexually transmitted diseases (STDs)
- Victims should be told about emergency birth control. It is important to receive birth control and treatment for STDs within 72 hours of the assault for maximum effectiveness. Although victims can get emergency contraception up to 5 days after, it will be less effective.

# Don'ts
- To preserve evidence, the victim should not take a bath, go to the bathroom, comb their hair, or change clothes until they have received a medical examination.
- Do not clean up anything at the site of the assault.
Spectinomycin dosage and administration

# Dosage and Administration
TROBICIN Sterile Powder, 2 grams: reconstitute with 3.2 mL of the accompanying diluent.
Shake vials vigorously immediately after adding diluent and before withdrawing dose. It is recommended that disposable syringes and needles be used to avoid contamination with penicillin residue, especially when treating patients known to be highly sensitive to penicillin.Use of a 20-gauge needle is recommended.
 Bacteriostatic Water for Injection with Benzyl Alcohol 0.945% w/v added as preservative.
Intramuscular injections should be made deep into the upper outer quadrant of the gluteal muscle.
Adults (Men and Women)Inject 5 mL intramuscularly for a 2-gram dose. This is also the recommended dose for patients being treated after failure of previous antibiotic therapy.
In geographic areas where antibiotic resistance is known to be prevalent, initial treatment with 4 grams (10 mL) intramuscularly is preferred. The 10-mL injection may be divided between two gluteal injection sites.

# Storage Conditions=
Store unreconstituted product at controlled room temperature 20 to 25C (68 to 77F) . Store prepared suspension at controlled room temperature 20 to 25C (68 to 77F) and use within 24 hours.
Sudden cardiac versus non-cardiac death

# Overview
- Sudden cardiac death (SCD) is a natural, rapid, unexpected death secondary to cardiac causes within an hour of symptom onset in witnessed scenarios, and within a day in unwitnessed cases .
- Sudden cardiac arrest (SCA) is the unexpected cessation of pumping blood into vital organs due to electrical disturbance in the pathway of sinoatrial node (SA node), atrioventricular node (AV node), His Purkinje fibers or  cardiac pumping failure due to cardiogenic shock, massive pulmonary thromboembolism,fulminant myocarditis, and ruptured left ventricular free wall.
- Without any intervention for immediate restoration of the circulation, biologic death will happen minutes to weeks after cardiac arrest. Sudden cardiac death in the United States ranges from 300,000 to 400,000 which is 50% of all causes of deaths.  In-hospital cardiac arrest happens in 290,000 adults every year in the United States. The most common cause of sudden cardiac death is coronary artery disease and atherosclerosis. The presence of underlying disorders such as malignancy or liver disease at the time of cardiac arrest makes the condition worse. Patients with acute myocardial infarction and in-hospital cardiac arrest with shockable rhythm have a better prognosis. Post cardiopulmonary resuscitation state management should be focused on neurologic complications, hemodynamic stability, and respiratory support.
TRANSCEND Study Misses Primary Endpoint
August 31, 2008 by Scott P. Williams 
ESC Congress 2008- Munich, DE:  Researchers from McMaster University reported that the angiotensin-receptor blocker (ARB), telmisartan, while well tolerated by patients and associated with a modest reduction in the secondary outcome of cardiovascular death, myocardial infarction, and stroke, failed to meet its primary endpoint. These results were presented by Dr. Koon Teo, on behalf of the TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease) Study investigators, as part of the Hot Line at the ESC 2008 Congress. The full results were published online today in The Lancet.
The TRANSCEND Study was composed of 5926 patients who are unable to tolerate angiotensin-converting enzyme (ACE) inhibitors. Following a three-week run-in period patients were randomized to either 80 mg/day of telmisartan (n=2954) or placebo (n=2972). Patients were recruited at 630 centers located in 40 countries. The duration of follow up was a median of 56 months, with a maximum and minimum of 64 and 51 months, respectively.
Telmisartan was well tolerated by patients. 23.8% (n=705) of patients in the placebo group permanently discontinued study drug compared to 21.6% (n=639) of patients who received telmisartan (p=0.055). The most frequent reason for study drug discontinuation was hypotensive symptoms, which was more frequent in patients who received telmisartan (0.54%  vs. 0.98% ). Patients who received telmisartan had a lower mean blood pressure than patients who received placebo in this study.
The trials primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure. 17.0% (n=504) of patients who received placebo sustained this composite outcome compared to 15.7% (n=465) of patients who received telmisartan (hazard ratio 0.92, 95% CI 0.811.05, p=0.216). 14.8% (n=440) of patients in the placebo group and 13.0% (n=384) of patients in the telmisartan group suffered a secondary efficacy outcome, a composite of cardiovascular death, myocardial infarction, and stroke (0.87, 0.761.00, p=0.048 unadjusted; p=0.068 after adjustment for multiplicity of comparisons and overlap with primary endpoint).
The TRANSCEND Study investigators call telmisartans lack of effect on hospitalization for heart failure unexpected and puzzling and consider this an area in need of further research.
The statistically significant 13% reduction in the composite occurrence of cardiovascular death, myocardial infarction, and stroke suggests thattelmisartan could prove valuable in reducing the occurrence of major cardiovascular events among patients who are unable to tolerate the standard therapy of ACE inhibitors.
The TRANSCEND Study was supported by a grant from Boehringer Ingelheim. Additionally, Dr. S. Yusuf was supported by the Heart and Stroke Foundation of Ontario, and a Senior Scientist Award from the Canadian Institutes of Health Research.
Reviewed by C. Michael Gibson, M.S., M.D.
TRIGLIDE patient counseling information

# Patient Counseling Information
Patients should be advised:
- of the potential benefits and risks of Triglide.
- not to use Triglide if there is a known hypersensitivity to fenofibrate or fenofibric acid.
- of medications that should not be taken in combination with Triglide.
that if they are taking coumarin anticoagulants, Triglide may increase their anti-coagulant effect, and increased monitoring may be necessary.
- to inform their physician of all medications, supplements, and herbal preparations they are taking and any change in their medical condition.
- to inform a physician prescribing a new medication, that they are taking Triglide.
- to continue to follow an appropriate lipid-modifying diet while taking Triglide.
- to take Triglide once daily at the prescribed dose, swallowing each tablet whole.
- to inform their physician of any muscle pain, tenderness, or weakness; onset of abdominal pain; or any other new symptoms.
- to return to their physicians office for routine monitoring.
Distributed by:
Shionogi Inc.
Florham Park, NJ  07932
Manufactured by:
Aenova France SAS,
38291 Saint-Quentin-Fallavier, France
Made in France
TRI-PI-03
Rev. 01/2013
 Shionogi Inc. All rights reserved.

## Manufactured for:
Lupin Pharma
Baltimore, Maryland 21202
United States.
Manufactured by:
Lupin Limited
Goa - 403 722
INDIA.
Address Medical Inquiries to:
Lupin Pharma Medical Inquiries
111 South Calvert Street, 21st Floor
Baltimore, MD 21202
-r Call: 1-800-399-2561
October 2013                                                                          ID: 235480
Telithromycin dosage and administration

# Dosage And Administration
The dose of KETEK tablets is 800 mg (2 tablets of 400 mg) taken orally once every 24 hours, for 710 days. KETEK tablets can be administered with or without food.
KETEK may be administered without dosage adjustment in the presence of hepatic impairment.
In the presence of severe renal impairment (CLCR < 30 mL/min), including patients who need dialysis, the dose should be reduced to KETEK 600 mg once daily. In patients undergoing hemodialysis, KETEK should be given after the dialysis session on dialysis days. (See CLINICAL PHARMACOLOGY, Renal insufficiency.)
In the presence of severe renal impairment (CLCR < 30 mL/min), with coexisting hepatic impairment, the dose should be reduced to KETEK 400 mg once daily. (See CLINICAL PHARMACOLOGY, Multiple insufficiency.)
Tetracycline hydrochloride how supplied

# How Supplied
Tetracycline Hydrochloride Capsules, USP are available as:
250 mg: Light Blue Opaque Cap/Yellow Opaque Body, Cap and Body Imprinted HP 17 in Black Ink.
Available in bottles of:
100 	NDC 23155-017-01
1000 	NDC 23155-017-10
500 mg: Light Blue Opaque Cap/Yellow Opaque Body, Cap and Body Imprinted HP 18 in Black Ink.
Available in bottles of:
100 	NDC 23155-018-01
500 	NDC 23155-018-05
Dispense in a tight, light-resistant containers as defined in the USP. Use child-resistant closure (as required).
Store at 20to 25C (68to 77F) .
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Tetracycline hydrochloride microbiology

# Microbiology
Tetracyclines are primarily bacteriostatic and exert their antimicrobial effect by the inhibition of protein synthesis. Tetracycline is active against a wide range of gram-negative and gram-positive organisms. The drugs in the tetracycline class have closely similar antimicrobial spectra, and cross-resistance among them is common. While in vitro studies have demonstrated the susceptibility of most strains of the following microorganisms, clinical efficacy for infections other than those included in the INDICATIONS AND USAGE section has not been documented.
Gram-negative Bacteria
Neisseria gonorrhea
Haemophilus ducreyi
Haemophilus influenzae
Yersinia pestis (formerly Pasteurella pestis)
Francisella tularensis (formerly Pasterurella tularensis)
Vibrio cholera (formerly Vibrio comma)
Bartonella bacilliformis
Brucella species
Because many strains of the following groups of gram-negative microorganisms have been shown to be resistant to tetracyclines, culture and susceptibility testing are recommended:
Escherichia coli
Klebsiella species
Enterobacter aerogenes
Shigella species
Acinetobacter species (formerly Mima species and Herellea species)
Bacteroides species
Gram-positive Bacteria
Because many strains of the following groups of gram-positive microorganisms have been shown to be resistant to tetracycline, culture and susceptibility testing are recommended. Up to 44 percent of strains of Streptococcus pyogenes and 74 percent of Streptococcusfaecalis have been found to be resistant to tetracycline drugs. Therefore, tetracyclines should not be used for streptococcal disease unless the organisms have been demonstrated to be susceptible.
Streptococcus pyogenes
Streptococcus pneumoniae
Enterococcus group (Streptococcus faecalis and Streptococcus faecium)
Alpha-hemolytic Streptococci (viridans group)
Other Microorganisms
Chlamydia psittaci
Chlamydia trachomatis
Ureaplasma urealyticum
Borrelia recurrentis
Treponema pallidum
Treponema pertenue
Clostridia species
Fusobacterium fusiforme
Actinomyces species
Bacillus anthraxis
Propionibacterium acnes
Entamoeba species
Balantidium coli
Susceptibility Testing
A tetracycline disk may be used to determine microbial susceptibility to drugs in the tetracycline class. If the Kirby-Bauer method of disk susceptibility testing is used, a 30 mcg tetracycline disk should give a zone of at least 19 mm when tested against a tetracycline susceptible bacterial strain. Microorganisms may be considered susceptible if the MIC (minimum inhibitory concentration) is not more than 4 mcg/mL and intermediate if the MIC is 4 to 12.5 mcg/mL.
Traumatic diaphragmatic hernia overview

# Overview
A traumatic diaphragmatic hernia is a type of diaphragmatic hernia which is acquired through an abdominal injury. This is in contrast to a congenital diaphragmatic hernia, which is present from birth.

# Historical Perspective
Traumatic diaphragmatic hernia apparently was described by Sennertus, who in 1541 reported an instance of delayed herniation of viscera through an injured diaphragm. Ambroise Pare, in 1579, described the first case of diaphragmatic rupture diagnosed at autopsy. The first successful diaphragmatic repair was reported by Riolfi in 1886 in a patient with omental prolapse, and Naumann in 1888 repaired the defect with herniated stomach.

# Differentiating Traumatic Diaphragmatic Hernia from other Diseases
Traumatic rupture of the diaphragm must be differentiated from atelectasis, space-consuming tumors of the lower pleural space, pleural effusion, and intestinal obstruction due to other causes.

# Epidemiology and Demographics
Diaphragmatic injury accounts for 0.8-1.6% of blunt trauma abdomen. Approximately 4-6% of patients who undergo surgery for trauma have a diaphragmatic injury.

# Natural History, Complications and Prognosis
Hemorrhage and obstruction may occur. If herniation is massive, progressive cardiorespiratory insufficiency may threaten life. The most severe complication is strangulating obstruction of the herniated viscera. Surgical repair of the rent in the diaphragm is curative, and the prognosis is excellent. The diaphragm supports sutures well, so that recurrence is practically unknown.

# Diagnosis

## Chest X Ray
Plain films of the chest may show a radiopaque area and occasionally an air-fluid level if hollow viscera have herniated. If the stomach has entered the chest, the abnormal path of a nasogastric tube may be diagnostic. The collar sign is seen when abdominal contents are seen in the thorax with/without focal constriction. Elevation and distortion of the hemi diaphragm are corroborative signs.

## CT
CT scan may demonstrate the diaphragmatic rent. A CT thorax has a sensitivity of 14-82% and a specificity of 87% and permits direct visualization of the contents and the rupture. Focused abdominal sonography for trauma (FAST) is now a good aid in diagnosing diaphragmatic hernia.

## MRI
MRI may demonstrate the diaphragmatic rent.

## Ultrasound
Ultrasound may demonstrate the diaphragmatic rent.

## Other Imaging Findings
Barium study of the colon may show irregular patches of barium in the colon above the diaphragm or a smooth colonic outline if the colon does not contain feces.

# Treatment

## Surgery
For acute ruptures, a transabdominal (most commonly) or transthoracic route is used depending on the procedure required to treat ancillary injuries. When the diaphragmatic tear is the only injury, it is usually fixed by laparotomy. Chronic injuries can be repaired by either approach. Asymptomatic tears of the diaphragm with herniated viscera should be repaired, because the risk of a strangulating obstruction is high.
Tweetbook: Cardiovascular Interventions
Submit Your Case Here

# About Us
Welcome to Tweetbook:Cardiovascular Interventions. Tweetbook seeks to memorialize all the interesting interventional cardiology cases that are posted on twitter. In four steps:
- Submit your case to tweetbook
- We review and publish your case here within 4 weeks
- We tweet a link to your case on tweetbook
- Discuss your case and save the link to share in other tweets!
To Learn More, follow the links:
- Author Instructions
- Topics of Interest
Read our cases here:
Case 1:
Case 2:
Case 3:
U2 small nuclear RNA auxiliary factor 1
Splicing factor U2AF 35 kDa subunit is a protein that in humans is encoded by the U2AF1 gene.

# Function
This gene belongs to the splicing factor SR family of genes. U2 auxiliary factor, comprising a large and a small subunit, is a non-snRNP protein required for the binding of U2 snRNP to the pre-mRNA branch site. This gene encodes the small subunit which plays a critical role in both constitutive and enhancer-dependent RNA splicing by directly mediating interactions between the large subunit and proteins bound to the enhancers. Alternatively spliced transcript variants encoding different isoforms have been identified.

# Interactions
U2 small nuclear RNA auxiliary factor 1 has been shown to interact with:
- ASF/SF2,
- NXF1,
- RP9,
- SMNDC1,
- U2AF2,  and
- ZRANB2.
University of Washington Medical Center
The University of Washington Medical Center is a nationally renowned hospital located in the University District of Seattle, Washington, USA. It is one of the teaching hospitals affiliated with the University of Washington School of Medicine.
The 2007 issue of U.S. News and World Report's "America's Best Hospitals" ranks the UWMC 11th out of 5,462 hospitals nationwide. Many UWMC programs score extremely high in specialty rankings, including: rehabilitation medicine (3); otolaryngology (13); endocrinology (16); orthopedics (15); geriatrics (13); oncology (6); gastroenterology (30); pulmonology (14); nephrology (16); neurology/neurosurgery (30); rheumatology (20); gynecology (9); urology (24) and internal medicine.
The University of Washington Medical Center opened on May 5, 1959. It grew out of the medical school that the university opened on October 2, 1946. It is home to the world's first pain center and was the location of the world's first long-term kidney dialysis, developed by UW professor Belding H. Scribner, M.D.
Valganciclovir hydrochloride overdosage

# Overdosage

## Experience With Valcyte Tablets
One adult developed fatal bone marrow depression (medullary aplasia) after several days of dosing that was at least 10-fold greater than recommended for the patient's estimated degree of renal impairment.
An overdose of Valcyte could also possibly result in increased renal toxicity .
Because ganciclovir is dialyzable, dialysis may be useful in reducing serum concentrations in patients who have received an overdose of Valcyte . Adequate hydration should be maintained. The use of hematopoietic growth factors should be considered .

## Experience With Intravenous Ganciclovir
Reports of overdoses with intravenous ganciclovir have been received from clinical trials and during postmarketing experience. The majority of patients experienced one or more of the following adverse events:
Hematological toxicity: pancytopenia, bone marrow depression, medullary aplasia, leukopenia, neutropenia, granulocytopenia
Hepatotoxicity: hepatitis, liver function disorder
Renal toxicity: worsening of hematuria in a patient with pre-existing renal impairment, acute renal failure, elevated creatinine
Gastrointestinal toxicity: abdominal pain, diarrhea, vomiting
Neurotoxicity: generalized tremor, convulsion
Valproate sodium nonclinical toxicology

# Nonclinical Toxicology

### 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 dose 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.