Persius/hicric huggingface dataset:
Interferon alfa-2b how supplied

# How Supplied
HOW SUPPLIED
INTRON A Powder for Injection
INTRON A Powder for Injection, 10 million IU per vial and Diluent for INTRON A (Sterile Water for Injection USP) 1 mL per vial; boxes containing 1 INTRON A vial and 1 vial of INTRON A Diluent (NDC 0085-0571-02).
INTRON A Powder for Injection, 18 million IU per vial and Diluent for INTRON A (Sterile Water for Injection USP) 1 mL per vial; boxes containing 1 vial of INTRON A and 1 vial of INTRON A Diluent (NDC 0085-1110-01).
INTRON A Powder for Injection, 50 million IU per vial and Diluent for INTRON A (Sterile Water for Injection USP) 1 mL per vial; boxes containing 1 INTRON A vial and 1 vial of INTRON A Diluent (NDC 0085-0539-01).
INTRON A Solution for Injection in Multidose Pens
INTRON A Solution for Injection, 6 doses of 3 million IU (18 million IU) Multidose Pen (22.5 million IU per 1.5 mL per pen); boxes containing 1 INTRON A Multidose Pen, six disposable needles and alcohol swabs (NDC 0085-1242-01).
INTRON A Solution for Injection, 6 doses of 5 million IU (30 million IU) Multidose Pen (37.5 million IU per 1.5 mL per pen); boxes containing 1 INTRON A Multidose Pen, six disposable needles and alcohol swabs (NDC 0085-1235-01).
INTRON A Solution for Injection, 6 doses of 10 million IU (60 million IU) Multidose Pen (75 million IU per 1.5 mL per pen); boxes containing 1 INTRON A Multidose Pen, six disposable needles and alcohol swabs (NDC 0085-1254-01).
INTRON A Solution for Injection in Vials
INTRON A Solution for Injection, 18 million IU multidose vial (22.8 million IU per 3.8 mL per vial); boxes containing 1 vial of INTRON A Solution for Injection (NDC 0085-1168-01).
INTRON A Solution for Injection, 25 million IU multidose vial (32 million IU per 3.2 mL per vial); boxes containing 1 vial of INTRON A Solution for Injection (NDC 0085-1133-01).
Pressure gradient (atmospheric)

# Overview
In atmospheric sciences (meteorology, climatology and related fields), the pressure gradient (typically of air, more generally of any fluid) is a physical quantity that describes in which direction and at what rate the pressure changes the most rapidly around a particular location. The pressure gradient is a dimensional quantity expressed in units of pressure per unit length. The SI unit is pascal per metre (Pa/m).

# Mathematical description
Assuming that the pressure p is an intensive quantity, i.e., a single-valued, continuous and differentiable function of three-dimensional space (often called a scalar field), i.e., that
where x, y and z are the coordinates of the location of interest, then the pressure gradient is the vector quantity defined as
\nabla p = \begin{pmatrix}
{\frac{\partial p}{\partial x}},  
{\frac{\partial p}{\partial y}}, 
{\frac{\partial p}{\partial z}}
\end{pmatrix}

# Physical interpretation
Strictly speaking, the concept of pressure gradient is a local characterization of the air (more generally of the fluid under investigation). The pressure gradient is defined only at those spatial scales at which pressure (more generally fluid dynamics) itself is defined.
Within planetary atmospheres (including the Earth's), the pressure gradient is a vector pointing roughly downwards, because the pressure changes most rapidly vertically, increasing downwards. The value of the strength (or norm) of the pressure gradient in the troposphere is typically of the order 9 Pa/m (or 90 hPa/km).
The pressure gradient often has a small but critical horizontal component, which is largely responsible for the wind circulation. The horizontal pressure gradient is a 2-dimensional vector resulting from the projection of the pressure gradient onto a local horizontal plane.
Near the Earth's surface, this horizontal pressure gradient is typically pointing towards high pressure air masses (anticyclones), its particular orientation at any one time and place depends strongly on the weather situation. At mid-latitudes, the typical horizontal pressure gradient may take on values of the order of 10-2 Pa/m (or 10 Pa/km), although rather higher values occur within meteorological fronts.

# Weather and climate relevance
Differences in air pressure between different locations are critical in weather forecasting and climate. As indicated above, the pressure gradient constitutes one of the main forces acting on the air to make it move as wind. Note that the pressure gradient force points from high towards low pressure zones, it is thus oriented in the opposite direction from the pressure gradient itself.
Sound waves and shock waves are events that can induce very large pressure gradients, but these are often transitory disturbances.

# Related Chapters
- Gradient
- Isobar
- Geopotential height
- Geostrophic wind
- Primitive equations
- Temperature gradient
Invasive hemodynamic monitoring

# Overview
Based upon the results of the ESCAPE trial, there is no benefit in clinical outcomes associated with the routine use of a pulmonary artery line in patients with decompensated CHF.

# Invasive Monitoring

## Supportive Trial Data
The ESCAPE trial (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness), was the first large, multicenter, randomized controlled trial that enrolled 433 patients across 26 sites, to determine the safety of pulmonary artery catheter (PAC) or Swan-Ganz catheter use to improve clinical outcomes in patients hospitalized with severe symptomatic and recurrent heart failure. Off the total 433 patients enrolled, 218 patients were randomized to clinical assessment alone (clinical arm) and the remaining 215 were randomized to both PAC and clinical assessment (PAC arm); with almost all patients being treated with loop diuretics (98%), ACE inhibitors (79%), beta-blockers (62%), and spironolactone (51%) and only a small percentage received inotropes (15%) and intravenous vasodilators (8%) at the time of randomization. At 6-month follow up, the primary endpoint achieved was identical and non-significant among both the arms with an overall mortality of 19%. Thus, the study concluded no benefit demonstrated with the use of PAC for the improvement of clinical outcomes in patients with advanced heart failure.

# 2009 ACC/AHA Focused Update and 2005 Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult (DO NOT EDIT) 

## Invasive Hemodynamic Monitoring in Patients Presenting With Heart Failure (DO NOT EDIT) 

# Vote on and Suggest Revisions to the Current Guidelines
- The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines
Isoniazid clinical pharmacology

# Clinical Pharmacology
Within 1 to 2 hours after oral administration, isoniazid produces peak blood levels which decline to 50 percent or less within 6 hours. It diffuses readily into all body fluids (cerebrospinal, pleural, and ascitic fluids), tissues, organs, and excreta (saliva, sputum, and feces). The drug also passes through the placental barrier and into milk in concentrations comparable to those in the plasma. From 50 to 70 percent of a dose of isoniazid is excreted in the urine in 24 hours.
Isoniazid is metabolized primarily by acetylation and dehydrazination. The rate of acetylation is genetically determined. Approximately 50 percent of Blacks and Caucasians are slow inactivators and the rest are rapid inactivators; the majority of Eskimos and Orientals are rapid inactivators.
The rate of acetylation does not significantly alter the effectiveness of isoniazid. However, slow acetylation may lead to higher blood levels of the drug and, thus, to an increase in toxic reactions.
Pyridoxine (vitamin B6) deficiency is sometimes observed in adults with high doses of isoniazid and is considered probably due to its competition with pyridoxal phosphate for the enzyme apotryptophanase.

## Mechanism of Action
Isoniazid inhibits the synthesis of mycolic acids, an essential component of the bacterial cell wall. At therapeutic levels isoniazid is bacteriocidal against actively growing intracellular and extracellular Mycobacterium tuberculosis organisms.
Isoniazid resistant Mycobacterium tuberculosis bacilli develop rapidly when isoniazid monotherapy is administered.
Jock itch (patient information)
For the WikiDoc page for this topic, click here

# Overview
Jock itch, also called tinea cruris or ringworm of the groin, is an infection of the groin area caused by fungus.

# What are the symptoms of Jock itch ?
- Itching in groin, thigh skin folds, or anus
- Red, raised, scaly patches that may blister and ooze -- The patches often have sharply-defined edges and are often redder around the outside with normal skin tone in the center
- Abnormally dark or light skin

# What causes Jock itch ?
Jock itch occurs when a particular type of fungus grows and spreads in the groin area.
Jock itch can be triggered by friction from clothes and prolonged wetness in the groin area, such as from sweating.
Jock itch may be contagious. It can be passed from one person to the next by direct skin-to-skin contact or contact with unwashed clothing.

# Who is at highest risk?
Jock itch occurs mostly in adult men and adolescent boys. It can sometimes accompany athlete's foot and ringworm. The fungus that causes jock itch thrives in warm, moist areas.

# Diagnosis
Your health care provider can usually diagnose jock itch based on how your skin looks.
Tests are usually not necessary. If tests are needed to confirm the diagnosis, either a culture or a skin lesion biopsy (for example, a scraping of the skin) may be done. A KOH (potassium hydroxide) test may be done in the office for quick diagnosis.

# When to seek urgent medical care?
Call your doctor if jock itch does not respond to home care after 2 weeks, or you have other symptoms.

# Treatment options
Your health care provider can usually diagnose jock itch based on how your skin looks.
Tests are usually not necessary. If tests are needed to confirm the diagnosis, either a culture or a skin lesion biopsy (for example, a scraping of the skin) may be done. A KOH (potassium hydroxide) test may be done in the office for quick diagnosis.

# Where to find medical care for Jock itch ?
Directions to Hospitals Treating Jock itch

# What to expect (Outlook/Prognosis)?
Jock itch usually responds promptly to treatment. It is often less severe than other tinea infections, but may last a long time.
Jock itch usually stays around the creases in the upper thigh and does not involve the scrotum or penis. Jock itch may spread to the anus, causing anal itching and discomfort.
Other causes of itching in the groin include:
- Lichen simplex chronicus
- Eczema
- Pubic lice
- Chemical irritation

# Possible complications
- Permanent change in the skin color of the area
- Secondary bacterial skin infections
- Side effects of medications

# Prevention of Jock itch
- Keep the groin area clean and dry.
- Don't wear clothing that rubs and irritates the area. Avoid tight-fitting and rough-textured clothing.
- Wear loose-fitting underwear.
- Wash athletic supporters frequently.
- After bathing, apply antifungal or drying powders if you are susceptible to jock itch.

# Sources
Journal of Medical Microbiology
The Journal of Medical Microbiology is a peer-reviewed academic journal that covers microbiological research relevant to human and animal disease. Topics covered include pathogenicity, virulence, host response, epidemiology, microbial ecology, diagnostics, typing, models for infection and antimicrobial agents relating to viruses, bacteria, fungi and eukaryotic parasites. The journal is published monthly by the Society for General Microbiology, from Reading, UK.
Established in 1968, the Journal of Medical Microbiology was published until 20014 by the Pathological Society of Great Britain and Ireland in conjunction with Lippincott Williams & Wilkins. As of 2007, its Editor-in-Chief is Charles Penn (University of Birmingham, UK).
Content from 2000 is available online in PDF and text formats. Papers are currently available free 12 months after print publication; additionally, selected papers considered of special importance are made freely available ahead of publication.
Its 2005 impact factor was 2.318.
Junctional bradycardia overview

# Overview
Junctional bradycardia is a slow (40 to 60 beats per minute) narrow complex escape rhythm that originates in the atrioventricular node to compensate for slow or impaired conduction of pacemaker activity in the atrium.

# Pathophysiology
Junctional bradycardia or an AV junctional escape is a delayed heartbeat originating from an ectopic focus somewhere in the AV junction to compensate for an SA node that is no longer handling the pacemaking activity.

# Causes
Junctional bradycardia occurs when the rate of depolarization of the SA node falls below the rate of the AV node or when the electrical impulses from the SA node fail to reach the AV node because of SA or AV block.  SA node fibrosis and inferior wall myocardial infarction causing sinus arrest may cause the AV node to become the dominant pacemaker of the heart.

# Differentiating Junctional Bradycardia from other Diseases
Junctional bradycardia or junctional escape rhythm need to be differentiated from other bradycardia conditions which has the bundle of His or the ventricles as their pacemaker compensating for the failed SA node.

# Epidemiology and Demographics
Junctional bradycardia is fairly uncommon.  It can occur in any age group, however it is more likely to be observed in elderly people with underlying heart disease.

# Natural History, Complications and Prognosis
Junctional bradycardia mostly results due to failure of impulse transmission from SA node.  Its severity of symptoms depends on the underlying cause.

# Diagnosis

## History and Symptoms
Junctional bradycardia symptoms mostly are due to decrease cardiac output and may present with sometimes with loss of consciousness and syncope.

## Physical Examination
Complete physical examination help determine any heart defects as a cause for junctional bradycardia and assess the severity of the condition.

## Laboratory Findings
Junctional bradycardia patients may have no definite cause or may be the result of various other problems.   If junctional bradycardia patients present with symptoms, a generalized approach is done to find the precipitating factors.

## Electrocardiography
Junctional bradycardia or AV junction rhythm is usually caused by the absence of the electrical impulse from the SA node.  This usually appears on an EKG with a normal QRS complex accompanied with an inverted P wave either before, during, or after the QRS complex.

# Treatment

## Medical Therapy
Treatment of junctional bradycardia depends on the severity of presentation.  Atropine can be used to manage symptomatic patients.

## Surgery
Junctional bradycardia patients should be placed on pacemaker if there is complete AV block or sick sinus syndrome.
Kanamycin clinical pharmacology

# Clinical Pharmacology
The drug is rapidly absorbed after intramuscular injection and peak serum levels are generally reached within approximately one hour.  Doses of 7.5 mg/kg give mean peak levels of 22 mcg/mL.  At 8 hours following a 7.5 mg/kg dose, mean serum levels are 3.2 mcg/mL.  The serum half-life is 2 1/2 hours.  Intravenous administration of kanamycin over a period of one hour resulted in serum concentrations similar to those obtained by intramuscular administration.
Kanamycin diffuses rapidly into most body fluids including synovial and peritoneal fluids and bile.  Significant levels of the drug appear in cord blood and amniotic fluid following intramuscular administration to pregnant patients.  Spinal fluid concentrations in normal infants are approximately 10 to 20 percent of serum levels and may reach 50 percent when the meninges are inflamed.
Studies in normal adult patients have shown only trace levels of kanamycin in spinal fluid.  No data are available on adults with meningitis.
The drug is excreted almost entirely by glomerular filtration and is not reabsorbed by the renal tubules.  Hence, high concentrations are attained in the nephron, and the urine may contain levels 10 to 20 times higher than those in serum.  Little, if any, metabolic transformation occurs.  Renal excretion is extremely rapid.  In patients with normal renal function, approximately one-half of the administered dose is cleared within 4 hours and excretion is complete within 24 to 48 hours.  Patients with impaired renal function or with diminished glomerular filtration pressure excrete kanamycin more slowly.  Such patients may build up excessively high blood levels which greatly increase the risk of ototoxic reactions.  In severely burned patients the half-life may be significantly decreased and resulting serum concentrations may be lower than anticipated from the mg per kg dose.
Kanamycin indications and usage

# Indications and Usage
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Kanamycin Injection and other antibacterial drugs, Kanamycin Injection 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.
Kanamycin injection is indicated in the shortterm treatment of serious infections caused by susceptible strains of the designated microorganisms below.  Bacteriological studies to identify the causative organisms and to determine their susceptibility to kanamycin should be performed.  Therapy may be instituted prior to obtaining the results of susceptibility testing.
Kanamycin may be considered as initial therapy in the treatment of infections where one or more of the following are the known or suspected pathogens:
- E. coli
- Proteus species (both indole-positive and indole-negative)
- Enterobacter aerogenes
- Klebsiella pneumoniae
- Serratia marcescens
- Acinetobacter species
The decision to continue therapy with the drug should be based on results of the susceptibility tests, the response of the infection to therapy, and the important additional concepts contained in the WARNING box above.
In serious infections when the causative organisms are unknown, kanamycin injection, may be administered as initial therapy in conjunction with a penicillin- or cephalosporin-type drug before obtaining results of susceptibility testing.  If anaerobic organisms are suspected, consideration should be given to using other suitable antimicrobial therapy in conjunction with kanamycin.
Although kanamycin is not the drug of choice for staphylococcal infections, it may be indicated under certain conditions for the treatment of known or suspected staphylococcal disease.  These situations include the initial therapy of severe infections where the organism is thought to be either a Gram-negative bacterium or a Staphylococcus, infections due to susceptible strains of staphylococci in patients allergic to other antibiotics, and mixed staphylococcal/Gram-negative infections.
LEM domain-containing protein 3
LEM domain-containing protein 3 (LEMD3), also known as MAN1, is an integral protein in the inner nuclear membrane (INM) of the nuclear envelope. It is encoded by the LEMD3 gene and was first identified after it was isolated from the serum of a patient with a collagen vascular disease.

# Structure
The protein is 82.3 kDa and has a 40 amino acid long LEM domain located at its amino-terminal region. In its carboxyl end it has a RNA recognition motif (RRM). The LEM domain is also common to two other integral proteins of the INM: lamina-associated polypeptide 2 (LAP2) and emerin.
The LEM segment enables LEMD3 to attach to the barrier-to-autointegration factor (BAF), and therefore, indirectly interact with the chromatin. LEMD3 also has several implications in regulating the cytokine family such as the transforming growth factor beta (TGF-) and bone morphogenic protein (BMPs). The RRM domain in its carboxylic region attaches to the SMAD (protein) proteins, which is involved in mediating TGF- cellular signalling. Consequently, LEMD3 indirectly regulates downstream genes.
LEMD3 seems to play an important role in regulating the expression of several fundamental genes.

# LEMD3 and disease
LEMD3 has been associated with laminopathies as well as osteopoikilosis. Mutations in the LEMD3 gene have been linked to several genetic diseases such as osteopoikilosis, melorheostosis and Buschke-Ollendorff syndrome.
Leslie Turnberg, Baron Turnberg
Leslie Arnold Turnberg, Baron Turnberg is British medical professional and an author of many publications and books related to the medical and health services fileds. His experience extends to areas of research in these fields, and maintaining a clinical practice. He has published four books and some 150 articles on medical and scientific research.

# Medical positions
Turnberg holds honorary fellowships from sixteen different UK and overseas colleges and has held many different  positions within the medical field, including Professor of Medicine at University of Manchester from 1973 to 1997 and President of the Royal College of Physicians from 1992 to 1997. His present appointments include President of the Medical Protection Society, Chairman of the Board of the Public Health Laboratory Service, President of the Medical Council on Alcoholism, scientific adviser to the Association of Medical Research Charities; trustee of the Wolfson Foundation, Vice President of the Academy of Medical Sciences, and Chair of the UK Forum for Genetics and Insurance. Turnberg also serves as a consultant gastroenterologist at Hope Hospital in Salford, and the Dean of the Faculty of Medicine.

## Refinement and reduction of animals in research
In May 2004 the UK Government announced that it is establishing a national centre for "best practice" in animal testing called The National Centre for the Replacement, Refinement and Reduction of Animals in Research. The board of the new centre is chaired by Lord Turnberg. The focus of the centre is on the "three R's": the replacement, refinement, and reduction of animal testing. The "three R's" were first published in the 1959 by WMS Russell and Rex Birch in the book The Principles of Humane Experimentation Technique. The centre will explore alternatives to animal testing, such as experiments on cultured cells or using computer simulations
The UK government currently still regards animal testing as necessary, but science minister Lord Sainsbury of Turville said that a "major opportunity" now existed to make progress in improving the welfare of animals used in testing through the three R's.
The centre will be housed within the Medical Research Council's existing Centre for Best Practice for Animals in Research (CBPAR) and build upon its work.

# Knight and Baron Turnberg
Turnberg, of Cheadle in the County of Cheshire, was knighted in 1994 and was made Baron Turnberg for life by Letters Patent on May 4, 2000.