Persius/hicric huggingface dataset:
Acyclovir adverse reactions

# Adverse Reactions

## Herpes Simplex
Short-Term Administration: The most frequent adverse events reported during clinical trials of treatment of genital herpes with ZOVIRAX 200 mg administered orally 5 times daily every 4 hours for 10 days were nausea and/or vomiting in 8 of 298 patient treatments (2.7%). Nausea and/or vomiting occurred in 2 of 287 (0.7%) patients who received placebo.
Long-Term Administration: The most frequent adverse events reported in a clinical trial for the prevention of recurrences with continuous administration of 400 mg (two 200-mg capsules) 2 times daily for 1 year in 586 patients treated with ZOVIRAX were nausea (4.8%) and diarrhea (2.4%). The 589 control patients receiving intermittent treatment of recurrences with ZOVIRAX for 1 year reported diarrhea (2.7%), nausea (2.4%), and headache (2.2%).

## Herpes Zoster
The most frequent adverse event reported during 3 clinical trials of treatment of herpes zoster (shingles) with 800 mg of oral ZOVIRAX 5 times daily for 7 to 10 days in 323 patients was malaise (11.5%). The 323 placebo recipients reported malaise (11.1%).

## Chickenpox
The most frequent adverse event reported during 3 clinical trials of treatment of chickenpox with oral ZOVIRAX at doses of 10 to 20 mg/kg 4 times daily for 5 to 7 days or 800 mg 4 times daily for 5 days in 495 patients was diarrhea (3.2%). The 498 patients receiving placebo reported diarrhea (2.2%).

## Observed During Clinical Practice
In addition to adverse events reported from clinical trials, the following events have been identified during post-approval use of ZOVIRAX. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. These events have been chosen for inclusion due to either their seriousness, frequency of reporting, potential causal connection to ZOVIRAX, or a combination of these factors.
General:Anaphylaxis, angioedema,fever, headache, pain, peripheral edema.
Nervous: Aggressive behavior, agitation, ataxia, coma, confusion, decreased consciousness, delirium,dizziness dysarthria, encephalopathy, hallucinations, paresthesia, psychosis, seizure, somnolence, tremors. These symptoms may be marked, particularly in older adults or in patients with renal impairment (see PRECAUTIONS).
Digestive: Diarrhea, gastrointestinal distress, nausea.
Hematologic and Lymphatic: Anemia,leukocytoclastic vasculitis, leukopenia, lymphadenopathy, thrombocytopenia.
Hepatobiliary Tract and Pancreas: Elevated liver function tests, hepatitis, hyperbilirubinemia, jaundice.
Musculoskeletal: Myalgia.
Skin: Alopecia,erythema multiforme,photosensitive rash,pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis,urticaria.
Special Senses: Visual abnormalities.
Urogenital: Renal failure, renal pain (may be associated with renal failure), elevatedblood urea nitrogen, elevated creatinine,hematuria (see WARNINGS).
Alagille Syndrome Diagnosis
The diagnosis is primarily clinical .Sequence analysis of JAG1 detects mutation in 90% of individuals with symptoms. Around 7% of affected individuals have microdeletion of 20p12. Mutations in NOTCH2 is found in less than 1%.
If family-specific mutation is known, molecular genetic testing is offered to first-degree relatives. Prenatal testing for pregnancies at increased risk is possible if the JAG1 or NOTCH2 disease-causing mutation in an affected family member is known. Prenatal testing cannot predict the occurrence or severity of clinical manifestations.
The severity of the disorder can vary within the same family, with symptoms ranging from so mild as to go unnoticed to severe heart and/or liver disease requiring transplantation. The major clinical feature is due to cholestasis, due to bile duct paucity  as seen on liver biopsy. Congenital heart defect, mostly pulmonary stenosis, typical facial features, skeletal features and posterior embryotoxon in the eye are commonly found. Renal and central nervous system abnormalities may occur.

# History and Symptoms
- Itching

# Physical Examination

## Head, Eyes, Ears, Nose, Throat
- A broad, prominent forehead, deep-set eyes, and a small pointed chin may be present. The sensitivity of facies identification to diagnose Alagille syndrome was 76%, the specificity 82%, the positive predictive value 81%, and the negative predictive value 77%.      These results suggest that the facies seen in Alagille syndrome is specific to this condition and its recognition is a valuable tool in diagnosis .
- Scleral icterus

## Skin
- Jaundice
- Xanthomas

## Extremities
Supernumerary digital flexion creases have been identified in one third of patients. Other digital abnormalities  include short distal phalanges and fifth finger clinodactyly. Normally, supernumerary digital creases have been reported in less than 1% of the general population.

# Lab Studies

## Biochemical Evaluation
Total Bilirubin >6.5 mg/dL, Conjugated Bilirubin >4.5 mg/dL, and cholesterol >520 mg/dL in children younger than 5 years of age are likely  be associated with severe liver disease in later life .

## Liver Biopsy
A liver biopsy may indicate too few bile ducts (bile duct paucity).

## X ray
An unusual butterfly shape of the bones of the spinal column that can be seen in an x-ray
Alternative periodic tables
Alternative periodic tables are chemical element displays different from the well known Mendeleev periodic table. Several have been devised often purely for didactic reasons as not all correlations between the chemical elements are effectively captured by the standard periodic table. The definitive work is Mazurs .
In Theodor Benfey's periodic table (1960) the elements spiral out in two dimensions starting from hydrogen folding their way around two islands, the transition metals & lanthanides and actinides. A superactinide island is already slotted in. In the Chemical Galaxy (2004) the elements spiral out in a similar way.
In the Extended periodic table,  suggested by Glenn T. Seaborg in 1969,  yet unknown elements are included up to atomic number 218. Helium is placed in the group 2 elements
Timmothy Stowe created the physicist's periodic table. This table is three-dimensional and the three axes represent the principal quantum number, orbital quantum number, and orbital magnetic quantum number. Helium is again a group 2 element.
Paul Giguere's 3-D periodic table consists of 4 billboards with the elements written on the front and the back. The first billboard has the group 1 elements on the front and the group 2 elements at the back with hydrogen and helium omitted altogether. At a 90 angle the second billboard contains the groups 13 to 18 front and back. Two more billboard each making 90 angles contain the other elements.
In the research field of superatoms, clusters of atoms have properties of single atoms of another element. It is suggested to extend the periodic table with a second layer to be occupied with these cluster compounds. The latest addition to this multi-story table is the aluminum Al7- cluster which behaves like a multivalent germanium atom 
In a commentary R.L. Rich  proposes a periodic table where elements appear more than once when appropriate. He notes that hydrogen shares properties with group 1 elements based on valency, with group 17 elements because hydrogen is a non-metal but also with the carbon group based on similarities in chemical bonding to transition metals and a similar electronegativity. In this rendition of the periodic table carbon and silicon also appear in the same group as titanium and zirconium.

# Aims
Alternative periodic tables are developed often to highlight or emphasize different chemical or physical properties of the elements which are not as apparent in traditional periodic tables. Some tables aim to emphasize both the nucleon and electronic structure of atoms. This can be done by changing the spatial relationship or representation each element has with respect to another element in the table.  Other tables aim to emphasize the chemical element isolations by humans over time.
Alveolar process of maxilla

# Overview
The alveolar process is the thickened ridge of bone that contains the tooth sockets on bones that bear teeth. It is also referred to as the alveolar bone. In humans, the tooth-bearing bones are the maxilla and the mandible.
On the maxilla, the alveolar process is a ridge on the inferior surface, and on the mandible it is a ridge on the superior surface.  It makes up the thickest part of the maxilla.
The buccinator muscle attaches to the alveolar processes of both the maxilla and mandible.
- This X-ray film reveals some bone loss in the lower right mandible.  The associated teeth exhibit poor crown-to-root ratios and may be subject to secondary occlusal trauma.
Fetal methotrexate syndrome
Synonyms and keywords:  Aminopterin embryopathy syndrome, aminopterin fetopathy syndrome, aminopterin syndrome, aminopterin fetopathy

# Overview
Congenital abnormalities have been documented with methotrexate and aminopterin, and collectively their teratogenic effects have become known as the fetal aminopterin syndrome.

# Diagnosis

## History
A directed history should be obtained to ascertain prenatal exposure of methotrexate and aminopterin.

## Physical Examination

### Head
- Craniosynostosis - some or all of the sutures in the skull of an infant or child close too early, causing problems with normal brain and skull growth.

### Ear
- Low-set ears

### Extremities
- Club foot
- Short limbs
- Syndactyly

### Neurologic
- Developmental delay
Amphotericin B microbiology

# Microbiology

## Mechanism of Action
The active component of ABELCET, amphotericin B, acts by binding to sterols in the cell membrane of susceptible fungi, with a resultant change in the permeability of the membrane. Mammalian cell membranes also contain sterols, and damage to human cells is believed to occur through the same mechanism of action.
Activity in vitro and in vivo
ABELCET shows in vitro activity against Aspergillus sp. (n=3) and Candida sp. (n=10), with MICs generally 10 mg/mL). However, standardized techniques for susceptibility testing for antifungal agents have not been established, and results of susceptibility studies do not necessarily correlate with clinical outcome.
ABELCET is active in animal models against Aspergillus fumigatus, Candida albicans, C. guillermondii, C. stellatoideae, and C. tropicalis, Cryptococcus sp., Coccidioidomyces sp., Histoplasma sp., and Blastomyces sp. in which end-points were clearance of microorganisms from target organ(s) and/or prolonged survival of infected animals.

## Drug Resistance
Fungal species with decreased susceptibility to amphotericin B have been isolated after serial passage in culture media containing the drug, and from some patients receiving prolonged therapy. Although the relevance of drug resistance to clinical outcome has not been established, fungal species which are resistant to amphotericin B may also be resistant to ABELCET.
Angiostrongyliasis overview
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# Overview
Angiostrongyliasis is an infection by a nematode from the Angiostrongylus genus of kidney and alimentary tract roundworms. For example, infection with Angiostrongylus cantonensis can occur after consuming raw Giant African land snails, Great Grey Slugs, or other mollusks.
In humans, Angiostrongylus is the most common cause of eosinophilic meningitis or meningoencephalitis.  Frequently the infection will resolve without treatment or serious consequences, but in cases with a heavy load of parasites the infection can be so severe it can cause permanent damage to the CNS or death.
Annals of Internal Medicine
Annals of Internal Medicine (Ann Intern Med) is an academic medical journal published by the American College of Physicians (ACP). It publishes research articles and reviews in the area of internal medicine. Its current editor is Harold C. Sox.
Annals of Internal Medicine had a 2006 impact factor of 14.8, which makes it among the most-cited of general clinical medical journals, only exceeded by JAMA, The Lancet and New England Journal of Medicine. In 2005, Annals' circulation approximated 90,000.

# History
Founded in 1927, Annals of Internal Medicine has been published twice monthly since 1988. Former Editor-in-Chief, Edward Huth, has published details of the journal's history.
Medical publishing innovations by the journal include:
1987: Proposal for structured abstracts published in the April issue; first structured abstracts published.
1994: Research on the effects of peer review.
1997: Guidelines for the use of Bayesian interpretation of significance testing included in information for authors.
1999: Summaries for patients introduced for original research articles.
2004: Limitations section added to standard structured abstracts.

# Online availability
An archive of issues from 1993 is available at the journal's website in text and PDF (from 1999) formats. Material over six months old is freely accessible, and access to all papers is also provided free of charge to developing countries.
Anterior interosseous nerve
The anterior interosseous nerve (volar interosseous nerve) is a branch of the median nerve that supplies the deep muscles on the front of the forearm, except the ulnar half of the flexor digitorum profundus.
It accompanies the anterior interosseous artery along the front of the interosseous membrane of the forearm, in the interval between the flexor pollicis longus and flexor digitorum profundus, supplying the whole of the former and the radial half of the latter, and ending below in the pronator quadratus and wrist joint.
Many texts, for simplicity's sake, consider this nerve part of the median nerve.

# Innervation
The anterior interosseous nerve innervates 2.5 muscles:
- flexor pollicis longus
- pronator quadratus
- the radial (lateral) half of flexor digitorum profundus
These muscles are in the deep level of the anterior compartment of the forearm.
Anterior pituitary basophil
An anterior pituitary basophil is a type of cell in the anterior pituitary which manufactures hormones.
It is called a basophil because it readily takes up base, and typically stains a relatively deep blue or purple.
These basophils are further classified by the hormones they produce. (It is usually not possible to distinguish between these cell types using standard staining techniques.)
Anti-cardiolipin antibodies

# Overview
Anti-cardiolipin antibodies (ACA) are antibodies often directed against cardiolipin and found in several diseases including syphilis, antiphospholipid syndrome, livedoid vasculitis, vertebrobasilar insufficiency, Behcet's syndrome, idiopathic spontaneous abortion, and systemic lupus erythematosus(SLE). They are a form of anti-mitochondrial antibody. In SLE, The anti-DNA antibodies and anti-cardiolipin act independently.  In rheumatoid arthritis w/systemic sclerosis (scleroderma) these antibodies may tie two conditions together.
Anti-cardiolipin antibodies come can be classified in two ways.
- As IgM, IgG or IgA
- As 2-glycoprotein dependent or independent
In autoimmune disease ACA are beta-2 glycoprotein dependent
syphilis ACA are beta-2 glycoprotein independent and can be assayed using the Venereal Disease Research Laboratory test
- In autoimmune disease ACA are beta-2 glycoprotein dependent
- syphilis ACA are beta-2 glycoprotein independent and can be assayed using the Venereal Disease Research Laboratory test

## Apolipoprotein H involvement
2-glycoprotein I has been identified as Apolipoprotein H and is required for the recognition of ACA in autoimmune disease. Only a subset of autoimmune anti-cardiolipin antibodies bind Apo-H, these anti-apolipoprotein antibodies are associated with increased thrombosis.
Anti-ganglioside antibodies

# Overview
Anti-ganglioside antibodies react to self-gangliosides are found in autoimmune neuropathies. These antibodies were first found to react with cerebellar cells. These antibodies show highest association with certain forms of Guillain-Barre syndrome.

# Antibodies to Ganglioside subtypes
Autoantigenic gangliosides that are currently known are GD3, GM1, GQ3 and GT1.

### Anti-GD3
Anti-GD3 antibodies have been found in association with specific forms of Guillain-Barre syndrome. In vivo studies of isolated anti-GM1 and GD3 antibodies indicate the antibodies can interfere with motor neuron function. Anti-GD1a antibodies were highly associated acute motor axonal neuropathy while high titers of anti-GM1 were more frequent indicating that GD1a possibly targets the axolemma and nodes of Ranvier most of the Ab+ patients had C. jejuni infections. Patients with Anti-GalNAc-GD1a antibodies were less common but had more severe disease (rapidly progressive, predominantly distal weakness).

### Anti-GM1
Levels of anti-GM1  are elevated in patients with various forms of dementia. Antibodies levels correlate with more severe Guillain-Barre syndrome. In Japan, levels to GM1 were elevated in patients with prodromal diarrhea.  Titers to GM1 in other diseases (rheumatoid arthritis, primary Sjogren's syndrome and systemic lupus erythematosus) was also elevated. additionally highly significant association was found with rheumatoid arthritis and peripheral neuropathies. Conflicting evidence suggests no significant elevation in motor neuron neuropathy but marginally elevated IgA in sensory neuron neuropathies. The autoimmune role of anti-GM1 is still unclear.

### Anti-GQ1b
Anti-GQ1b are found in Miller-Fisher syndrome. Studies of these antibodies reveal large disruption of the Schwann cells. 
Anti-GQ1b IgG levels were elevated in patients with ophthalmoplegia in Gullian-Barre syndrome

# Triggering agents
Microbial agents include: Campylobacter jejuni and Mycoplasma pneumoniae.

### Campylobacter jejuni
Antibodies to a GM1 epitope as well as to one with the GT1a or GD3 epitope were found in different strains of Campylobacter jejuni and patients with Guillain-Barre syndrome have a high occurrence of C. jejuni infection.  Many studies indicate that C. jejuni may be causative for a subset of some forms of neuropathies.

### Coeliac disease
Antibodies to ganglioside are found to be elevated in coeliac disease. Recent studies show
that gliadin can cross-linke to gangliosides in a transglutaminase indepedent manner, indicating that gliadin specific T-cell could present these antigens to the immune system.

# Immunoglobin isotypes
IgG. In multiple sclerosis, antibodies to GM1 are dominated by the IgG1, IgG3 and IgG4. Also anti-GM1 IgG has been identified in Guillain-Barre syndrome or chronic inflammatory demyelinating polyradiculoneuropathy. while controlled studies failed to find any significant association with these disease.
IgA. IgA to gangliosides have been observe in Gullien-Barre' syndrome. 
IgM. IgM antibodies have been detected in early work but their significance in disease is controversial.
Aortic insufficiency stages

# Overview
According to the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease, aortic insufficiency is classified into 4 stages based on the valve's anatomy, hemodynamics, and the patients symptoms.

# Stages
Shown below is a table summarizing the stages of aortic regurgitation (AR) according to the 2014 AHA/ACC  Guideline for the Management of Patients With Valvular Heart Disease.   
Abbreviations: AR: aortic regurgitation; HF: heart failure; IE: infective endocarditis; LV: left ventricular; LVEF: left ventricular ejection fraction; LVESD: left ventricular end-systolic dimension; LVOT: left ventricular outflow tract; Jet/LVOT : jet width and LVOT ratio
Apoptosis DNA Fragmentation
Apoptosis DNA Fragmentation is a key feature of programmed cell death and also occurs in certain stages of necrosis. Apoptosis is characterized by the activation of endogenous endonucleases with subsequent cleavage of chromatin DNA into internucleosomal fragments of 180 BP and multiples thereof.
DNA cleavage during apoptosis occurs at sites between nucleosomes, protein-containing structures that occur in chromatin at ~200-BP intervals. This DNA fragmentation is often analyzed using agarose gel electrophoresis to demonstrate a "ladder" pattern at ~200-BP intervals. Necrosis, on the other hand, is characterized by random DNA fragmentation which forms a "smear" on agarose gels.
DNA fragmentation is a secondary consequence, rather than an integral cause, of apoptosis. Endonuclease involved might be similar to DNAse I, a potential indication that the DNA fragmentation might occur after the release of enzymes from cytoplasmic membrane lysis, an event that would potentially occur only after the final lytic event in the apoptotic sequence. More recently, data have shown that specific proteases residing in the cytoplasm mediate the terminal events of apoptosis, including those of nuclear morphology. Even so, the detection of DNA fragmentation and the presence of single strand ends of DNA has continued to be an assay used in many studies to detect apoptotic cells, particularly in intact tissues. This is in spite of the fact that necrosis also produces single-strand DNA ends in cell nuclei. Therefore, the interpretation of these in situ assays of DNA fragmentation [in situ nick-translation (ISNT); terminal transferase (TUNEL) must be carefully assessed together with morphological features of apoptotic cells.
Even though much work has been performed on the analysis of apoptotic events, little information is available to link the timing of morphological features at the cell surface and in the nucleus to the biochemical degradation of DNA in the same cells. Apoptosis can be initiated by a myriad of different mechanisms in different cell types, and the kinetics of these events vary widely, from only a few minutes to several days depending on the cell system.
There are many methods to assess the DNA fragmentation caused by apoptosis and also many commercial kits are available. Some new methods do quantification assays for DNA Fragmentation by flow cytometry and fluorescent assays.