Persius/hicric huggingface dataset:
Rifampin description

# Description
RIFADIN (rifampin capsules USP) for oral administration contain 150 mg or 300 mg rifampin per capsule. The 150 mg and 300 mg capsules also contain, as inactive ingredients: corn starch, D&C Red No. 28, FD&C Blue No. 1, FD&C Red No. 40, gelatin, magnesium stearate, and titanium dioxide.
RIFADIN IV (rifampin for injection USP) contains rifampin 600 mg, sodium formaldehyde sulfoxylate 10 mg, and sodium hydroxide to adjust pH.
Rifampin is a semisynthetic antibiotic derivative of rifamycin SV. Rifampin is a red-brown crystalline powder very slightly soluble in water at neutral pH, freely soluble in chloroform, soluble in ethyl acetate and in methanol. Its molecular weight is 822.95 and its chemical formula is C43H58N4O12. The chemical name for rifampin is either:
3-methyl]rifamycin
-r
5,6,9,17,19,21-hexahydroxy-23-methoxy-2,4,12,16,20,22
heptamethyl-8--2,7-(epoxypentadecatrienimino)naphthofuran-1,11(2H)-dione 21-acetate.
Its structural formula is:
Right lymphatic duct
The right lymphatic duct, about 1.25 cm. in length, courses along the medial border of the Scalenus anterior at the root of the neck. In most cases it ends in the right subclavian vein, at its angle of junction with the right internal jugular vein, although the termination can be variable.
Its orifice is guarded by two semilunar valves, which prevent the passage of venous blood into the duct.

# Drainage
The right duct drains lymph fluid from:
- the upper right section of the trunk, (right thoracic cavity, via the right bronchomediastinal trunk),
- the right arm (via the right subclavian trunk),
- and right side of the head and neck (via the right jugular trunk).
All other sections of the human body are drained by the thoracic duct.

# History
The discovery of this structure has been credited to Niels Stensen.

# Additional images
- Deep lymph nodes and vessels of the thorax and abdomen (diagrammatic).
Ritonavir overdosage

# Overdosage

## Acute Overdosage - Human Overdose Experience
Human experience of acute overdose with NORVIR is limited. One patient in clinical trials took NORVIR 1500 mg per day for two days. The patient reported paresthesias which resolved after the dose was decreased. A post-marketing case of renal failure witheosinophilia has been reported with ritonavir overdose.
The approximate lethal dose was found to be greater than 20 times the related human dose in rats and 10 times the related human dose in mice.

## Management of Overdosage
Treatment of overdose with NORVIR consists of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient. There is no specific antidote for overdose with NORVIR. If indicated, elimination of unabsorbed drug should be achieved by emesis or gastric lavage; usual precautions should be observed to maintain the airway. Administration of activated charcoal may also be used to aid in removal of unabsorbed drug. Since ritonavir is extensively metabolized by the liver and is highly protein bound, dialysis is unlikely to be beneficial in significant removal of the drug. A Certified Poison Control Center should be consulted for up-to-date information on the management of overdose with NORVIR.
RomanoWard syndrome

# Overview
RomanoWard syndrome is the major variant of long QT syndrome. It is a condition that causes a disruption of the heart's normal rhythm. This disorder is a form of long QT syndrome, which is a heart condition that causes the cardiac muscle to take longer than usual to recharge between beats. If untreated, the irregular heartbeats can lead to fainting, seizures, or sudden death.

# Inheritance
RomanoWard syndrome is inherited in an autosomal dominant pattern. It is the most common form of inherited long QT syndrome, affecting an estimated 1 in 5,000 people worldwide, although more people may be affected but never experience any signs or symptoms of the condition.

# Causes
Mutations in the ANK2, KCNE1, KCNE2, KCNH2, KCNQ1, and SCN5A genes can cause RomanoWard syndrome. The proteins made by most of these genes form channels that transport positively-charged ions, such as potassium and sodium, in and out of cells. In cardiac muscle, these ion channels play critical roles in maintaining the heart's normal rhythm. Mutations in any of these genes alter the structure or function of channels, which changes the flow of ions between cells. A disruption in ion transport alters the way the heart beats, leading to the abnormal heart rhythm characteristic of RomanoWard syndrome.
Unlike most genes related to RomanoWard syndrome, the ANK2 gene does not produce an ion channel. The protein made by the ANK2 gene ensures that other proteins, particularly ion channels, are inserted into the cell membrane appropriately. A mutation in the ANK2 gene likely alters the flow of ions between cells in the heart, which disrupts the heart's normal rhythm and results in the features of RomanoWard syndrome.
This article incorporates public domain text from The U.S. National Library of Medicine

# Treatment
An imbalance between the right and left sides of the sympathetic nervous system may play a role in the etiology of this syndrome.  The imbalance can be temporarily abolished with a left stellate ganglion block, which shorten the QT interval.  If this is successful, surgical ganglionectomy can be performed as a permanent treatment.
Ryanodine receptor 2
Ryanodine receptor 2 (RYR2) is a protein found primarily in cardiac muscle. In humans, it is encoded by the RYR2 gene. In the process of cardiac calcium-induced calcium release, RYR2 is the major mediator for sarcoplasmic release of stored calcium ions.

# Structure
The channel is composed of RYR2 homotetramers and FK506-binding proteins found in a 1:4 stoichiometric ratio. Calcium channel function is affected by the specific type of FK506 isomer interacting with the RYR2 protein, due to binding differences and other factors.

# Function
The RYR2 protein functions as the major component of a calcium channel located in the sarcoplasmic reticulum that supplies ions to the cardiac muscle during systole. To enable cardiac muscle contraction, calcium influx through voltage-gated L-type calcium channels in the plasma membrane allows calcium ions to bind to RYR2 located on the sarcoplasmic reticulum. This binding causes the release of calcium through RYR2 from the sarcoplasmic reticulum into the cytosol, where it binds to the C domain of troponin, which shifts tropomyosin and allows the myosin ATPase to bind to actin, enabling cardiac muscle contraction. RYR2 channels are associated with many cellular functions, including mitochondrial metabolism, gene expression and cell survival, in addition to their role in cardiomyocyte contraction.

# Clinical significance
Deleterious mutations of the ryanodine receptor family, and especially the RYR2 receptor, lead to a constellation of pathologies leading to both acute and chronic heart failure collectively known as "Ryanopathies."
Mutations in the RYR2 gene are associated with catecholaminergic polymorphic ventricular tachycardia, stress-induced polymorphic ventricular tachycardia, and arrhythmogenic right ventricular dysplasia.
Mice with genetically reduced RYR2 exhibit a lower basal heart rate and fatal arrythmias.

# Interactions
Ryanodine receptor 2 has been shown to interact with:
- AKAP6,
- PRKACA,
- PRKACB,
- PRKACG, and
- SRI.
SA-response elements
"Salicylic acid (SA) is an important signal in plant defence  and a SA-response element (SARE) has been identified in the tobacco PR2-d gene. A 76bp fragment conferred a 20-fold induction by SA in transgenic tobacco plants and protein binding studies indicated that the core sequence of this SARE is TTCGACCTCC ."

# Acknowledgements
The content on this page was first contributed by: Henry A. Hoff.
Initial content for this page in some instances came from Wikiversity.
Surfactant protein C
Surfactant protein C (SP-C), is one of the pulmonary surfactant proteins. In humans this is encoded by the SFTPC gene.
It is a membrane protein which manufactures surfactant.
The propeptide of pulmonary surfactant C has an N-terminal alpha-helical segment whose  suggested function was stabilization of the protein structure, since the latter can irreversibly transform from its native alpha-helical structure to beta-sheet aggregates and form amyloid fibrils. The correct intracellular trafficking of proSP-C has also been reported to depend on the propeptide.

# Clinical significance
It is associated with surfactant metabolism dysfunction type 2.
Humans and animals born lacking SP-C tend to develop progressive interstitial lung disease.
ST segment alternans
Synonyms and keywords: ST alternans
Related chapter: electrical alternans

# Overview
Electrical alternans is an electrocardiographic phenomenon which describes teh beat to beat alternation in the height (ie.e amplitude), duration (the length of the interval) or the direction (up or down) of any of the EKG complexes or intervals.  While electrical alernans is usually thought of as alternation in the height or direction of the QRS complex, there can also be P wave, PR interval, QRS complex, R-R interval, ST segment, T wave, or U wave forms of alternans (see classification below).

# Historical Perspective
- 1909: First described by Hearing
- 1910: Elaborated upon by Sir Thomas Lewis
- 1948: First description of electrical alternans on the surfce EKG by Kalter and Schwartz 
- 1978: The term pseudoelectrical alternans was first described by Klein, Segni and Kaplinsky

# Pathophysiology
ST segment alternans is defined as beat to beat variation in the magnitude or amplitude of ST segment elevation.   It is due to abnormalities of calcium handling in the sarcoplastic reticulum as a result of myocardial ischemia.

# Causes
It is most often due to myocardial ischemia and includes causes such as:
- Vasospastic angina pectoris
- Acute myocardial infarction
- Angina pectoris
- Myocardial ischemia during an exercise tolerance test
- Percutaneous transluminal coronary angioplasty (PTCA)
- Subarachnoid hemorrhage

### Natural History, Complications and Prognosis
The presence of ST segment alternans in the setting of myocarial ischemia is associated with ventricular tachycardia and ventricular fibrillation.

# Differentiating Electrical Alternans form other Disorders
The electrical form of alternans should be differentiated from the mechanical form alternans in which case there is alternation of the strength of the pulse as is observed in pulsus alternans.  Electrical and mechanical alternans may coexist.
Sandbox: attribution

# Overview
- The images you upload on WikiDoc should be adapted from copyleft sources. We have a list of some of the copyleft websites that we can use here.
- Some websites provide the attribution text while downloading the image while some others do not.

# Radiopedia
- Radiopedia provides the attribution text along with the download link.

# Wikipedia
- On wikipedia and wikimedia commons, the attribution text is present after opening the image in the media viewer window and pressing the download button.

## Wikimedia commons

# CDC and WHO
- If you use images from the CDC or the WHO websites, you should attribute them as the following: Source: / or Source: / .
- The attribution text should be put in the comment under the photo using the WikiDoc code.

# Video
- This video illustrates how to attribute your image
Sandbox:landing lung

# Overview
Pulmonary mass is generally defined as any area of pulmonary opacification that measures more than 30 mm in the lung. Pulmonary mass can be benign or malignant. On the other hand, pulmonary nodule is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. Pulmonary nodule can be classified into 2 categories: solitary or multiple.

# Classification
For more details about each specific type of condition, click on the links in blue in the algorithm below.
In order to distinguish pulmonary mass from solitary pulmonary nodule, click here 

# Liver

# Diagnostic Algorithm for a suspected HCC
Sandbox:risk factors

# Overview
- There are no established risk factors for .
OR
- The most potent risk factor in the development of  is . Other risk factors include , , and .
- Common risk factors in the development of  include , , , and .
- Common risk factors in the development of  may be occupational, environmental, genetic, and viral.

# Risk Factors
- There are no established risk factors for .
OR
- The most potent risk factor in the development of  is . Other risk factors include , , and .
- Common risk factors in the development of  include , , , and .

## Common Risk Factors
- Common risk factors in the development of  may be occupational, environmental, genetic, and viral.
- Common risk factors in the development of  include:

## Less Common Risk Factors
- Less common risk factors in the development of  include:
Sandbox ammu WNV EPi

# Overview
Universal screening for WNV is not recommended. As blood and transplant-related transmissions of the virus have been reported, nucleic acid tests (NAT) may be used to screen for WNV among potential blood and solid organ donors. In blood donation, individual screening is not recommended either. Instead, a "minipool" nucleic acid testing program (MP NAT) is implemented. Positive pools warrant further investigation for individuals. Patients with positive NAT may not donate blood or solid organs for at least 120 days. Re-testing after 120 days is indicated.

# Screening
Universal screening for WNV is not recommended. Screening is only recommended for blood and solid organ transplant donors.

## Screening donor blood products
Following the discovery of WNV transmission by blood transfusions, WNV blood donor screening is performed using nucleic acid testing (NAT). A "minipool" nucleic acid testing program (MP NAT) is currently implemented to detect WNV viremia among donors. In contrast, serological testing is not feasible for screening purposes because IgM seroconversion may be detectable approximately 5 months following infection. Pools with positive NAT results warrant further investigation for individual screening. Individual patients with positive NAT may not donate blood for at least 120 days.

## Screening solid organ transplant donors
Although the only data on human-to-human transmission by organ transplantation is derived from reports that included deceased donors, transmission to recipients may still occur if donors have NAT-negative IgM-positive results. These findings suggest that clearance of the WNV from solid organs may be delayed compared to its clearance from plasma. Accordingly, screening for WNV among transplant donors is recommended using NAT. There is no evidence to demonstrate the optimal time for solid organ donation in cases of positive NAT, but re-testing after 120 days to confirm negative NAT has become common practice. Patients with negative results after 120 days may donate solid organs.
Schisandra chinensis
Schisandra chinensis ( in Chinese, pinyin: wu wei zi, literally "five flavor berry") is a deciduous woody vine hardy to USDA Zone 4 and is dioecious, meaning individual plants are either male or female, thus both male and female plants must be grown if seeds are desired. It is very tolerant to shade. Its Chinese name comes from the fact that its berries possess all five basic flavors:  salty, sweet, sour, pungent (spicy), and bitter.
Its berries are used in traditional Chinese medicine, where it is considered one of the 50 fundamental herbs. They are most often used in dried form, and boiled to make a tea.  Medicinally it is used as a tonic and restorative adaptogen with notable clinically documented liver protecting effects. The primary hepatoprotective (liver protecting) and immuno-modulating constituents are the lignans schizandrin, deoxyschizandrin, gomisins, and pregomisin, which are found in the seeds of the fruit. It should not be used by pregnant women.
In China, a wine is made from the berries.
In Korean the berries are known as omija (hangul: ), and the tea made from the berries is called omija cha (hangul:  ). In Japanese, they are called gomishi.
In 1998, Russia released a postage stamp depicting S. chinensis.

# Use in traditional Chinese medicine
In traditional Chinese medicine, Schisandra chinensis (known as wu wei zi) is believed to:
- Astringe Lung Qi and nourish the Kidneys
- Restrain the essence and stop Diarrhea--astringe Kidneys
- Arrest excessive sweating from Yin or Yang deficiency
- Calm the Spirit by tonification of Heart and Kidney
- Generate body fluids and alleviate thirst
Wu wei zi is believed to enter the Lung, Heart and Kidney meridians and its properties are considered to be sour and warm.  The typical dose is between 1.5 and 9 grams.
Contraindications include: Internal Excess Heat with External Syndrome, early stage Cough, Rash, Rubella, or Peptic Ulcer, Epileptic Seizure, Hypertension, and Intercranial Pressure.
Scientific pluralism
Scientific pluralism is the view that some phenomena observed in science require multiple explanations to account for their nature. Pluralists observe that scientists present varioussometimes even incompatiblemodels of the world and argue that this is due to the complexity of the world and representational limitations.
Scientific pluralists argue that the pluralistic nature of the scientific process is a major factor in the rapid growth of knowledge. In turn, an increase in knowledge arguably leads to increased human welfare due to, for example, greater productivity, economic growth and better medical technology.

# Bibliography
- Jeroen Van Bouwel, The consequences of scientific pluralism for science policy, Proceedings of V Jornadas Latinoamericanas de estudios sociales de la ciencia y de la tecnologia, 2004
- Jeroen Van Bouwel, The plurality of epistemic interests in scientific understanding - exemplified in political science, In: Henk de Regt, Sabina Leonelli and Kai Eigner (eds.). Philosophical Perspectives on Scientific Understanding, Pittsburgh: University of Pittsburgh Press (forthcoming).
- Paul A. Bove, The Ineluctability of Difference: Scientific Pluralism and the Critical Intelligence, Boundary 2, Vol. 11, No. 1/2, Engagements: Postmodernism, Marxism, Politics, (Autumn, 1982 - Winter, 1983), pp. 155-176
- John Dupre, Scientific pluralism and the plurality of the sciences: Comments on David Hull's Science as a Process, Journal Philosophical Studies, Springer, Netherlands, ISSN 0031-8116 (Print) 1573-0883 Volume 60: 1-2, January, 1990 pp.61-76
- Kellert, Stephen H (Editor), and Longino, Helen E (Editor), and Waters, C Kenneth (Editor), Scientific Pluralism, University of Minnesota Press: 2006, ISBN 0-8166-4763-1 ISBN = 13-978-0-8166-4763-7 
- Esther-Mirjam Sent, Please for Pluralism, post-autistic economics review, 18:5, February 2003 
cs:Pluralismus (veda)
Screening of obesity

# 2017 USPSTF Guideline on the Screening of Obesity in Children and Adolescents 6 Years and older

## Recommendations for Screening of Obesity

# 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society (DO NOT EDIT)

## Identifying Patients Who Need to Lose Weight (BMI and Waist Circumference (DO NOT EDIT)

# 2012 USPSTF Guideline on the Screening of Obesity in Adults

## Recommendations for Screening of Obesity in Adults
Seborrheic keratosis
A seborrheic keratosis is a benign skin growth that is very common among people over 40 years of age.

# Presentation
The growths resemble flattened or raised warts, but have no viral origins and may exhibit a variety of colors, from pink or yellow through brown and black.  Because only the top layers of the epidermis are involved, seborrheic keratoses are often described as having a "pasted-on" appearance.

# Treatment
Because the tumors are rarely painful, treatment is not often necessary.  There is a small risk of localized infection caused by picking at the lesion.  If a growth becomes excessively itchy, or if it is irritated by clothing or jewelry, cryosurgery has been found to be highly effective in their removal.  The main danger associated with seborrheic keratoses lies in their resemblance to malignant melanomas, which has sometimes led to a misdiagnosis of the cancerous lesions.  If there is any doubt, a skin biopsy will allow a physician to make a correct diagnosis.

# Causes
A mutation of a gene coding for a growth factor receptor (FGFR3), has been associated with seborrheic keratosis.
Semliki Forest Virus
The Semliki Forest virus (or Semiliki Forest virus) was first isolated from mosquitoes in the Semliki Forest, Uganda by the Uganda Virus Research Institute in 1942.  It is known to cause disease in both animals and man. It is an Alphavirus found in central, eastern, and southern Africa.
The Semliki Forest virus is a positive-stranded RNA virus with icosahedral capsid which is enveloped by a lipid bilayer, derived from the host cell.   The outermost surface of the virus is almost entirely covered by heterodimers of glycoproteins E1 and E2, arranged in interconnective trimers, which form an outer shell. Trimers are anchored in the membrane by an E2 cytoplasmic domain that associates with the nucleocapsid.
The size of the virus genome is approximately 13,000 base pairs.  The 5 two thirds of the genome encode non-structural proteins and the structural proteins are encoded in the 3 third.  Replication occurs via a negative strand intermediate giving rise to a full length genomic RNA for export in new virions and a subgenomic message that is translated into the structural proteins.
Semliki Forest virus is spread mainly by mosquito bites. It is not able to infect mammals through inhalation or gastrointestinal exposure although rodents in the laboraty can be infected by intranasal instillation. The virus is able to cause a lethal encephalitis in rodents, but only one lethal human infection has been reported. Even in this one case, the patient was immunodeficient and had been exposed to large amounts of virus in the laboratory.
Semliki Forest virus has been used extensively in biological research as a model of the viral life cycle and of viral neuropathy. Due to its broad host range and efficient replication, it has also been developed as a vector for genes encoding vaccines and anti-cancer agents, and as a tool in gene therapy.
Sexual health clinic
Steven C. Campbell, M.D., Ph.D.

# Overview
A sexual health clinic is a clinic that specializes in treatment of sex-related problems. Sexual health clinics have been known as VD clinics, STD clinics and GUM clinics (GUM for genitourinary medicine).
Almost every sexual health clinic will, at the very least, employ a public health nurse who can discuss sexual issues with visitors and patients and provide referrals to community agencies for additional information. Larger clinics may offer a full medical staff who are able to provide a full range of sexuality-related services, including testing for, protection from or treatment of sexually-transmitted diseases, and perhaps even psychological counselling. Very few sexual health clinics offer abortion services, although many offer "morning after" pills to female patients.
Many clinics target specific populations such as men, women, the LGBT population, ethnic minorities, or students, although some do generalize. Even clinics who service everyone tend to have separate hours or facilities for men and women, and most clinics of a decent size will let the patient choose if they would be more comfortable with male or female staff members.
Most clinics offer some degree of anonymity to their clients, or at the very least a "don't-ask-don't-tell" policy, due to the sensitive and personal nature of sexual problems and issues.
While few clinics offer 24-7 services, many of them see walk-in patients and do not require appointments except for complex or sensitive procedures.