Persius/hicric huggingface dataset:
Childhood disintegrative disorder (patient information)
For the WikiDoc page for this topic, click here
Synonyms and Keywords: Disintegrative psychosis; Heller syndrome

# Overview
Childhood disintegrative disorder is a condition in which children develop normally through age 3 or 4. Then, over a few months, children lose language, motor, social, and other skills that they already learned.

# What are the symptoms of Childhood disintegrative disorder?
- Delay or lack of spoken language
- Impairment in nonverbal behaviors
- Inability to start or maintain a conversation
- Lack of play
- Loss of bowel and bladder control
- Loss of language or communication skills
- Loss of motor skills
- Loss of social skills
- Problems forming relationships with other children and family members

# What causes Childhood disintegrative disorder?
- The cause of childhood disintegrative disorder is unknown, but it has been linked to brain and nervous system problems.
- A child who is affected loses:
- Communication skills
- Nonverbal behaviors
- Skills they had already learned
- The condition is similar to autistic disorder.

# When to seek urgent medical care?
Call your provider if your child has any delays in development or starts to lose developmental abilities.

# Diagnosis
- The health care provider will determine whether the child has this disorder, or a similar condition such as childhood schizophrenia or pervasive developmental disorder (autism).
- The most important sign of childhood disintegrative disorder is the loss of developmental milestones. Generally, the diagnosis is made if the child has lost function in at least two areas of development.

# Treatment options
- Treatment is the same as for autistic disorder because the two disorders are similar.
- One experimental treatment uses steroid medications to slow the progression of the condition.

# Where to find medical care for Childhood disintegrative disorder?
Directions to Hospitals Treating Childhood disintegrative disorder

# What to expect (Outlook/Prognosis)?
- The outlook for this disorder is poor.
- Most children with the condition have an impairment similar to that of children with severe autism by age 10.

# Source
Clindamycin palmitate hydrochloride labels and packages
Mfd. by:
Lyne Laboratories, Inc.
Brockton, MA 02301
R4-08/12
NDC 0374-5070-01
Clindamycin
Palmitate
Hydrochloride
for Oral Solution,
USP (Pediatric)
75 mg*/5 mL  
when reconstituted
100 mL (when mixed)       Rx only
Date of reconstitution ________________________
Warning - NOT FOR INJECTION
Store at 20 to 25C (68 to 77F) [See USP Controlled Room
Temperature].
Do not refrigerate reconstituted solution.
Keep container tightly closed. Shake well before each use. Discard any
unused portion two weeks after reconstitution.
DOSAGE AND USE: See accompanying prescribing information.
Reconstitute with 75 mL of water. Add a large portion of the water and
shake vigorously; add the remainder of the water and shake until the 
solution is uniform.
- When reconstituted with water as directed, each 5 mL (teaspoonful)
-f solution contains clindamycin palmitate HCl equivalent to 75 mg
clindamycin.
Mfd. by:
Lyne Laboratories, Inc.
Brockton, MA 02301
R4-08/12
Differentiating Lactose intolerance from other diseases

# Overview
Lactose intolerance must be differentiated from other diseases that cause diarrhea such as pancreatic insufficiency, irritable bowel syndrome, small intestinal bacterial overgrowth, celiac disease, and inflammatory bowel disease

# Differentiating lactose intolerance from other Diseases
- Lactose intolerance must be differentiated from other diseases that cause diarrhea such as pancreatic insufficiency, irritable bowel syndrome, small intestinal bacterial overgrowth, celiac disease, and inflammatory bowel disease
- Lactose intolerance must be differentiated from other causes that produce bloating and flatulence such as beans that contain stachyose and raffinose, two indigestible sugars.
Duke Clinical Medicine Series/CTR TV Interview Schedule
How to add yourself to the Duke Clinical Medicine Series/CTR TV Interview Schedule
- Click on the Log in /create account button on the upper right corner of this page.  Follow the easy directions to create an account if you do not have one.
- Scroll down on this page until you find the date and time slot that you would like to fill.
- Click on the edit tab to the right of this time slot.
- Type in your information as if you were using a word processing program.
- Click on the Save page button (a little below the text box).
- If the time you would like is unavailable, or if you have additional questions, please email E. Lord, L. Biller or S. Williams

# Time
- Interviewer:
- Interviewee (if applicable):
- Topic:
- Slides being used (Y or N):
- Additional information: if CMG available or filming to take place in CMG suite
Ezetimibe/Simvastatin how supplied storage and handling

# How Supplied Storage and Handling
No. 3873  Tablets VYTORIN 10/10 are white to off-white capsule-shaped tablets with code "311" on one side.
They are supplied as follows:
NDC 66582-311-31 bottles of 30
NDC 66582-311-54 bottles of 90
NDC 66582-311-82 bottles of 1000 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-311-87 bottles of 10,000 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-311-28 unit dose packages of 100.
No. 3874  Tablets VYTORIN 10/20 are white to off-white capsule-shaped tablets with code "312" on one side.
They are supplied as follows:
NDC 66582-312-31 bottles of 30
NDC 66582-312-54 bottles of 90
NDC 66582-312-82 bottles of 1000 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-312-87 bottles of 10,000 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-312-28 unit dose packages of 100.
No. 3875  Tablets VYTORIN 10/40 are white to off-white capsule-shaped tablets with code "313" on one side.
They are supplied as follows:
NDC 66582-313-31 bottles of 30
NDC 66582-313-54 bottles of 90
NDC 66582-313-74 bottles of 500 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-313-86 bottles of 5000 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-313-52 unit dose packages of 50.
No. 3876  Tablets VYTORIN 10/80 are white to off-white capsule-shaped tablets with code "315" on one side.
They are supplied as follows:
NDC 66582-315-31 bottles of 30
NDC 66582-315-54 bottles of 90
NDC 66582-315-74 bottles of 500 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-315-66 bottles of 2500 (If repackaged in blisters, then opaque or light-resistant blisters should be used.)
NDC 66582-315-52 unit dose packages of 50.

## Storage
Store at 20-25C (68-77F).  Keep container tightly closed.
Storage of 10,000, 5000, and 2500 count bottles
Store bottle of 10,000 VYTORIN 10/10 and 10/20, 5000 VYTORIN 10/40, and 2500 VYTORIN 10/80 capsule-shaped tablets at 20-25C (68-77F).  Store in original container until time of use. When product container is subdivided, repackage into a tightly-closed, light-resistant container. Entire contents must be repackaged immediately upon opening.
Familial Mediterranean fever diagnostic study of choice

# Overview
Familial Mediterranean fever is primarily diagnosed based on the clinical presentation.

# Diagnostic Study of Choice

## Study of choice
Familial Mediterranean fever is primarily diagnosed based on the clinical presentation. There are two sets of criteria for the diagnosis of this disorder in adults, including:
- Tel Hashomer criteria, which is used widely
- Livneh criteria, which is developed recently.
There is another set of criteria for the diagnosis of FMF in children.
Since FMF occurs due to a mutation in MEFV gene, genetic analysis is also available for the diagnosis. However, it would not be cost-effective.
- Genetic analysis is recommended according to the following algorithm.

### The comparison of various diagnostic studies for familial Mediterranean fever
 is the preferred investigation based on the sensitivity and specificity

### The Tel Hashomer for diagnosing familial Mediterranean fever
The definitive diagnosis requires at least two major criteria or one major plus two minor criteria.

### The Livneh criteria for diagnosing familial Mediterranean fever
The diagnosis of FMF is made when at least one major criterion, or at least two minor criteria, or 1 minor criterion plus 5 supportive criteria, or 1 minor criterion plus 4 of the five supportive
criteria are present.
G protein-coupled inwardly-rectifying potassium channel
The G protein-coupled inwardly-rectifying potassium channels (GIRKs) are a family of inward-rectifier potassium ion channels which are activated (opened) via a signal transduction cascade starting with ligand-stimulated G protein-coupled receptors (GPCRs).  GPCRs in turn release activated G-protein - subunits (G) from inactive heterotrimeric G protein complexes (G).  Finally, the G dimeric protein interacts with GIRK channels to open them so that they become permeable to potassium ions, resulting in hyperpolarization of the cell membrane. G protein-coupled inwardly-rectifying potassium channels are a type of G protein-gated ion channels because of this direct activation of GIRK channels by G protein subunits.
GIRK1 to GIRK3 are distributed broadly in the central nervous system, where their distributions overlap. GIRK4, instead, is found primarily in the heart.

# Subtypes

# Examples
A wide variety of G protein-coupled receptors activate GIRKs, including the M2-muscarinic, A1-adenosine, 2-adrenergic, D2-dopamine, - -, and -opioid, 5-HT1A serotonin, somatostatin, galanin, m-Glu, GABAB, TAAR1, CB1 and CB2, and sphingosine-1-phosphate receptors.
Examples of GIRKs include a subset of potassium channels in the heart, which, when activated by parasympathetic signals such as acetylcholine through M2 muscarinic receptors, causes an outward current of potassium, which slows down the heart rate.  These are called muscarinic potassium channels (IKACh) and are heterotetramers composed of two GIRK1 and two GIRK4 subunits.
IMPROVE and IMPROVEDD scores for venous thromboembolism
To see a risk calculator according to IMPROVEDD scores, click here.
To see a risk calculator according to IMPROVE scores, click here.

# Overview
The IMPROVE score for venous thromboembolism (VTE) assesses the risk of VTE among hospitalized medical patients.  The IMPROVE predictive score for VTE includes 4 independent risk factors for VTE which are present at admission.  The IMPROVE associative score for VTE includes 7 variables present either at admission or during hospitalization; however, the timing of the presence of some of the factors compared to the onset of VTE was not available. The IMPROVEDD score adds D-dimer as a recognized risk factor to the conventional IMPROVE associative score which includes 7 variables present either at admission or during hospitalization.

# IMPROVE-DD score for VTE risk stratification
The IMPROVEDD VTE risk score assesses the risk of VTE among hospitalized medical patients. The IMPROVEDD score adds D-dimer as a recognized risk factor to the conventional IMPROVE associative score which includes 7 variables present either at admission or during hospitalization; however the timing of the presence of some of the factors compared to the onset of VTE is not available.

## Calculation of the IMPROVEDD Associative Score

## Interpretation of the IMPROVEDD Associative Score

# IMPROVE Associative Score for VTE
IMPROVE associative risk score assesses the risk of VTE among hospitalized medical patients. While the IMPROVE predictive score includes 4 independent risk factors for VTE which are present at admission, IMPROVE associative score includes 7 variables present either at admission or during hospitalization; however the timing of the presence of some of the factors compared to the onset of VTE is not available.

## Calculation of the IMPROVE Associative Score

## Interpretation of the IMPROVE Associative Score
Incontinentia pigmenti achromians (patient information)
For the WikiDoc page for this topic, click here

# Overview
Incontinentia pigmenti achromians is a rare birth defect that causes unusual patches of light-colored (hypopigmented) skin and possible neurological and skeletal problems.

# What are the symptoms of Incontinentia pigmenti achromians?
- Crossed eyes (strabismus)
- Increased body hair (hirsutism)
- Scoliosis
- Seizures
- Streaked, whirled or mottled patchs of skin on the arms, legs, and middle of the body
- Varying degrees of retardation

# What causes Incontinentia pigmenti achromians?
The cause is unknown.

# Who is at highest risk?
It is slightly more common in girls than in boys.

# Diagnosis
A Wood's lamp examination of the skin lesions may help confirm the diagnosis. Your doctor may also recommend chromosome analysis or a further medical workup to discover any related medical problems.

# When to seek urgent medical care?
Call your health care provider if your child exhibits an unusual pattern of the color of the skin.

# Treatment options
There is no treatment for the hypopigmentation. Treatment consists of treating the symptoms. Cosmetics or clothing may be used to cover the hypopigmented spots if desired. Seizures, scoliosis, and other problems are treated as necessary.

# Where to find medical care for Incontinentia pigmenti achromians?
Directions to Hospitals Treating Incontinentia pigmenti achromians

# What to expect (Outlook/Prognosis)?
What happens depends on the type and severity of symptoms that develop. In most cases, the skin pigment eventually returns to normal.

# Possible complications
- Discomfort and walking problems due to scoliosis
- Emotional distress related to the physical appearance
- Mental retardation
- Seizures and resulting possible injury

# Sources
Infants with dextro-transposition of the great arteries

# Overview
Infants with dextro-transposition of the great arteries initially attract attention because of cyanosis or congestive heart failure 	or both.

# Infants with d-TGA
- Essentially, all these patients attract attention in infancy because of cyanosis or CHF or both.
- Normally, the lungs are examined first, then the heart is examined if there are no apparent problems with the lungs. These examinations are typically performed using ultrasound, known as an echocardiogram when performed on the heart.
- On the rare occasion, initial symptoms may go unnoticed, resulting in the infant being discharged without treatment in the event of a hospital or birthing center birth, or a delay in bringing the infant for diagnosis in the event of a home birth. On these occasions, a layperson is likely not to recognize symptoms until the infant is experiencing moderate to serious congestive heart failure (CHF) as a result of the heart working harder in a futile attempt to increase oxygen flow to the body; this overworking of the heart muscle eventually leads to hypertrophy and may result in cardiac arrest if left untreated.
Narcissistic personality disorder (patient information)
For the WikiDoc page for this topic, click here

# Overview
Narcissistic personality disorder is a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves.

# What are the symptoms of Narcissistic personality disorder?
A person with narcissistic personality disorder may:
- React to criticism with rage, shame, or humiliation
- Take advantage of other people to achieve his or her own goals
- Have excessive feelings of self-importance
- Exaggerate achievements and talents
- Be preoccupied with fantasies of success, power, beauty, intelligence, or ideal love
- Have unreasonable expectations of favorable treatment
- Need constant attention and admiration
- Disregard the feelings of others, and have little ability to feel empathy
- Have obsessive self-interest
- Pursue mainly selfish goals

# What causes Narcissistic personality disorder?
- The causes of this disorder are unknown.
- An overly sensitive personality and parenting problems may affect the development of this disorder.

# Diagnosis
Like other personality disorders, narcissistic personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms.

# Treatment options
Psychotherapy (for example, talk therapy) may help the affected person relate to other people in a more positive and compassionate way.

# Where to find medical care for Narcissistic personality disorder?
Directions to Hospitals Treating Condition

# What to expect (Outlook/Prognosis)?
The outcome depends on the severity of the disorder.

# Possible complications
- Alcohol or other drug dependence
- Relationship, work, and family problems

# Source
Oxytetracycline hydrochloride dosage and administration

# Dosage and Administration
Urobiotic-250 is recommended in adults only. A dose of 1 capsule four times daily is suggested. In refractory cases 2 capsules four times a day may be used.
Therapy should be continued for a minimum of seven days or until bacteriologic cure in acute urinary tract infections.
Administration of adequate amounts of fluid along with capsule forms of drugs in the tetracycline class is recommended to wash down the drugs and reduce the risk of esophageal irritation and ulceration. (SeeAdverse Reactions.)
To aid absorption of the drug, it should be given at least one hour before or two hours after eating. Aluminum hydroxide gel given with antibiotics has been shown to decrease their absorption and is contraindicated.
Peripheral T-cell lymphoma, not otherwise characterized
Synonyms and keywords: Lennerts lymphoma; Lymphoepithelioid lymphoma.

# Overview

# Historical Perspective

# Classification

# Pathophysiology

# Causes

# Differentiating Peripheral T-cell lymphoma, not otherwise characterized from other Diseases

# Epidemiology and Demographics

# Risk Factors

# Natural History, Complications and Prognosis

# Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | CT | Other Diagnostic Studies

# Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Future or Investigational Therapies |  Cost Effectiveness of Therapy

# Case Studies
Special considerations for creating a single-page topic

# Overview
Instead of a microchaptered-page, a single-page should be created for a disease topic without extensive content.  Special considerations should be made in the presence of differential diagnosis tables, which may occupy the full width of the page and collide with the sidebar.

# Single-page without differential diagnosis table(s)
- For a single-page without differential diagnosis table(s), use this template to create the page.
- Note that the sidebar should be inserted using the code: {{SI}}

# Single-page with differential diagnosis table(s)
- For a single-page with differential diagnosis table(s), the single-page should be divided into two pages: a Main Page and a separate Differential Diagnosis Page.
- The Main Page should be created with this template.
- Note that in the differential diagnosis section of the Main Page, the following sentence (with a hyperlink to the Differential Diagnosis Page) should be included: For further information about the differential diagnosis, click here.
- The Differential Diagnosis Page should be created with this template.
- Note that the sidebar on the Differential Diagnosis Page should be replaced with the Return to Home button that links back to the Main Page.
Twin-to-twin transfusion syndrome (patient information)
For the WikiDoc page for this topic, click here
Synonyms and Keywords: TTTS; Fetal transfusion syndrome

# Overview
Twin-to-twin transfusion syndrome (TTTS) is a rare condition that occurs only in identical twins while they are in the womb.

# What are the symptoms of Twin-to-twin transfusion syndrome?
- The donor twin is usually born smaller than the other twin, usually with paleness, anemia, and dehydration.
- The recipient twin is born larger, with redness, too much blood, and increased blood pressure. Because of the increased blood volume, the recipient twin may develop cardiac failure and also require medications to strengthen heart function.
- The unequal size of identical twins is referred to as discordant twins.

# What causes Twin-to-twin transfusion syndrome?
- TTTS occurs when blood moves from one twin to the other.
- The twin that loses the blood is called the donor twin. The twin that receives the blood is called the recipient twin.
- Both infants may have problems depending on the severity of the transfusion. The donor twin may have too little blood, and the other may have too much blood. The donor twin may need a blood transfusion, while the recipient twin may need to have the amount of blood in his or her body reduced.

# Diagnosis
- This condition is usually diagnosed by ultrasound during pregnancy.
- After birth, the infants will receive the following tests:
- Blood clotting studies, including prothrombin time (PT) and partial thromboplastin time (PTT)
- Comprehensive metabolic panel to determine electrolyte balance
- Complete blood count
- Chest x-ray

# Treatment options
- Treatment may require repeated amniocentesis''' during pregnancy.
- Fetal laser surgery may be done to interrupt the flow of blood from one twin to the other.
- After birth, treatment depends on the infant's specific symptoms. The donor twin may need a blood transfusion to treat anemia.
- The recipient twin may need to have the volume of body fluid reduced. This may involve an exchange transfusion.
- Medications may be given to treat heart failure in the recipient twin.

# Where to find medical care for Twin-to-twin transfusion syndrome?
Directions to Hospitals Treating Twin-to-twin transfusion syndrome

# What to expect (Outlook/Prognosis)?
If the twin-to-twin transfusion is mild, full recovery is expected for both babies. However, severe cases may result in the death of a twin.

# Source
Valproic acid capsule delayed release contraindications

# Contraindications
Stavzor should not be administered to patients with hepatic disease or significant hepatic dysfunction . is contraindicated in patients known to have mitochondrial disorders caused by mutations in mitochondrial DNA polymerase  (POLG; e.g., Alpers-Huttenlocher Syndrome) and children under two years of age who are suspected of having a POLG-related disorder.
Stavzor is contraindicated in patients with known hypersensitivity to the drug. .
Stavzor is contraindicated in patients with known urea cycle disorders .
Stavzor is contraindicated for use in prophylaxis of migraine headaches in pregnant women .