Persius/hicric huggingface dataset:
Holt-Oram syndrome
Synonyms and keywords: HOS1; heart-hand syndrome; atriodigital dysplasia

# Overview
Holt-Oram syndrome is a disorder that affects bones in the arms and hands (the upper limbs) and is associated with  atrial septal ostium secundum defects.

# Pathophysiology

## Genetics
Holt-Oram syndrome is considered an autosomal dominant disorder, which means one copy of the altered gene in each cell is sufficient to cause this syndrome. Many cases of Holt-Oram syndrome result from new mutations in the TBX5 gene and occur in people with no history of the disorder in their family.
Mutations in the TBX5 gene cause Holt-Oram syndrome. The TBX5 gene plays a role in the development of the heart and upper limbs before birth. In particular, this gene appears to be important for the process that divides the developing heart into four chambers (cardiac septation). The TBX5 gene also appears to play a critical role in regulating the development of bones in the arm and hand. Mutations in this gene probably disrupt the development of the heart and upper limbs, leading to the characteristic features of Holt-Oram syndrome.

## Associated Conditions
About 75 percent of individuals with Holt-Oram syndrome have heart problems. The most common problem is a defect in the muscular wall, or septum, that separates the right and left sides of the heart. Atrial septal defects (ASD) are caused by a hole in the septum between the left and right upper chambers of the heart (atria), and ventricular septal defects (VSD) are caused by a hole in the septum between the left and right lower chambers of the heart (ventricles). Sometimes people with Holt-Oram syndrome have cardiac conduction disease, which is caused by abnormalities in the electrical system that coordinates contractions of the heart chambers. Cardiac conduction disease can lead to problems such as a slower-than-normal heart rate (bradycardia) or a rapid and ineffective contraction of the heart muscles (fibrillation). Cardiac conduction disease can occur along with other heart defects (such as septal defects) or as the only heart problem in people with Holt-Oram syndrome.

# Epidemiology and Demographics
Holt-Oram syndrome is estimated to affect 1 in 100,000 individuals.

# Diagnosis

## Physical Examination

### Extremities
All people with this disorder have at least one limb abnormality that affects bones in the wrist (carpal bones). Often, these wrist bone abnormalities can be detected only by X-ray. Affected individuals may have additional bone abnormalities that can include a missing thumb or a thumb that looks like a finger, partial or complete absence of bones in the forearm, an underdeveloped bone of the upper arm, and abnormalities that affect the collar bone and shoulder blades. Bone abnormalities may affect each arm differently, and the left side can be affected more than the right side. In some cases, only one arm and/or hand is affected.
Atrophic gastritis

# Overview
Atrophic gastritis is a process of chronic inflammation of the stomach mucosa, leading to loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. As a result, the stomach's secretion of essential substances such as hydrochloric acid, pepsin, and intrinsic factor is impaired, leading to digestive problems, vitamin B12 deficiency, and megaloblastic anemia. It can be caused by persistent infection with Helicobacter pylori, or can be autoimmune in origin.
Autoimmune Metaplastic Atrophic Gastritis (AMAG) is an inherited form of atrophic gastritis characterized by an immune response directed toward parietal cells and intrinsic factor. The presence of serum antibodies to parietal cells and to intrinsic factor are characteristic findings. The autoimmune response subsequently leads to the destruction of parietal cell mass which then results in profound hypochlorhydria (and elevated gastrin levels). The inadequate production of intrinsic factor also leads to vitamin B12 malabsorption and pernicious anemia. AMAG is typically confined to the gastric body and fundus
Hypochlorhydria induces G Cell (Gastrin producing) hyperplasia which leads to hypergastrinemia. Gastrin exerts a trophic effect on enterochromaffin-like cells (ECL cells are responsible for histamine secretion) and is hypothesized to be one mechanism to explain the malignant transformation of ECL cells into carcinoid tumors in AMAG.
Patients with AMAG and pernicious anemia are also at increased risk for the development of gastric adenocarcinoma. The optimal endoscopic surveillance strategy is not known but all nodules and polyps should be removed in these patients.
Environmental metaplastic atrophic gastritis (EMAG) is due to environmental factors, such as diet and H. pylori infection. EMAG is typically confined to the body of the stomach. Patients with EMAG are also at increased risk of gastric carcinoma.
Recent research has shown that AMAG is a result of the immune system attacking the parietal cells,the attack is being triggered by H. pylori through a mechanism called molecular mimicry.

# Historical Perspective

# Classification

# Pathophysiology

## Causes

## Drug Side Effect
Pantoprazole

# Differentiating Atrophic gastritis from Other Diseases

# Epidemiology and Demographics

# Risk Factors

# Screening

# Natural History, Complications, and Prognosis

## Natural History

## Complications

## Prognosis

# Diagnosis

## Diagnostic Criteria

## History and Symptoms

## Physical Examination

## Laboratory Findings

## Imaging Findings

## Other Diagnostic Studies

# Differential diagnosis

# Differential Diagnosis
Atrophic gastritis must be differentiated from:

# Treatment

## Medical Therapy

## Surgery

## Prevention
Attribution theory
Attribution theory is a social psychology theory developed by Fritz Heider, Harold Kelley, Edward E. Jones, and Lee Ross.
The theory is concerned with the ways in which people explain (or attribute) the behavior of others or themselves (self-attribution) with something else.  It explores how individuals "attribute" causes to events and how this cognitive perception affects their usefulness in an organization.

# Internal vs. External
The theory divides the way people attribute causes to events into two types.
- "External" or "situational" attribution assigns causality to an outside factor, such as the weather.
- "Internal" or "dispositional" attribution assigns causality to factors within the person, such as their own level of intelligence or other variables that make the individual responsible for the event.
The covariation model developed by Harold Kelley examines how people decide whether an internal or an external attribution will be made.
Atypical pneumonia
For the WikiPatient page for this topic, click here

# Causes
- Legionella pneumophila: Causes a severe form of pneumonia with a relatively high mortality rate, known as legionellosis or Legionnaires' disease..
- Mycoplasma pneumoniae: Usually occurs in younger age groups and may be associated with neurological and systemic (e.g. rashes) symptoms.
- Chlamydophila pneumoniae: Mild form of pneumonia with relatively mild symptoms.
- The severe acute respiratory syndrome (SARS) was also considered a kind of atypical pneumonia and is still called so in the Chinese mainland.

# Symptoms
- Symptoms include pyrexia, shortness of breath, laboured breathing, cough, arthralgia (joint pain), malaise, loss of appetite, confusion, rash, and diarrhea.

# Differential diagnosis
Consider causes of prolonged acute bronchitis:
- Mycoplasma pneumonia
- Chlamydia pneumoniae
- Bordetella pertussis

# Treatment
- Treatment is with oral antibiotics, mainly with those which interfere with protein synthesis e.g. erythromycin, and diagnosis is confirmed by blood cultures and sputum samples.
Azithromycin can treat:
- Mycoplasma pneumonia
- Chlamydia pneumoniae
- Bordetella pertussis

# Prognosis
- Prognosis is usually good and is influenced by age and immunosuppression.
Ausktribosphenidae
Ausktribosphenidae is a group name that has been given to some rather puzzling fossils which:
- appear to have tribosphenic  molars, a type of tooth which is otherwise known only in placentals.
- come from mid Cretaceous deposits in Australia - but Australia was connected only to Antarctica, and placentals originated in the northern hemisphere and were confined to it until continental drift formed land connections from North America to South America, from Asia to Africa and from Asia to India (the late Cretaceous map at  shows how the southern continents are separated.
- are represented only by skull and jaw fragments, which is not very helpful.
Ausktribosphenidae and monotremes have been assigned to the larger group Australosphenida.  But Australosphenida is a group which has been defined only in order to include the Ausktribosphenidae and monotremes - in other words, it may be just a fiction, unless someone finds a fossil which can sensibly be described as a "basal australosphenid" (member of the Australosphenida which belongs to neither Ausktribosphenidae nor monotremes).
Autistic Pride Day
Autistic Pride Day is a celebration  of the neurodiversity of people on the autism spectrum on June 18 each year. Autistic pride is pride in autism, about shifting views of autism from "disease" to "difference".  Autistic pride emphasises the innate potential in all human phenotypic expressions and celebrates the diversity various neurological types express.
Autistic pride asserts that autistic people are not sick; rather, they have a unique set of characteristics that provide them many rewards and challenges, not unlike their non-autistic peers. Researchers and people with high-functioning autism have contributed to a shift in attitudes away from the notion that autism is a deviation from the norm that must be treated or cured, and towards the view that AS is a difference rather than a disability.  New Scientist magazine released an article entitled "Autistic and proud" on the first Autistic Pride Day that discussed the idea.
Autistic Pride day is an Aspies for Freedom initiative, an autism rights group that aims to educate the general public with initiatives to end ignorance of the issues involving the autistic community.  June 18 was picked as Autistic Pride Day because it was the birthday of Aspies For Freedom's youngest member (Matthew Schimmel).  Families around the world celebrate in numerous public events; there are also gatherings of autistics via IRC so that many can communicate together in real time.

# Philosophy
Advocates of autistic pride reject the notion that there is an ideal, and thus desirable, structure to the human brain. This notion leads many practitioners of psychiatry to assume that any deviation requires a "cure" to achieve conformity to the 'neurotypical' norm. Some supporters believe a form of ethnic cleansing is being imposed by advocates of a cure for autism. All believe that, at a bare minimum, there should be greater consideration shown for members of the autistic community as unique individuals.
Advocates of autistic pride point out that homosexuality was once classified as a form of mental illness that could be treated medically with libido-reducing hormonal therapy. Only after political agitation from the gay rights movement did this classification become obsolete. One of the enduring expressions of this movement is gay pride. The Autistic Pride Day hopes to start the same process of education of this view and activism, with the goals of promoting the basic human rights of autistics and finding a valued home for their individual voice and talents in modern society.

# Themes
The main event of 2005 was in Brasilia, capital of Brazil.
The main events of 2006 were an Autistic Pride Summer Camp in Germany, and an event at Scienceworks in Melbourne, Australia.  There is no information available to suggest that any Autistic Pride Day events took place in 2007, nor any evidence to suggest that there are any events planned for 2008.
- 2005 Acceptance not cure
- 2006 Celebrate Neurodiversity
- 2007 Autistics Speak. It's time to listen
Autogenic training
Autogenic training is a relaxation technique developed by the German psychiatrist Johannes Schultz and first published in 1932. The technique involves the daily practice of sessions that last around 15 minutes, usually in the morning, at lunch time, and in the evening. During each session, the practitioner will repeat a set of visualisations that induce a state of relaxation. Each session can be practiced in a position chosen amongst a set of recommended postures (e.g. lying down, sitting meditation, sitting like a rag doll, etc.).  The technique can be used to alleviate many stress-induced psychosomatic disorders.
Schultz emphasized parallels to techniques in yoga and meditation.  It is a method for influencing one's autonomic nervous system. Abbe Faria and Emile Coue are the forerunners of Schultz.  There are many parallels to progressive relaxation.

# Example of an autogenic training session
- sit in the meditative posture and scan the body
- "my left arm is heavy and warm" (repeat 3 times)
- "my arms and legs are heavy and warm" (repeat 3 times)
- "my heartbeat is calm and regular" (repeat 3 times)
- "my solar plexus is warm" (repeat 3 times)
- finish part one by cancelling
- start part two by repeating from steps 2 to cancelling
- part three repeat steps 2 to cancelling
Quite often, one will ease themselves into the "trance" by counting to ten, and exit by counting backwards from ten. This is another practice taken from progressive relaxation.

# Effects of autogenic training
- Autogenic Training restores the balance between the activity of the sympathetic (flight or fight) and the parasympathetic (rest and digest) branches of the autonomic nervous system. This has important health benefits, as the parasympathetic activity promotes digestion and bowel movements, lowers the blood pressure, slows the heart rate, and promotes the functions of the immune system.

# Counter-indications
Autogenic Training is counter-indicated, or needs to be adapted, for a series of conditions including: heart problems such as myocardial infarction, diabetes, psychotic conditions such as schizophrenia, glaucoma, alcohol or drug abuse, epilepsy.
Autoimmune disease

# Overview
Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body attacks its own cells. This may be restricted to certain organs (e.g. in thyroiditis) or involve a particular tissue in different places (e.g. Goodpasture's disease which may affect the basement membrane in both the lung and the kidney). The treatment of autoimmune diseases is typically with immunosuppressionmedication which decreases the immune response.

# Occurrence and onset
Hormone levels have been shown to affect the severity of some autoimmune diseases such as multiple sclerosis.  Other causes may include the presence of fetal cells in the maternal bloodstream, i.e. microchimerism. 

# Autoimmune diseases
It is possible to classify autoimmune diseases by corresponding type of hypersensitivity: type II, type III, or type IV. (No type of autoimmune disease mimics type I hypersensitivity.)

# Development of therapies
In both autoimmune and inflammatory diseases the condition arises through aberrant reactions of the human adaptive or innate immune systems. In autoimmunity, the patients immune system is activated against the body's own proteins. In inflammatory diseases, it is the overreaction of the immune system, and its subsequent downstream signaling (TNF, IFN, etc), which causes problems.
A substantial minority of the population suffers from these diseases, which are often chronic, debilitating, and life-threatening. There are more than eighty illnesses caused by autoimmunity. It has been estimated that autoimmune diseases are among the ten leading causes of death among women in all age groups up to 65 years.
Currently, a considerable amount of research is being conducted into treatment of these conditions. According to a report from Frost & Sullivan, the total alliance payouts in the autoimmune/inflammation segment from 1997 to 2002 totaled $489.8 million, where Eli Lilly, Suntory, Procter & Gamble, Encysive, and Novartis together account for 98.6 percent of alliance payouts.
Azoospermia factor
Azoospermia factor (AZF) refers to one of several proteins or their genes, which are coded from the AZF region on the human male Y chromosome. Deletions in this region are associated with inability to produce sperm. Subregions within the AZF region are AZFa (sometimes AZF1), AZFb and AZFc (together referred to as AZF2). AZF is the term used by the HUGO Gene Nomenclature Committee.

# AZF1
The AZF1 (Azoospermia Factor 1) gene is likely located in the euchromatic part of the long arm in Yq11.23. AZF1 is 792kb long and just distal to the centromere of the Y chromosome. AZF1 genes are involved in spermatogenesis in the testes.

# AZF2
Originally, the AZFb and AZFc genes were identified and thought to be separate regions.  They were later found to be overlapping and are now referred to as AZF2.

## AZFc
AZFc is one of the most genetically dynamic regions in the human genome, possibly serving as counter against the genetic degeneracy associated with the lack of a partner chromosome during meiosis. However, such strategy comes has the adverse effects that some rearrangements represent a risk factor or a de facto causative agent of spermatogenic disruption.
A specific partial deletion of AZFc called gr/gr deletion is significantly associated with male infertility among Caucasians in Europe and the Western Pacific region.

# AZF mutations
Mutations or deletions in the AZF genes are associated with inability or lessened ability to create sperm. It may cause azoospermia (not having any measurable level of sperm in semen). Deletions in the USP9Y gene, which is located within AZF1, are usually but not always associated with inability to form sperm.
Bovine coronavirus

# Overview
Bovine coronavirus (BCV) is as a member of the Coronaviridae family which are enveloped, single-stranded, positive-sense RNA viruses with a club-shaped surface. Infection causes Calf Enteritis' and contributes to the 'Enzootic Pneumonia complex' in calves. It can also cause 'Winter Dysentery' in adult cattle. It can infect both domestic and wild ruminants and has a worldwide distribution. Transmission is horizontal, via oro-fecal or respiratory routes.

# Diagnosis
Infection normally occurs in calves between the ages of one week and three months. Gastrointestinal signs include profuse diarrhea, dehydration, depression, reduced weight gain and anorexia. Respiratory infection in the calf produces a serous to purulent nasal discharge. Clinical signs may worsen with secondary bacteria infection.
Infection in adults is normally subclinical, the exception being with Winter Dysentry, which affects housed cattle over the Winter months. Clinical signs include profuse diarrhea and a significant drop in milk yield is seen in Winter Dysentry outbreaks.
A presumptive diagnosis can be made based on the history and clinical signs. Definitive diagnosis of an enteric coronavirus infection is achieved by performing electron microscopy or an ELISA on a faecal or tissue sample. In respiratory disease, diagnosis is confirmed by performing a direct fluorescent antibody test on nasal washes - which identifies the viral antigen.
The haemagglutination inhibition test can be used to establish the strain of coronavirus.

# Treatment
Animals should be treated symptomatically. The disease can be controlled by vaccinating the dam with a live vaccine (ATCvet code QI02) whilst she is pregnant as this provides antibodies to the virus in the colostrum. Additional management factors such as insuring adequate colostrum intake in newborn calves, using appropriate hygiene methods and ventilation of housing reduce disease incidence.
Balloon septostomy
Balloon septostomy is the widening of a foramen ovale, patent foramen ovale (PFO), or atrial septal defect (ASD) via cardiac catheterization (heart cath) using a balloon catheter. This procedure allows a greater amount of oxygenated blood to enter the systemic circulation in some cases of cyanotic congenital heart defect (CHD).
After the catheter is inserted, the deflated balloon catheter is passed from the right atrium through the foramen ovale, PFO or ASD into the left atrium, it is then inflated and pulled back through to the right atrium, thereby enlarging the opening and allowing greater amounts of blood to pass through it. The resulting man-made opening is one of many forms of shunting, and is often referred to as an ASD.
This is normally a palliative procedure used to prepare a patient for, or sustain them until, a corrective surgery can be performed. At this time the ASD is closed using either sutures or a cardiac patch, depending on the size and/or nature of the opening.
CME Category::Cardiology
Baskerville effect
The Baskerville effect, or the Hound of the Baskervilles effect is a statistical observation that mortality through heart attacks is increased by psychological stress. It is named after the fictional Charles Baskerville from the Sherlock Holmes novel The Hound of the Baskervilles who died as a result of the stress of encountering the fierce dog after which the story is named.
It was discovered by David Phillips and his colleagues at the University of California, San Diego, who found that daily number of deaths of the 200,000 Chinese and Japanese Americans who died from heart attacks between 1973 and 1988 was 7% higher on the fourth of the month compared to the average for the other days in that week.
Four (, formal writing: , pinyin si4) is considered an unlucky number in Chinese and Japanese (as well as Korean) cultures because it sounds like "death" ( pinyin si3).  Some Chinese and Japanese hotels and hospitals do not use it as a room number.
His hypothesis was that the peak was caused by stress induced by the superstition surrounding this number.  Previous research had also shown a complementary effect, mortality falling before auspicious occasions and rising again afterwards.
Beaker (glassware)
A beaker is a simple container for stirring, mixing and heating liquids, they are commonly used in any laboratory.  Beakers are generally cylindrical in shape, with a flat bottom.  Beakers are available in a wide range of sizes, from 1 mL up to several litres.
They may be made of glass (very often borosilicate glass) or of various plastics. Beakers used for holding solutions of corrosive chemicals such as acids or other highly reactive chemicals, are often made of PTFE or other low reactivity materials. Beakers have a cylindrical shape, with flat bottoms so that that they can be set onto many different types of surfaces, and they usually have a thick top with a spout to make it easier to pour liquids.
Beakers may be covered, perhaps by a watch glass, to prevent contamination or loss of the contents. Beakers are often graduated, marked on the side with lines indicating the volume contained.  For instance, a 250 mL beaker might be marked with lines to indicate 50, 100, 150, 200, and 250 mL of volume.  The accuracy of these marks can vary from one beaker to another.
A beaker is distinguished from a flask by having sides which are straight rather than sloping. Beakers are used more often in general chemistry than flasks.