tbuckley/cabot-search huggingface dataset:
We need statistical thinking, not statistical rituals
Authors: Gerd Gigerenzer
Journal: Behavioral and Brain Sciences (1998)

What Chow calls NHSTP is an inconsistent hybrid of Fisherian and Neyman-Pearsonian ideas. In psychology it has been practiced like ritualistic handwashing and sustained by wishful thinking about its utility. Chow argues that NHSTP is an important tool for ruling out chance as an explanation for data. I disagree. This ritual discourages theory development by providing researchers with no incentive to specify hypotheses.
Fungal nail infection
Authors: T. C o. Hartman, E. v. Rijswijk
Journal: BMJ (2008)

A 38 year old woman comes to you with a cosmetic problem in her toenails. She describes her nails as yellowish brown and crumbly and with detachment and thickening of parts of the nails. The problem appeared gradually, but she is now too embarrassed to wear open shoes. She wants to know whether it can be treated.

Key signs of fungal nail infections —The main changes in onychomycosis are nail thickening, discoloration, and onycholysis (separation of the nail plate from the nail bed). Onycholysis also gives a crumbly aspect to the nail.⇓



Fungal infection of the toenail



Causes and prevalence —In fungal nail infection dermatophytes invade the nail plate. The prevalence of the infection increases with age. Several studies report a prevalence of 15-20% in patients aged ≥40 years. In the general population the prevalence is 3-5%.

Patients requiring extra vigilance —Some patients (those with diabetes or poor peripheral circulation) are at risk of secondary …
Endoscopic Neodymium:YAG Laser Coagulation in Gastrointestinal Hemorrhage
Authors: P. Kiefhaber, K. Kiefhaber, F. Huber, G. Nath
Journal: Endoscopy (1986)

The aim of a resolute, endoscopic treatment in acute gastrointestinal hemorrhage by a neodymium:YAG laser is to prevent massive loss of blood and to avoid transformation of the hemorrhagic shock event into an irreversible state. Parallel to endoscopic procedure treatment of coagulopathies is necessary. 1,029 (94%) out of 1,092 acute bleeding episodes of 852 unselected patients were treated successfully. In bleeding esophageal varices, reduction of mortality from 70% to 36.2% has been achieved by sclerotherapy following laser coagulation of the acute bleeding. Compared with the results of surgery the mortality rate of bleeding acute ulcers has been reduced from 58% to 23.4%, and of bleeding chronic ulcers from 25% for resection and 15% for vagotomy to 0%. For optimal treatment of the patients close cooperation with surgeons is also desirable.
Changing the death taboo for medical students
Authors: J Gibbins, C Reid, E J Chambers, C Campbell, R McCoubrie, K Forbes
Journal: BMJ (2008)

With reference to Riley’s editorial on a strategy for end of life care,1 we explored, as part of a national mixed methods study, what coordinators of undergraduate palliative care teaching are trying to achieve in the medical curriculum. Perhaps not surprisingly, they are aiming to help medical students overcome the same fears held by the …
Genetics: the Basics
Authors: Janet M. Torpy
Journal: JAMA (2008)

Genetics: the Basics Genetics includes the study of how human characteristics are inherited from one' s parents.It explains how traits as simple as eye color or as complex as susceptibility to diseases run in families.Genes are units of heredity passed from parents to offspring and are contained in a person' s cells-every human cell contains about 20 000 to 25 000 genes.Genes vary greatly from person to person and influence personality, intelligence, physical appearance, and other traits to a certain extent, but learning and environment play important roles as well.The March 19, 2008, issue of JAMA is a theme issue on genetics.
Giant-cell pneumonia caused by measles and methotrexate in childhood leukaemia in remission.
Authors: M J Lewis, A H Cameron, K J Shah, D R Purdham, J R Mann
Journal: BMJ (1978)

Four children who had acurate lymphoblastic leukaemia in remission and developed pneumonia were studied. Investigations including electron microscopy and immunofluorescence of lung biopsy material disclosed measles, although there was no clinical evidence of the disease. Despite an identical presentation, two types of illness developed: two children died of giant-cell pneumonia, while the other two developed pneumonia indistinguishable from that associated with methotrexate treatment, recovering when treated with steroids and gammaglobulin. Measles infection is easily overlooked in the absence of rash. The diagnosis may be suggested by clinical and radiological features and confirmed by specific immunofluorescence staining of lung biopsy tissue.
Distant lymph nodes serve as pools of <scp>Th</scp>1 cells induced by neonatal <scp>BCG</scp> vaccination for the prevention of asthma in mice
Authors: G. Zhang, P. Wang, Z. Qiu, X. Qin, X. Lin, N. Li, H. Huang, H. Liu, W. Hua, Z. Chen, H. Zhao, W. Li, H. Shen
Journal: Allergy (2013)

Abstract Background Neonatal Bacillus C almette– G uérin ( BCG ) vaccination induces vigorous T‐helper type 1 ( Th 1) responses and inhibits allergy‐related airway dysfunction, but the exact mechanisms remain unclear. The objective of this study was to address where the Th 1 cells induced by neonatal BCG vaccination are generated and stored, and how they are recruited into the inflamed airway for the prevention of allergen‐induced airway inflammation. Methods We vaccinated neonatal C57 BL /6 mice with BCG in a mouse model of asthma and analyzed the expression and function of Th 1 cells in vivo and in vitro . Results BCG vaccination–induced Th1 cells in the local inguinal lymph nodes ( ILN ) migrated into the lungs upon inhaled ovalbumin ( OVA ) challenge in OVA ‐sensitized mice. These CD 4 + T cells in the ILN exhibited potentials of activation, proliferation and cytokine secretion and expressed high levels of CXCR 3. Adoptive transfer of CD 4 + T cells from BCG ‐treated ILN significantly decreased allergic airway responses. In addition, the protective effect of BCG vaccination against allergic airway inflammation was lost upon the excision of the ILN . Conclusions These data demonstrate that ILN serves as a ‘weapon’ pool of Th 1 cells following BCG vaccination, and these cells are ready for the migration into the inflamed lungs upon the allergen challenge, thereby inhibiting allergen‐induced airway disorder.
Comparison of case fatality in south Asian and white patients after acute myocardial infarction: observational study
Authors: P. Wilkinson, J. Sayer, K. Laji, C. Grundy, B. Marchant, P. Kopelman, A. D Timmis
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To compare mortality in south Asian (Indian, Pakistani, and Bangladeshi) and white patients in the six months after hospital admission for acute myocardial infarction. <b>Design</b>: Observational study. <b>Setting</b>: District general hospital in east London. <b>Patients</b>: 149 south Asian and 313 white patients aged &lt;65 years admitted to the coronary care unit with acute myocardial infarction from 1 December 1988 to 31 December 1992. <b>Main outcome measure</b>: All cause mortality in the first six months after myocardial infarction. <b>Results</b>: The admission rate in the south Asians was estimated to be 2.04 times that in the white patients. Most aspects of treatment were similar in the two groups, except that a higher proportion of the south Asians received thrombolytic drugs (81.2% v 73.8%). After adjustment for age, sex, previous myocardial infarction, and treatment with thrombolysis or aspirin, or both, the south Asians had a poorer survival over the six months from myocardial infarction (hazard ratio 2.02 (95% confidence interval 1.14 to 3.56), P=0.018), but a substantially higher proportion were diabetic (38% v 11%, P&lt;0.001), and additional adjustment for diabetes removed much of their excess risk (adjusted hazard ratio 1.26 (0.68 to 2.33), P=0.47). <b>Conclusion</b>: South Asian patients had a higher risk of admission with myocardial infarction and a higher risk of death over the ensuing six months than the white patients. The higher case fatality among the south Asians, largely attributable to diabetes, may contribute to the increased risk of death from coronary heart disease in south Asians living in Britain. <h3>Key messages</h3> This study shows that south Asians have high mortality in the first six months after a heart attack This may contribute to the high standardised mortality ratios for coronary disease in south Asians living in the Britain Diabetes may be an important contributor to this excess risk The high prevalence of diabetes and relatively poor prognosis after myocardial infarction in south Asian patients are important to consider in clinical management
A biphasic response of hepatobiliary cholesterol metabolism to dietary fat at the onset of obesity in the mouse
Authors: Suheeta Roy, Hideyuki Hyogo, Suresh K. Yadav, Michele K. Wu, Linda A. Jelicks, Joseph D. Locker, Philippe G. Frank, Michael P. Lisanti, David L. Silver, David E. Cohen
Journal: Hepatology (2005)

Human obesity is associated with abnormal hepatic cholesterol homeostasis and resistance to leptin action. Because leptin administration to rodents promotes the biliary elimination of plasma cholesterol, this study was designed to elucidate a pathophysiological role for leptin during the development of obesity. We fed mice diets containing high or low saturated fat contents. Before and after the onset of obesity, we measured downstream targets of leptin action and evaluated plasma, hepatic, and biliary cholesterol metabolism. Although not obese at 28 days, mice fed a high fat diet became hyperleptinemic. Sensitivity to leptin was evidenced by downregulation of both hepatic stearoyl CoA desaturase-1 and fatty acid synthase. Due principally to upregulation of adenosine triphosphate–binding cassette proteins A1 and G5, plasma high density lipoprotein (HDL) cholesterol concentrations increased, as did relative secretion rates of biliary cholesterol. A smaller, more hydrophilic bile salt pool decreased intestinal cholesterol absorption. In this setting, hepatic cholesterol synthesis was downregulated, indicative of increased uptake of plasma cholesterol. After 56 days of high fat feeding, obesity was associated with leptin resistance, as evidenced by marked hyperleptinemia without downregulation of stearoyl CoA desaturase-1 or fatty acid synthase and by upregulation of hepatic cholesterol and bile salt synthesis. Hypercholesterolemia was attributable to overproduction and decreased clearance of large HDL1 particles. In conclusion, before the onset of obesity, preserved leptin sensitivity promotes biliary elimination of endogenous cholesterol in response to dietary fat. Leptin resistance due to obesity leads to a maladaptive response whereby newly synthesized cholesterol in the liver is eliminated via bile. (HEPATOLOGY 2005;41:887–895.)
Smad2/Smad3 in endothelium is indispensable for vascular stability via S1PR1 and N-cadherin expressions
Authors: Fumiko Itoh, Susumu Itoh, Tomomi Adachi, Kei Ichikawa, Yutaka Matsumura, Takahiro Takagi, Maria Festing, Takuya Watanabe, Michael Weinstein, Stefan Karlsson, Mitsuyasu Kato
Journal: Blood (2012)
Idiopathic dilated cardiomyopathy. An immunologic, genetic, or infectious disease, or all of the above?
Authors: J R Bender
Journal: Circulation (1991)

Third New International Dictio- nary defines "idiopathic" as "arising spontaneously or from an obscure or un- known cause."Medical diagnostic terminology has included this adjective for many years,' and its mys- terious nature has survived into the current era of sophisticated technology and molecular analyses.Id- iopathic dilated cardiomyopathy (IDC) is character- ized by increased left ventricular intracavitary dimen- sions, reduced systolic function, and, commonly, a congestive heart failure syndrome, but IDC is with- out a clear-cut etiology.Within the context of idiopathy, attempts have been made to associate IDC with various medical entities frequently connected to ill- nesses of obscure origin; for example, with autoim- munity and undiagnosable viral infections.In fact, numerous results indicating multiple immunologic defects have been generated from patients with IDC.See p 515 These have included defects in natural killer2 and suppressor lymphocyte3'4 activity, myocyte-specific cy- totoxic T cell responses,5 and the presence of a wide array of autoantibodies directed at apparently normal or abnormal cardiac tissue.67Although of considerable interest, these data have been primarily phenomenological, and by no means etiologically definitive.Because of the immune hypothesis of IDC and the association between diseases with autoimmune features and specific human leukocyte antigen (HLA) molecules, in 1984 Anderson et a18 undertook a retrospective HLA-typing study in IDC patients.Although no single HLA type accounted for a ma- jority of cases, the HLA-DR4 allele was positively associated with the disease.This suggested that ge- netically determined immune responses may play a role in the pathogenesis of IDC.
Intravenous iron administration induces oxidation of serum albumin in hemodialysis patients
Authors: Makoto Anraku, Kenichiro Kitamura, Ayumi Shinohara, Masataka Adachi, Ayaka Suenaga, Toru Maruyama, Kei Miyanaka, Taku Miyoshi, Naoki Shiraishi, Hiroshi Nonoguchi, Masaki Otagiri, Kimio Tomita
Journal: Kidney International (2004)
Prescribing for the elderly.
Authors: M R Bliss
Journal: BMJ (1981)

Generally, prescribing in Britain today is in a mess : the annual expenditure of the NHS on drugs is ?500m; expenditure on drugs not taken, non-compliance, is 3C20m.1 Prescription rates are as follows : 55% of the whole male population receive at least one prescription a year2; 65% of the whole female population receive at least one prescription a year2; 33% of all women aged 45-59 receive psychotrophic drugs2; 37% of all women aged 75 and over receive psychotrophic drugs2; 75% of the whole population aged 75 and over receive drugs of some kind2; two-thirds receive one to three drugs, and one third four to six drugs simultaneously3; 25% of all adults are taking medicines first prescribed more than one year previously4; 75% of prescriptions are repeat prescriptions4; 50% of patient's bottles seen in a geriatric outpatient clinic have no dosage directions (personal observation) ; 80% of patients admitted to geriatric wards are receiving drugs3; for most of these patients, and for patients seen in geriatric outpatient clinics, it is impossible to be certain what the drugs are; and 10% of admissions to geriatric wards are due to iatrogenic disease caused by drugs.3 The need for a prescription for every ill felt by both doctors and patients is not new. Readers of George Eliot's Middlemarch will recall the struggles of young Dr Lydgate and the unpopu? larity that he brought on himself, with both his colleagues and his patients, by trying to resist the demand for useless bottles of physic. In this respect doctors are more culpable than patients. Studies5 have shown that, whereas 80-90% of doctors expect patients to want prescriptions, only 30-50% of patients actually do; the remainder would prefer an examination, advice, and reassurance, but are frequently given a prescription instead. In the past placebos, or the bona-fide medicines of the day, were often unpleasant, but they seldom had the powerful physiological actions of today's drugs, nor were they so freely available. Today the elderly are the main victims of modern drugs and the system by which they are administered. The reasons for this are: (1) multiple pathology of the elderly, (2) polypharmacy, (3) increased sensitivity of the elderly to drugs and side effects, (4) doctors' lack of training in geriatric pre? scribing, (5) unsuitable drug packaging and instructions, (6) poor supervision of elderly patients, and (7) dual prescribing systems in hospitals and in general practice, which prevent doctors from being fully responsible for their own prescribing.
Comparison of Radionuclide Brain Scan and Computerized Tomography for the Detection of Intracranial Infections
Authors: STEVEN PINSKY, HA YONG YUM, DUSHYANT PATEL, CARLOS BEKERMAN, U YUN RYO
Journal: Clinical Nuclear Medicine (1981)

The findings of radionuclide brain scans and computerized tomography (CT) were compared in 25 consecutive patients with intracranial infectious disease. Seventeen of the 25 patients had diffuse disease and eight had brain abscesses. The radionuclide scans showed abnormalities in 13 of the 17 patients with diffuse inflammatory disease, whereas the CT scans showed abnormalities compatible with inflammatory disease in five. All eight abscesses were demonstrated on the radionuclide scans, whereas the CT scans indicated abnormalities in seven cases. The authors conclude that the radionuclide brain scan is more sensitive than the CT scan for the demonstration of diffuse intracranial infectious disease.
Use of Post-pituitary Extract in Obstetrics
Authors: G. W. Theobald, A. Graham, J. Campbell, P. D. Gange, W. J. Driscoll
Journal: BMJ (1948)

In NOD mice and also likely humans, B lymphocytes play an important role as APC-expanding autoreactive T cell responses ultimately causing type 1 diabetes (T1D). Currently, humans at high future T1D risk can only be identified at late prodromal stages of disease indicated by markers such as insulin autoantibodies. When commenced in already insulin autoantibody<sup>+</sup> NOD mice, continuous BAFFR-Fc treatment alone or in combination with anti-CD20 (designated combo therapy) inhibited T1D development. Despite eliciting broader B lymphocyte depletion, continuous combo therapy afforded no greater T1D protection than did BAFFR-Fc alone. As previously observed, late disease stage–initiated anti-CD20 monotherapy did not inhibit T1D, and in this study was additionally found to be associated with development of drug-blocking Abs. Promisingly, NOD mice given transient late disease stage BAFFR-Fc monotherapy were rendered T1D resistant. However, combo treatment abrogated the protective effect of transient BAFFR-Fc monotherapy. NOD mice receiving transient BAFF blockade were characterized by an enrichment of regulatory B lymphocytes that inhibit T1D development through IL-10 production, but this population is sensitive to deletion by anti-CD20 treatment. B lymphocytes from transient BAFFR-Fc–treated mice suppressed T cell proliferation to a greater extent than did those from controls. Proportions of B lymphocytes expressing CD73, an ecto-enzyme operating in a pathway converting proinflammatory ATP to anti-inflammatory adenosine, were also temporarily increased by transient BAFFR-Fc treatment, but not anti-CD20 therapy. These collective studies indicate transient BAFFR-Fc–mediated B lymphocyte depletion elicits long-term T1D protection by enriching regulatory B lymphocytes that are deleted by anti-CD20 cotherapy.
Peptic ulcer and piroxicam
Authors: D. A Henry
Journal: BMJ (1985)

AIDs and class II microbiological safety cabinets SIR,-The information about class II microbio- logical safety cabinets presented by Sheila McKechnie (30 March, p 1006) needs correction.She states "there is sound evidence that they provide little or no operator protection."Collins indicated that class II cabinets that satisfy the requirements of the National Sanitation Foundation Standard No 49 (1976) and British Standard 5726 (1979) are available and are effective.The most pertinent information indicating the effectiveness of class II cabinets is in a table from the recent National Institutes of Health slide series that accompanies the Fundamentals for safe Micro- biological Research, a series used to teach biosafety.Leak factors for safety cabinets* Type Activity Leak factor Class I None io06 to ItI Simulated labwork Or5 to 1t2 Class IIA None 10 to 106 Simulated labwork IY7 to 1O5 Class IIB None 1o9to Ior Simulated labwork 10 to o-5 Class III Transfer through autoclave 6104 *The leakage factors were arrived at by sampling outside while aerosols were inside.The data were collected by placing cabinets in a wind tunnel.All air passing the cabinet was collected in a large volume sampler.A leak factor of 10-6 implies that one out of every million particles generated in the cabinet would escape containment under normal operating conditions.
Preemptive Therapy in Immunocompromised Hosts
Authors: Robert H. Rubin
Journal: New England Journal of Medicine (1991)

TRANSPLANTATION, of both bone marrow and solid organs, must be regarded as one of the great success stories of 20th-century biomedical science. At the same time, it must be recognized that the manipulations required to achieve long-term graft function create a series of biologic and clinical phenomena affecting the recipients that are without precedent in clinical medicine. Paramount among these are the interactions among immunologically active cells capable of responding to and destroying foreign tissue, immunosuppressive therapy aimed at controlling these cells, and certain infectious agents that are modulated by both factors.In patients undergoing bone marrow transplantation, the best . . .
Leukocyte function-associated antigen 1 is an activation molecule for human T cells.
Authors: M C Wacholtz, S S Patel, P E Lipsky
Journal: The Journal of Experimental Medicine (1989)

The leukocyte function-associated antigen 1 (LFA-1) molecule is well established as a surface protein involved in cellular adhesion and interaction, but there has been little information about whether engagement of this molecule can also directly modify cellular activation. These studies demonstrate that crosslinking the LFA-1 molecule on human T cell clones transmits a unique signal to the cell. Crosslinking LFA-1 alone did not increase intracellular calcium ([ CA2+]i), nor did crosslinking LFA-1 activate the cells as measured by IL-2 production or [3H]thymidine incorporation. However, when CD3 and LFA-1 were crosslinked, a more prolonged calcium signal was observed than when CD3 alone was crosslinked. Moreover, IL-2 production and DNA synthesis were greatly augmented. These responses could be demonstrated when LFA-1 was crosslinked via either the alpha or the beta chain, and required surface expression of the LFA-1 molecule as no enhancement was observed in T cell clones from a child with leukocyte adhesion deficiency. The enhancement of cellular activation by LFA-1 did not require that it be directly crosslinked to the CD3 complex. Thus, crosslinking LFA-1 alone with isotype-specific secondary antibodies on cells also pretreated with an anti-CD3 mAb of a different Ig isotype stimulated the cells as effectively as crosslinking both surface antigens with GaMIg. Similarly, a delayed, but sustained increase in [Ca2+]i was elicited. This increase in [Ca2+]i and the enhanced functional responses required engagement of CD3 with an intact bivalent anti-CD3 mAb, as crosslinking LFA-1 on cells also reacted with Fab fragments of an anti-CD3 mAb did not increase [Ca2+]i, nor activate the cells. These data indicate that LFA-1 can convey activation signals to T cells. Synergism in signaling can be observed upon crosslinking of LFA-1 and independently crosslinking CD3. In the physiologic interaction between T cells and accessory cells, the interaction of LFA-1 with its ligand, intercellular adhesion molecule 1, may therefore not only facilitate cellular adhesion, but also may amplify T cell activation by delivering costimulatory signals.
INTRAVENOUS INJECTION OF SOAMIN IN CEREBRO-SPINAL MENINGITIS: TWO CASES WITH RECOVERIES
Authors: T. A. Johnston
Journal: BMJ (1910)

4ime sulphonal, 10 grains dissolved in hot water or tea, was given in the evening, and repeated if necessary at bed- ,time for two nights; as, though it induced sleep, heappeared tobe more restless, and his speech more indistinct next day it was discontinued at the request of the patient's friends.When he had been home about three weeks he was one day very excitable, swinging the croquet mallet about in an alarming fashion, so *that it was deemed advisable to engage an attendant.