tbuckley/cabot-search huggingface dataset:
DePuy knew about hip implant's high failure rate three years before it was recalled
Authors: D. Cohen
Journal: BMJ (2013)

Post-marketing studies carried out by the US orthopaedic company DePuy showed a high revision rate for its ASR (articular surface replacement) hip implant three years before it was recalled from the global market, newly released internal documents show.

The controversial prosthesis was recalled in August 2010 after “new data” from the National Joint Registry of England and Wales showed that it was failing at a higher rate than competing implants, a “Dear doctor” letter sent out by the company to surgeons said. It stated revision rates of 8-9% at three years.

The ASR comes in two types, one used in a resurfacing technique and the other as part of a total hip replacement called the ASR XL.

However, an unpublished survival analysis conducted in June 2007 from the company’s own database showed …
Lyell's Toxic Epidermal Necrolysis
Authors: J. G. Holmes, A. C. Kendall, J. E. M. Whitehead
Journal: BMJ (1967)

We are surprised that in the majority of their cases the common bile duct was sufficiently dilated to allow a 2-cm.transverse incision (producing about a 1.5-cm.stoma after two-layered anastomosis) and also surprised that with a stoma that size they had no cases of cholangitis.On preliminary review, our experience is that a 2.5-cm.stoma is advisable, as recommended by Capper,' and this can be obtained in most cases only by a longitudinal incision in the common bile duct and a transverse (or, preferably, longitudinal) incision in the duodenum.The importance of the larger stoma seems to be to allow free return of duodenal contents from the common bile duct rather than to prevent stenosis, but we are investigating these points further.-Weare, etc.,
THE IMPORTANCE OF ANAESTHESIA BY LUMBAR INJECTION IN OPERATIONS FOR ACUTE ABDOMINAL DISEASES
Authors: H. P. Dean
Journal: BMJ (1906)

THE harmful effect of the administration of a general anaesthetic, such as clhloroform or ether, upon a patient suffering from an acute abdominal disease, especially peritonitis and appendicitis, has led to many attempts on the part of surgeons to do without this very serious hindrance to success.Many cases have been reported in which cocaine anaesthesia has been used for this purpose in two ways:1. Locally, being injected under the skini. 2. Intraspinal injection in the lumbar region.I have myself tried the first method on several occa- sions, and as a general procedure it is certainly out of the range of practical surgery.The second method, by inject- ing small doses of cocaine, generally about A gr., into the lumbar spinal canal, has been emplo.yedvery largely, especially in France.I have seen abdominal operations performed by this method; they were cases in which the anaesthesia required was well below the umbilicus-an inguinal colotomy and a radical cure of hernia.In cases in which there is acute general peritonitis the effect of a dose of cocaine large enough to produce sufficient anaesthesia would be to diminish the already damnaged vitality of the patient.These two methods, therefore, could be applied only in exceptional cases, and could not be looked upon as a regular surgical procedure for obtaining anaesthesia in acute diseases of the abdomen.The anaesthetic under consideration is the chlorhydrate of one of the amino-alcohols.'It has been given the name stovaine.This new body has been examined carefully, and researches made upon it in various directions have already been published.2It can be used in all cases where cocaine is employed; for example, Paul Reclus3 states that he injects stovaine without fear in cases where he used to inject cocaine-that lie has been able to perform operations which would not have been possible with cocaine.
Bacterial co-infection with H1N1 infection in patients admitted with community acquired pneumonia
Authors: Catia Cillóniz, Santiago Ewig, Rosario Menéndez, Miquel Ferrer, Eva Polverino, Soledad Reyes, Albert Gabarrús, Maria Angeles Marcos, Juan Cordoba, Josep Mensa, Antoni Torres
Journal: Journal of Infection (2012)

Bacterial co-infection is an important contributor to morbidity and mortality during influenza pandemics .We investigated the incidence, risk factors and outcome of patients with influenza A H1N1 pneumonia and bacterial co-infection.Prospective observational study of consecutive hospitalized patients with influenza A H1N1 virus and community-acquired pneumonia (CAP). We compared cases with and without bacterial co-infection.The incidence of influenza A H1N1 infection in CAP during the pandemic period was 19% (n, 667). We studied 128 patients; 42(33%) had bacterial co-infection. The most frequently isolated bacterial pathogens were Streptococcus pneumoniae (26, 62%) and Pseudomonas aeruginosa (6, 14%). Predictors for bacterial co-infection were chronic obstructive pulmonary disease (COPD) and increase of platelets count. The hospital mortality was 9%. Factors associated with mortality were age ≥ 65 years, presence of septic shock and the need for mechanical ventilation. Although patients with bacterial co-infection presented with higher Pneumonia Severity Index risk class, hospital mortality was similar to patients without bacterial co-infection (7% vs. 11%, respectively, p = 0.54).Bacterial co-infection was frequent in influenza A H1N1 pneumonia, with COPD and increased platelet count as the main predictors. Although associated with higher severe scales at admission, bacterial co-infection did not influence mortality of these patients.
470. ABCB4 P-Glycoprotein Reduces Infectivity of Lentiviral Particles by Increasing Their Phosphatidylcholine Content
Authors: Niek P. van Til, Kirstin Heutinck, Ronald P.J. Oude Elferink, Jurgen Seppen
Journal: Molecular Therapy (2006)

Human Immunodeficiency Virus-1 (HIV-1) particles are assembled and released from membrane microdomains (lipid rafts). The membrane composition of the viral particle, which is important for viral integrity and infectivity, is therefore determined by the raft lipid composition.
The man of the crowd
Authors: T. Dalrymple
Journal: BMJ (2010)

The behaviour of people in crowds is rather different from that of the same people in the privacy of their own homes; so much is obvious. But it was the French doctor, writer, and all round intellectual Gustave Le Bon (1841-1931) who was the first to consider the difference at book length. His Psychology of Crowds , published in 1895, was a founding text of social psychology.

Le Bon is usually said to have qualified as a doctor in Paris in 1866, though some have disputed whether he ever passed his baccalaureat, let alone his doctorate. Be that as it may, he practised for a time and published widely on such …
Analysis of serial measurements in medical research.
Authors: J N Matthews, D G Altman, M J Campbell, P Royston
Journal: BMJ (1990)

In medical research data are often collected serially on subjects. The statistical analysis of such data is often inadequate in two ways: it may fail to settle clinically relevant questions and it may be statistically invalid. A commonly used method which compares groups at a series of time points, possibly with t tests, is flawed on both counts. There may, however, be a remedy, which takes the form of a two stage method that uses summary measures. In the first stage a suitable summary of the response in an individual, such as a rate of change or an area under a curve, is identified and calculated for each subject. In the second stage these summary measures are analysed by simple statistical techniques as though they were raw data. The method is statistically valid and likely to be more relevant to the study questions. If this method is borne in mind when the experiment is being planned it should promote studies with enough subjects and sufficient observations at critical times to enable useful conclusions to be drawn. Use of summary measures to analyse serial measurements, though not new, is potentially a useful and simple tool in medical research.
Three Cases of Long-Lasting Tumor Control with Erlotinib after Progression with Gefitinib in Advanced Non-Small Cell Lung Cancer
Authors: Cesare Gridelli, Paolo Maione, Domenico Galetta, Guiseppe Colantuoni, Filomena Del Gaizo, Carmine Ferrara, Ciro Guerriero, Dario Nicolella, Antonio Rossi
Journal: Journal of Thoracic Oncology (2007)
CHA2DS2VASC SCORE IS SUPERIOR TO ATRIAL FIBRILLATION IN PREDICTING POST-OPERATIVE ISCHEMIC STROKE IN PATIENTS UNDERGOING CARDIOTHORACIC SURGERY
Authors: Julio Peguero, Carlos Podesta, Omar Issa, Orlando Santana, Jason Jacobson, Gervasio Lamas
Journal: Journal of the American College of Cardiology (2014)
Supporters of "personal budgets" for patients with long term conditions need to proselytise, minister says
Authors: N. Hawkes
Journal: BMJ (2015)

Personal budgets are the future of healthcare for large numbers of patients in England, the minister responsible for them told a Westminster Health Forum seminar in London on 27 January. 

Norman Lamb, the minister of state for care and support, said that the Health and Social Care Act 2012 had enshrined the concepts of control and freedom in healthcare and social care: control over budgets and freedom for the individual to choose the most appropriate care package. “And I expect these concepts to be honoured and valued,” he added. “They will make people’s lives better and save millions of pounds.”

So far personal budgets are much more firmly established in social care, where some 650 000 …
Impedance plethysmography: the relationship between venous filling and sensitivity and specificity for proximal vein thrombosis.
Authors: R Hull, D W Taylor, J Hirsh, D L Sackett, P Powers, A G Turpie, I Walker
Journal: Circulation (1978)

We investigated the hypothesis that the diagnostic accuracy of impedance plethysmography (IPG) for thrombosis of the popliteal or more proximal veins increases with enhanced venous filling. Venous filling was increased by prolonging cuff occlusion and by sequential testing. IPG and vengography were performed on 169 legs with and 317 legs without proximal vein thrombosis. The sensitivity and specificity of IPG rose significantly with increased venous filling. Changes in venous filling were associated with corresponding changes in emptying in normal legs, but not those with proximal vein thrombosis, so that the regression lines relating venous filling and emptying in normal and abnormal legs diverged significantly (P less than 0.001). If the IPG sequence had been terminated after only a single 45 second occlusion time test, sensitivity would have deteriorated by 10% and specificity by 20%. These observations indicate that the accuracy of IPG can be significantly enhanced if optimal venous filling is obtained.
Coccidioidouria: Clinical Significance
Authors: ESKILD A. PETERSEN
Journal: Annals of Internal Medicine (1976)

Twelve patients had urine cultures positive for Coccidioides immitis. Ten patients showed the usual criteria for dissemination, but 2 were believed, before urine culture, to have only chronic pulmonary involvement. In 8 patients, there was impairment of host defense mechanisms due either to associated disease or immunosuppressive drug therapy. Only 2 of 11 patients tested reacted to coccidioidin skin-test antigen. Colony counts of C. immitis in the first voided morning urine specimens ranged from 0.03/ml to 17/ml. With prostatic involvement, colony counts in the expressed secretions ranged from 15/ml to 120/ml. The site of urinary tract coccidioidomycosis, which could be adduced in 9 patients, was the upper tract in 1, lower tract in 6, and in both upper and lower tracts in 2. In patients with lower tract infection, the prostate was involved in 4 and the epididymis in 2.
Angiotensin II stimulation of hydrogen ion secretion in the rat early proximal tubule. Modes of action, mechanism, and kinetics.
Authors: F Y Liu, M G Cogan
Journal: Journal of Clinical Investigation (1988)

Physiologic concentrations of angiotensin II stimulate sodium transport by intestinal and renal early (S1) and late (S2) proximal tubule epithelial cells. We recently found that hydrogen ion secretion, which effects sodium bicarbonate absorption, was a transport function preferentially and potently increased by angiotensin II in S1 cells. S1 cells are normally responsible for half of the total renal hydrogen ion secretion. The mechanism by which angiotensin II regulates intestinal sodium transport is by potentiating sympathetic nerve activity and norepinephrine release. Direct control of hydrogen ion secretion by angiotensin II via receptors on epithelial cells has not been previously demonstrated. We now report that stimulation of in vivo hydrogen ion secretion in the rat early proximal tubule by angiotensin II was not mediated via change in nerve activity. Rather, enhanced hydrogen ion secretion by angiotensin II correlated with increased angiotensin II receptor density on epithelial cells in the early compared to late microdissected proximal tubule. Basolateral as well as luminal angiotensin II stimulated bicarbonate absorption. Angiotensin II reduced bicarbonate permeability and caused alteration in the apparent substrate affinity, but not maximal capacity, of the proximal hydrogen ion secretory system involving the Na+/H+ antiporter.
The Estrogenic Effect of Bisphenol A Disrupts Pancreatic β-Cell Function <i>In Vivo</i> and Induces Insulin Resistance
Authors: Paloma Alonso-Magdalena, Sumiko Morimoto, Cristina Ripoll, Esther Fuentes, Angel Nadal
Journal: Environmental Health Perspectives (2005)

The function of the pancreatic β-cell is the storage and release of insulin, the main hormone involved in blood glucose homeostasis. The results in this article show that the widespread environmental contaminant bisphenol-A (BPA) imitates 17β-estradiol (E2) effects in vivo on blood glucose homeostasis through genomic and nongenomic pathways. The exposure of adult mice to a single low dose (10 μg/kg) of either E2 or BPA induces a rapid decrease in glycemia that correlates with a rise of plasma insulin. Longer exposures to E2 and BPA induce an increase in pancreatic β-cell insulin content in an estrogen-receptor–dependent manner. This effect is visible after 2 days of treatment and starting at doses as low as 10 μg/kg/day. After 4 days of treatment with either E2 or BPA, these mice developed chronic hyperinsulinemia, and their glucose and insulin tolerance tests were altered. These experiments unveil the link between environmental estrogens and insulin resistance. Therefore, either abnormal levels of endogenous estrogens or environmental estrogen exposure enhances the risk of developing type 2 diabetes mellitus, hypertension, and dyslipidemia.
Smoking behavior and association of melanoma and nonmelanoma skin cancer in the Women's Health Initiative
Authors: Michael T. Henderson, Jessica T. Kubo, Manisha Desai, Sean P. David, Hilary Tindle, Animesh A. Sinha, Kristina Seiffert-Sinha, Lifang Hou, Catherine Messina, Nazmus Saquib, Marcia L. Stefanick, Jean Y. Tang
Journal: Journal of the American Academy of Dermatology (2014)
935-38 Restenosis After Coronary Angioplasty is Associated with the Activation Status of Circulating Phagocytes Before Treatment
Authors: Patrick W. Serruys, Anneke Pietersma, Marcel Kofflard, L. Elly A. de Wit, Theo Stijnen, Johan F. Koster, Wim Sluiter
Journal: Journal of the American College of Cardiology (1995)
Initial Experience With Partial Liquid Ventilation in Adult Patients With the Acute Respiratory Distress Syndrome
Authors: Ronald B. Hirschl, Thomas Pranikoff, Constance Wise, Michael C. Overbeck, Paul Gauger, Robert J. Schreiner, Ronald Dechert, Robert H. Bartlett
Journal: JAMA (1996)

<h3>Objective.</h3> —To evaluate the safety and efficacy of partial liquid ventilation (PLV). <h3>Design.</h3> —Before-after trial. <h3>Setting.</h3> —The surgical intensive care unit at the University of Michigan, Ann Arbor, from April to December 1994. <h3>Patients.</h3> —A consecutive sample of 10 patients aged 19 to 55 years with the acute respiratory distress syndrome who were receiving extracorporeal life support. <h3>Intervention.</h3> —Perflubron was administered into the trachea until the dependent zone of the lung was filled. Gas ventilation of the perflubron-filled lung was then performed (PLV). Volatilized perflubron replacement was repeated daily for from 1 to 7 days with a median cumulative dose of 38 mL/kg (range, 15 to 62 mL/kg). <h3>Main Outcome Measures.</h3> —Physiologic shunt and static pulmonary compliance. <h3>Results.</h3> —Physiologic shunt decreased from a median of 0.72 (range, 0.37 to 1.0) to 0.46 (range, 0.21 to 0.96) over the 72 hours following initiation of PLV (<i>P</i>=.01 by repeated measures analysis of variance). Static pulmonary compliance corrected for patient weight increased from a median of 0.16 mL/cm H<sub>2</sub>O per kilogram (range, 0.01 to 0.48 mL/cm H<sub>2</sub>O per kilogram) to 0.27 mL/cm H<sub>2</sub>O per kilogram (range, 0.05 to 1.11 mL/cm H<sub>2</sub>O per kilogram) over the same time period (<i>P</i>=.04 by repeated measures analysis of variance). Overall survival was five (50%) of 10 patients. Complications that were potentially associated with PLV included pneumothorax development in one patient and mucus plug formation in one patient. <h3>Conclusions.</h3> —Perflubron may be safely administered into the lungs of patients with severe respiratory failure receiving extracorporeal life support and may be associated with improvement in gas exchange and pulmonary compliance. (<i>JAMA</i>. 1996;275:383-389)
Exposure to aflatoxin B1 in animal-feed production plant workers.
Authors: J L Autrup, J Schmidt, H Autrup
Journal: Environmental Health Perspectives (1993)

The exposure to aflatoxin B1 (AFB) in animal-feed processing plants was assessed using binding of AFB to serum albumin. The albumin fraction was digested with pronase, and the digest was purified on a C18 Sepak column and an aflatest affinity column before quantification by ELISA. The level of detectability was 5 pg/mg albumin. The workers served as their own controls, as blood samples were taken upon return from vacation and after 4 weeks of work. A total of 7 of 45 samples were positive for AFB, with an estimated average daily intake of 64 ng AFB/kg body weight. The exposed workers had been disembarking cargos contaminated with AFB or working at places where the dust contained detectable amounts of AFB. The sera from the exposed workers had a significantly higher titer against an aflatoxin B1-epitope than a nonexposed Danish control group. The level of exposure could partly explain the increased risk of liver cancer in workers in the animal-feed processing industry.
LATENT GAS BACILLUS INFECTION COMPLICATING GANGRENE OF THE LOWER EXTREMITY
Authors: ROBERT R. LINTON
Journal: JAMA (1930)

In the treatment of gangrene of the lower extremity a line of demarcation is frequently awaited before amputation is performed. This form of treatment is usually carried out in order to save as much of the affected limb as possible, without at the same time jeopardizing the patient's life.  If the patient presents what is termed moist, or septic, gangrene with definite signs of an inflammatory process superimposed on the gangrenous one, a close watch is maintained in order to detect any signs that the infection is ascending. When there are signs of an ascending infection, one does not hesitate to advise amputation immediately, and at the same time insist on a high amputation, usually at or above the knee, so that the operation may be carried out in sound tissues with a good blood supply. On the other hand, when the patient presents dry, or what some surgeons term
Differentiation of Ion-Associated and Osmotically Driven Water Transport in Canine Airways
Authors: BEN T. CHEN, DONOVAN B. YEATES
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

We hypothesized that water transport associated with fluxes of Na+ and Cl− across airway epithelium coexists and is distinct from osmotically driven water transport. To investigate this, we anesthetized and mechanically ventilated dogs (n = 8) with warm humid air. The trachea of each dog was sequentially challenged with 250-mOsm and 950-mOsm mannitol aerosols given 30 min apart. Respiratory tract fluid output (RTFO) was collected at the posterior commissure at 6-min intervals. The percentages of mannitol in the RTFO were determined with fluorescent tracers and were subtracted from the RTFO to give airway secretory output (ASO). Unbound [Na+] and [Cl−] in the RTFO were measured. Following the 250-mOsm mannitol challenge, the ASO as well as its Na+ and Cl− contents increased. Following the 950-mOsm challenge, there was a further increase in ASO without any further increases in Na+ and Cl− contents. Increased mucociliary transport accounted for only part of the increase in ASO. These data are consistent with the hypothesis that net water transport into the airway lumen is the vectorial sum of the water fluxes associated with actively driven intracellular Na+ and Cl− transport and the water flux due to osmosis.
Mechanical stress enhances serotonin 2B receptor modulating brain natriuretic peptide through nuclear factor-κB in cardiomyocytes
Authors: Y LIANG, L LAI, B WANG, S JUANG, C CHANG, J LEU, K SHYU
Journal: Cardiovascular Research (2006)

Serotonin via serotonin 2B receptors (SR2BR) regulates cardiac embryonic development and adult heart functions. However, the role of SR2BR in the failing heart due to pressure overload is not well understood.Wistar rats of aortic banding and neonatal cardiomyocyte with mechanical stretch were used as cardiomyopathy models.After two weeks of aortic banding surgery, serum serotonin, mRNA and protein expression of SR2BR increased significantly. The selective SR2BR antagonist, SB215505 (SB), significantly reduced the increase in heart weight, decreased heart wall thickness, left ventricular mass and the expression of the brain natriuretic peptide (BNP) but did not attenuate the up-regulation of SR2BR protein expression in rats after aortic banding for three weeks. After following in vitro mechanical stretch of cardiomyocytes and incubation with serotonin 1 muM, the level of SR2BR and BNP protein increased time-dependently. When transfected by specific siRNA of SR2BR or pretreated with caffeic acid phenethyl ester in cardiomyocytes, the increase of nuclear factor-kappaB (NF-kappaB) translocation and BNP protein induced by serotonin incubation plus mechanical stretch were both reversed.SR2BR expression is involved in pressure-induced cardiomyopathy and its downstream signaling may involve NF-kappaB to modulate BNP expression in cardiomyocyte.