tbuckley/cabot-search huggingface dataset:
Surgical Site Infections After Foot and Ankle Surgery
Authors: Dane K. Wukich, Ryan L. McMillen, Nicholas J. Lowery, Robert G. Frykberg
Journal: Diabetes Care (2011)

This prospective study was designed to evaluate the rate of surgical site infection (SSI) after foot and ankle surgery in patients with and without diabetes.The study prospectively evaluated 1,465 consecutive foot and ankle surgical cases performed by a single surgeon.The overall SSI rate in this study was 3.5%, with significantly more infections occurring in individuals with diabetes than in those without (9.5 vs. 2.4%, P < 0.001). Peripheral neuropathy, Charcot neuroarthropathy, current or past smoking, and increasing length of surgery were significantly associated with SSI on multivariate analysis.This study demonstrates significant associations between the development of SSI and chronic complications of diabetes. We confirm previous findings that it is peripheral neuropathy and not diabetes itself that most strongly determines the development of postoperative infections in these surgical patients.
Is a patient's self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975
Authors: F. Efficace, A. Bottomley, E.F. Smit, P. Lianes, C. Legrand, C. Debruyne, F. Schramel, H.J. Smit, R. Gaafar, B. Biesma, C. Manegold, C. Coens, G. Giaccone, J. Van Meerbeeck
Journal: Annals of Oncology (2006)
Virotherapy of Ovarian Cancer With Polymer-cloaked Adenovirus Retargeted to the Epidermal Growth Factor Receptor
Authors: Joanne Morrison, Simon S Briggs, Nicola Green, Kerry Fisher, Vladimir Subr, Karel Ulbrich, Sean Kehoe, Leonard W Seymour
Journal: Molecular Therapy (2007)

Adenovirus gene therapy for intraperitoneal (IP) cancer is limited in clinical trials by inefficient tumor cell transduction and development of peritoneal adhesions. We have shown previously that normal virus tropism can be ablated by physically shielding the virus surface with reactive hydrophilic polymers and that linkage of novel ligands enables virus "retargeting" through chosen receptors. To achieve tumor-selective infection, polymer-coated virus was retargeted using murine epidermal growth factor (mEGF). The resulting mEGF-polymer coated adenovirus lost its normal broad tropism and transduced cells selectively via the EGF receptor (EGFR). We assessed whether this approach could be used to target lytic "virotherapy" using wild-type adenovirus (Ad5WT) in a peritoneal xenograft model of human ovarian cancer. Oncolytic activity of Ad5WT was retained following polymer coating and mEGF-retargeting. Importantly, adhesion formation was markedly decreased compared with the unmodified virus, and no dose-limiting toxicities were observed following treatment with mEGF-retargeted polymer-coated virus. Restricting virus tropism by physical coating, coupled with tumor-selective retargeting promises to combine good anticancer efficacy with acceptable toxicity, enabling application of elevated virus doses leading to an improved therapeutic outcome. Adenovirus gene therapy for intraperitoneal (IP) cancer is limited in clinical trials by inefficient tumor cell transduction and development of peritoneal adhesions. We have shown previously that normal virus tropism can be ablated by physically shielding the virus surface with reactive hydrophilic polymers and that linkage of novel ligands enables virus "retargeting" through chosen receptors. To achieve tumor-selective infection, polymer-coated virus was retargeted using murine epidermal growth factor (mEGF). The resulting mEGF-polymer coated adenovirus lost its normal broad tropism and transduced cells selectively via the EGF receptor (EGFR). We assessed whether this approach could be used to target lytic "virotherapy" using wild-type adenovirus (Ad5WT) in a peritoneal xenograft model of human ovarian cancer. Oncolytic activity of Ad5WT was retained following polymer coating and mEGF-retargeting. Importantly, adhesion formation was markedly decreased compared with the unmodified virus, and no dose-limiting toxicities were observed following treatment with mEGF-retargeted polymer-coated virus. Restricting virus tropism by physical coating, coupled with tumor-selective retargeting promises to combine good anticancer efficacy with acceptable toxicity, enabling application of elevated virus doses leading to an improved therapeutic outcome.
Electrocardiographic Patterns During Resuscitation After Experimentally Induced Ventricular Fibrillation
Authors: DAVID I. MILLER, MARVIN M. NACHLAS
Journal: Circulation Research (1964)

Continuous closed-chest massage (mechanized and manual) and ventilation with pure oxygen were performed for 15 and 30-minute periods, to maintain viability in 43 dogs with electrically induced ventricular fibrillation. External countershocks were applied and 32 of the animals lived more than 48 hours. The return of electrical and hemodynamic functions of the heart, as well as the function of the central nervous system, were graded arbitrarily to characterize recovery from poor to excellent. Electrocardiographic changes (lead II) were studied in detail and compared with the gross result of survival or death, and also with more quantitative characterization of recovery. When the initial electrocardiogram after defibrillation contained a P wave, the prognosis was most favorable. When the P wave was absent the amount of ST segment depression in the initial complex differentiated the better from the poorer results. During the first hour following defibrillation, a variety of arrhythmias was noted, as well as varying degrees of change in the R, T, and ST portions of the electrocardiogram. The most serious arrhythmias, in decreasing severity, were idioventricular rhythm, atrio-ventricular block, and multiple premature ventricular contractions. Recovery was poorest when multiple arrhythmias occurred. Changes in the voltage of the R and T waves could not be correlated with prognosis. However, more favorable recoveries were noted in animals without significant changes in the ST segment than in animals having ST segment depression greater than 4 mm.
Can minimally invasive puncture and drainage for hypertensive spontaneous Basal Ganglia intracerebral hemorrhage improve patient outcome: a prospective non-randomized comparative study
Authors: Guo-Qiang Wang, Shi-Qiang Li, Yong-Hua Huang, Wei-Wei Zhang, Wen-Wei Ruan, Jia-Zhen Qin, Ying Li, Wei-Min Yin, Yun-Jun Li, Zheng-Jun Ren, Ji-Qiang Zhu, Yun-Yan Ding, Jun-Qi Peng, Pei-Jian Li
Journal: Military Medical Research (2014)

The treatment of hypertensive spontaneous intracranial hemorrhage (ICH) is still controversial. The purpose of the present study was to investigate whether minimally invasive puncture and drainage (MIPD) could improve patient outcome compared with decompressive craniectomy (DC).Consecutive patients with ICH (≧30 mL in basal ganglia within 24 hours of ictus) were non-randomly assigned to receive MIPD (group A) or DC (group B) hematoma evacuation. The primary outcome was death at 30 days after onset. Functional independence was assessed at 1 year using the Glasgow Outcome Scale.A total of 198 patients met the per protocol analysis (84 in group A and 114 in group B). The initial Glasgow Coma Scale (GCS) score was 8.1 ± 3.4 and the National Institutes of Health Stroke Scale (NIHSS) score was 20.8 ± 5.3. The mean hematoma volume (HV) was 56.7 ± 23.0 mL, and there was extended intraventricular hemorrhage (IVH) in 134 patients. There were no significant intergroup differences in the above baseline data, except group A had a higher mean age than that of group B (59.4 ± 14.5 vs. 55.3 ± 11.1 years, P = 0.025). The cumulative mortalities at 30 days and 1 year were 32.3% and 43.4%, respectively, and there were no significant differences between groups A and B. However, the mortality for patients ≦60 years, NIHSS < 15 or HV≦60 mL was significantly lower in group A than that in group B (all P < 0.05). The cumulative functional independence at 1 year was 26.8%, and the difference between group A (33/84, 39.3%) and group B (20/114, 17.5%) was significant (P = 0.001). Multivariate logistic regression analysis showed that a favorable outcome after 1 year was associated with the difference in therapies, age, GCS, HV, IVH and pulmonary infection (all P <0.05).For patients with hypertensive spontaneous ICH (HV≧30 mL in basal ganglia), MIPD may be a more effective treatment than DC, as assessed by a higher rate of functional independence at 1 year after onset as well as reduced mortality in patients ≦60 years of age, NIHSS < 15 or HV≦60 mL.
The tortuous history of the implementation of early ambulation after delivery
Authors: K J van Stralen, E M Terveer, C J M Doggen, F M Helmerhorst, J P Vandenbroucke
Journal: Journal of the Royal Society of Medicine (2007)

One of earliest known risk factors for venous thrombosis is pregnancy. As long ago as 1718 Mauriceau described the ‘milk leg’. He suspected that, in pregnant women, a venous thrombosis in the leg was caused by ‘redundancy and metastasis’ of breast milk causing the swelling and pain.1,2 This idea lasted for more then a century and is generally accepted as the first description of a venous thrombosis.2 It was not until the 1850s that people realized venous thrombosis was not only a disease of women during or after pregnancy.2 By the beginning of the twentieth century venous thrombosis occurred in approximately eight out of 1000 women who had just given birth and was fatal in about a third of the cases.3

For a long period, even until after the Second World War, most clinicians believed that venous thrombosis was an infectious disease and could be contagious.4 In 1856 Virchow described venous thrombosis as a disease caused by clotting of the blood.5 He developed the now famous Triad of Virchow in which he described three major causes for venous thrombosis—damage to the vessel wall, changes in the blood composition, and slowing down of the bloodstream. Currently it is believed that the latter two risk factors are the most important for venous thrombosis. During pregnancy and shortly after delivery coagulation factors are increased which ensures that bleeding during delivery is not prolonged.6 At the end of the pregnancy, the velocity of the bloodstream also falls by 50%7,8 due to compression of the inferior vena cava.7,9 To ensure that the circulation returns to normal after childbirth, women are nowadays stimulated to get out of bed as early as possible. However, even though stasis had been postulated as a potential cause of venous thrombosis as early as 1856, early ambulation only became widely accepted after the Second World War, whilst immediate ambulation after delivery has only become a general rule since the 1980s. In the Netherlands gymnastic exercises start on the first day after delivery.10 Women are advised to get out of bed early and bruises, piles, and stitches are no reason not to participate. After a caesarean delivery exercises start on day two.10

Given that Virchow postulated the risk of venous stasis in 1856, and pregnancy was known to be an important risk factor for venous thrombosis, why was it not until the 1980s that early ambulation after delivery was generally implemented in hospitals? On what evidence was early mobilization based? These questions are the focus of our extensive literature search, the results of which are reported here.
Gender Differences in Survival among Adult Patients Starting Antiretroviral Therapy in South Africa: A Multicentre Cohort Study
Authors: Morna Cornell, Michael Schomaker, Daniela Belen Garone, Janet Giddy, Christopher J. Hoffmann, Richard Lessells, Mhairi Maskew, Hans Prozesky, Robin Wood, Leigh F. Johnson, Matthias Egger, Andrew Boulle, Landon Myer
Journal: PLoS Medicine (2012)

Background Increased mortality among men on antiretroviral therapy (ART) has been documented but remains poorly understood. We examined the magnitude of and risk factors for gender differences in mortality on ART. Methods and Findings Analyses included 46,201 ART-naïve adults starting ART between January 2002 and December 2009 in eight ART programmes across South Africa (SA). Patients were followed from initiation of ART to outcome or analysis closure. The primary outcome was mortality; secondary outcomes were loss to follow-up (LTF), virologic suppression, and CD4+ cell count responses. Survival analyses were used to examine the hazard of death on ART by gender. Sensitivity analyses were limited to patients who were virologically suppressed and patients whose CD4+ cell count reached >200 cells/µl. We compared gender differences in mortality among HIV+ patients on ART with mortality in an age-standardised HIV-negative population. Among 46,201 adults (65% female, median age 35 years), during 77,578 person-years of follow-up, men had lower median CD4+ cell counts than women (85 versus 110 cells/µl, p<0.001), were more likely to be classified WHO stage III/IV (86 versus 77%, p<0.001), and had higher mortality in crude (8.5 versus 5.7 deaths/100 person-years, p<0.001) and adjusted analyses (adjusted hazard ratio [AHR] 1.31, 95% CI 1.22–1.41). After 36 months on ART, men were more likely than women to be truly LTF (AHR 1.20, 95% CI 1.12–1.28) but not to die after LTF (AHR 1.04, 95% CI 0.86–1.25). Findings were consistent across all eight programmes. Virologic suppression was similar by gender; women had slightly better immunologic responses than men. Notably, the observed gender differences in mortality on ART were smaller than gender differences in age-standardised death rates in the HIV-negative South African population. Over time, non-HIV mortality appeared to account for an increasing proportion of observed mortality. The analysis was limited by missing data on baseline HIV disease characteristics, and we did not observe directly mortality in HIV-negative populations where the participating cohorts were located. Conclusions HIV-infected men have higher mortality on ART than women in South African programmes, but these differences are only partly explained by more advanced HIV disease at the time of ART initiation, differential LTF and subsequent mortality, and differences in responses to treatment. The observed differences in mortality on ART may be best explained by background differences in mortality between men and women in the South African population unrelated to the HIV/AIDS epidemic. Please see later in the article for the Editors' Summary.
The Treatment of Cancer by Injections
Authors: C. H. Moore
Journal: BMJ (1866)

The tumour consisted of two cysts, one large, and a small one with solid matter at the base; it weighed 181lbs., and was filled with a dark thick fluid, very like boiled glue.She was sick, pale, and very much depressed, for some hours after the operation; and complained of pain in the back.5 P.m.Pulse 129; respirations 60 in the minute.Ice and champagne were ordered.A suppository of a grain of muriate of morphia was administered. 9.30 P.M.She felt more comfortable, was less sick, and had less pain.Pulse 114; respirations 40; skin moist.A catheter was used.Sept. 19th, 8 A.M.She was very comfortable;slept well during the night; was not sick.Pulse 120, small; skin moist.She was not in much pain.Her countenance looked less anxious.She took wine, ice, and grapes.9 P.M.She had had a comfortable day, but had slight hiccup to-night.Pulse 132; respirations 36.She was ordered to have a suppository.Sept. 20th, 8 A.M.She had been in pain in the night.The abdomen was distended and tympanitic.She vomited once, and had hiccup.Her countenance was anxious.Pulse 106; respirations 34.She was ordered to have brandy and water in small quantities frequently, and a grain of solid opium every three hours.9 P.M.She had been very uncomfortable during the day, sick, and in pain; the abdomen was very much distended.The suppository was administered in the afternoon, and she was easier to-night.She had slept soundly, and was perspiring freely, and was not so sick.She took gin and water.Pulse 114; respirations 30.The countenance was less anxious; hiccup troublesome; urine plentiful.Sept. 21st, 8.30 A.M.She had passed a quiet night, slept well, and perspired freely.She had been sick once.Pulse 114.She began to menstruate last night.* Necrobiotic (Fr.nicrobiotiquO), from ve"OpS, dead, and 4ios, life, £ term deoting the deat of tissues during Vie life of the individual.
Combined Hormone Therapy at Menopause and Breast Cancer: A Warning—Short-Term Use Increases Risk
Authors: Leslie Bernstein
Journal: Journal of Clinical Oncology (2009)

years is necessary. 7 Not all patients are appropriately treated with preoperative chemoradiotherapy,particularlythosewithpathologicallynegativepelvic nodes. In the German trial reported by Sauer et al, 3 18% of patients who were considered to have cT3N0 disease and underwent initial surgery without preoperative therapy actually had pT1-2N0 disease. Thosepatientswouldhavebeenovertreatedhadtheyreceivedpreoperative therapy. The subset of patients with cT3N0 disease were not reported in the NSAPB R-03 trial. 4 However, for all patients who underwent surgery first, 4% had pT1-2N0 disease and would have therefore been overtreated had they received preoperative therapy. Although not ideal, administering preoperative therapy is still preferred to performing initial surgery, because even after preoperative chemoradiotherapy (which downstages tumors) 22% of patients will have lymph node‐pathologically positive disease at time of surgery. 8 Inpatientswhoundergosurgeryalone,thisnumberisashigh as 40%. These patients will then require postoperative chemoradiotherapy, in which inferior local control, higher acute and chronic toxicity,and—whenlowanastomosiswasperformed—inferiorfunctional results were demonstrated in the CAO/ARO/AIO 94 trial, 3 compared with preoperative chemoradiotherapy. Clearly, the development of more accurate methods to identify lymph node-positive disease, including improved imaging techniques and molecular markers, is essential as more patients are treated with preoperative chemoradiotherapy.Otherinvestigatorsadvocatetheselectionofpreoperative therapy on the basis of risk of a positive circumferential identified by high-resolution magnetic resonance imaging. 9 Highresolution magnetic resonance imaging was not used in the CAO/ ARO/AIO 94 and NSABP R-03 trials. The most pressing question is notwhetherpreoperativetherapyispreferred;rather,itishowtomore
Interventions designed to reduce sedentary behaviours in young people: a review of reviews
Authors: Stuart J H Biddle, Irene Petrolini, Natalie Pearson
Journal: British Journal of Sports Medicine (2013)

Background Leisure time is increasingly spent in sedentary pursuits such as screen-viewing (eg, television/DVD viewing and computer use), motorised travel, school/work and sitting-based socialising (eg, social media and chatting). Sedentary screen time, particularly TV, appears to play an important role in the aetiology of obesity due to its co-occurrence with other unhealthy behaviours such as snacking on energy-dense foods, low levels of physical activity and inadequate sleep. More information is needed on how to reduce sedentary behaviours. Most interventions have focused on young people and a number of systematic reviews exist on this topic. Objective To synthesise systematic reviews and meta-analyses of interventions aimed at decreasing sedentary behaviours among children and adolescents. Methods Papers were located from computerised and manual searches. Included articles were English language systematic reviews or meta-analyses of interventions aiming at reducing sedentary behaviour in children (&lt;11 years) and adolescents (12–18 years). Results Ten papers met the inclusion criteria and were analysed. All reviews concluded some level of effectiveness in reducing time spent in sedentary behaviour. When an effect size was reported, there was a small but significant reduction in sedentary time (highest effect size=−0.29; CI −0.35 to −0.22). Moderator analyses showed a trend favouring interventions with children younger than 6 years. Effective strategies include the involvement of family, behavioural interventions and electronic TV monitoring devices. Conclusions Results from systematic reviews and meta-analyses show that interventions to reduce children's sedentary behaviour have a small but significant effect. Future research should expand these findings examining interventions targeting different types of sedentary behaviours and the effectiveness of specific behaviour change techniques across different contexts and settings.
509 TLR-4 EXPRESSION IN THE LIVER AND IN THE IMMUNO-HEMATOPOIETIC SYSTEM IS NECESSARY IN THE IMMEDIATE PROCESS OF HEPATIC ISCHEMIA/REPERFUSION INJURY*
Authors: Z. Ben Ari, O. Pappo, O. Avlas, Y. Chepurko, E. Hochhauser
Journal: Journal of Hepatology (2011)
Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies
Authors: Joanna Szram, Susie J. Schofield, Martin P. Cosgrove, Paul Cullinan
Journal: European Respiratory Journal (2012)

While the acute respiratory risks of welding are well characterised, more chronic effects, including those on lung function, are less clear. We carried out a systematic review of published longitudinal studies of lung function decline in welders. Original cohort studies documenting two or more sequential measurements of lung function were reviewed. Meta-analysis was carried out on studies with suitable data on forced expiratory volume in 1 s (FEV 1 ). Seven studies were included; their quality (measured on the Newcastle–Ottawa scale) was good, although exposure assessment was limited and the studies showed significant heterogeneity. Five had data suitable for meta-analysis; the pooled estimate of the difference in FEV 1 decline between welders and nonwelders was -9.0 mL·year −1 (95% CI -22.5–4.5; p=0.193). The pooled estimates of difference in annual FEV 1 decline between welders and referents who smoked was -13.7 mL·year −1 (95% CI -33.6–6.3; p=0.179). For welders and referents who did not smoke the estimated difference was -3.8 mL·year −1 (95% CI -20.2–12.6; p=0.650). Symptom prevalence data were mainly narrative; smoking appeared to have the greatest effect on symptom evolution. Collectively, available longitudinal data on decline of lung function in welders and respiratory symptoms suggest a greater effect in those who smoke, supporting a focus on smoking cessation as well as control of fume exposure in this trade. Further prospective studies are required to confirm these findings.
Improvement of HbA1c during treatment with humanised anti-interleukin 6 receptor antibody, tocilizumab: Figure 1
Authors: Atsushi Ogata, Atsuyoshi Morishima, Toru Hirano, Yoshihiro Hishitani, Keisuke Hagihara, Yoshihito Shima, Masashi Narazaki, Toshio Tanaka
Journal: Annals of the Rheumatic Diseases (2010)

Type II diabetes mellitus (T2DM) and insulin resistance (IR) are associated with a systemic, chronic inflammatory response.1 Indeed, inflammatory markers such as interleukin 6 (IL-6) or C-reactive protein are independent risk factors for T2DM.2 Recent studies suggest that IL-6 is involved in the pathology of T2DM-related IR.3 Chronic exposure to IL-6 impairs insulin signalling in hepatocytes and adipocytes by stimulating the suppressor of cytokine signalling-1.3 4 Acute IL-6 infusion increases insulin sensitivity in muscle. The action of IL-6 on glucose homoeostasis is complex.

Although the influence of anti-tumour necrosis factor5 6 and anti-IL-1 treatments7 on glucose homoeostasis has been reported, no reports of the influence of anti-IL-6 treatment in humans have been published. We report that HbA1c decreased in diabetic patients with rheumatoid arthritis (RA) who were treated with a humanised anti-IL-6 antibody, tocilizumab (TCZ). …