The Black Swan, a metaphor for highly improbable, high impact events, warns us to understand the limits of our predictions and expect the “unknown unknowns” everywhere, from war to science and industry. From the earliest stages of discovery to post-marketing events, we argue that fundamentally the structure of pharmaceutical industry is driven by and impacted by both positive and negative Black...

Pulmonary artery (PA) rupture caused by a PA Swan-Ganz catheter is a rare complication but remains fatal in almost 50% of cases. False aneurysm of the PA is a rare presentation of PA rupture and should be considered as a possible diagnosis in a patient with a new lung mass after PA catheterization. We present a case of sudden-onset pulmonary alveolar hemorrhage during cardiovascular surgery due...

We examined whooper swans naturally infected with avian influenza virus (H5N1) to evaluate the possible zoonotic risk of swan feathers. Viruses were isolated from feather calami. Immunohistochemical testing revealed that virus antigens were present in the feather epidermis and feather follicle wall epidermis of some feathers. RT-PCR and genetic sequencing using paraffin sections of swan feather...

Newcastle disease virus (NDV) neuraminidase (NA) inhibition with elution-inhibition (EI) antibodies was estimated with the EI reaction using strain 575 isolated from a mute swan (Cygnus olor). The NA inhibition was assessed by persistent red blood cell (RBC) agglutination patterns, rather than by the standard test involving the reduction in the cleavage of added artificial substrates. The more ...

It has been found that after pulmonary valvotomy for pulmonary valvular stenosis with an intact interventricular septum a satisfactory fall in right ventricular pressure is not always achieved immediately. In order to explain this, Kirklin, Connolly, Ellis, Burchell, Edwards, and Wood (1953) concluded that before the development of open heart surgery there were two main reasons: (1) failure to ...

The Swan-Ganz balloon flotation catheter was introduced in 1970. It can be placed at the bedside within a few minutes even in critically ill patients. Although placement of these catheters is not difficult, some training and experience are required to avoid complications and for proper interpretation of the hemodynamic data that can be obtained by pulmonary artery catheterization. Because of th...

While the development of land for residential housing along the Swan and Canning Rivers in Perth, WA, Australia has reduced natural mosquito breeding sites, the role of backyard container breeding remains a relatively unknown factor. Local Governments responsible for these areas focus management and control efforts on low lying, tidally driven mosquito habitats to control Aedes vigilax (Skuse) ...

Despite studies clearly demonstrating significant benefit from increasing oxygen delivery in the peri-operative period in high risk surgical patients, the technique has not been widely accepted. This is due to a variety of reasons, including non-availability of beds, particularly in the pre-operative period, and the requirement of inserting a pulmonary artery catheter. There are now data that s...