Blood letting and the therapeutic use of Hirudo medicinalis date back to ancient Egypt and the beginning of civilisation. Their popularity has varied over the years, reaching such a peak in Europe ...between 1825 and 1850 that supplies were exhausted. Towards the end of the century they fell out of favour and, during this period, the leech, once used by the physicians of emperors and influential academic surgeons, became associated with lay therapists and quackery. Leeches have enjoyed a renaissance in reconstructive microsurgery during the last 15 years, having been used by maxillofacial Br. J. Oral Maxillofac. Surg 41 (2003) 44 and other reconstructive surgeons to aid salvage of compromised microvascular free tissue transfers Laryngoscope 108 (1998) 1129; Br. J. Plast. Surg. 34 (1984) 358, replanted digits Int. J. Microsurg. 3 (1981) 265, ears Ann. Plast. Surg. 43 (1999) 427, lips Plast. Reconstr. Surg. 102 (1998) 358; J. Reconstr. Microsurg. 9 (1993) 327 and nasal tips Br. J. Oral Maxillofac. Surg. 36 (1998) 462. Peer-reviewed evidence suggests that the survival of compromised, venous-congested tissues is improved by early application of a leech J. Reconstr. Microsurg. 12 (1996) 165; Arch. Otolaryngol. Head Neck Surg. 114 (1988) 1395; Br. J. Plast. Surg. 45 (1992) 235. Leeches have also recently been used to treat a wide range of conditions, including periorbital haematomas Br. J. Ophthalmol. 75 (1991) 755, severe macroglossia Otolaryngol. Head Neck Surg. 125 (2001) 649; J. Laryngol. Otol. 109 (1995) 442 and purpura fulminans Ann. Plast. Surg. 35 (1995) 300. The first medicinal leech farm, Biopharm, was set up in Swansea in 1981 by Dr Roy Sawyer, and now supplies leeches to hospitals all over the world. In this paper, we summarise the history of treatment with Hirudo medicinalis from its origin to the present day, and take a brief look at the possible future of the annelid.
Summary Orthopaedic literature regarding lower limb joints reports a decline in operative management of rheumatoid arthritis since the 1980s. We investigated whether the demand for hand surgery for ...rheumatoid disease had changed over the last 13 years in our unit. Data for all patients undergoing operative treatment for rheumatoid arthritis of the hand and wrist over a 13-year period were analysed. Between 1996 and 2009, 1,069 patients with rheumatoid disease (182 men, 887 women) underwent a total of 1,109 hand surgery procedures. The operations were synovectomy (430, 39%), arthroplasty (252, 23%), arthrodesis (194, 18%) and tendon surgery (233, 21.0%). Linear regression analysis showed a statistically significant decrease in the number of synovectomies, arthroplasties and arthrodeses between 1996 and 2009, but no decrease in tendon surgery. We explore possible factors responsible for this change in operative workload.
Hurricane Katrina Levitt, Jeremy I; Whitaker, Matthew C
04/2009
eBook
On August 29, 2005, Hurricane Katrina slammed into the Gulf Coast states of Louisiana and Mississippi. The storm devastated the region and its citizens. But its devastation did not reach across ...racial and class lines equally. In an original combination of research and advocacy,Hurricane Katrina:
America's Unnatural
Disasterquestions the efficacy of the national and global responses to Katrina's central victims, African Americans.
This collection of polemical essays explores the extent to which African Americans and others were, and are, disproportionately affected by the natural and manmade forces that caused Hurricane Katrina. Such an engaged study of this tragic event forces us to acknowledge that the ways in which we view our history and life have serious ramifications on modern human relations, public policy, and quality of life.
Pregnancy after breast cancer Upponi, S.S; Ahmad, F; Whitaker, I.S ...
European Journal of Cancer,
04/2003, Letnik:
39, Številka:
6
Book Review, Journal Article
Recenzirano
The issue of pregnancy in patients previously treated for breast cancer is controversial. This paper reviews the literature using Medline and Embase databases over the last 50 years to address the ...issue. Overall survival in patients treated for breast cancer who subsequently become pregnant compares favourably with controls. This paper also addresses the effects of adjuvant therapy (loco-regional and systemic) on subsequent pregnancy. Introduction of a national registry of these patients may help inform such patients in the future.
Nitrous oxide (N2O) from agricultural soil is a significant source of greenhouse gas emissions. Biochar amendment can contribute to climate change mitigation by suppressing emissions of N2O from ...soil, although the mechanisms underlying this effect are poorly understood. We investigated the effect of biochar on soil N2O emissions and N cycling processes by quantifying soil N immobilisation, denitrification, nitrification and mineralisation rates using 15N pool dilution techniques and the FLUAZ numerical calculation model. We then examined whether biochar amendment affected N2O emissions and the availability and transformations of N in soils.
Our results show that biochar suppressed cumulative soil N2O production by 91% in near-saturated, fertilised soils. Cumulative denitrification was reduced by 37%, which accounted for 85–95 % of soil N2O emissions. We also found that physical/chemical and biological ammonium (NH4+) immobilisation increased with biochar amendment but that nitrate (NO3−) immobilisation decreased. We concluded that this immobilisation was insignificant compared to total soil inorganic N content. In contrast, soil N mineralisation significantly increased by 269% and nitrification by 34% in biochar-amended soil.
These findings demonstrate that biochar amendment did not limit inorganic N availability to nitrifiers and denitrifiers, therefore limitations in soil NH4+ and NO3− supply cannot explain the suppression of N2O emissions. These results support the concept that biochar application to soil could significantly mitigate agricultural N2O emissions through altering N transformations, and underpin efforts to develop climate-friendly agricultural management techniques.
•Soil N2O emissions and denitrification rates decreased in biochar-amended soil.•Soil N supply from mineralisation and nitrification rates increased in amended soil.•Immobilisation of NH4+ was increased by a small amount.•Biochar effect on N availability could not explain N2O suppression.
To assess the independent relation of neonatal cranial ultrasound (US) abnormalities in low birth weight (LBW) infants to cognitive outcomes at 6 years of age.
Prospective cohort study.
Six-year ...follow-up data were obtained on a regional birth cohort of LBW infants (< 2 kg) systematically screened as neonates with serial US. US abnormalities were dichotomized into isolated germinal matrix/intraventricular hemorrhage (GM/IVH) and parenchymal lesions/ventricular enlargement (PL/VE). Global cognitive outcomes (mental retardation, borderline intelligence, and normal intelligence) and selected specific cognitive abilities were assessed at 6 years of age with standardized instruments. Multivariate techniques were used to assess the effects of US independent of maternal social disadvantage at birth and other perinatal and neonatal risk factors.
The sample as a whole had a significantly elevated rate of mental retardation (MR; 5%), almost all moderate to profound in severity. PL/VE was independently related to MR (odds ratio OR, 65.8; confidence interval CI, 19.1 to 22.4) and borderline intelligence (OR, 3.7; CI, 1.3 to 10.8); isolated GM/IVH was more modestly related to MR (OR, 4.6; CI, 1.2 to 18.6) but not related to borderline intelligence. Approximately half of the cases of MR were attributable to PL/VE independent of other factors. Of non-US factors, the number of days receiving mechanical ventilation increased the risk for MR. Maternal social disadvantage increased the risk for borderline intelligence but not MR. Among children of normal intelligence, those with PL/VE, but not isolated GM/IVH, performed more poorly than those without US abnormalities on tests of visual perceptual organization but not on tests of language, memory, or quantitative skills.
Prevention of white matter injury would substantially improve cognitive outcomes for LBW infants.
Although high risk HPVs are associated with an increased risk of prostate cancer it is not known if they have a causal role. The purpose of this study is to investigate the potential role of human ...papilloma viruses (HPVs) in prostate cancer. The aims are (i) to investigate the presence and confirm the identity of high risk HPVs in benign prostate tissues prior to the development of HPV positive prostate cancer in the same patients, and (ii) to determine if HPVs are biologically active.
We used polymerase chain reaction (PCR) to identify HPVs in specimens from 52 Australian men with benign prostate biopsies who 1 to 10 years later developed prostate cancer. Immunohistochemistry (IHC) was used to assess the expression of HPV E7 oncoproteins, cytokeratin and prostate specific antigen (PSA). We used RNASeq data from The Cancer Genome Atlas (TCGA) to identify possible HPV RNA sequences in prostate cancer.
HPV screening using standard PCR was conducted on 28 of the 52 sets of benign and later prostate cancers. HPV L1 genes were identified in 13 (46%) benign and 8 (29%) of 28 later prostate cancers in the same patients. HPV E7 genes were identified in 23 (82%) benign and 19 (68%) of 28 subsequent prostate cancers in the same patients. The same HPV types were present in both the benign and subsequent prostate cancers in 9 sets of specimens. HPV type 16 was identified in 15% of benign and 3% of prostate cancers. HPV type 18 was identified in 26% of benign and 16% of prostate cancers. Small numbers of HPV types 45, 47, 76 and 115 were also identified. High confidence RNA-Seq evidence for high risk HPV types 16 and 18 was identified in 12 (2%) of the 502 TCGA prostate cancer transcriptomes. High risk HPV E7 oncoprotein was positively expressed in 23 (82%) of 28 benign prostate specimens but only in 8 (29%) of 28 of the later prostate cancer specimens. This difference is statistically significant (
= 0.001). Prostate specific antigen (PSA) was more highly expressed in 26 (50%) of 52 prostate cancer specimens as compared to prior benign prostate specimens in the same patients.
High risk HPVs are present in benign prostate tissues prior to the development of HPV positive prostate cancer. There is a significantly higher expression of HPV E7 oncoproteins in benign prostate tissues as compared to late prostate cancer that subsequently developed in the same patients. This observation suggests that HPV oncogenic activity is an early phenomenon in a majority of prostate oncogenesis. TCGA RNA-Seq data suggests that HPV is biologically active in some prostate tumour samples.
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