Cardiopulmonary bypass: development of John Gibbon's heart-lung machine

To provide a brief review of the development of cardiopulmonary bypass. A review of the literature on the development of extracorporeal circulation techniques, their essential role in cardiovascular surgery, and the complications associated with their use, including hemolysis and inflammation. The advancement of extracorporeal circulation techniques has played an essential role in minimizing the complications of cardiopulmonary bypass, which can range from various degrees of tissue injury to multiple organ dysfunction syndrome. Investigators have long researched the ways in which cardiopulmonary bypass may insult the human body. Potential solutions arose and laid the groundwork for development of safer postoperative care strategies. Steady progress has been made in cardiopulmonary bypass in the decades since it was first conceived of by Gibbon. Despite the constant evolution of cardiopulmonary bypass techniques and attempts to minimize their complications, it is still essential that clinicians respect the particularities of each patient's physiological function.

Book Review of Laud Humphreys: Prophet of Homosexuality and Sociology by John F. Galliher, Wayne H. Brekhus, and David P. Keys

As an undergraduate sociology major, the only thing I learned about Oklahoman Laud Humphreys's classic, Tearoom Trade (1970) was how it violated standards of informed consent in social science research. As Galliher, Brekhus, and Keys recount in their biography, Laud Humphreys: Prophet of Homosexuality and Sociology, sociology graduate student Laud Humphreys needed to supplement his (quite likely, participant) observational research of men who had sex in public bathrooms (i.e., tearooms) in St. Louis in the mid-1960s with a formal questionnaire. Knowing that these men would never agree if they knew they were selected because of their participation in highly stigmatized and criminal behavior, Humphreys recorded their license plates, got their home addresses, and interviewed them as part of a "community health survey." Herein lies the deception and the major source of the controversy. What I didn't fully appreciate when I was a student, however, and what the authors so deftly illuminate is the importance of this work not only for debates around ethical issues of social science research, but more importantly, perhaps, for the study of sexuality, deviance, and urban life.

A review of the genus Speocarcinus Stimpson, 1859 (Crustacea: Brachyura: Xanthidae), with a key to its species and the description of one new species

Speocarcinus dentatus n. sp. is described from the southwestern Atlantic. The new species can be easily separated from its congeners by a suite of carapace and appendage characters. Speocarcinus Stimpson, 1859, now includes eight extant species, all from the Atlantic or Pacific coasts of the Americas. Additional characters to further differentiate between S. carolinensis Stimpson, 1859, and S. lobatus Guinot, 1969, and between S. granulimanus Rathbun, 1894, and S. spinicarpus Guinot, 1969 are documented. The lectotype of S. granulimanus is first described and a key to the species of Speocarcinus is provided.

John Ronald Reuel Tolkien fra critica e traduzione: Il caso della history of Middle-Earth

Il progetto si propone di tradurre parti di un’opera di John Ronald Reuel Tolkien inedita in Italia. Si tratta dell'introduzione e di un capitolo del settimo volume della History of Middle-Earth, che raccoglie l’intero corpus degli scritti tolkeniani e ne ricostruisce l’evoluzione narrativa. La tesi, oltre al capitolo dedicato alla traduzione dall'inglese all'italiano e alla discussione delle scelte traduttive, include: alcune notizie biografiche su Tolkien, con particolare riferimento agli anni giovanili; una discussione sulla legittimità di un suo eventuale inserimento all'interno dei canoni letterari; una discussione sulle differenti interpretazioni de Il Signore degli Anelli; una discussione sui contenuti di tutti i volumi della History e sulle difficoltà che sorgono nella traduzione delle opere di Tolkien.

Microsurgical reconstruction of the head and neck - Current practice of maxillofacial units in Germany, Austria, and Switzerland

Refinement in microvascular reconstructive techniques over the last 30 years has enabled an increasing number of patients to be rehabilitated for both functional and aesthetic reasons. The purpose of this study was to evaluate different microsurgical practice, including perioperative management, in Germany, Austria, and Switzerland. The DÖSAK collaborative group for Microsurgical Reconstruction developed a detailed questionnaire which was circulated to units in the three countries. The current practice of the departments was evaluated. Thirty-eight questionnaires were completed resulting in a 47.5% response rate. A considerable variation in the number of microsurgical reconstructions per year was noted. In relation to the timing of bony reconstruction, 10 hospitals did reconstructions primarily (26.3%), 19 secondarily (50%) and 9 (23.7%) hospitals used both concepts. In the postoperative course, 15.8% of hospitals use inhibitors of platelet aggregation, most hospitals use low molecular heparin (52.6%) or other heparin products (44.7%). This survey shows variation in the performance, management, and care of microsurgical reconstructions of patients. This is due in part to the microvascular surgeons available in the unit but it is also due to different types of hospitals where various types of care can be performed in these patients needing special perioperative care.

Delivery room management of very low birth weight infants in Germany, Austria and Switzerland--a comparison of protocols

Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR) management of very low birth weight infants (VLBWI, <1500g) at birth, despite regularly updated international guidelines.

Current state of evidence on 'off-label' therapeutic options for systemic lupus erythematosus, including biological immunosuppressive agents, in Germany, Austria and Switzerland--a consensus report

Systemic lupus erythematosus (SLE) can be a severe and potentially life-threatening disease that often represents a therapeutic challenge because of its heterogeneous organ manifestations. Only glucocorticoids, chloroquine and hydroxychloroquine, azathioprine, cyclophosphamide and very recently belimumab have been approved for SLE therapy in Germany, Austria and Switzerland. Dependence on glucocorticoids and resistance to the approved therapeutic agents, as well as substantial toxicity, are frequent. Therefore, treatment considerations will include 'off-label' use of medication approved for other indications. In this consensus approach, an effort has been undertaken to delineate the limits of the current evidence on therapeutic options for SLE organ disease, and to agree on common practice. This has been based on the best available evidence obtained by a rigorous literature review and the authors' own experience with available drugs derived under very similar health care conditions. Preparation of this consensus document included an initial meeting to agree upon the core agenda, a systematic literature review with subsequent formulation of a consensus and determination of the evidence level followed by collecting the level of agreement from the panel members. In addition to overarching principles, the panel have focused on the treatment of major SLE organ manifestations (lupus nephritis, arthritis, lung disease, neuropsychiatric and haematological manifestations, antiphospholipid syndrome and serositis). This consensus report is intended to support clinicians involved in the care of patients with difficult courses of SLE not responding to standard therapies by providing up-to-date information on the best available evidence.