Computer memories: the history of computer form

This paper looks at the computer as a truly global form. The similar beige boxes found in offices across the world are analysed from the perspective of design history rather than that of the history of science and technology. Through the exploration of an archive of computer manufacturer's catalogues and concurrent design texts, this paper examines the changes that have occurred in the production and consumption of the computer in the context of the workplace, from its inception as a room-sized mainframe operated through a console of flashing lights, to the personal computer as a 'universal' form, reproduced by many manufacturers. It shows how the computer in the past has been as diverse as any other product, and asks how and why it now appears as a standardised, sanitised object. In doing so our relationship with the office computer, past and present is explored, revealing a complex history of vicissitude.</p

Can medical therapy mimic the clinical efficacy or physiological effects of bariatric surgery?

The number of bariatric surgical procedures performed has increased dramatically. This review discusses the clinical and physiological changes, and in particular, the mechanisms behind weight loss and glycaemic improvements, observed following the gastric bypass, sleeve gastrectomy and gastric banding bariatric procedures. The review then examines how close we are to mimicking the clinical or physiological effects of surgery through less invasive and safer modern interventions that are currently available for clinical use. These include dietary interventions, orlistat, lorcaserin, phentermine/topiramate, glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, pramlintide, dapagliflozin, the duodenal–jejunal bypass liner, gastric pacemakers and gastric balloons. We conclude that, based on the most recent trials, we cannot fully mimic the clinical or physiological effects of surgery; however, we are getting closer. A ‘medical bypass' may not be as far in the future as we previously thought, as the physician's armamentarium against obesity and type 2 diabetes has recently got stronger through the use of specific dietary modifications, novel medical devices and pharmacotherapy. Novel therapeutic targets include not only appetite but also taste/food preferences, energy expenditure, gut microbiota, bile acid signalling, inflammation, preservation of β-cell function and hepatic glucose output, among others. Although there are no magic bullets, an integrated multimodal approach may yield success. Non-surgical interventions that mimic the metabolic benefits of bariatric surgery, with a reduced morbidity and mortality burden, remain tenable alternatives for patients and health-care professionals

Superior Mesenteric Artery (Wilkie's) Syndrome as a Result of Cardiac Cachexia

Superior mesenteric artery (SMA) syndrome is a rare acquired disorder in which acute angulation of SMA causes compression of the third part of the duodenum between the SMA and the aorta, leading to obstruction. Loss of fatty tissue as a result of a variety of debilitating conditions is believed to be the etiologic factor causing the acute angulation. We report a case of an 86-year-old man with prolonged congestive heart failure and aortic stenosis in which SMA syndrome developed as a result of cardiac cachexia. Because of poor functional status and comorbidities, he was not a suitable candidate for decompressive surgery. Conservative treatment using a gastrostomy tube with jejunal extension led to improvement in nutritional status and resolution of symptoms

Laparoscopic Duodenojejunostomy for Superior Mesenteric Artery Syndrome - How I Do It

Introduction: Superior mesenteric artery (SMA) syndrome is a well-described condition involving mechanical compression of the third part of the duodenum by the SMA and the aorta, resulting in proximal obstruction. Discussion: Although there are a handful of case reports describing various techniques of laparoscopic duodenojejunostomy, a technique that involves creating the anastomosis in the infracolic compartment provides a more dependent stoma for the patient. Conclusion: This is a safe, effective, and relatively simple procedure for the experienced minimally invasive surgeon.Thomas C. Morris, Peter G. Devitt and Sarah K. Thompso