Medical Literary Messenger (Vol. 5, No. 1, Fall/Winter 2017)

Home Visit / Melissa Fournier -- Stiffness / Hannah Shea -- Exile / Lane Falcon -- Good Intentions / Laura Foley -- Resurrection / Les Cohen -- Visits / Craig W. Steele -- That Last Night / Laura Foley -- Taste / Dan Campion -- Bumblebees Don’t Always Sting / Diane M. Parker -- Mental Status Exam / Melissa Fournier -- Dystrophia I / Ashley Purdy -- Muck Out / Mitchell Krockmalnik Grabois -- Endoscope / Lane Falcon -- Leftovers / Erynn Porter -- Another Autumn / Deborah Fleming -- Autism / Laura Foley -- Nearly Sunset / Craig W. Steele -- Palms / Mitchell Krockmalnic Grabois -- concentric / Michele Riedel -- Hashimoto’s / Hannah Shea -- Uncharted Territory / Katacha Díaz -- Skeletal Survey / Melissa Fournier -- Humanism in Medicine: Reflections from Diastole / Helen Lin -- Late Voyage / Laura Foley -- Sponge Bath / Dan Campion

Comment on "Multiconfiguration Dirac-Fock energy levels and radiative rates for Br-like tungsten" by S. Aggarwal, A.K.S. Jha, and M. Mohan [Can . J. Phys. 91 (2013) 394]

We report calculations of energy levels and oscillator strengths for transitions in W XL, undertaken with the general-purpose relativistic atomic structure package ({\sc grasp}) and flexible atomic code ({\sc fac}). Comparisons are made with existing results and the accuracy of the data is assessed. Discrepancies with the most recent results of S. Aggarwal et al. [Can. J. Phys. {\bf 91} (2013) 394] are up to 0.4 Ryd and up to two orders of magnitude for energy levels and oscillator strengths, respectively. Discrepancies for lifetimes are even larger, up to four orders of magnitude for some levels. Our energy levels are estimated to be accurate to better than 0.5% (i.e. 0.2 Ryd), whereas results for oscillator strengths and lifetimes should be accurate to better than 20%.Comment: Text 7p, Tables 4, will appear in Canadian Journal of Physics (2013

Fournier Gangreni’ni Taklit Eden Massif Pelvik Sellülit: Olgu Sunumu ve Literatür Derlemesi

Introduction: Fournier’s gangrene (FG), a localized form of necrotizing fasciitis (NF), is a rapidly progressive infectious disease that particularly affects the genital area. Cellulitis, however, is a mild disease that affects the skin and extremities. Case Report: We report a case involving a 71-year-old woman with a rash, extending from her thigh to her breast, which had begun two days prior to her visit to the ER. She was referred to our clinic with an initial diagnosis of extensive pelvic cellulitis mimicking Fournier's gangrene. Following the first assessment (blood glucose >500 mg/dL, pyrexia of 38.3 °C), she was admitted to the intensive care unit, where she received antibiotics and dressings and was monitored. Showing a good recovery, she was discharged in two weeks. Discussion: In the diagnosis and treatment of Fournier's gangrene, significant advancements have been made since it was first described by Jean-Alfred Fournier in 1883. The disease’s morbidity and mortality, however, is still between 25% and 35%. Conclusion: In patients with FG, early diagnosis and aggressive treatment are highly recommended.Giriş: Fournier gangreni Nekrotizan fasiitin localize formu olup, genellikle genital bölgede görülen ve hızlı ilerleyen enfeksiyöz bir hastalıktır. Sellülit ise daha çok ekstremite ve deride görülen daha ılımlı bir hastalıktır. Olgu Sunumu: 71 yaşında bayan hasta, öyküsünde son 2 günde gelişen her iki uyluktan başlayıp memelere kadar uzanan Fournier gangrenini taklit eden geniş pelvik sellülit ile başvurdu. İlk değerlendirmeden sonra (Kan şekeri >500 mg/dl, ateş 38,3 oC) hasta yoğun bakıma alındı, hastaya antibiyotik tedavisi verildi ve sık aralıklarla pansumanlar yapıldı. Hasta iki hafta içerisinde şifa ile taburcu edildi. Tartışma: 1883 yılında Jean-Alfred Fournier tarafından tanımlanan Fournier gangreni tedavisinde, o zamandan beri önemli gelişmeler olmuştur. Ancak, morbidite ve mortalitesi hala yüksektir (%25–35). Sonuç: Fournier gangrenli veya bizim hastamızdaki gibi geniş pelvik sellülitli hastalarda, tanı erken konulmalı ve tedavi gecikmeden yapılmalıdır

Erythroblastose accompagnant un syndrome à prédominance épileptoïde chez le Chien

Groulade Paul, Fournier J., Drieux Henri, Labié Ch. Érythroblastose accompagnant un syndrome à prédominance épileptoïde chez le chien. In: Bulletin de l'Académie Vétérinaire de France tome 114 n°1, 1961. pp. 37-41

EXPERIENCIA EN EL MANEJO DE LA GANGRENA DE FOURNIER EN HOSPITAL GENERAL TOLUCA DEL P.R. DR. NICOLÁS SAN JUAN DEL 1 DE ENERO DEL 2007 AL 31 DE DICIEMBRE DEL 2012 “HOSPITAL GENERAL TOLUCA P.R. DR. NICOLÁS SAN JUAN”

INTRODUCCIÓN: La gangrena de Fournier es una fascitis necrotizante fulminante y progresiva de origen polimicrobiano que afecta las regiones perianal, perineal, genital, abdominal y en el 95 % de los casos su etiología puede ser identificada. OBJETIVO: Analizar la experiencia en el manejo de pacientes con gangrena de Fournier en el Hospital General del P.R Toluca Dr. Nicolás San Juan. Durante 5 años. HIPOTESIS: Hipótesis de trabajo. Es un estudio descriptivo el cual no amerita hipótesis. MATERIAL Y MÉTODOS: Es un estudio observacional, descriptivo, transversal, analítico de los expedientes clínicos de pacientes de esta institución, con diagnostico de gangrena de Fournier, las variables que se analizaron fueron: edad, genero, causa de gangrena de fournier, numero de cirugías, tiempo entre eventos quirúrgicos, causa concomitante, índice de severidad (Laor) y antibiótico empleado. RESULTADOS: Se obtuvo una muestra de 14 pacientes en el periodo comprendido entre el 1 de enero del 2007 al 31 de diciembre del 2012. El intervalo de edad más afectado fue de 36-45 años, el género más común el masculino 13 (93%). La causa etiopatogenica mas común fue la urológica 8 (57%), la Diabetes Mellitus fue la comorbilidad mas común 8 (57%) y el antibiótico más usado fue cefalosporina de 3 generacion con 8 (57%) pacientes

J.J. Lankes (1884-1960): Woodcuts of Rural America

J.J. Lankes (1884-1960): Woodcuts of Rural America 1994 Marsh Art Gallery, University of Richmond Museums Introduction In 1917, while working at the Newton Arms Company factory in Buffalo, New York, Julius John (J. J.) Lankes created his first woodcut. His only implements were a graver, used to score rifle stocks, and a block of apple wood he had cut from a fallen tree. The experiment proved a turning point in the life of the thirty-one-year-old laborer, draftsman, and erstwhile art student. Rapidly mastering the difficult white on black woodcutting technique, he went on to produce some 1,300 designs over the next forty years. J. J. Lankes moved to Virginia in 1925. His artistic interests were ideally suited to the depiction of the landscape and houses of rural Tidewater Virginia in the 1920s. He saw in these deteriorating buildings the erosion by time and nature on man and his monuments. Lankes found and recorded, in its unretouched condition, a Williamsburg of decaying eighteenth-century structures together with more stately edifices. In virtually all his images, nature is a strong, often controlling, presence: beneath the surface of the natural object, it lurks as a mysterious, perhaps hostile, force. Generally, we are reminded of the power and endurance of nature, beside which man and his creations are shown as insignificant and transitory. Lankes\u27 major subject was pre-industrial America, rich in natural beauty, history, and sturdy people who bonded with the land. In his life as in his work Lankes remained a democrat -- a scoffer at pretension, a skeptic of entrenched authority, champion of the plain, and respecter of the natural. These values, combined with extraordinary technical skills, won praise from such notable contemporaries as John Taylor Arms, Charles Burchfield, Rockwell Kent, Ray Nash, Charles Harris Whitaker, and Carl Zigrosser. Several of these artists helped pave Lankes\u27 way as an illustrator of books by prominent authors of the 1920s and \u2730s, most notably Sherwood Anderson, Roark Bradford, Robert P. Tristram Coffin, Robert Frost, and Ellen Glasgow. Today, Lankes\u27 woodcuts remain evocative representations of American rural life of an earlier time. His unique vision is evident in this retrospective, which includes works ranging in date from 1917 to 1955. Carl Zigrosser wrote in 1942, his woodcuts are of the country, and have the smell and feel of the country in them. We not only perceive Lankes\u27 contribution to American scene printmaking but also take delight in his vision of early twentieth-century America and of universal themes. But one should bear in mind that however lofty the larger themes of his work may be, Lankes\u27 approach to art was primarily specific and not theoretical. Thus his more expansive ideas are to be inferred. As Sherwood Anderson observed in \u27\u27J.J. Lankes and His Woodcuts (1931), Lankes is a man deeply concerned with life, but it is his way to get at life through things. He feels always the reflected life in things, in barns, sheds back of barns, in little houses in which poor people live. \u27Look,\u27 he says. \u27Look again. Don\u27t you see it? .. . Life is here in these inanimate things people have touched. \u27 The things subsumed in these images reflect a broad and richly detailed spectrum. They range from historical figures and buildings to rural domestic life; from the seasons to commonplace natural objects; from literature to plowing; from Buffalo, New York, to the lower Chesapeake Bay; from the James River to the stars. The sheer variety of these subjects defies neat summarization; each image conveys a unique message. However all of them, to borrow a phrase from Gray\u27s Elegy, are short and simple annals evoking a rural past that has all but disappeared. Welford Dunaway TaylorJames A. Bostwick Professor of English, University of Richmond Richard WallerDirector, Marsh Art Gallery, University of Richmondhttps://scholarship.richmond.edu/exhibition-brochures/1005/thumbnail.jp