New forms for dominance: how a corporate lawyer created the American military establishment

The world of Elihu Root threw him and his fellow elites into a vortex of global change. His life "covered a period of extraordinary development and change throughout the world," he wrote, "a period in which consciously or unconsciously the whole world was in motion and when directing influences for good or evil were potent beyond experience." As the first member of the establishment elite that dominated United States national security institutions and policies for much of the twentieth century, Elihu Root's basic assumptions fundamentally shaped the modern military establishment. The decisions and choices he made at a critical time in the transformation of the American military had ramifications that still resonate today. The web of formal and informal connections that he wove between Wall Street, Washington and the military became conduits of power. The importance of the networks Root created did not dissipate with his departure, but persisted in the institutions he built and the cultural template he created for the elite policymakers who followed his lead. Through Root's influence, that power was deployed in ways that insured the creation of a national security state. The cultural world that produced Elihu Root and sustained his bid for wealth and upper class status had a direct impact on the American military establishment and the way in which America exercised military power. Elihu Root was a bridge between the continental power the United States once was and the world power it made itself

Biochemical effects of phosphate-containing replacement fluid for continuous venovenous hemofiltration

Aims: To examine biochemical effects of phosphate-containing replacement fluid (Phoxilium®) for continuous venovenous hemofiltration (CVVH). Methods: Retrospective comparison of respective serum biochemistry with sequential use of Accusol TM and Phoxilium, each over 48 h of CVVH. Results: We studied 15 critically ill patients. Accusol was switched to Phoxilium after 5 (4-8) days of CVVH. Respective serum biochemistry after 36-42 h of Accusol versus Phoxilium were: phosphate 1.02 (0.82-1.15) versus 1.44 (1.23-1.78) mmol/l, ionized calcium 1.28 (1.22-1.32) versus 1.12 (1.06-1.21) mmol/l, bicarbonate 24 (23-25) versus 20 (19-22) mmol/l, base excess 0 (-2 to 1) versus -4 (-6 to -3) mmol/l (p < 0.001). Cumulative phosphate intakes during respective periods were 69.6 (56.6-76.6) versus 67.2 (46.6-79.0) mmol (p = 0.45). Plasma strong ion differences were narrower with Phoxilium (p < 0.05), with similar strong ion gaps. No additional intravenous phosphate was given during Phoxilium use. Seven patients had serum phosphate >1.44 mmol/l. Conclusions: Phoxilium versus Accusol use during CVVH effectively prevented hypophosphatemia but contributed to mild hyperphosphatemia, and is associated with relative hypocalcemia and metabolic acidosis