Natural History Of Syphilitic Aortitis

No large studies of cardiovascular syphilis at necropsy have been reported since 1964. We examined at necropsy 90 patients who had characteristic morphologic findings of syphilitic aortitis. None had ever undergone cardiovascular surgery. With the exception of 2 cases seen more recently, the hearts and aortas of the 90 patients were examined and categorized by one of us (W.C.R.) from 1966 to 1990. All 90 had extensive involvement of the tubular portion of the ascending aorta by the syphilitic process, which spared the sinuses of Valsalva in all but 4 patients. The aortic arch was also involved in 49 (91%) of 54 patients and the descending thoracic aorta in 47 (90%) of 52 patients. Syphilis was the cause of death in 23 (26%) of the 90 patients. It was secondary to rupture of the ascending or descending thoracic aorta in 12, severe aortic regurgitation leading to heart failure in 10, and severe narrowing of the aortic ostium of the right coronary artery in 1 patient. Of the 40 patients who had undergone serologic testing for syphilis, 28 (70%) had a positive (reactive) finding. Those patients with a negative or nonreactive test or who did not undergo a serologic test for syphilis had morphologic and histologic findings in the aorta at necropsy similar to the findings of those patients who had had a positive serologic test for syphilis. In conclusion, cardiovascular syphilis has not disappeared. In patients with dilated ascending aortas, with or without aortic regurgitation, a serologic test for syphilis is recommended. If the findings are positive or if characteristic morphologic features of cardiovascular syphilis are suspected, irrespective of the results of the serologic tests, antibiotic therapy appears desirable. (C) 2009 Elsevier Inc. All rights reserved. (Am J Cardiol 2009;104:1578-1587)Integrative Biolog

Psychosocial Effects of Providing Nursing Care to Patients from a Multi-Casualty, School-Associated Shooting Event

Secondary traumatic stress describes symptoms consistent with post-traumatic stress disorder but that result from witnessing or experiencing the trauma of another individual through a helping relationship. The associated symptoms include intrusions, avoidance, and hyperarousal. Secondary traumatic stress is also associated with the development of compassion fatigue and burnout. The current state of the science identifies that secondary traumatic stress may affect those nurses who provide care to critically ill or injured patients. Research has most commonly examined the prevalence of secondary traumatic stress, compassion fatigue, and burnout among nurses in emergency department settings. While attention is frequently given to the actual and projected shortages in the nursing workforce in support of increasing the number of graduate nurses, there is a need to foster increased efforts to promote welfare, resilience, and retention of nurses in clinical settings. The purpose of this research was to explore the phenomena of secondary traumatic stress through the experiences of emergency department and trauma unit nurses who provided care to patients injured in a multi-casualty, school-associated shooting event to understand the psychosocial effects on their roles with these patients and to identify opportunities for strategies and interventions to mitigate secondary traumatic stress. Emergency nurses would typically experience a shorter duration of exposure to these patients but these encounters would be in the most acute phases of the traumatic event. In contrast, trauma specialty nurses would routinely experience longer exposure to these patients across the clinical work shift with additional exposure to family members of the patients. Using qualitative case series methodology, this research identified themes and findings that have implications for nursing practice and education, public policy, social change, and future research. These implications may translate to the development and implementation of primary, secondary, and tertiary prevention strategies to alleviate the prevalence of secondary traumatic stress among nurses and mitigate the incidence of mass shooting events. Benefits of this research may ultimately include improved mental health among nurses who care for critically ill and injured patients, better patient outcomes from the receipt of care from proficient nurses, retention of tenured nurses to serve as mentors for nurses entering clinical specialties, and abatement of rising health care costs through decreased expenses associated with nurse burnout and turnover

Intelligent Design and Creationism in our Schools

I describe and elaborate what both ID /Creationism and evolution , and their respective claims, are. I also explain which are allowed in a high school science classroom. Before one can decide whether any view belongs in the science classroom, one must know what the basis is for claiming any explanation in science; this is particularly important when dealing with origins . Finally, I will explain the legal precedence for understanding why ID and Creationism cannot be included in any science class. It may, however, still be included in the curriculum by teaching them in a humanities class

Vitamin D Inhibits Expression of Protein Arginine Deiminase 2 and 4 in Experimental Autoimmune Encephalomoyelitis Model Of Multiple Sclerosis

Indiana University-Purdue University Indianapolis (IUPUI)Multiple sclerosis (MS) is a disabling disease that afflicts an estimated two million people worldwide. The disease is characterized by degradation of the myelin sheath that insulates neurons of the central nervous system manifesting as a heterogeneous collection of symptoms. Two enzymes, protein arginine deaminases type 2 and 4 (PAD2 and PAD4) have been implicated to play an etiologic role in demyelination and neurodegeneration by catalyzing a post-translational modification of arginine peptide residues to citrulline. The pathogenesis of MS is poorly understood, though vitamin D deficiency is a well-associated risk factor for developing the disorder. Using the experimental autoimmune encephalomyelitis (EAE) model of MS we demonstrate vitamin D treatment to attenuate over-expression of PAD 2 and 4 in the brain and spine during EAE. In addition, we identify two molecules produced by peripheral immune cells, IFNɣ and IL-6, as candidate signaling molecules that induce PAD expression in the brain. We demonstrate vitamin D treatment to inhibit IFNɣ mediated up regulation of PAD2 and PAD4 both directly within the brain and by modulating PAD-inducing cytokine production by infiltrating immune cells. These results provide neuroprotective rational for the supplementation of vitamin D in MS patients. More importantly, these results imply an epigenetic link between vitamin D deficiency and the pathogenesis of MS that merits further investigation

SLIDES: Summary: Sources of Stress and the Changing Context of Natural Resources Law and Policy in the New West

Presenter: Dr. William R. Travis, Department of Geography, University of Colorado at Boulder 43 slide

Tradewinds and Traditions: Exploring the Archaeology of German Gulch

The German Gulch Archaeological Collection, a result of archaeological investigation at German Gulch by Butte, Montana cultural resource management firm GCM and the Beaverhead-Deerlodge National Forest during the late 1980s and early 1990s, represents a unique opportunity to explore ethnic relationships in rural Montana mining communities during the last half of the 19th century. The German Gulch site was a location of cultural interaction, between Overseas Chinese, European, and European American communities all focused on mining the mineral resources of the gulch. The collection presents an opportunity to test assumptions about bounded ethnic relationships as well as the process of cultural resource management. This thesis is the result of a project aimed at curating the German Gulch collection and exploring differences in curation techniques between the 1990s and the present day. This thesis is also an examination of the theoretical framework of Overseas Chinese archaeology and the changes in the discipline over the last 40 years. Themes that explore dynamic cultural interactions between German Gulch’s Overseas Chinese community and the largely European American community with which they interacted, are explored through the lens of the merchant as cultural ambassador and the possibility of encountering Chinese manufactured goods outside of Overseas Chinese community contexts