Marie (Mary) Ester Brandt Holding a Child

Marie (Mary) Ester Brandt began keeping a diary on November 29, 1849. She began her first entry with the statement "Cronicle [sp] of events, for future refference[sp]." She made daily entries until February 13, 1869. Although different dates are given for her birth, the inscription on her headstone in the Hanover Cemetery lists her birth as May 14, 1823 and her death February 28, 1915. During the time of the diaries she lived in and around Hanover, Indiana. Her parents were born in Switzerland and emigrated to this country in 1818. Her father died in 1829 and her mother appears to have supported a large family of eight children by running a boarding house. Marie never married and lived with her unmarried sister Cecilia and for many years her unmarried brother Henry. The diaries recount daily domestic activities of washing, cleaning, gardening, canning, tending animals, and caring for the ill, as well as social activities such as visiting friends, attending lectures, taking painting classes, and trips into Madison. The Sunday entries always had attendance at chapel, preaching, and Sabbath School where she was a teacher. Interposed with these entries are observations about national events--the election of President Lincoln, Civil War battles, etc. Her diary gives readers a detailed picture of ordinary life during her lifetime

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable