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Modern Era (modern + era)
Selected AbstractsHistory of the ketogenic dietEPILEPSIA, Issue 2008James W. Wheless Summary Fasting and other dietary regimens have been used to treat epilepsy since at least 500 BC. To mimic the metabolism of fasting, the ketogenic diet (KD) was introduced by modern physicians as a treatment for epilepsy in the 1920s. For two decades this therapy was widely used, but with the modern era of antiepileptic drug treatment its use declined dramatically. By the end of the twentieth century this therapy was available in only a small number of children's hospitals. Over the past 15 years, there has been an explosion in the use, and scientific interest in the KD. This review traces the history of one of the most effective treatments for childhood epilepsy. [source] Perpetual Imagining: Nationhood in a Global EraINTERNATIONAL STUDIES REVIEW, Issue 1 2003Sheila L. Croucher At the turn of the millennium, nations and nationalism persist in spite of scholarship that has both anticipated and proclaimed their demise. This article assesses the empirical reality and the state of scholarly analysis on nationhood in the context of globalization beginning with an overview and update of the definitional dilemma that surrounds the concept of the nation. Subsequent sections review competing conceptualizations of nation as either premodern, modern, or postmodern and synthesize existing theoretical insights, leading to the conclusion that even though nations are, indeed, constructed, nothing suggests that their construction was, is, or will be restricted to the modern era. [source] No Old Man Ever Forgot Where He Buried His Treasure: Concepts of Cognitive Impairment in Old Age Circa 1700JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2005Daniel Schäfer PhD Cognitive impairment in old age is one of the most important topics in modern geriatrics. This article discusses the historical dimensions of this phenomenon. To this end, a number of primary sources ranging from antiquity to the modern era are evaluated. Although a physiology and pathology of old age were conceptualized in Greco-Roman times, cognitive impairment in old age remained a marginal issue until the 17th century. Alternatively, after 1500, medicine boasted detailed theories on the physiology and pathology of old age. There are several possible explanations for this unusual situation. Underlying conflict between idealistic and materialistic views of man played a decisive role, for these concepts differed considerably regarding the intellectual and mental functioning of the soul as well as the effects of the passage of time. After Cartesianism and Iatromechanism had pushed these traditional boundaries back, the problem of cognitive impairment in old age was increasingly regarded as a physical illness and began to receive more attention. Just as its philosophical and theological context shaped early modern medicine, contemporary nonmedical disciplines such as genetics, (neuro-)biology, and the information sciences influence modern research. [source] Diagnosis of tuberculosis: Available technologies, limitations, and possibilitiesJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 5 2003Sanjay K. Garg Abstract Rapid diagnosis and treatment are important for preventing transmission of Mycobacterium tuberculosis. However, the diagnosis of tuberculosis continues to pose serious problems, mainly because of difficulties in differentiating between patients with active tuberculosis and those with healed lesions, normal mycobacterium boris BCG (Bacillus Calmette Guerin) vaccinated individuals, and unvaccinated Manteux positives. Physicians still rely on conventional methods such as Ziehl-Neelsen (ZN) staining, fluorochrome staining, sputum culture, gastric lavage, and other non-traditional methods. Although the tuberculin test has aided in the diagnosis of tuberculosis for more than 85 years, its interpretation is difficult because sensitization with nontuberculous mycobacteria leads to false-positive tests. There have been numerous unsuccessful attempts to develop clinically useful serodiagnostic kits for tuberculosis. A number of proteinaceous and nonprotein antigens (such as acyltrehaloses and phenolglycolipids) have been explored from time to time for the development of such assays but they have not proved to be clinically useful. It has been difficult to develop an ELISA utilizing a suitable antigen because M. tuberculosis shares a large number of antigenic proteins with other microorganisms that may or may not be pathogenic. With the advent of molecular biology techniques, there have been significant advances in nucleic acid-based amplification and hybridization, which are helping to rectify existing flaws in the diagnosis of tuberculosis. The detection of mycobacterial DNA in clinical samples by polymerase chain reaction (PCR) is a promising approach for the rapid diagnosis of tuberculous infection. However, the PCR results must be corrected for the presence of inhibitors as well as for DNA contamination. In the modern era of genetics, marked by proteomics and genomics, the day is not far off when DNA chip-based hybridization assays will instantly reveal mycobacterial infections. J. Clin. Lab. Anal. 17: 155,163, 2003. © 2003 Wiley-Liss, Inc. [source] Do anticoagulants improve survival in patients presenting with venous thromboembolism?JOURNAL OF INTERNAL MEDICINE, Issue 6 2003J. Kelly Abstract. Anticoagulants have been available since around 1940 and have become the standard of treatment for venous thromboembolism (VTE) for over four decades. However, as with other treatments which became established before the evidence-based era, there is a paucity of evidence from randomized controlled trials validating their effectiveness in preventing the most feared complication of VTE, recurrent fatal pulmonary embolism (PE). Only two such trials have been performed, the results of which conflict. The bulk of data supporting their use are derived from three sources. First, studies of thromboprophylaxis, and comparisons of shorter and longer courses of anticoagulants in high-risk patients with established VTE have clearly demonstrated their effectiveness in primary and late secondary prevention. Given that heparin has an immediate onset of action, anticoagulants should therefore also be effective in early secondary prevention, the proposed mechanism of action in the acute treatment of VTE. Secondly, studies of inadequately treated patients have consistently shown higher recurrence rates than in those adequately treated. Finally, comparisons of outcomes in untreated and treated historical series, and of untreated historical series to treated series in the modern era have shown substantially lower rates of fatal PE in anticoagulated patients. Because these differences are so marked, harmonize with our current understanding of the mechanism of action of anticoagulants and are supported by other evidence, it is much more likely that they at least partly reflect the effectiveness of anticoagulants as opposed to being explicable purely in terms of accumulated biases and a changing distribution of disease severity. [source] Humanitarian Intervention, Altruism, and the Limits of CasuistryJOURNAL OF RELIGIOUS ETHICS, Issue 1 2000Richard B. Miller This essay argues that the ethics of humanitarian intervention cannot be readily subsumed by the ethics of just war without due attention to matters of political and moral motivation. In the modern era, a just war draws directly from self-benefitting motives in wars of self-defense, or indirectly in wars that enforce international law or promote the global common good. Humanitarian interventions, in contrast, are intuitively admirable insofar as they are other-regarding. That difference poses a challenge to the casuistry of humanitarian intervention because it makes it difficult to reason by analogy from the case of war to the case of humanitarian intervention. The author develops this point in dialogue with Michael Walzer, the U.S. Catholic bishops, and President Clinton. He concludes by showing how a casuistry of intervention is possible, developing a motivational rationale that draws on the Golden Rule. [source] New opportunities in biological and chemical crystallographyJOURNAL OF SYNCHROTRON RADIATION, Issue 1 2002John R. Helliwell Banerjee [Proc. R. Soc. (1933), 141, 188,193] offered a new way of approaching the crystallographic phase problem which not only broke new ground beyond the `trial and error' structure solution method of that time but also heralded the extremely powerful direct methods of crystallography of the modern era from the 1970s onwards in chemical crystallography. Some 200000 crystal structures are known today. More complex crystal structures such as proteins required new experimental and theoretical methods to solve the phase problem. These are still evolving, and new methods and results involving synchrotron radiation at softer X-ray wavelengths (2,Å) are reported. In addition, an overview is given of the new opportunities that are possible for biological and chemical crystallography, especially via harnessing synchrotron radiation and neutron beams. [source] Nitric oxide in wound-healingMICROSURGERY, Issue 5 2005Jeff S. Isenberg M.D., M.P.H. Modulation of the complex process of wound-healing remains a surgical challenge. Little improvement beyond controlling infection, gentle tissue handling, and debridement of necrotic tissue has been had in the modern era. However, increasing appreciation of the process from a biomolecular perspective offers the potential for making significant strides in wound modulation. The bioactive molecule nitric oxide was found to have wide-ranging impact on cellular activities, including the cellular responses engendered by wound healing. Current research suggests that nitric oxide and several nitric oxide donors can exert biologic effects, although the particular net responses of cells contributing to wound repair are context-dependent. © 2005 Wiley-Liss, Inc. Microsurgery 25:442,451, 2005. [source] Dancing the Foreign Aid Appropriations Dance: Recurring Themes in the Modern CongressesPUBLIC BUDGETING AND FINANCE, Issue 2 2000Lewis G. Irwin In studying changes and continuities in the Congress since the early 1960s, a persistent set of "rules of the game' in the foreign aid appropriations process emerged from the analysis. These rules shape both the foreign aid appropriations process as well as the nature of the relationship between the executive and legislative branches on this issue. Utilizing involved actor accounts and detailed, descriptive case studies of the passage of foreign aid appropriations laws in the early 1960s and 1990s, I argue here that the foreign aid appropriations process is a routinely choreographed political production with important recurring continuities in the modern era. I describe and analyze recurring features of the foreign aid appropriations process that constrain or benefit the various political actors interested in thwarting, advancing, or using the aid program. Furthermore, I argue that from the legislative actors' perspective, the underlying continuities that define the legislative process trump the changes to the process in perceived importance, and that the actors view people, rather than procedure, as the most important determinant of success or failure. [source] Paradise Lost and the Question of LegitimacyRATIO, Issue 1 2004Wendy C. Hamblet This paper reconstructs the deficiencies of formal democracies to explain the internal injustices of the modern state, the self-righteous swaggering foreign policy of Western powers, and the dangerously over-simplified, polar logic characterizing the war rhetoric of the modern era. In a brief tour through the non-liberal tradition of democratic thought, drawing connections between the tragic mythological origins of Western understandings of self and world, the paper attempts to demonstrate that a failure to find alternate, healthier means of value-creation has caused Westerners, in their constructive identity work, to adhere themselves to their systems with a ritualized, ,religious' fervour. Legitimacy in the world becomes, in the final analysis, a simple matter of might. The possession of firearms and bread render self-sanctifying myths legitimating aggressions on the argument of ,good' powers fighting the battle against ,evil' contaminants. [source] Intraoperative Assessment of an Implantable Electrode Array for Cavernous Nerve StimulationTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2008Arthur L. Burnett ABSTRACT Introduction., Erectile dysfunction remains a major functional complication of radical prostatectomy in the modern era despite surgical techniques to preserve the penile autonomic nerve supply. Aim., To develop and evaluate a neurostimulation system for cavernous nerve electrical stimulation for future use as a chronic implantation device that neurotrophically promotes erectile function recovery following radical prostatectomy. Method., After radical retropubic prostatectomy, the neurovascular bundle was stimulated using a temporarily placed electrode array of an implantable neurostimulation system (20 Hz frequency, 260 µ seconds pulse width, 5 mA,60 mA amplitude up to 10 minutes), and penile circumference increases were measured. Main Outcome Measure., Increase in penile circumference. Results., Among 12 men (mean age 60.3 years) enrolled in this study, 6 (50%) demonstrated measurable increases in penile circumference in response to cavernous nerve stimulation. Among these six men, the mean increase was 5.0 mm (range 1.6 mm to 7.0 mm). Temporary surgical placement of the device was done with relative ease, and there was no evidence of injury to the neurovascular bundle. Conclusions., A chronic implantable nerve stimulation system for cavernous nerve stimulation having possible neuromodulatory effects on the recovery of penile erections after radical prostatectomy is feasible. Burnett AL, Teloken PE, Briganti A, Whitehurst T, and Montorsi F. Intraoperative assessment of an implantable electrode array for cavernous nerve stimulation. J Sex Med 2008;5:1949,1954. [source] A Risk Prediction Model for Delayed Graft Function in the Current Era of Deceased Donor Renal TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2010W. D. Irish Delayed graft function (DGF) impacts short- and long-term outcomes. We present a model for predicting DGF after renal transplantation. A multivariable logistic regression analysis of 24 337 deceased donor renal transplant recipients (2003,2006) was performed. We developed a nomogram, depicting relative contribution of risk factors, and a novel web-based calculator (http://www.transplantcalculator.com/DGF) as an easily accessible tool for predicting DGF. Risk factors in the modern era were compared with their relative impact in an earlier era (1995,1998). Although the impact of many risk factors remained similar over time, weight of immunological factors attenuated, while impact of donor renal function increased by 2-fold. This may reflect advances in immunosuppression and increased utilization of kidneys from expanded criteria donors (ECDs) in the modern era. The most significant factors associated with DGF were cold ischemia time, donor creatinine, body mass index, donation after cardiac death and donor age. In addition to predicting DGF, the model predicted graft failure. A 25,50% probability of DGF was associated with a 50% increased risk of graft failure relative to a DGF risk <25%, whereas a >50% DGF risk was associated with a 2-fold increased risk of graft failure. This tool is useful for predicting DGF and long-term outcomes at the time of transplant. [source] ARCHAEOMETRIC STUDY OF SHELLS OF HELICIDAE FROM THE EDERA CAVE (NORTHEASTERN ITALY),ARCHAEOMETRY, Issue 1 2009L. BONIZZONI The Edera Cave, near Aurisina in the Trieste Karst, retains a stratigraphy that extends from the Mesolithic to the modern era. At Sauveterrian layers, many specimens of Helix cincta are present, which are considerably crushed, and a small percentage of which are also blackened. Chemical analyses show that the blackened specimens were exposed to a temperature of between 500 and 550°C, and suggest that many others were destroyed by fire at temperatures of above 700°C. Consequently, only a part of the Helix cincta shells is assumed to be the residue of human meals, since several factors render plausible an accidental combustion of shells already present in the ground before the lighting of Mesolithic hearths. [source] Using information technology to improve surgical safetyBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2004D. W. Bates Patient Safety Leading Article Series, 2004 Dr David W Bates of Harvard Medical School, and Brigham and Women's Hospital, Boston, has for some years had a major interest in information technology in healthcare. Here, he continues our ,Patient Safety' series of leading articles, exploring how the tools of the modern era can help avoid harm in the surgical arena. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Kjelland's forceps in the new millennium.AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 5 2009Maternal, neonatal outcomes of attempted rotational forceps delivery Background:, The use of Kjelland's forceps is now uncommon, and published maternal and neonatal outcome data are from deliveries conducted more than a decade ago. The role of Kjelland's rotational delivery in the ,modern era' of high caesarean section rates is unclear. Aims:, To compare the results of attempted Kjelland's forceps rotational delivery with other methods of instrumental delivery in a tertiary hospital. Methods:, Retrospective review of all instrumental deliveries for singleton pregnancies 34 or more weeks gestation in a four-year birth cohort, with reference to adverse maternal and neonatal outcomes. Results:, The outcomes of 1067 attempted instrumental deliveries were analysed. Kjelland's forceps were successful in 95% of attempts. Kjelland's forceps deliveries had a rate of adverse maternal outcomes indistinguishable from non-rotational ventouse, and lower than all other forms of instrumental delivery. Kjelland's forceps also had a lower rate of adverse neonatal outcomes than all other forms of instrumental delivery. Conclusions:, Prudent use of Kjelland's forceps by experienced operators is associated with a very low rate of adverse maternal and neonatal outcomes. Training in this important obstetric skill should be reconsidered urgently, before it is lost forever. [source] GLOBALISATION: PAST AND PRESENTECONOMIC AFFAIRS, Issue 1 2010Dilip K. Das This article compares and contrasts the two modern eras of globalisation, namely the one that started in the mid-nineteenth century and ended on the eve of World War I, and the contemporary era. Although in both periods globalisation brought down national barriers and integrated economies and societies, there were distinct characteristic features of both periods. For example, the scale of global integration through trade and financial channels during the contemporary era was unmatched by the previous phase of globalisation. Furthermore, never in history had global integration involved so many countries and people, both in absolute numbers and as a percentage of the global population. [source] THE SOCIAL LIFE OF THE BYZANTINE GIFT: THE ROYAL CROWN OF HUNGARY RE-INVENTEDART HISTORY, Issue 5 2008CECILY J. HILSDALE Inspired by what anthropologists have called the social life of things, this article traces the shifting significations of the Royal Crown of Hungary. As an object central to notions of legitimacy in a land that served as a battleground for Eastern and Western powers during the medieval and modern eras, the crown over its contested history has come to be seen as a composite symbol of political independence and Western cultural affiliation. A thorough archaeology of the crown, however, reveals its origins as an eleventh-century diadem designed for a Byzantine princess. Subsequently this open crown was transformed into the closed crown worn by the king of a powerful and emerging Western monarchy. In the process of this re-gendering, the object was reconceived as papal gift. Bridging both instantiations is the crown's status as a gift, replete with associations of power and subjugation that anthropologists of gift-giving practices have long recognized. [source] Review of the functional surgical treatment of dystoniaEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2001Paul Krack A review of functional surgery for dystonia is presented. Recently renewed interest in stereotaxy for dystonia has followed the resurgence of pallidotomy and the introduction of deep brain stimulation (DBS) in Parkinson's disease (PD) in the early 1990s. However, even since the 1950s, small series of patients treated with ablative surgery have been carefully studied, providing useful information, notably regarding the tolerability of surgery. In the setting of dystonia, thalamotomy was first performed with substantial benefits, but some authors outlined the great variability in outcome, and the high incidence of operative side-effects. In the ,modern' era of functional surgery for movement disorders, the globus pallidus internus (GPi) has emerged to be currently the best target for dystonia, based on small series of patients published in the last few years. Both bilateral posteroventral pallidotomy (PVP) and bilateral pallidal stimulation, performed by several teams, have benefited a variety of patients with severe dystonia, the most dramatic improvements being seen in primary dystonia with a mutation in the DYT1 gene. Whereas patients with secondary dystonia have often shown a lesser degree of improvement, some publications have nevertheless reported major benefit. There is today a strong need for carefully controlled studies comparing secondary and primary dystonia, DYT1 and non-DYT1 dystonia, ablative surgery and DBS, with additional assessment of neuropsychological changes, especially in children treated with bilateral pallidal procedures. [source] | ||||||||||||||||