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2021 ◽  

Frank Lloyd Wright (b. 1867–d. 1959) was perhaps the most well-known American architect, and one of the most important figures in modern architecture of the 20th century. After apprenticing in Chicago, importantly with Louis Sullivan in the firm of Adler and Sullivan, Wright began his independent practice in 1893 in the suburb of Oak Park. There, to 1909, Wright developed the spatially expansive and stylistically innovative type of the Prairie House. In this period Wright also designed his first major larger works, the Larkin Co. Administration Building, Buffalo, New York (1902–1906), and Unity Temple, Oak Park (1905–1909). Wright created a home and studio, Taliesin (1911–1913), amid the farmlands of his maternal family in southern Wisconsin. He also designed the Midway Gardens (1913–1914) in Chicago. Wright spent much of the next eight years in Tokyo working on the Imperial Hotel there, which survived the Great Kanto Earthquake in 1923. He also designed Hollyhock House (1919–1921) in Los Angeles for Aline Barnsdall, and in 1923–1925, living in Los Angeles, Wright built four “textile block houses.” Based at Taliesin, rebuilt after a second fire in 1925, and in winters from 1937 at Taliesin West near Scottsdale, Arizona, Wright worked with apprentices who formed the Taliesin Fellowship, to create such key works as Fallingwater (1934–1937), at Bear Run in southwestern Pennsylvania, and the S. C. Johnson Company Administration Building (1936–1939) in Racine, Wisconsin. Wright also wrote on new ideas for urbanism, especially his Broadacre City, first exhibited in New York City in 1935. The following year Wright built the first of many Usonian houses designed for clients with modest incomes and featuring many dimensional and material economies while maintaining a sense of spaciousness. In the last phase of his career following World War II, Wright and his apprentices continued to build houses for a national clientele, and such larger works as the S. C. Johnson Company Research Tower (1943–1950) in Racine, the H. C. Price Company Tower (1952–1956) in Bartlesville, Oklahoma, the Marin County Civic Center (1957–1970) in California, and his most influential late work, the Solomon R. Guggenheim Museum (1943–1959) in New York City. Wright’s later public buildings also included a series of religious structures, perhaps most notably Beth Sholom Synagogue, Elkins Park, near Philadelphia, Pennsylvania (1954–1959), and Annunciation Greek Orthodox Church, Wauwatosa, near Milwaukee, Wisconsin (1956–1963). Oxford University Press online bibliographies usually have 50–150 citations. This bibliography of scholarly literature on Frank Lloyd Wright is limited to about four hundred citations, which is a small percentage of the thousands of publications on Wright from his earliest years through his death in 1959 and continuing through 2020. For publications on Wright through 2002, see Donald Langmead, Frank Lloyd Wright: A Bio-Bibliography (Langmead 2003, cited under Research and Reference Guides), with its over 3,500 entries. For a complete list of references on Wright since 2002, the reader may profitably consult several relevant online scholarly databases such as the Avery Index to Architecture Periodicals, Bibliography of the History of Art, America: History and Life, and Applied Science and Engineering. In this Oxford Bibliography article, publications contemporaneous with the completion of Wright’s works have largely been omitted in favor of later historical accounts of them. For scholarly writing, if an author’s article or book chapter was substantially incorporated into a later book by that same author, references to such earlier articles or chapters have been omitted. Also, the large literature on Wright which is almost exclusively photographic or popular has been mostly omitted, with the exception of local and comprehensive guidebooks to Wright’s architecture. Photographic volumes with substantive essays have been included. Unpublished dissertations and theses have not been included. These can be searched through such databases as Dissertations & Theses Global.


2021 ◽  
pp. 299-304
Author(s):  
Edward Shorter

The Texas Medication Algorithm Project (TMAP), which featured atypical antipsychotics, was considered more of a commercial scam than science. TMAP had its beginning in 1995, when it was granted $1.7 million by the Robert Wood Johnson Foundation and various officials and academics in Texas to develop a model mental health treatment program for incorporation into public mental health and prison systems. The Foundation was related to the Johnson & Johnson company, and what they funded was a “guidelines” project for schizophrenia. The TMAP subverted scientific integrity; it appeared to be a purely scientific venture when it was actually a marketing venture for Risperdal. The guidelines produced by TMAP became the basis for the TMAP algorithms, giving a market edge to the J&J products in Texas.


2021 ◽  
Vol 11 (1) ◽  
pp. 361-371
Author(s):  
Ye. O. Loza ◽  
T. M. Homeluk ◽  
I. Ya. Krynytska ◽  
A. A. Hudyma ◽  
M. I. Marushchak

Diabetes mellitus and its complications are one of the most important causes of death. As a consequence of hyperglycemia in patients with diabetes there is an increased risk of concomitant diseases, and one of the important consequences of diabetes is impaired ability to repair. Healing disorders in diabetes are the result of complex pathophysiology involving vascular, neuropathic, immune and biochemical componentsAim of research: was to analyze changes in inflammation markers, microbial contamination and nonspecific immunity in skin homogenate of rats with diabetes after using sutures and skin glue.Material and research methods. Experimental studies were performed on 130 white outbred adult male rats, weight from 240 to 320 g. Diabetes mellitus was induced by using streptozotocin (Sigma, USA) (intraperitoneally - 65 mg / kg) with previous (15 minutes) injection of nicotinamide (intraperitoneally - 230 mg / kg). On the background of obesity, which was caused by 4 weeks of keeping animals on a high-fat diet. The development of diabetes mellitus 2 was confirmed by determining the concentration of glucose in the blood using a glucometer BAYER Contour Next (Germany). Animals of all groups (I-IV) under thiopental anesthesia (40 mg / kg body weight of rats) were made full-layer rectilinear incisions, 2 cm long, in the anterior-lateral region of the abdomen. All animals were divided into 4 experimental groups: І group (30 rats) – healthy rats, wound edges were sutured with Vicryl 5/0 thread (ETHICON, Inc. and Johnson & Johnson company (USA); ІI group (30 rats) – healthy rats, fixing of the wound edges was performed by applying skin glue Dermabond (ETHICON, Inc. and Johnson & Johnson company (USA)); ІII group (30 rats) – rats with diabetes mellitus, wound edges were sutured with Vicryl 5/0 thread; IV group (30 rats) – Rats with diabetes mellitus, fixing of the wound edges was performed by applying skin glue Dermabond. For control, all the results were compared with those of intact animals (10 rats). Animals were removed from the experiment on 3, 7, 28 days after surgery under thiopental anesthesia (90 mg / kg body weight of rats).The degree of contamination of the wound with opportunistic and pathogenic microflora determined by the level of urease activity using Nessler's reagent. Lysozyme activity was determined by bacteriolytic method, using as a substrate a suspension of bacteria Micrococcus lysodeicticus.Results. The obtained results prove that the wound process under conditions of streptozotocin diabetes mellitus in rats leads to a significantly greater contamination of the wound with pathogenic and opportunistic microflora and a decrease in nonspecific immunity, compared with healthy animals. Also, different effects of suture materials on the indicators of microbial contamination and immune protection were found: significantly larger deviations from the norm were found in groups of rats, where we used surgical sutures to fix the wound edges. When comparing the intensity of microbial contamination and nonspecific immunity in the long term (28 days) in the homogenate of the skin of rats with diabetes mellitus and the use of skin glue, the level of urease was 27.3% lower and the level of lysozyme 7.0% lower than in III group where we used surgical sutures.Changes in the activity of the antimicrobial enzyme lysozyme allow to assess the state of nonspecific immunity in the studied tissues. Many authors note a decrease in lysozyme activity in various bioliquids and tissues in diabetes mellitus. The results of our studies prove a significant decrease in the activity of lysozyme in the homogenate of postoperative skin wounds of rats with diabetes.Conclusion. Wound process in rats with experimental diabetes mellitus leads to reliable contamination of the wound with pathogenic and opportunistic microflora, as evidenced by increased urease activity, and reduced nonspecific immunity, characterized by reduced lysozyme activity in the homogenate of postoperative wound/scar tissue in relation to intact animals during all the terms of observation.In the remote period (28 days) in the skin homogenate of rats with diabetes where skin glue was used for wound closure, the level of urease was 27.3% lower and the level of lysozyme was 7.0% lower than that of rats with diabetes, where surgical sutures were used.


2019 ◽  
Vol 17 (1) ◽  
pp. 10-12
Author(s):  
Binod Kumar Mahaseth

Background: Surgical site infection is the most common post-surgical complication in surgical patients. The incidence of surgical site infection varies from 3-20% (or even more) in different part of the world. To date, the best method and material for skin closure has not been recommended by anybody. Triclosan is an antiseptic agent used for coating a suture material to prevent the infections. This case-controlled study was carried out to determine the comparative efficacy of sutures; Objective: This case-controlled study was carried out to determine the comparative efficacy of sutures: vicryl® and vicryl plus® (triclosan, an antiseptic incorporated with suture), in reducing surgical site infection in laparotomy for clean Gyn/Obs operations. Material and method: This case-controlled study was carried out in Dept. Of Gynae/Obs at Nepalgunj Medical College Teaching Hospital, Kohalpur. The period of the study was from Jan 2018 to January 2019. A total of 50 participants were enrolled in the study, who met the inclusion criteria. The patients were divided into two groups A and B, each consisting of 25 patients. The patients were allocated in the groups alternately to remove bias. The Group A consisted of patients where Vicrylplus® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 with triclosan) was used and Group B consisted of patients where vicryl ® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 alone) was used. Patients whose abdominal wounds were found infected, pus swab for culture were taken and sent for aerobic culture and sensitivity. All patients received ceftriaxone and metronidazole single dose before operations prophylactically. Result: Surgical site infection ingroup A was 3 cases out of 25 (12%) and in group B it was 6 cases out of 25(24%). Triclosan added polyglactin910 suture found to be statistically non significant concerning prevention of SSI as compared to polyglactin910 (p=0.472). The mean age of the study population was in group A was (29.76±7.47) and in group B was (27.12±7.42).


OP-Journal ◽  
2017 ◽  
Vol 33 (02) ◽  
pp. 166-172
Author(s):  
Patrick Haubruck ◽  
Gerhard Schmidmaier

ZusammenfassungPerioperative implantatassoziierte Infektionen stellen eine schwerwiegende Komplikation für betroffene Patienten dar, welche die Therapie prolongiert und große sozioökonomische Auswirkung haben kann. Trotz moderner Therapieoptionen und aufwendigen Bestrebungen, neue Therapien zu etablieren, verbleibt eine Inzidenz zwischen 1% nach Niedrigenergietraumata und bspw. 30% nach komplexen offenen Tibiafrakturen. Insbesondere offene Frakturen stellen ein hohes perioperatives Infektionsrisiko dar. Bis zu 60% dieser Frakturen sind bereits initial bakteriell kontaminiert. Die Therapie implantatassoziierter Infektionen ist häufig schwierig, daher sind effektive Präventionsmaßnahmen sinnvoll. Eine vielversprechende Option stellen hierbei mit Antibiotika beschichtete Implantate dar. In den letzten Jahren konnte erfolgreich eine Poly-D,L-Lactid- und Gentamycinbeschichtung für intramedulläre Implantate entwickelt und in die Klinik eingeführt werden. Erste In-vivo-Studien zeigten eine protektive Wirkung der Beschichtung auf Implantatbesiedelung. Weiterhin zeigten Studien ein vorteilhaftes Freisetzungsprofil des Gentamycins mit hoher initialer Freisetzung und effektiven lokalen Konzentrationen des Wirkstoffs. Die Ergebnisse der tierexperimentellen, In-vitro- und ersten klinischen Studien führten zur Entwicklung der ersten zugelassenen Implantate, die eine Beschichtung mit Antibiotika aufwiesen: Der „Unreamed Tibia Nail“ (UTN) PROtect™ (DepuySynthes, Johnson/Johnson Company, Inc New Jersey, USA), der im August 2005 die CE-Zulassung erhielt, und dessen Nachfolger, der Expert Tibia Nail (ETN) PROtect™, welches das aktuell einzige zur Verfügung stehende mit Antibiotikum beschichtete Implantat in der Frakturversorgung ist. Klinische Studien bestätigten die Effizienz der beschichteten Implantate zur Prävention von implantatassoziierten Infektionen vor allem bei Hochrisikopatienten. Die Verwendung des ETN PROtect sowohl bei frischen Frakturen als auch in Revisionsfällen kann das Auftreten von implantatassoziierten Infektionen und Osteomyelitis verhindern ohne gentamycinassoziierte Nebenwirkungen hervorzurufen. Antimikrobiell beschichtete Implantate stellen daher eine vielversprechende Option dar, implantatassoziierte Infektionen zu verhindern und damit die Komplikationsrate insgesamt zu reduzieren.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2061-2061
Author(s):  
Fiona L Dignan ◽  
Michael N Potter ◽  
Mark E Ethell ◽  
Joy Brennan ◽  
Louise McNamara ◽  
...  

Abstract Abstract 2061 The impact of graft versus host disease (GvHD) on readmission rates following allogeneic stem cell transplantation (SCT) has not been reported. We hypothesised that patients with GvHD would have a higher readmission rate than patients without GvHD. To test this hypothesis a retrospective review was undertaken of 187 consecutive patients who underwent allogeneic SCT from 1/1/2006 to 30/4/2009 at the Royal Marsden Hospital, UK. Data were collected from the electronic patient record. The study was approved by the hospital audit committee. Patient characteristics: male 113(60%), median age 47 yrs (17–70), diagnosis: acute leukaemia 123 (66%), chronic leukaemia 22 (12%), lymphoma 23 (12%), myeloma 12 (6%), other 7 (4%), donor: sibling 60 (32%), unrelated 115 (61.5%), cord 12 (6.5%), stem cell source: PBSC: 158 (84.5%), BM 17 (9%), cord 12 (6.5%); donor sex: M 111(59.5%), F 64 (34%), cord 12 (6.5%); match: full 130 (69.5%), mismatch 45 (24%), cord 12 (6.5%), conditioning intensity: full 73 (39%), reduced 114 (61%); use of alemtuzumab 113 (60%); GvHD prophylaxis: cyclosporine 116 (62%), mycophenolate 32 (17%), cyclosporine and methotrexate 26 (14%), other 13 (7%). Median follow up was 3.8 (2.2–5.5) yrs from transplant. 118/187 (63%) of patients developed GvHD. There was no significant difference between patients with or without GvHD except for increased use of alemtuzumab in the non-GvHD group (71% v 54%, p=0.024). GvHD was diagnosed clinically at the transplant centre. Biopsies were undertaken if the diagnosis was unclear. Glucksberg criteria were used to stage acute GvHD (aGvHD). NIH criteria were used to diagnose chronic GvHD (cGvHD). 45/118 (38%) had biopsy-proven GvHD. 88/187 (47%) had aGvHD (grades: 1 – 17 (9%), 2 – 43 (23%), 3 – 15 (8%), 4 –13 (7%)). 58/187 (31%) of patients had cGvHD. 36/187 (19%) had both acute and chronic GvHD (52 (29%) had aGvHD alone, 22 (12%) had cGvHD alone). 8 developed GvHD following donor lymphocyte infusion. 104/118 (88%) required steroid treatment. 61/118 (52%) commenced steroids within 100 days of transplant. 61/118 (52%) were steroid refractory. 5 patients had received a second allogeneic transplant for relapse to induce GvHD and graft versus malignancy effect. The median duration of initial transplant admission was 31 days (20–138) in GvHD group compared to 32 days (16–103) in non GvHD group (p=NS). 14 patients died during initial admission (5 in GvHD group, 9 in non-GvHD group) and were excluded from readmission analysis. The overall readmission rate was higher in GvHD patients (89% (101/113) v 41/60 (68%), p=0.001). In the first 100 days post transplant, 42/56 (75%) of patients who had started steroids were readmitted compared to 60/117 (51%) in patients who started steroids after day 100 or had no GvHD (p=0.003).Critical care unit admission was higher in the GvHD group (38/113 (34%) v 7/60 (12%),p=0.002). The mean total number of admission days was higher in the GvHD group (42 days v 18 days, p<0.001). 337/455 (74%) of readmission episodes and 231/305 (76%) of infection-related admissions were in the GvHD group. Patients with grade 3/4 GvHD had a higher readmission rate (96%) than grade 1/2 GvHD patients (88%) or patients with no aGvHD (74%). The mean total number of admission days was 57 days in grade 3/4 GvHD compared to 37 days in grade 1/2 GvHD. (p=0.054). Costs were calculated based on the 2010 hospital tariff (€600/inpatient day and €2295/CCU day). The mean cost of readmission was higher in GvHD patients (€32217) than in non-GvHD patients (€15622) (p=0.003). Mean cost was higher in grade3/4 GvHD (€44535) than in grade 1/2 GvHD (€27001) (p=0.032). These figures do not include drug or procedural costs. Overall survival was 42% at 2 years. Survival was higher in the GvHD group (48%) than in the non GvHD group (30%) (p=0.006). Survival was higher in those with grade 1/2 GvHD (55%) compared to those with grade 3 or 4 GvHD (14%) (p<0.001). There was no significant difference in survival in those with grade 1/2 GvHD (55%) and those with no GvHD (43%) (p=0.15). In conclusion, patients with GvHD had significantly higher readmission rates and longer duration of admission than those without GvHD. Despite the high readmission rate, patients with grades 1/2 GvHD had improved survival. Patients with grade 3/4 GvHD had a very high level of readmission and poor outcome. Improving strategies for managing GvHD may help to reduce post transplant readmission rates and the associated burden on the healthcare system. Disclosures: Dignan: Therakos, a Johnson and Johnson company: Honoraria, Research Funding. Shaw:Therakos, a Johnson and Johnson company: Honoraria, Speakers Bureau.


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