Elizabeth Hospital Research Articles

Surgery of the stomach and duodenum. By J. Shelton Horsley, M.D., F.A.C.S., LL.D., Attending Surgeon, St. Elizabeth's Hospital, Richmond, Va. Royal 8vo. Pp. 260, with 136 illustrations. 1933. London: Henry Kimpton. 35s. net

Journal Article Surgery of the stomach and duodenum. By J. Shelton Horsley, M.D., F.A.C.S., LL.D., Attending Surgeon, St. Elizabeth's Hospital, Richmond, Va. Royal 8vo. Pp. 260, with 136 illustrations. 1933. London: Henry Kimpton. 35s. net Get access Surgery of the Stomach and Duodenum. By J Shelton Horsley, M.D., F.A.C.S., LL.D., Attending Surgeon, St. Elizabeth's Hospital, Richmond, Va. Royal 8vo. Pp. 260, with 136 illustrations. 1933. London: Henry Kimpton. 35s. net. British Journal of Surgery, Volume 21, Issue 84, April 1934, Page 713, https://doi.org/10.1002/bjs.1800218423 Published: 05 December 2005

Operative surgery. By J. Shelton Horsley, M.D., LL.D., F.A.C.S., Attending Surgeon, St. Elizabeth's Hospital, Richmond, Va., and Isaac A. Bigger, M.D., Professor of Surgery, Medical College of Virginia, Surgeon-in-Chief, Medical College of Virginia Hospitals, Richmond, Va. With contributions by C. C. Coleman, M.D., F.A.C.S., John S. Horsley, jun., M.D., Austin I. Dodson, M.D., F.A.C.S., and Donald M. Faulkner, M.D. Fourth

Operative surgery. By J. Shelton Horsley, M.D., LL.D., F.A.C.S., Attending Surgeon, St. Elizabeth's Hospital, Richmond, Va., and Isaac A. Bigger, M.D., Professor of Surgery, Medical College of Virginia, Surgeon-in-Chief, Medical College of Virginia Hospitals, Richmond, Va. With contributions by C. C. Coleman, M.D., F.A.C.S., John S. Horsley, jun., M.D., Austin I. Dodson, M.D., F.A.C.S., and Donald M. Faulkner, M.D. Fourth

Conversation with Joseph V. Brady

Conversation with Joseph V. Brady

Severe persistent pulmonary hypertension of the newborn in a setting where limited resources exclude the use of inhaled nitric oxide: successful treatment with sildenafil

We present the case of a full term neonate with severe persistent pulmonary hypertension of the newborn (PPHN) after birth asphyxia cared for at the St. Elizabeth Hospital in Curacao, Netherlands Antilles. Although the child was ventilated with high pressures and was given high doses of cardiovascular pressors, the arterial oxygen levels remained low with an alveolar-arterial O2 gradient of 651 mmHg. As a last resort, sildenafil (1.5 mg/kg) was given via a nasogastric tube. This resulted in an immediate and sustained elevation of arterial oxygenation and subsequent complete recovery. After administration of sildenafil there was a transient hypotension which was corrected by a single bolus of saline. We discuss the current treatment modalities of persistent pulmonary hypertension of the newborn and the potential use of phosphodiesterase 5 inhibitors such as sildenafil in a situation where the standard of practice with inhaled nitric oxide and extracorporeal membrane oxygenation is not available.

Ethnicity May Influence Seasonal Affective Disorder

Ethnicity May Influence Seasonal Affective Disorder

Excess Bleeding After Surgery Found In Patients Taking SSRIs

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessExcess Bleeding After Surgery Found In Patients Taking SSRIsJim RosackJim RosackSearch for more papers by this authorPublished Online:19 Dec 2003https://doi.org/10.1176/pn.38.24.0013aA large new European study strongly suggests that patients taking SSRIs are nearly four times more likely to require a blood transfusion following surgery than patients who are not taking a serotonergic antidepressant.According to the new study, surgeons have not been in the practice of specifically noting whether patients are taking antidepressant medications prior to having a procedure. After analyzing data from the report, which appeared in the October 27 Archives of Internal Medicine, they may consider doing so.A group of researchers at St. Elizabeth Hospital and TweeSteden Hospital, both in Tilburg, the Netherlands, along with investigators at the University of Utrecht’s Institute for Pharmaceutical Sciences at Utrecht University, undertook a retrospective follow-up study of hospital and pharmacy data to look for relationships between the need for blood transfusion following orthopedic surgery and the use of serotonergic antidepressants.A total of 520 patients were classified as users of serotonergic antidepressants (any serotonin reuptake inhibitor, or venlafaxine and clomipramine), users of nonserotonergic antidepressants, or nonusers of an antidepressant. Patients taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, calcium channel blockers, and other medications commonly linked to bleeding problems were also identified.In addition, the researchers tracked whether each patient had diabetes, heart failure, hypertension, hepatic or renal disorders, or bleeding disorders.Of the 520 persons who underwent hip, knee, or spinal surgery from January 1, 1999, through December 31, 2000, 40 (8 percent) were taking antidepressants at the time of surgery. Of that group, 26 patients were taking a serotonergic antidepressant, and 14 were taking nonserotonergic antidepressants. Of those 26 patients, six required blood transfusions, while only one of the 14 patients taking nonserotonergic medications required a transfusion.“Use of [serotonergic] antidepressants was significantly associated with increased blood loss during surgery (1,019 mL of blood lost for users, compared with 582 mL for nonusers),” the authors concluded. “The risk of blood transfusion almost quadrupled for the serotonergic antidepressant group, compared with the [antidepressant] nonusers.”The elevated risk for transfusion was not found for nonserotonergic antidepressants, calcium channel blockers, or steroid treatment. Users of both aspirin and NSAIDs in the study had expectedly elevated risks for transfusion.The authors noted that there is some evidence that serotonin concentrations within blood platelets is reduced by SSRIs, leading to decreased platelet activation and more bleeding. This, they speculated, may be exacerbated by increased serotonin levels thought to be associated with surgical procedures. In essence, surgical patients experience the effect twice, once from their medication, then as a transient effect during surgery.The authors noted that Dutch orthopedic surgeons are now learning to pay attention to their patients’ medications more closely—looking and listening for the mention of any serotonergic antidepressant. They advise surgeons everywhere to follow that lead.An abstract of the study, “Relationship of Serotonergic Antidepressants and Need for Blood Transfusion in Orthopedic Surgical Patients,” is posted on the Web at http://archinte.ama-assn.org/cgi/content/abstract/163/19/2354. ▪ Arch Intern Med 2003 163 2354 ISSUES NewArchived

Olga Rudge and Ezra Pound: "What thou lovest well... "

A loving and admiring companion for half a century to literary titan Ezra Pound, concert violinist Olga Rudge was the muse who inspired the poet to complete his epic poem, The Cantos, and the mother of his only daughter, Mary. Strong-minded and defiant of conventions, Rudge knew the best and worst of times with Pound. With him, she coped with the wrenching dislocations brought about by two catastrophic world wars and experienced modernism's radical transformation of the arts. In this enlightening biography, Anne Conover offers a full portrait of Olga Rudge (1895-1996), drawing for the first time on Rudge's extensive unpublished personal notebooks and correspondence. Conover explores Rudge's relationship with Pound, her influence on him and his career, and her perspective on many details of his controversial life, as well as her own musical career as a violinist and musicologist and a key figure in the revival of Vivaldi's music in the 1930s. In addition to mining documentary sources, the author interviewed Rudge and family members and friends. The result is a vivid account of a highly intelligent and talented woman and the controversial poet whose flame she tended to the end of her long life. The book quotes extensively from the Rudge-Pound letters, an almost daily correspondence that began in the 1920s and continued until Pound's death in 1972. These letters shed light on many aspects of Pound's disturbing personality; the complicated and delicate balance he maintained between the two most significant women in his life, Olga and his wife Dorothy, for fifty years; the birth of Olga and Ezra's daughter Mary de Rachewiltz; Pound's alleged anti-Semitism and Fascist sympathies; his wartime broadcasts over Rome radio and indictment for treason; and his twelve-year incarceration in St. Elizabeth's Hospital for the mentally ill.

The Ins and Outs of Venous Access: Part II

Nutrition in Clinical PracticeVolume 17, Issue 3 p. 142-155 Invited Review The Ins and Outs of Venous Access: Part II Vincent W. Vanek MD, FACS, CNSP, Corresponding Author Vincent W. Vanek MD, FACS, CNSP vince_vanek@hmis.org Department of Surgery, St. Elizabeth Health Center, Youngstown, OhioCorrespondence: Vincent W. Vanek, MD, CNSP, FA, St. Elizabeth Hospital, 1044 Belmont Ave., P.O. Box 1790, Youngstown, OH 44501–1790. Electronic mail may be sent to vince_vanek@hmis.org.Search for more papers by this author Vincent W. Vanek MD, FACS, CNSP, Corresponding Author Vincent W. Vanek MD, FACS, CNSP vince_vanek@hmis.org Department of Surgery, St. Elizabeth Health Center, Youngstown, OhioCorrespondence: Vincent W. Vanek, MD, CNSP, FA, St. Elizabeth Hospital, 1044 Belmont Ave., P.O. Box 1790, Youngstown, OH 44501–1790. Electronic mail may be sent to vince_vanek@hmis.org.Search for more papers by this author First published: 01 June 2002 https://doi.org/10.1177/0115426502017003142Citations: 16AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume17, Issue3June 2002Pages 142-155 RelatedInformation

Hippocampal pathology in two mentally ill paraphiliacs

Paraphilias or disorders of sexual behavior have markedly increased in prevalence during the last decade. Until now no published neuropathological studies on paraphilia have appeared in the medical literature. A computerized search was done on all available medical and autopsy records of a large urban hospital (St. Elizabeths Hospital, Washington, DC) for any mention of deviant sexual behavior. Cases were then reviewed for presence of a history consistent with DSM-IV diagnoses of paraphilia. Two such cases were identified. Neuropathological examination in both cases revealed simple cell atrophy of pyramidal cells confined to different hippocampal subfields. Reactive astrocytosis was present in the outer strata of the affected regions. The pathological changes in the hippocampus resemble those reported after persistent stress or long-term chronic glucocorticoid administration. The accompanying astrocytosis indicates a reactive, ongoing process. The findings suggest new therapeutic interventions in the treatment of paraphilia.

Dr. Jeffrey M. Isner 1947–2001

View Large Image | View Hi-Res Image | Download PowerPoint SlideWe have lost a leader in cardiovascular gene therapy and therapeutic angiogenesis. Jeffrey M. Isner died on October 31, 2001, at his home in Weston, Massachusetts, at the age of 53. The cause was a heart attack.Jeff Isner was an interventional cardiologist who worked at St. Elizabeth's Hospital for two decades and was on the faculty of Tufts University. Jeff developed an early interest in the clinical syndrome of restenosis, the process by which a smooth muscle cell-rich lesion redevelops within the site of angioplasty dilatation 3 to 6 months after the initial procedure. When I met Jeff in 1989, he had spent several years exploring the role of intravascular laser devices to treat restenosis, but to no avail. He was firmly committed to alternative strategies to treat vascular diseases and quickly saw the promise of gene transfer. On numerous occasions, we discussed applications of gene transfer to blood vessel diseases and visited each other's laboratories, sharing methods and data from our respective vascular gene transfer studies. Jeff was firmly committed to developing the technology and to clinical applications.In the early 1990s, Jeff turned his attention to the burgeoning field of angiogenesis. He and others reasoned that vascular endothelial growth factor (VEGF) could induce new blood vessel growth in patients with peripheral vascular disease. After a series of proof-of-principle experiments in rabbits, Jeff put the idea to the test in 1994, being the first to coat angioplasty catheters with plasmid DNA encoding VEGF and to treat patients with peripheral vascular lesions. He coined the term “therapeutic angiogenesis,” and over the past 7 years he treated over 200 patients in various protocols for myocardial and peripheral angiogenesis.Many questions still need answers before gene therapy becomes standard treatment for vascular disease. Although his studies were promising, Jeff faced significant hurdles. A demonstration that intact collateral vessels—rather than leaky capillaries—were formed following treatment is lacking. Evidence that increased blood flow persisted for many months is not yet obtained. Jeff's early successes also placed him in the middle of the debate regarding the role of physicians conducting clinical studies sponsored by companies in which they had a financial interest.Last year, the Food and Drug Administration temporarily suspended the research conducted by Jeff, Vascular Genetics (a company he founded), and St. Elizabeth's, claiming that the researchers had failed to properly report the death of two patients participating in a study. Jeff said that the two patients had died of underlying cardiovascular disease, rather than the treatments. But the company acknowledged administrative problems with the research and corrected the situation. Jeff resumed his studies this past spring, and recently received a Center of Excellence in Gene Therapy grant from the National Heart, Lung, and Blood Institute. His patients gathered this summer at St. Elizabeth's to acknowledge his pioneering work and to encourage its continuation. Jeff was undaunted in spirit and vowed to continue his work.In addition to his clinical studies in angiogenesis, Jeff made other important scientific contributions. He was one of the first researchers to demonstrate the presence of endothelial cell progenitors in the bone marrow, and subsequent studies have established the role of endothelial cell progenitors in the process of angiogenesis.Jeff will be remembered as a courageous and committed physician. He cared deeply for his patients, and he was passionate in his desire to bring gene therapy to viable clinical treatments. The gene therapy and cardiovascular communities will miss his creativity and energy. Jeff was not only an innovator, he also inspired many trainees to pursue clinical research. It is tragic indeed that his life ended before he witnessed his and others’ research come to fruition—angiogenesis therapies on the market and routinely used to treat patients with atherosclerosis. This will be his legacy, and one that he would have thoroughly enjoyed.

Some Women Pioneers In Haematology

Some Women Pioneers In Haematology

"I cease not to yowl": Ezra Pound's letters to Olivia Rossetti Agresti

During the height of his own literary acclaim, Ezra Pound became notorious for supporting Mussolini, openly criticizing Franklin Delano Roosevelt during the war, and launching anti-Semitic tirades. Until now the depth and breadth of his many virulent views could only be imagined. I Cease Not to Yowl provides the most comprehensive and sustained record to date of Ezra Pound's pro-Fascist activities and involvement. This never-before-published correspondence began in 1937 and continued throughout Pound's incarceration at St. Elizabeths Hospital in Washington, D.C., where he was committed when he was found mentally unfit to stand trial for treason. The Pound-Agresti correspondence is a moving document, providing direct insight into Pound's recurring preoccupations, views, and opinions. These letters help dispel the view that Pound's fascism and anti-Semitism were anomalous and short-lived and that his Rome Radio ravings constituted mere rhetorical excesses of a mind under enormous pressure. On the contrary, Pound's correspondence with one who shared his pro-Fascist, pro-Axis, anti-Allies sentiments (though not his anti-Semitism or his impatience with the teachings of the Catholic church) establishes beyond doubt the permanence of his political and racial views.

Day Room: St. Elizabeths Hospital

Day Room: St. Elizabeths Hospital

The 10 Most Common Questions About Bartonella (Rochalimaea) Species

Is an infectious diseases specialist and director of the Special Microbiology Laboratory at The Medical Center of Central Massachusetts, Worcester, Massachusetts. She is involved in infectious diseases consultation, teaching, and research, and is an associate professor at the University of Massachusetts Medical School. Before she became associated with the Worcester facility, she was in the Infectious Diseases Section, St. Elizabeth's Hospital, Brighton, Massachusetts, where in 1986 she isolated an unidentified organism from the blood of a patient with endocarditis. In 1993, along with co-workers at St. Elizabeth's and the Centers for Disease Control and Prevention, she formally described the species Bartonella (Rochalimaea) elizabethae, naming it for St. Elizabeth's Hospital.

Psychopharmacology: Finding one's way

The paper recalls the experiences of the author over the past forty-eight years in a field which later became known as psychopharmacology. The author began in physical chemistry and traditional pharmacology. His interest in the nervous system stemmed from X-ray diffraction studies on the structure of living myelin, and led, by way of studies on the distribution of cholinesterases and the effects of atropine, to the study of the effects of drugs on the electrical activity of the brain in the conscious animal. At the clinical level it included studies of the effects of drugs on catatonic schizophrenic stupor. These studies took place before the discovery of chlorpromazine. They led to the creation, in 1951, of the Department of Experimental Psychiatry in Birmingham, England, the first department of its kind in the world. The department included neurochemical, electrophysiological, and animal behavior laboratories and a strong clinical facility (the Uffculme Clinic). The first blind trial of chlorpromazine was carried out in that department in 1953 and 1954. The existence of families of neuroregulatory compounds, having uneven distribution in the brain, and exerting regional chemical field effects in relation to function was postulated on the basis of experimental and clinical findings. The work of colleagues and participants in the various studies is gratefully acknowledged in the text. In 1954 the author served as convening executive secretary of the first International Symposium on Neurochemistry at Oxford, England, the first meeting of its kind. He came to the United States in 1957 and founded, and served as first director of, the new Clinical Neuropharmacology Research Center, now the Center for Neuroscience at St. Elizabeth's Hospital, Washington, DC. He directed this program from 1957 to 1963. Subsequent activities at Johns Hopkins, the World Health Organization, and the International Brain Research Organization (IBRO) are recalled. In 1961 he was elected first president of the American College of Neuropsychopharmacology. In looking back, he notes the sparse and personal nature of the field in the late 1940s and early 1950s, its explosive growth in the wake of the major clinical discoveries, and above all, the emergence of a new science through the interaction of neurochemistry, electrophysiology, studies of animal behavior, and the refinement of the clinical trial. He regards the emergence of concepts of regional chemistry of the brain as particularly significant, and feels that psychopharmacology is ideally positioned to act as an intermediary between classical pharmacology and quantrum biology. The transdisciplinary nature of psychopharmacology provides a template for a comprehensive psychiatry of the future--a discipline which is now positioned to lead.(ABSTRACT TRUNCATED AT 400 WORDS)

Laryngotracheal stenosis after percutaneous tracheostomy

AnaesthesiaVolume 50, Issue 3 p. 261-261 Free Access Laryngotracheal stenosis after percutaneous tracheostomy P. Ciaglia, P. Ciaglia St. Elizabeth Hospital, Utica, New York, USASearch for more papers by this authorW. Marx, W. Marx SUNY Health Science Centre, Syracuse, New York, USASearch for more papers by this author P. Ciaglia, P. Ciaglia St. Elizabeth Hospital, Utica, New York, USASearch for more papers by this authorW. Marx, W. Marx SUNY Health Science Centre, Syracuse, New York, USASearch for more papers by this author First published: March 1995 https://doi.org/10.1111/j.1365-2044.1995.tb04576.xCitations: 6AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume50, Issue3March 1995Pages 261-261 RelatedInformation

Repeat Victims of Violence in an Urban Trauma Center

Repeat victims of violence are overwhelming urban trauma centers, yet little is written about them in the medical literature. This study combined medical record and survey data to study urban trauma recidivism among patients presenting at the Emergency Department [ED] of St. Elizabeth Hospital in Youngstown, Ohio during a 4-year period. Two-fifths of urban trauma patients were repeat victims. Repeat victims were more likely to be poor African-American males, have substance abuse and mental health problems, and live in neighborhoods where violence is pervasive. Most have no health insurance. Demographic characteristics were less important in explaining recidivism than were the circumstances surrounding violent behaviors. ED physicians must be trained to take into account a wide variety of environmental, personal, and circumstantial factors in treating and managing urban trauma patients. This may require reforms in health care financing.

A comparison of different imaging modalities and direct inspection after periosteal stripping in predicting the invasion of the mandible by oral squamous cell carcinoma

To compare the predictability of orthopantomograms (OPG), bone scans, computerised tomography (CT), magnetic resonance imaging (MRI) and periosteal stripping with direct inspection in predicting both the presence and extent of tumor invasion of the mandible. Prospective study. Queen Elizabeth Hospital, Birmingham; Wordsley Hospital, Stourbridge; North Staffordshire Royal Infirmary, Stroke-on-Trent. 35 consecutive patients requiring a mandibular resection as part of their treatment for oral squamous cell carcinoma. The prediction of the extent of bone invasion for each of the investigations and direct inspection after periosteal stripping. The actual extent of invasion of the mandible from a detailed histological assessment. The OPG underpredicted the width and depth of invasion by on average 13 mm and 2 mm. There were 5 false negative reports. Bone scans overpredicted the width and depth by 14 mm and 15 mm with 1 false negative. CT scans underpredicted the width of invasion by 5 mm and overpredicted depth by 3 mm, but 7 false negatives were returned. MRI scans overpredicted width and depth of invasion by 19 mm and 10 mm with 1 false negative. Direct inspection after periosteal stripping underpredicted the width and depth of invasion by 5 mm and 3 mm with 1 false negative. OPG's and bone scans are useful for the initial assessment of all tumours in the region of the mandible. MRI is a more useful investigation than CT in the assessment of mandibular invasion by oral squamous cell carcinomas. Exploratory periosteal stripping at the time of resection can accurately predict the presence of tumour invading the mandible.

American political prisoners: prosecutions under the espionage and sedition acts

Foreword by Howard Zinn Introduction Background to the Sedition Laws and Their Use During the World War I Era The Espionage and Sedition Acts of 1917 and 1918: Then and Now The Selective Service Act Inside Golgotha: The Prison Experience of the World War I Sedition Act Inmates and Conscientious Objectors The Convictions Prison Discipline A Transfer to St. Elizabeth's Hospital for the Insane A Death The Most Indolent Man at Leavenworth Military Justice Isolation Relief from the Psychopathic Ward Release The Prisoners Federal Espionage and Sedition Act Prisoners State Anti-Sedition and Criminal Syndicalism Prisoners Political Prisoners Who Died While Incarcerated in Federal, Military, or State Prisons Conclusion Selected Bibliography Index

An interview with Janet Adler

Janet Adler, Ph.D., ADTR, has been a dance/movement therapist since 1963 when she trained with Marian Chace at St. Elizabeth's Hospital in Washington, D.C. She documented her work with autistic children in the award winning film “Looking For Me,” in 1968. A student of Mary Whitehouse, the first person to describe Authentic Movement, Janet further developed the work and, in 1981 founded and directed the Mary Starks Whitehouse Institute, the first school for Authentic Movement. Since moving to Northern California in 1985, she has been leading training groups in the study and practice of Authentic Movement. In 1988, she created a film about Authentic Movement called “Still Looking,” and completed her doctoral degree in mystical studies in 1992. She currently lectures, offers groups in the United States, Europe, and teaches in the Authentic Movement Institute in the San Francisco Bay Area.