Legionnaire's Disease
Legionellosis is an infectious disease caused by bacteria belonging to the genus Legionella. Over 90% of legionellosis cases are caused by Legionella pneumophila, a ubiquitous aquatic organism that thrives in warm environments (25 to 45 °C with an optimum around 35 °C).
Legionellosis takes two distinct forms:
Legionnaires' disease is the more severe form of the infection and produces pneumonia.
Pontiac fever is caused by the same bacterium, but produces a milder respiratory illness without pneumonia which resembles acute influenza.
Legionnaires' disease acquired its name in 1977 when an outbreak of pneumonia occurred among people attending a convention of the American Legion in Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown bacterium, subsequently named Legionella.
Patients with Legionnaires' disease usually have fever, chills, and a cough, which may be dry or may produce sputum. Some patients also have muscle aches, headache, tiredness, loss of appetite, loss of coordination (ataxia) and, occasionally diarrhea and vomiting. Laboratory tests may show that patients’ renal functions, liver functions and electrolytes are deranged, including hyponatremia. Chest X-rays often show pneumonia with bi-basal consolidation. It is difficult to distinguish Legionnaires' disease from other types of pneumonia by symptoms or radiologic findings alone; other tests are required for diagnosis.
Persons with Pontiac fever experience fever and muscle aches without pneumonia. They generally recover in 2 to 5 days without treatment.
People of any age may get Legionnaires' disease, but the illness most often affects middle-aged and older persons, particularly those who smoke cigarettes or have chronic lung disease. Immunocompromised patients are also at elevated risk. Pontiac fever most commonly occurs in persons who are otherwise healthy.
The most useful diagnostic tests detect the bacteria in sputum, find Legionella antigens in urine samples, or compare antibody levels to Legionella in two blood samples obtained 3 to 6 weeks apart. The urine antigen test is simple, quick, and very reliable; however it will only detect Legionella pneumophila serogroup #1. Also the urine antigen test will not identify the specific subtyping so it cannot be used to match the patient with the environmental source of infection.
Current treatments of choice are the respiratory tract quinolones (levofloxacin, moxifloxacin, gemifloxacin) or newer macrolides (azithromycin, clarithromycin, roxithromycin). The antibiotics used most frequently have been levofloxacin and azithromycin. Macrolides are used in all age groups while tetracyclines are prescribed for children above the age of 12 and quinolones above the age of 18.Rifampin can be used in combination with a quinolone or macrolide.
Philadelphia, 1976
The first recognized outbreak occurred on July 27, 1976 at the Bellevue Stratford Hotel in Philadelphia, Pennsylvania, where members of the American Legion, a United States military veterans association, had gathered for the American Bicentennial. Within two days of the event’s start, veterans began falling ill with a then-unidentified pneumonia.
Numbers differ, but perhaps as many as 221 people were given medical treatment and 34 deaths occurred. At the time, the U.S. was debating the risk of a possible swine flu epidemic, and this incident prompted the passage of a national swine flu vaccination program. That cause was ruled out, and research continued for months, with various theories discussed in scientific and mass media that ranged from toxic chemicals to terrorism (domestic or foreign) aimed at the veterans.
The U.S. Centers for Disease Control and Prevention mounted an unprecedented investigation and by September, the focus had shifted from outside causes, such as a disease carrier, to the hotel environment itself. In January 1977, the Legionellosis bacterium was finally identified and isolated, and found to be breeding in the cooling tower of the hotel’s air conditioning system, which then spread it through the entire building. This finding prompted new regulations worldwide for climate control systems.
Sunday, January 27, 2008
Thursday, January 24, 2008
giggle
On their 50th wedding anniversary, a couple summed up the reason for their long and happy marriage.
The husband said, "I have tried never to be selfish. After all, there is no 'I' in the word 'marriage.'"
The wife said, "For my part, I have never corrected my husband's spelling." !
The husband said, "I have tried never to be selfish. After all, there is no 'I' in the word 'marriage.'"
The wife said, "For my part, I have never corrected my husband's spelling." !
Wednesday, January 23, 2008
In memoriam: William Francis Ganong
In Memoriam
William Francis ("Fran") Ganong was an outstanding scientist, educator, and writer. He was completely dedicated to the field of physiology, and to medical education in general. Chairman of the Department of Physiology at the University of California, San Francisco for many years, he received numerous teaching awards and loved working with medical students.
Over the course of 40 years and some 22 editions, he was the sole author of the best-selling Review of Medical Physiology and a coauthor of 5 editions of Pathophysiology of Disease: An Introduction to Clinical Medicine. He was one of the "deans" of the Lange group of authors, who produced concise medical textbooks and review books that to this day remain extraordinarily popular in print and now in digital formats. Dr. Ganong made a gigantic impact on the education of countless medical students and clinicians.
A general physiologist par excellence and a neuro-endocrine physiologist by subspecialty, Fran developed and maintained a rare understanding of the entire field of physiology. This allowed him to write each new edition (every 2 years!) of the Review of Medical Physiology as a sole author, a feat very few in any field of medical science could duplicate. The resulting consistency of style and tone is one of the many reasons for the great ongoing success of the book.
He was an excellent writer and far ahead of his time with his objective of distilling a complex subject into a concise presentation. Like his good friend, Dr. Jack Lange, founder of the Lange series of books, Fran took great pride in the many different translations of the Review of Medical Physiology and was always delighted to receive a copy of the new edition in any language.
He was a model author, organized and dedicated and enthusiastic. His book was his pride and joy, and like other best-selling authors, he would work on the next edition seemingly every day, updating references, rewriting as needed, and always ready and on time when the next edition was due to the publisher. He did the same with his other book, Pathophysiology of Disease: An Introduction to Clinical Medicine, a book that he worked on meticulously in the years following his formal retirement and appointment as an emeritus professor at UCSF. Fran Ganong will always have a seat at the head table of the greats of the art of medical science education and communication.
Fran Ganong died on December 23, 2007. All of us at Lange and McGraw-Hill who knew him and worked with him will miss him greatly.
William Francis ("Fran") Ganong was an outstanding scientist, educator, and writer. He was completely dedicated to the field of physiology, and to medical education in general. Chairman of the Department of Physiology at the University of California, San Francisco for many years, he received numerous teaching awards and loved working with medical students.
Over the course of 40 years and some 22 editions, he was the sole author of the best-selling Review of Medical Physiology and a coauthor of 5 editions of Pathophysiology of Disease: An Introduction to Clinical Medicine. He was one of the "deans" of the Lange group of authors, who produced concise medical textbooks and review books that to this day remain extraordinarily popular in print and now in digital formats. Dr. Ganong made a gigantic impact on the education of countless medical students and clinicians.
A general physiologist par excellence and a neuro-endocrine physiologist by subspecialty, Fran developed and maintained a rare understanding of the entire field of physiology. This allowed him to write each new edition (every 2 years!) of the Review of Medical Physiology as a sole author, a feat very few in any field of medical science could duplicate. The resulting consistency of style and tone is one of the many reasons for the great ongoing success of the book.
He was an excellent writer and far ahead of his time with his objective of distilling a complex subject into a concise presentation. Like his good friend, Dr. Jack Lange, founder of the Lange series of books, Fran took great pride in the many different translations of the Review of Medical Physiology and was always delighted to receive a copy of the new edition in any language.
He was a model author, organized and dedicated and enthusiastic. His book was his pride and joy, and like other best-selling authors, he would work on the next edition seemingly every day, updating references, rewriting as needed, and always ready and on time when the next edition was due to the publisher. He did the same with his other book, Pathophysiology of Disease: An Introduction to Clinical Medicine, a book that he worked on meticulously in the years following his formal retirement and appointment as an emeritus professor at UCSF. Fran Ganong will always have a seat at the head table of the greats of the art of medical science education and communication.
Fran Ganong died on December 23, 2007. All of us at Lange and McGraw-Hill who knew him and worked with him will miss him greatly.
Monday, January 21, 2008
Toilet-to-Tap!!
"Your golden retriever may drink water out of the toilet with no ill effects. But that doesn't mean humans should do the same."
So says the San Diego Union-Tribune, which recently joined the chorus of opponents, including San Diego's mayor, of a project that would blend supertreated sewage water in a local drinking water reservoir. The idea is known as toilet-to-tap. The idea appears to offend the sensibilities, at least in San Diego. It's an understandable first-flush reaction.
Alas, it seems time to let San Diegans and any other squirming citizens in on a little secret about water supplies: Toilet-to-tap is as old as civilization in California. And if San Diego shuns blended toilet water, it's about to become very thirsty.
With little groundwater underneath it, San Diego has two primary supplies. One is the Sacramento-San Joaquin Delta. The other is the Colorado River. The proposed project, to reuse water rather than drain it into the ocean, is one viable way to create a reliable local supply for San Diego. But it does involve the blending of treated water with untreated water in a reservoir. Technically, this means drinking treated toilet water. Is this really new for San Diego or most cities? Of course not.
Consider the Sacramento and San Joaquin rivers, whose waters San Diego draws from the Delta. More than 300 farmers and cities are permitted to discharge their treated and untreated runoff into these rivers. Counties empty treated sewage water into rivers every day. Almost 10 percent of the average flow of these rivers is discharge, according to San Diego's water department.
Yuck? Consider the Colorado River. Las Vegas dumps 58 billion gallons of treated sewage water into nearby Lake Mead, from whence it flows into the Colorado. More than 17 percent of this river's flow is discharge. Guess who drinks some of this, San Diego? It's not just the golden retriever.
California has no choice but to stretch its available water supplies. Reclamation and reuse projects can be some of the most affordable and reliable options. San Diego's water department has been trying to educate citizens about water recycling for years. A committee of the City Council has endorsed this recycling project, setting up yet another showdown before the full council this fall.
Short of drinking snowflakes as they fall, most of us are and will be drinking a blend that includes previously treated (as in flushed) water.
Squirm away. It's just a fact.
*Culled from an editorial of the Sacramento Bee
So says the San Diego Union-Tribune, which recently joined the chorus of opponents, including San Diego's mayor, of a project that would blend supertreated sewage water in a local drinking water reservoir. The idea is known as toilet-to-tap. The idea appears to offend the sensibilities, at least in San Diego. It's an understandable first-flush reaction.
Alas, it seems time to let San Diegans and any other squirming citizens in on a little secret about water supplies: Toilet-to-tap is as old as civilization in California. And if San Diego shuns blended toilet water, it's about to become very thirsty.
With little groundwater underneath it, San Diego has two primary supplies. One is the Sacramento-San Joaquin Delta. The other is the Colorado River. The proposed project, to reuse water rather than drain it into the ocean, is one viable way to create a reliable local supply for San Diego. But it does involve the blending of treated water with untreated water in a reservoir. Technically, this means drinking treated toilet water. Is this really new for San Diego or most cities? Of course not.
Consider the Sacramento and San Joaquin rivers, whose waters San Diego draws from the Delta. More than 300 farmers and cities are permitted to discharge their treated and untreated runoff into these rivers. Counties empty treated sewage water into rivers every day. Almost 10 percent of the average flow of these rivers is discharge, according to San Diego's water department.
Yuck? Consider the Colorado River. Las Vegas dumps 58 billion gallons of treated sewage water into nearby Lake Mead, from whence it flows into the Colorado. More than 17 percent of this river's flow is discharge. Guess who drinks some of this, San Diego? It's not just the golden retriever.
California has no choice but to stretch its available water supplies. Reclamation and reuse projects can be some of the most affordable and reliable options. San Diego's water department has been trying to educate citizens about water recycling for years. A committee of the City Council has endorsed this recycling project, setting up yet another showdown before the full council this fall.
Short of drinking snowflakes as they fall, most of us are and will be drinking a blend that includes previously treated (as in flushed) water.
Squirm away. It's just a fact.
*Culled from an editorial of the Sacramento Bee
Syndrome of the week
Von Willebrand disease (vWD) is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. It arises from a qualitative or quantitative deficiency of von Willebrand factor (vWF), a multimeric protein that is required for platelet adhesion. It is known to affect humans and in veterinary medicine, dogs. There are four types of hereditary vWD. Other factors including ABO blood groups may also play a part in the severity of the condition.
The various types of vWD present with varying degrees of bleeding tendency. Severe internal or joint bleeding is rare (only in type 3 vWD); bruising, nosebleeds, heavy menstrual periods (in women) and blood loss during childbirth (rare) may occur. Death may occur.
When suspected, blood plasma of a patient needs to be investigated for quantitative and qualitative deficiencies of vWF. This is achieved by measuring the amount of vWF in a vWF antigen assay and the functionallity of vWF with a glycoprotein (GP)Ib binding assay, a collagen binding assay or, a ristocetin cofactor activity (RiCof) or ristocetin induced platelet agglutination (RIPA) assays. Factor VIII levels are also performed as factor VIII is bound to vWF which protects the factor VIII from rapid breakdown within the blood. Deficiency of vWF can therefore lead to a reduction in factor VIII levels. Normal levels do not exclude all forms of vWD: particularly type 2 which may only be revealed by investigating platelet interaction with subendothelium under flow (PAF), a highly specialized coagulation study not routinely performed in most medical laboratories.
Acquired vWD can occur in patients with autoantibodies. In this case the function of vWF is not inhibited but the vWF-antibody complex is rapidly cleared from the circulation.
A form of vWD occurs in patients with aortic valve stenosis, leading to gastrointestinal bleeding (Heyde's syndrome). This form of acquired vWD may be more prevalent than is presently thought.
Acquired vWF has also been described in the following disorders: Wilms' tumour, hypothyroidism and mesenchymal dysplasias.
Patients with vWD normally require no regular treatment, although they are always at increased risk for bleeding. Prophylactic treatment is sometimes given for patients with vWD who are scheduled for surgery. They can be treated with human derived medium purity factor VIII concentrates complexed to vWF(antihemophilic factor, more commonly known as Humate-P®) Mild cases of vWD can be trialled on desmopressin (1-desamino-8-D-arginine vasopressin, DDAVP) (desmopressin acetate, Stimate®), which works by raising the patient's own plasma levels of vWF by inducing release of vWF stored in the Weibel-Palade bodies in the endothelial cells.
vWD is named after Erik Adolf von Willebrand, a Finnish paediatrician (1870–1949). He first described the disease in 1926.
The various types of vWD present with varying degrees of bleeding tendency. Severe internal or joint bleeding is rare (only in type 3 vWD); bruising, nosebleeds, heavy menstrual periods (in women) and blood loss during childbirth (rare) may occur. Death may occur.
When suspected, blood plasma of a patient needs to be investigated for quantitative and qualitative deficiencies of vWF. This is achieved by measuring the amount of vWF in a vWF antigen assay and the functionallity of vWF with a glycoprotein (GP)Ib binding assay, a collagen binding assay or, a ristocetin cofactor activity (RiCof) or ristocetin induced platelet agglutination (RIPA) assays. Factor VIII levels are also performed as factor VIII is bound to vWF which protects the factor VIII from rapid breakdown within the blood. Deficiency of vWF can therefore lead to a reduction in factor VIII levels. Normal levels do not exclude all forms of vWD: particularly type 2 which may only be revealed by investigating platelet interaction with subendothelium under flow (PAF), a highly specialized coagulation study not routinely performed in most medical laboratories.
Acquired vWD can occur in patients with autoantibodies. In this case the function of vWF is not inhibited but the vWF-antibody complex is rapidly cleared from the circulation.
A form of vWD occurs in patients with aortic valve stenosis, leading to gastrointestinal bleeding (Heyde's syndrome). This form of acquired vWD may be more prevalent than is presently thought.
Acquired vWF has also been described in the following disorders: Wilms' tumour, hypothyroidism and mesenchymal dysplasias.
Patients with vWD normally require no regular treatment, although they are always at increased risk for bleeding. Prophylactic treatment is sometimes given for patients with vWD who are scheduled for surgery. They can be treated with human derived medium purity factor VIII concentrates complexed to vWF(antihemophilic factor, more commonly known as Humate-P®) Mild cases of vWD can be trialled on desmopressin (1-desamino-8-D-arginine vasopressin, DDAVP) (desmopressin acetate, Stimate®), which works by raising the patient's own plasma levels of vWF by inducing release of vWF stored in the Weibel-Palade bodies in the endothelial cells.
vWD is named after Erik Adolf von Willebrand, a Finnish paediatrician (1870–1949). He first described the disease in 1926.
Friday, January 18, 2008
Adieu,Robert "Bobby" Fischer.
On Friday, January 18, 2008, chess master Bobby Fischer died at age 64, the same number, Susan Polgar points out, as the number of squares on a chessboard.
Susan Polgar played chess and developed a friendship with Bobby Fisher from 1992 to 1994 in Hungary.
No cause of death was given for Fischer, the eccentric genius who was renowned for his Cold War defeat of Russian chess champ Boris Spassky in 1972; his two-decade retreat from chess; and his trip to Yugoslavia in 1992, in defiance of U.S. sanctions, for a rematch with Spassky.
After Fischer beat Spassky again, winning $3.5 million, he vanished from the scene once more. He spent his later life denouncing the U.S. and moved to Iceland, where he died.
CNN.com asked readers to share their memories of Fischer and his sometimes triumphant, often turbulent life. Below are a collection of their responses, some of which have been edited for length and clarity.
Frank Taylor of Philadelphia, Pennsylvania :Bobby Fischer was simply the best! His aura was the main reason I took up chess, and the more I understood about chess, the more I came to appreciate his sheer genius. Like many others, I did have a problem with his anti-America, anti-Semitic outbursts and views, but his chess playing was pure magic. I'd always hoped and dreamed he would make a final appearance and play Garry Kasparov. What a match that would have been. What a loss of talent.
Gregory Campbell of Lewisville, Texas :When I returned home from Vietnam, the game between Bobby Fischer and Spassky had just started. I did not play the game that well, but watching Bobby play was a welcome home for me. He inspired me to learn more about the game, and in so doing, I was able to recover from the war. I will always remember that game and what Bobby has done for me through the game of chess.
Don't Miss
World-class chess player, eccentric Bobby Fischer dies
Susan Polgar of Lubbock, Texas: In spite of his obvious flaws, he will be remembered as "The King of Chess," a genius on the board and the man who broke through the Iron Curtain. I mostly admired him as a chess player and what he did for chess. He put chess on the map in the U.S. and changed the economic opportunities for chess players. If it weren't for him, demanding reparation and prizes in the '60s and '70s, players wouldn't be making the money they are today.
He was fanatic about chess; he was working on chess most of his life, even years and years after he retired. His dedication, passion and love for the game, it was his life. It was his profession. It was how he expressed himself. It's symbolic that he died at age 64, for the 64 squares of the chessboard.
Tom Brabant Jr. of Lexington, Kentucky :Bobby Fischer was a childhood hero of mine. His match with Spassky resounds in my memory like the Apollo moon missions, and he inspired me to learn chess. His book on the subject [Bobby Fischer Teaches Chess] was a focused treatment of winning chess games (using back-rank mates). It was also a wonderful example of "programmed instruction." While I mourn his death, I teach college and would like to believe that a little bit of Bobby lives on in my classroom.
Daryl Bertrand of Ottawa, Ontario :As a chess player, I've always been astounded by the mysterious power of Bobby Fischer's play. As a chess teacher, I've always tried to instill his courage and determination in my students. Surely this is the darkest day in the history of chess.
Philip Skipper of Lake Charles, Louisiana When I was a young boy, Bobby Fischer was no less than a hero for me. I am now 51 years old, and I still have the yellowed newspaper clippings of his famous match with Boris Spassky in my desk.
Unfortunately, Bobby obviously suffered from mental illness that progressed as the years passed by and eventually destroyed him. His remarks (ravings) of support for the 9/11 attackers upon the United States will certainly be as much of a legacy as being the American Cold War hero, and first American world chess champion three decades earlier. Bobby Fischer was a genius, a hero, a villain and a very sick man. It's a shame that no one could reach him many years ago and save him from himself.
Judy Winters of Port Charlotte, Florida :Bobby Fischer was my first boyfriend. Starting about 1955, I would go to the Manhattan chess club with my father. My father would play, and I would drink soda. I saw Bobby a few times there, and we would talk a little. (We were both the same age and very shy.) I fell in love with him at a tournament at Asbury Park, in New Jersey. We went to the boardwalk together, went on rides and played games of chance. His mother was real mad at him when we got back because he was almost late for his game.
I think it was Memorial Day or Labor Day, Maybe 1955 or 1958. The Asbury Park newspaper had a picture of me watching one of his games. I wish I could get a copy of that picture. We wrote back and forth for a while, and then I got too cool for chess and he got famous. One time, a Jewish friend of mine said I couldn't marry him because he was Jewish and I wasn't. I wish I could have seen her when he converted.
I love remembering him in such an innocent time. He was just a person, like you and me, with a wonderful gift (and he was very cute). If anyone can get that picture from the Asbury Park newspaper, please let me know. I think it was on the front page, because we were only about 13 or 15, and he won.
Gerry Christmas of Carrboro, North Carolina :What happened to Robert J. "Bobby" Fischer was tragic, Shakespearean in scope. Raised in a New York apartment by a single mother, he rose to take on and vanquish single-handedly the Russian chess behemoth. At age 13, Fischer defeated Donald Byrne in a game now dubbed "The Game of the Century." Fischer deserved honor, respect and glory for his great chess achievements, not ridicule, exile and shame.
Carlos Calderon of New York, New York :That has to be the greatest loss for all chess players. ... I learned to play the game when he played B. Spassky, and I've been playing the game since then. I've been playing chess all this time, and it's all about fun, and Fischer has been my inspiration. Just a week ago, as I was trying to inspire some kids from a school to learn to play chess, I mentioned to them that Fischer was the greatest American chess player. They were fascinated with the story, and it will be really hard to tell them that Fischer has died.
It's a sad day.
Susan Polgar played chess and developed a friendship with Bobby Fisher from 1992 to 1994 in Hungary.
No cause of death was given for Fischer, the eccentric genius who was renowned for his Cold War defeat of Russian chess champ Boris Spassky in 1972; his two-decade retreat from chess; and his trip to Yugoslavia in 1992, in defiance of U.S. sanctions, for a rematch with Spassky.
After Fischer beat Spassky again, winning $3.5 million, he vanished from the scene once more. He spent his later life denouncing the U.S. and moved to Iceland, where he died.
CNN.com asked readers to share their memories of Fischer and his sometimes triumphant, often turbulent life. Below are a collection of their responses, some of which have been edited for length and clarity.
Frank Taylor of Philadelphia, Pennsylvania :Bobby Fischer was simply the best! His aura was the main reason I took up chess, and the more I understood about chess, the more I came to appreciate his sheer genius. Like many others, I did have a problem with his anti-America, anti-Semitic outbursts and views, but his chess playing was pure magic. I'd always hoped and dreamed he would make a final appearance and play Garry Kasparov. What a match that would have been. What a loss of talent.
Gregory Campbell of Lewisville, Texas :When I returned home from Vietnam, the game between Bobby Fischer and Spassky had just started. I did not play the game that well, but watching Bobby play was a welcome home for me. He inspired me to learn more about the game, and in so doing, I was able to recover from the war. I will always remember that game and what Bobby has done for me through the game of chess.
Don't Miss
World-class chess player, eccentric Bobby Fischer dies
Susan Polgar of Lubbock, Texas: In spite of his obvious flaws, he will be remembered as "The King of Chess," a genius on the board and the man who broke through the Iron Curtain. I mostly admired him as a chess player and what he did for chess. He put chess on the map in the U.S. and changed the economic opportunities for chess players. If it weren't for him, demanding reparation and prizes in the '60s and '70s, players wouldn't be making the money they are today.
He was fanatic about chess; he was working on chess most of his life, even years and years after he retired. His dedication, passion and love for the game, it was his life. It was his profession. It was how he expressed himself. It's symbolic that he died at age 64, for the 64 squares of the chessboard.
Tom Brabant Jr. of Lexington, Kentucky :Bobby Fischer was a childhood hero of mine. His match with Spassky resounds in my memory like the Apollo moon missions, and he inspired me to learn chess. His book on the subject [Bobby Fischer Teaches Chess] was a focused treatment of winning chess games (using back-rank mates). It was also a wonderful example of "programmed instruction." While I mourn his death, I teach college and would like to believe that a little bit of Bobby lives on in my classroom.
Daryl Bertrand of Ottawa, Ontario :As a chess player, I've always been astounded by the mysterious power of Bobby Fischer's play. As a chess teacher, I've always tried to instill his courage and determination in my students. Surely this is the darkest day in the history of chess.
Philip Skipper of Lake Charles, Louisiana When I was a young boy, Bobby Fischer was no less than a hero for me. I am now 51 years old, and I still have the yellowed newspaper clippings of his famous match with Boris Spassky in my desk.
Unfortunately, Bobby obviously suffered from mental illness that progressed as the years passed by and eventually destroyed him. His remarks (ravings) of support for the 9/11 attackers upon the United States will certainly be as much of a legacy as being the American Cold War hero, and first American world chess champion three decades earlier. Bobby Fischer was a genius, a hero, a villain and a very sick man. It's a shame that no one could reach him many years ago and save him from himself.
Judy Winters of Port Charlotte, Florida :Bobby Fischer was my first boyfriend. Starting about 1955, I would go to the Manhattan chess club with my father. My father would play, and I would drink soda. I saw Bobby a few times there, and we would talk a little. (We were both the same age and very shy.) I fell in love with him at a tournament at Asbury Park, in New Jersey. We went to the boardwalk together, went on rides and played games of chance. His mother was real mad at him when we got back because he was almost late for his game.
I think it was Memorial Day or Labor Day, Maybe 1955 or 1958. The Asbury Park newspaper had a picture of me watching one of his games. I wish I could get a copy of that picture. We wrote back and forth for a while, and then I got too cool for chess and he got famous. One time, a Jewish friend of mine said I couldn't marry him because he was Jewish and I wasn't. I wish I could have seen her when he converted.
I love remembering him in such an innocent time. He was just a person, like you and me, with a wonderful gift (and he was very cute). If anyone can get that picture from the Asbury Park newspaper, please let me know. I think it was on the front page, because we were only about 13 or 15, and he won.
Gerry Christmas of Carrboro, North Carolina :What happened to Robert J. "Bobby" Fischer was tragic, Shakespearean in scope. Raised in a New York apartment by a single mother, he rose to take on and vanquish single-handedly the Russian chess behemoth. At age 13, Fischer defeated Donald Byrne in a game now dubbed "The Game of the Century." Fischer deserved honor, respect and glory for his great chess achievements, not ridicule, exile and shame.
Carlos Calderon of New York, New York :That has to be the greatest loss for all chess players. ... I learned to play the game when he played B. Spassky, and I've been playing the game since then. I've been playing chess all this time, and it's all about fun, and Fischer has been my inspiration. Just a week ago, as I was trying to inspire some kids from a school to learn to play chess, I mentioned to them that Fischer was the greatest American chess player. They were fascinated with the story, and it will be really hard to tell them that Fischer has died.
It's a sad day.
giggles
Chad nervously approached his girlfriend's father and said "Excuse me, Mr. Scott, but there was something I wanted to ask you."
"Well, of course, young man!" the proud father replied. "You have my full blessing. My daughter's happiness is all I want."
"Blessing, sir?" Chad stammered.
"Yes, of course. You want to marry my daughter, right?" Mr. Scott said.
"Uh, no sir, that's not it." said Chad. "Actually, my car payment is due and I'm a little short until payday, and I wanted to know if I could borrow fifty dollars until Friday."
"Heck no!" yelled Mr. Scott. "I hardly know you."
........................................................................................................................................................................
Watching her mother as she tried on her new fur coat, young Jackie said unhappily, "Mom, do you realize how some poor dumb beast suffered so you could have that?"
The woman shot her an angry look, "Jackie, how dare you talk about your father like that!"
"Well, of course, young man!" the proud father replied. "You have my full blessing. My daughter's happiness is all I want."
"Blessing, sir?" Chad stammered.
"Yes, of course. You want to marry my daughter, right?" Mr. Scott said.
"Uh, no sir, that's not it." said Chad. "Actually, my car payment is due and I'm a little short until payday, and I wanted to know if I could borrow fifty dollars until Friday."
"Heck no!" yelled Mr. Scott. "I hardly know you."
........................................................................................................................................................................
Watching her mother as she tried on her new fur coat, young Jackie said unhappily, "Mom, do you realize how some poor dumb beast suffered so you could have that?"
The woman shot her an angry look, "Jackie, how dare you talk about your father like that!"
Sunday, January 13, 2008
syndrome of the week
Wolff-Parkinson-White syndrome (WPW) is a syndrome of pre-excitation of the ventricles of the heart due to an accessory pathway known as the bundle of Kent. This accessory pathway is an abnormal electrical communication from the atria to the ventricles.
The incidence of WPW syndrome is between 0.1 and 3% of the general population.
While the vast majority of individuals with a bundle of Kent remain asymptomatic throughout their entire lives, there is a risk of sudden death associated with the syndrome. Sudden death due to WPW syndrome is rare (incidence of less than 0.6%), and is due to the effect of the accessory pathway on tachyarrhythmias in these individuals.
Acutely, people with WPW who are experiencing a tachydysrhythmia may require electrical cardioversion if their condition is critical, or, if more stable, medical treatment may be used. Patients with atrial fibrillation and rapid ventricular response are often treated with amiodarone or procainamide to stabilize their heart rate.
Adenosine and other AV node blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it; this inlcudes adenosine, diltiazem, verapamil, other calcium channel blockers and beta-blockers. Patients with a rapid heart beat with narrow QRS complexes (circus movement tachycardias) may also be cardioverted, alternatively, adenosine may be administered if equipment for cardioversion is immediately available as a backup.
The definitive treatment of WPW syndrome is a destruction of the abnormal electrical pathway by radiofrequency catheter ablation. This procedure is performed almost exclusively by cardiac electrophysiologists. Radiofrequency catheter ablation is not performed in all individuals with WPW syndrome because there are inherent risks involved in the procedure.
When performed by an experienced electrophysiologist, radiofrequency ablation has a high success rate. If radiofrequency catheter ablation is successfully performed, the patient is generally considered cured. Recurrence rates are typically less than 5% after a successful ablation. The one caveat is that individuals with underlying Ebstein's anomaly may develop additional accessory pathways during progression of their disease.
The incidence of WPW syndrome is between 0.1 and 3% of the general population.
While the vast majority of individuals with a bundle of Kent remain asymptomatic throughout their entire lives, there is a risk of sudden death associated with the syndrome. Sudden death due to WPW syndrome is rare (incidence of less than 0.6%), and is due to the effect of the accessory pathway on tachyarrhythmias in these individuals.
Acutely, people with WPW who are experiencing a tachydysrhythmia may require electrical cardioversion if their condition is critical, or, if more stable, medical treatment may be used. Patients with atrial fibrillation and rapid ventricular response are often treated with amiodarone or procainamide to stabilize their heart rate.
Adenosine and other AV node blockers should be avoided in atrial fibrillation and atrial flutter with WPW or history of it; this inlcudes adenosine, diltiazem, verapamil, other calcium channel blockers and beta-blockers. Patients with a rapid heart beat with narrow QRS complexes (circus movement tachycardias) may also be cardioverted, alternatively, adenosine may be administered if equipment for cardioversion is immediately available as a backup.
The definitive treatment of WPW syndrome is a destruction of the abnormal electrical pathway by radiofrequency catheter ablation. This procedure is performed almost exclusively by cardiac electrophysiologists. Radiofrequency catheter ablation is not performed in all individuals with WPW syndrome because there are inherent risks involved in the procedure.
When performed by an experienced electrophysiologist, radiofrequency ablation has a high success rate. If radiofrequency catheter ablation is successfully performed, the patient is generally considered cured. Recurrence rates are typically less than 5% after a successful ablation. The one caveat is that individuals with underlying Ebstein's anomaly may develop additional accessory pathways during progression of their disease.
Thursday, January 10, 2008
Giggle
The Switchboard says.......
Hello, and thankyou for calling St Jude''s Psychiatric Hospital. Please choose one of the following options.
If you have obsessive-compulsive disorder, please press 1 repeatedly
If you are co-dependent please ask someone else to press 2.
If you have multiple personality, please press 3,4,5 & 6
If you are paranoid, we know what you want & who you are. Please stay on the line while we trace your call.
If you have delusions, press 7 and your call will be forwarded to the mother ship.
If you have schizophrenia, listen carefully and a voice will tell you which number to press.
If you are depressed it doesn't matter which number you press as no- one will answer.
If you are dyslexic, press 96969696966
For chronic anxiety queries, please fidget with the Hash key till someone responds.
For Bipolar disorder please leave a message after the beep or before the beep or after the beep, but please wait for the beep.
If you have short-term memory loss, press 9 If you have short-term memory loss, press 9 If you have short-term memory loss, press 9
If you have low self-esteem, please hang up. Our operators are too busy to talk to people like you.
Please do not press any buttons if you're blonde, as you'll just mess it up.
Alzheimer's patients should press the button with the number remaining when you've finished subtracting seven from a hundred. !!!!!!!!!
Hello, and thankyou for calling St Jude''s Psychiatric Hospital. Please choose one of the following options.
If you have obsessive-compulsive disorder, please press 1 repeatedly
If you are co-dependent please ask someone else to press 2.
If you have multiple personality, please press 3,4,5 & 6
If you are paranoid, we know what you want & who you are. Please stay on the line while we trace your call.
If you have delusions, press 7 and your call will be forwarded to the mother ship.
If you have schizophrenia, listen carefully and a voice will tell you which number to press.
If you are depressed it doesn't matter which number you press as no- one will answer.
If you are dyslexic, press 96969696966
For chronic anxiety queries, please fidget with the Hash key till someone responds.
For Bipolar disorder please leave a message after the beep or before the beep or after the beep, but please wait for the beep.
If you have short-term memory loss, press 9 If you have short-term memory loss, press 9 If you have short-term memory loss, press 9
If you have low self-esteem, please hang up. Our operators are too busy to talk to people like you.
Please do not press any buttons if you're blonde, as you'll just mess it up.
Alzheimer's patients should press the button with the number remaining when you've finished subtracting seven from a hundred. !!!!!!!!!
Monday, January 7, 2008
Giggle
Last week, we took some friends out to a new restaurant, and noticed that the waiter who took our order carried a spoon in his shirt pocket. It seemed a little strange, but I ignored it. However, when the busboy brought out water and utensils, I noticed he also had a spoon in his shirt pocket, then looked around the room and saw that all the staff had spoons in their pockets.
When the waiter came back to serve our soup I asked, "Why the spoon?" "Well," he explained, "the restaurant's owners hired Andersen Consulting, experts in efficiency, in order to revamp all our processes. After several months of statistical analysis, they concluded that customers drop their spoons 73.84 percent more often than any other utensil. This represents a drop frequency of approximately 3 spoons per table per hour. If our personnel are prepared to deal with that contingency, we can reduce the number of trips back to the kitchen and save 15 man-hours per shift."
As luck would have it I dropped my spoon and he was able to replace it with his spare spoon. "I'll get another spoon next time I go to the kitchen instead of making an extra trip to get it right now." I was rather impressed. The waiter served our main course and I continued to look around. I then noticed that there was a very thin string hanging out of the waiter's fly. Looking around, I noticed that all the waiters had the same string hanging from their flies. My curiosity got the better of me and before he walked off, I asked the waiter, "Excuse me, but can you tell me why you have that string right there?
"Oh, certainly!" he answered, lowering his voice. "Not everyone is as observant as you. That consulting firm I mentioned also found out that we can save time in the restroom."
"How so?"
"See," he continued, "by tying this string to the tip of you know what, we can pull it out over the urinal without touching it and that way eliminate the need to wash the hands, shortening the time spent in the restroom by 76.39 percent."
"Okay, that makes sense, but . . .. if the string helps you get it out, how do you put it back in?"
Well," he whispered, lowering his voice even further, "I don't know about the others, but I use the spoon."
When the waiter came back to serve our soup I asked, "Why the spoon?" "Well," he explained, "the restaurant's owners hired Andersen Consulting, experts in efficiency, in order to revamp all our processes. After several months of statistical analysis, they concluded that customers drop their spoons 73.84 percent more often than any other utensil. This represents a drop frequency of approximately 3 spoons per table per hour. If our personnel are prepared to deal with that contingency, we can reduce the number of trips back to the kitchen and save 15 man-hours per shift."
As luck would have it I dropped my spoon and he was able to replace it with his spare spoon. "I'll get another spoon next time I go to the kitchen instead of making an extra trip to get it right now." I was rather impressed. The waiter served our main course and I continued to look around. I then noticed that there was a very thin string hanging out of the waiter's fly. Looking around, I noticed that all the waiters had the same string hanging from their flies. My curiosity got the better of me and before he walked off, I asked the waiter, "Excuse me, but can you tell me why you have that string right there?
"Oh, certainly!" he answered, lowering his voice. "Not everyone is as observant as you. That consulting firm I mentioned also found out that we can save time in the restroom."
"How so?"
"See," he continued, "by tying this string to the tip of you know what, we can pull it out over the urinal without touching it and that way eliminate the need to wash the hands, shortening the time spent in the restroom by 76.39 percent."
"Okay, that makes sense, but . . .. if the string helps you get it out, how do you put it back in?"
Well," he whispered, lowering his voice even further, "I don't know about the others, but I use the spoon."
Thursday, January 3, 2008
The amazing story of Pauline Jacobi
92-year-old Pauline Jacobi reads her Bible everyday. Her strong faith keeps her going in life and may have saved it after she almost became the victim of a parking lot robbery.
Jacobi had just finished putting her groceries inside her car at a Dyersburg Wal-Mart when a man jumped into the car through the passenger's side door. He told Jacobi he had a gun and that he would shoot her if she didn't give him money.
"I'm not going to give you my money," Jacobi said.
In fact. She told him "no" three times.
Then she started to talk to him. "As quick as you kill me I'll go to heaven and you'll go to hell," Jacobi said she told the man. "'Jesus is in this car and he goes with me everywhere I go."
"He just looked around and the tears just began coming down his eyes."
She told him to ask God for forgiveness and ministered to him for 10 minutes inside her car.
"He says, 'I think I'll go home and pray tonight,'" Jacobi said. "'You don't have to wait until tonight. You can pray anytime you want to.'" As tears were rolling down the man's face, Jacobi voluntarily gave him $10. All the money she had.
"When I told him I was going to give him the money, I said, 'Don't you go spend it on whiskey either,'" Jacobi said. The man thanked her for the money and kissed her on the cheek. Then he walked away.
He told Jacobi his name was Ricky and he was from Halls, Tennessee. She doesn't want to see him in jail, but also doesn't want him to hurt anybody. However, police do want to see him in jail and are asking for help.
Jacobi had just finished putting her groceries inside her car at a Dyersburg Wal-Mart when a man jumped into the car through the passenger's side door. He told Jacobi he had a gun and that he would shoot her if she didn't give him money.
"I'm not going to give you my money," Jacobi said.
In fact. She told him "no" three times.
Then she started to talk to him. "As quick as you kill me I'll go to heaven and you'll go to hell," Jacobi said she told the man. "'Jesus is in this car and he goes with me everywhere I go."
"He just looked around and the tears just began coming down his eyes."
She told him to ask God for forgiveness and ministered to him for 10 minutes inside her car.
"He says, 'I think I'll go home and pray tonight,'" Jacobi said. "'You don't have to wait until tonight. You can pray anytime you want to.'" As tears were rolling down the man's face, Jacobi voluntarily gave him $10. All the money she had.
"When I told him I was going to give him the money, I said, 'Don't you go spend it on whiskey either,'" Jacobi said. The man thanked her for the money and kissed her on the cheek. Then he walked away.
He told Jacobi his name was Ricky and he was from Halls, Tennessee. She doesn't want to see him in jail, but also doesn't want him to hurt anybody. However, police do want to see him in jail and are asking for help.
Subscribe to:
Posts (Atom)
