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No currently available treatment is reported to reduce the exaggerated airway wall inflammation of chronic obstructive pulmonary disease. We tested the hypothesis that inhaled combined long-acting beta2-agonist (salmeterol) and corticosteroid (fluticasone propionate) will reduce inflammation. Bronchial biopsies and induced sputum were taken from 140 current and former smokers (mean age, 64 yr) with moderate to severe disease, randomized in a 13-wk double-blind study to placebo (n = 73) or salmeterol/fluticasone propionate 50/500 microg (n = 67) twice daily. Biopsies were repeated at 12 wk and sputa at 8 and 13 wk. After adjustment for multiplicity, comparisons between active and placebo were made for median change from baseline in the numbers of biopsy CD8+ and CD68+ cells/mm2 and sputum neutrophils. Combination therapy was associated with a reduction in biopsy CD8+ cells of -118 cells/mm2 (95% confidence interval [CI], -209 to -42; p = 0.02), a reduction of 36% over placebo (p = 0.001). CD68+ cells were unaffected by combination treatment. Sputum differential (but not total) neutrophils reduced progressively and, at Week 13, significantly with combination treatment (median treatment difference, 8.5%; 95% CI, 1.75%-15.25%; p = 0.04). The combination also significantly reduced biopsy CD45+ and CD4+ cells and cells expressing genes for tumor necrosis factor-alpha and IFN-gamma and sputum total eosinophils (all p < or = 0.03). These antiinflammatory effects were accompanied by a 173-ml (95% CI, 104-242; p < 0.001) improvement in prebronchodilator FEV1. The combination of salmeterol and fluticasone propionate has a broad spectrum of antiinflammatory effects in both current and former smokers with chronic obstructive pulmonary disease, which may contribute to clinical efficacy.

Much work has been done over the past several decades to delineate new theatre historiographies and reimagine theoretical approaches to telling the history of the theatre. Growing, in part, out of the rejection of positivism and the standard histories of institutions and power structures, postmodern thinking opened up new avenues of looking at theatre history, often by inverting the traditional perspective. One avenue of particular interest is the growing field of microhistory, which seems particularly suited to theatre but which, to date, has not been fully realized.

Background: Patients with human immunodeficiency virus (HIV) infection have been found to have impaired wound healing. This study aimed to determine whether the healed wounds from these patients have an impaired intrinsic strength. Methods: The healed wounds of patients with HIV infection who were undergoing a subsequent surgical procedure were excised and examined immediately by tensionometry. A non-HIV group with wounds of the same range of maturity were used as controls. Results: The wounds of 11 patients with HIV were compared with those of 11 controls. There was no significant difference between the groups’ preoperative hemoglobin or albumin; however, the white cell count was lower in the HIV group ( P = 0.005). When examined biomechanically, wounds of the HIV group had a lower resilience ( P = 0.0138), toughness ( P = 0.0138), and maximum extension ( P = 0.0235) compared with the control group. Conclusions: The wounds of patients with HIV infection when measured biomechanically are weaker than those of normal non-HIV controls.

[...]New York fell into a depression beginning in 1748. The billeting of Royal troops meant a city with nearly twice the potential customers than had been available five years earlier. [...]Army regulars meant a potential audience open to theatrical amusements. [...]what effect might this choice have had on their success, or more accurately lack thereof? Since the earliest days of Dutch occupation, the southern tip of Manhattan Island had been a strictly commercial seaport.27 The small town that grew up around it was connected directly to the major docks and wharves that lined the shore. [...]John Jr. was not getting along very well at the time with James De Lancey, the colony's Lieutenant Governor and chief justice.

The number of individuals in the UK who are HIV seropositive is increasing as is their presentation with abdominal complications. Poor wound healing following anorectal surgery in HIV-positive patients has been well reported. This study reviews the incidence of wound complications following laparotomy. The hospital records of all HIV-positive patients who underwent laparotomy at a London teaching hospital over a 10-year period were reviewed and compared to an equal number of matched non-HIV patients. Between April 1986 and April 1996, 64 laparotomies were carried out on 53 patients. There was a significantly greater incidence of wound complications (χ 2 = 12.75, 1 d.f., p = 0.0003) and wound breakdown (χ 2 = 10.45, 1 d.f., p = 0.012) in the HIV group following laparotomy than in the non-HIV control group.

Since it was first published in 1953, Rosai and Ackerman's Surgical Pathology has been established as one of the pre-eminent textbooks of systemic surgical pathology. [...]in its eagerly awaited 9th edition, this must-have textbook aims to continue this fine tradition into the 21st century. Since the previous edition some 8 years ago developments in surgical pathology have been rapid, both in techniques such as molecular genetics, and in the inevitable changes in clinical management brought about by our deepening understanding of the processes underlying disease. The authoritative text alone is worth the price, but with the beautiful accompanying photography this classic book starts to look like a real bargain.