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The boy from nowhere
The warm, funny memoir of Gregor Fisher, the much loved Scottish actor best known for Rab C. Nesbitt, told as he uncovers his dramatic family history. Growing up in the Glasgow suburbs, Gregor was 14 when he asked where he was christened and was told that he was adopted. But it wasn't quite that simple. And so began an unfolding of truths, half-truths and polite cover-ups from his various families. In 2014 Gregor approached Times columnist Melanie Reid to help him tell his story. Together they travelled through the mining villages of central Scotland to uncover the mystery of his birth and early life. What emerged was a story of secrets, deception, tragic accidents and early death, coldness and rejection from the very people who should have cherished him most, but a welcome from the most unexpected of quarters. From the squalor of industrial Coatbridge after WW1 to his own 1950s Glasgow childhood, via a love letter found in the wallet of a dead man and meeting his sister outside lost luggage at Glasgow Central, Gregor shares his family story with warmth and blunt Scottish humour.
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Guillain–Barré and Miller Fisher syndromes—new diagnostic classification
Several distinct autoimmune neuropathies can be referred to collectively as Guillain–Barré syndrome (GBS). Wakerley and colleagues argue that confusing terminology hinders diagnosis, and they present a revised classification of 'classic' GBS, Miller Fisher syndrome and related conditions. This new approach to diagnosis might facilitate work-up, thereby helping to identify the correct treatment as quickly as possible.
Guillain–Barré syndrome (GBS) and its variant, Miller Fisher syndrome (MFS), exist as several clinical subtypes with different neurological features and presentations. Although the typical clinical features of GBS and MFS are well recognized, current classification systems do not comprehensively describe the full spectrum of either syndrome. In this Perspectives article, GBS and MFS are classified on the basis of current understanding of the common pathophysiological profiles of each disease phenotype. GBS is subclassified into classic and localized forms (for example, pharyngeal–cervical–brachial weakness and bifacial weakness with paraesthesias), and MFS is divided into incomplete (for example, acute ophthalmoparesis, acute ataxic neuropathy) and CNS subtypes (Bickerstaff brainstem encephalitis). Diagnostic criteria based on clinical characteristics are suggested for each condition. We believe this approach to be more inclusive than existing systems, and argue that it could facilitate early clinical diagnosis and initiation of appropriate immunotherapy.
Journal Article
The princess diarist
\"With these excerpts from her handwritten notebooks, [this] is Fisher's intimate and revealing recollection of what happened on one of the most famous film sets of all time--and what developed behind the scenes. And today, as she reprises her most iconic role for the latest Star Wars trilogy, Fisher also ponders the joys and insanity of celebrity, and the absurdity of a life spawned by Hollywood royalty, only to be surpassed by her own outer-space royalty\"--Amazon.com.
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Extensions of the Mandelstam–Tamm quantum speed limit to systems in mixed states
The Mandelstam–Tamm quantum speed limit (QSL) puts a bound on how fast a closed system in a pure state can evolve. In this paper, we derive several extensions of this QSL to closed systems in mixed states. We also compare the strengths of these extensions and examine their tightness. The most widely used extension of the Mandelstam–Tamm QSL originates in Uhlmann’s energy dispersion estimate. We carefully analyze the underlying geometry of this estimate, an analysis that makes apparent that the Bures metric, or equivalently the quantum Fisher information, will rarely give rise to tight extensions. This observation leads us to address whether there is a tightest general extension of the Mandelstam–Tamm QSL. Using a geometric construction similar to that developed by Uhlmann, we prove that this is indeed the case. In addition, we show that tight evolutions of mixed states are typically generated by time-varying Hamiltonians, which contrasts with the case for systems in pure states.
Journal Article
My girls : a lifetime with Carrie and Debbie
In December 2016, the world was shaken by the sudden deaths of Carrie Fisher and her mother Debbie Reynolds, occurring less than 24 hours apart. Debbie's only remaining child, Todd Fisher, somehow retained his grace and composure under the glare of the media spotlight as he struggled with his own overwhelming grief. In My girls, Todd shares his heart and his memories of Debbie and Carrie with deeply personal stories from his earliest years to those last unfathomable days.
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Antecedent infections in Fisher syndrome: sources of variation in clinical characteristics
The clinical features of Guillain–Barré syndrome (GBS) are highly variable, according to the type of antecedent infection. Although a major GBS phenotype, Fisher syndrome (FS), has been shown to be preceded by infections similar to those preceding GBS, whether or not the clinical features in FS also vary according to antecedent infection remains unclarified. Frequent antecedent infections among this study of 70 FS patients included Haemophilus influenzae [n = 15 (21%)], Campylobacter jejuni [n = 10 (14%)], and cytomegalovirus (CMV) [n = 6 (8.6%)]. Compared with other FS patients, H. influenzae-seropositive FS patients more frequently had a history of prior upper respiratory tract infection; double vision as the initial symptom; and, except for oculomotor disturbance, more rarely showed cranial nerve involvement. C. jejuni-related FS occurred predominantly in younger male patients and characteristically presented with blurred vision. According to GBS disability scale, CMV-related FS tended to be more severe, although every patient received immunotherapy. Serum anti-GQ1b IgG antibodies were detected in most cases, regardless of antecedent infection type. At the nadir of illness, the most frequent diagnosis in H. influenzae-related cases was “pure FS” without limb weakness or central nervous system involvement (71%), in C. jejuni-related cases “incomplete FS” such as acute ophthalmoparesis with or without ataxia (60%), and in CMV-related cases (50%) advanced conditions such as GBS overlap and Bickerstaff brainstem encephalitis. These findings indicate that the type of preceding infection determined the neurological features of FS. CMV-related FS appeared to be similar to H. influenzae- and C. jejuni-related FS regarding anti-GQ1b antibody-mediated pathogenesis, as opposed to CMV-related GBS.
Journal Article
Antiganglioside antibody frequency in routine clinical care settings
Background and purpose Antiganglioside antibodies (AGAs) might be involved in the etiopathogenesis of many neurological diseases, such as Miller–Fisher syndrome (MFS) and Guillain–Barré syndrome (GBS). Available comprehensive reference data regarding AGA positivity rates and cross‐responsiveness among AGAs (where one line immunoblot is positive for ≥1 AGA) during routine clinical care are scant. Methods In this 10‐year monocentric retrospective study, 3560 immunoglobulin (Ig) G and IgM line blots (GA Generic Assays' Anti‐Ganglioside Dot kit) obtained using cerebrospinal fluid (CSF) and serum samples from 1342 patients were analyzed for AGA positivity in terms of 14 diagnosis categories and AGA cross‐responsiveness. Results Of all 3560 line blots 158 (4.4%) and of all CSF samples 0.4% (4/924) CSF line blots were AGA positive. For serum IgG, blots with positivity rates higher than the standard deviation of 15.6% were associated with MFS (GD3, GD1a, GT1a and GQ1b) and acute motor axonal neuropathy (AMAN) (GM1, GD1a and GT1a). For serum IgM, blots with positivity rates higher than the standard deviation of 8.1% were associated with AMAN (GM2, GT1a and GQ1b), MFS (GM1, GT1a and GQ1b), multifocal motor neuropathy (MMN) (GM1, GM2 and GQ1b) and chronic inflammatory demyelinating polyneuropathy (CIDP) (GM1). Cross‐responsiveness was observed in 39.6% of all positive serum AGA. Conclusions Testing for AGAs during routine clinical care rarely led to positive findings, both in serum and even less in CSF, except for the diagnoses AMAN, MFS, MMN and CIDP. Nonspecific findings found as cross‐responsiveness between different AGA samples occur frequently, impacting the positivity of most AGA subtypes.
Journal Article
Growing up Fisher : musings, memories, and misadventures
A memoir by the half-sister of the late Carrie Fisher describes their upbringing in Hollywood, her personal struggles with identity, her experiences as a mother to five children, and how she became motivated to pursue a creative life in the wake of Carrie's death.
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