A portrait of integrity: Arnold Bennett Donawa, DDS.
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As a uniquely human talent that has evolved from prehistoric cave paintings, art draws on many brain areas responsible for various cognitive processes. The pattern of degeneration in dementia leads to predictable changes in art. The visuospatial deficits in Alzheimer disease lead to less precision and attention to spatial relationships. In some cases of frontotemporal dementia, artistic creativity appears anew as the disease develops. The artwork is approached in a compulsive manner and is often realistic or surrealistic in style. Art in the context of dementia provides a unique window into the cognitive processes of various brain regions and an opportunity for rehabilitation.
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HYPOTHESIS: A prospective statewide quality assessment and improvement project requiring active participation and case entry by surgeons is feasible provided that confidentiality and peer review protection are provided. DESIGN: Inception cohort. SETTING: Acute-care hospitals in Vermont. PATIENTS: Consecutive series of 364 patients undergoing elective surgery for colorectal cancer between April 1, 1999, and March 31, 2001, who were prospectively entered into a database created by the Vermont Chapter of the American College of Surgeons under peer review protection from the Vermont Program for Quality Health Care. INTERVENTION: Surgery for invasive colorectal cancer. MAIN OUTCOME MEASURES: Case entry compliance, surgical complications, length of stay, demographics, cancer-specific characteristics, and use of adjuvant therapy. RESULTS: The calculated case entry compliance rate was 78%. There were 7 deaths (2%) and 45 major complications in 39 patients (12.3%). All patients were offered referral for adjuvant therapy when appropriate based on National Institutes of Health Consensus Conference standards. Mean age was 68.7 years, and 52% of cancers occurred in women. The most common site of cancer was the right colon (36.6% of patients), and only 47.9% of malignancies were in the rectum or sigmoid. Eighty-two percent of patients had symptoms on presentation. CONCLUSIONS: Elective colorectal cancer surgery in Vermont is reasonably safe, and adherence to national standards for the use of adjuvant therapy is outstanding. Surgeons will provide outcome data if confidentiality and peer review protection are provided. The predominance of right-sided lesions and the low incidence of asymptomatic detection have significant implications for screening efforts in Vermont.
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The potential and reliability of DNA analysis for the identification of human remains are demonstrated by the study of a recent bone sample, which represented a documented case of sickle cell anemia. beta-globin gene sequences obtained from the specimen revealed homozygosity for the sickle cell mutation, proving the authenticity of the retrieved residual DNA. Further investigation of mitochondrial and Y chromosome DNA polymorphic markers indicated that this sample came from a male of maternal West African (possibly Yoruban) and paternal Bantu lineages. The medical record, which became available after the DNA analyses had been completed, revealed that it belonged to a Jamaican black male. These findings are consistent with this individual being a descendent of Africans brought to Jamaica during the trans-Atlantic slave trade. This study exemplifies how a "reverse population genetics" approach can be applied to reconstruct a genetic profile from a bone specimen of an unknown individual.
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