Personal reminiscences of the origin and history of cardiopulmonary resuscitation (CPR).
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Most cardiac surgical procedures performed in 1989 are accomplished with the aid of some type of controlled, chemically induced cardiac standstill. Although the physiological principles involved were described in the late 19th century, the first clinical application was not until 1955. Because many surgeons believed that myocardial injury resulted from the toxicity of the agents used, the technique was largely abandoned for about 15 years. With the increasing volume of coronary revascularization surgery and with the need for protection of donor hearts intended for orthotopic transplantation, chemically induced cardiac standstill became more appealing and the technique was revived and reevaluated in several centers. In the last several years, the constitution of cardioplegic solutions and the methods by which they are delivered have been greatly modified. Although the most effective solution and technique may yet remain to be described, unquestionably controlled chemically induced cardiac standstill has contributed substantially to the ease and safety with which cardiac surgical procedures can be accomplished. This vignette, although far from complete, outlines some of the important works that have contributed to the evolution of cardioplegic techniques.
I recall the origins of cardiac surgery and the evolution of cardiac transplantation. Although the results of transplantation have been greatly improved during the past two decades, newer concepts and research offer the hope of an even greater future.
Internal mammary artery-coronary artery anastomosis is currently considered the newest and best technique for surgical revascularization of ischemic myocardium. The origin and evolution of this technique are reviewed.
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The present study examined the role of childhood trauma, major depressive disorder (MDD), and anxiety disorder (AD) in overgeneral autobiographical memory. Ninety-three outpatients and 24 healthy controls completed a childhood trauma questionnaire and an autobiographical memory test (AMT). Results showed that MDD diagnosis rather than trauma history predicted AMT-performance. Memory specificity was not related to AD diagnosis, recovered MDD, or self-rated depression severity. The present findings cast doubts on theories that emphasize the role of childhood trauma in overgeneral autobiographical memory.
Reviewing the literature on autobiographical memory overgenerality, as measured by a cueing task like the Autobiographical Memory Test (AMT), gives a diffuse view of the moderating role of depression. This meta-analysis is an attempt to investigate the role of depression in the specificity of autobiographical memory, while accounting for the role of patient and task variables as possible moderators. Meta-analytic techniques are used to synthesize data from 14 studies on the recall of specific autobiographical memories in psychiatric and non-psychiatric samples. The results confirm the relationship between overgenerality and depression. The psychiatric patients are less specific than their non-clinical controls. It is not possible to establish that this result is solely due to a (co-morbid) diagnosis of depression. Self-reported depressed mood is also related to an impairment of autobiographical memory specificity. The way of presenting cues, audio taping responses and the maximum available amount of time to respond, are moderators of AMT performance.
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