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Biomedical subjects

G Sternbach

Publications and source records attributed to G Sternbach.

54 records · Page 3Linked to original sources
PubMedDate not supplied

Austin Flint: on cardiac murmurs.

Austin Flint first ausculted the murmur associated with his name in 1859. Suspecting it to be of mitral origin, he identified it as occurring in aortic insufficiency three years later. Recent echocardiographic study has indicated that this murmur is produced by an aortic insufficiency jet colliding with the anterior mitral valve leaflet. Flint was among the first to recognize the importance of normal cardiac and respiratory sounds. He advocated routine auscultation on all patients, and had great influence in popularizing auscultation in American medicine.

Aortic Valve Insufficiency↗
PubMedDate not supplied

John Barlow: mitral valve prolapse.

Although the systolic click was first mentioned in the medical literature in 1887, it was not until the investigations of John Barlow and his colleagues in the 1960s that it became linked to the mitral valve and mitral valve prolapse identified as the cause. Mitral valve prolapse is currently the most commonly diagnosed cardiac valvular abnormality. Significant complications may occur with mitral valve prolapse, though most patients are asymptomatic. However, a number of issues persist regarding mitral valve prolapse, especially with respect to the mitral valve prolapse syndrome, a term which has been applied to patients who develop a variety of symptoms, including chest pain, shortness of breath, fatigue, lightheadedness, syncope, palpitations, anxiety, and panic attacks.

History, 20th Century↗
PubMedDate not supplied

Wilhelm Konrad Roentgen: a new kind of rays.

Wilhelm Konrad Roentgen presented a preliminary report on his discovery of x-rays in 1895. In his initial experiments with these rays, he had taken a radiograph of his wife's hand. This picture immediately implied a medical use for the new discovery by demonstrating the bones of the hand. Various aspects of medical treatment were soon revolutionized by the technique of radiography. There were concerns expressed by the medical community regarding the use of x-rays. Many of these concerns regarded deficiencies that were subsequently overcome by technical improvements, resulting in a higher quality of radiographs. However, the benefit of ever-improving radiographic techniques is undergoing greater scrutiny regarding its cost and utility.

Germany↗
PubMedDate not supplied

Octave Landry: Guillain-Barré syndrome.

The clinical features of Guillain-Barré syndrome were initially described by Octave Landry in 1859. Subsequently, Guillain, Barré, and Strohl described a similar syndrome that also displayed a marked increase in cerebrospinal fluid albumin without an increase in white blood cells--an "albuminocytologic dissociation." The hallmark clinical findings in Guillain-Barré syndrome are symmetrical ascending paralysis and areflexia. The differential diagnosis is large, and early cases are often misdiagnosed. Of importance to the emergency physician are the various spinal cord compression syndromes that may present in similar fashion. Acute therapy includes hospitalization and frequent assessment of vital capacity to determine the need for ventilatory assistance.

Diagnosis, Differential↗
PubMedDate not supplied

Moritz Kaposi: idiopathic pigmented sarcoma of the skin.

Moritz Kaposi first published a description of the entity that bears his name in 1872, calling it "idiopathic multiple pigmented sarcoma of the skin." For many years thereafter, Kaposi's sarcoma was considered to be a relatively rare, slow-growing malignancy, most commonly seen in middle-aged and elderly men. This changed in 1981, with Alvin Friedman-Kein's report of what eventually proved to be HIV-associated (epidemic) Kaposi's sarcoma. Kaposi's sarcoma is now one of the diagnostic markers of the acquired immunodeficiency syndrome, as well as the most common neoplastic complication of that disease. HIV-associated Kaposi's sarcoma tends to disseminate widely to mucous membranes and the viscera. Almost all of the cases reported in the United States have occurred in homosexual and bisexual men, and a number of hypotheses have been suggested to explain this association. Over the past several years, however, the incidence of HIV-associated Kaposi's sarcoma has declined, and the reasons for this are also uncertain.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Percivall Pott: tuberculous spondylitis.

Tuberculous spondylitis, also known as Pott's disease, is an entity that produces a characteristic kyphotic deformity, and was described by Sir Percivall Pott in 1779 and 1782. The majority of his patients were infants and young children. Although the incidence of tuberculosis in the industrialized world has since declined dramatically, the number of cases of extrapulmonary disease, though small, has remained relatively unchanged. In developing countries, spondylitis is still generally a disease of children, but in Europe and North America, it more commonly involves older adults. Pott's spondylitis represents a reactivation of latent disease, frequently years after the initial infection. Clinical findings include complaints of back pain and symptoms of fever, chills, weight loss, malaise, and fatigue. Characteristically a late finding, paraplegia is occasionally the initial indicator of spinal involvement. There is an average delay of a year between the onset of symptoms and patient presentation. Plain spinal radiographs usually are the initial diagnostic modality utilized. Computed tomography scanning and magnetic resonance imaging can be used to further define the process. The differential diagnosis includes neoplasm, pyogenic or disseminated fungal infection, and sarcoid arthritis.

England↗
PubMedDate not supplied

Willy Burgdorfer: Lyme disease.

The documented history of erythema migrans dates to 1909, when Arvid Afzelius described a case of this skin lesion at a dermatologic meeting in Sweden. He felt that the eruption was likely produced by the bite of a tick. The initial description of Lyme arthritis appeared in 1977, and a number of the patients described in this series developed a rash thought to be erythema migrans. Four years later, Burgdorfer discovered the presence of spirochetes (subsequently named Borrelia burgdorferi) in ticks from an endemic locus of Lyme arthritis and determined this to be the causative organism of the disease. Lyme disease is the most common tickborne infection in the United States. Its natural course has been divided into three clinical stages. The infection begins with a rash and flulike symptoms and may progress after days to weeks to a disseminated stage and in months to years to a late stage. There is little information (except erythema migrans) about the clinical features of the illness that is specific for Lyme disease. There are a number of effective antibiotic treatment regimens, and although acute infection generally responds well to treatment, management of chronic illness with antibiotics has been less consistently successful. With respect to antibiotic prophylaxis, the few studies performed have led to the conclusion that, even in endemic areas, the risk of infection is so low that routinely instituting treatment following a tick bite is not warranted.

History, 20th Century↗
PubMedDate not supplied

Joseph Jones: infection with flesh eating bacteria.

A Confederate Army surgeon, Joseph Jones, is generally credited to have provided the first modern description of necrotizing fasciitis, then known as hospital gangrene. This is a soft tissue infection characterized by a rapid and progressive course. In the 1990s, this entity has been popularized by the media as representing infection with "flesh eating bacteria." Certain patients are at particular risk to develop necrotizing soft tissue infections. Those with impaired immunity, diabetes mellitus, and intravenous drug abuse are particularly vulnerable, but these infections can also occur in previously healthy patients. Diagnostic radiographic testing is often helpful, including the use of plain radiographs, computed tomographic (CT) scan and magnetic resonance imaging (MRI). The most frequent infecting bacterial organism is Group A beta-hemolytic streptococcus, and there are indications to suggest that this organism may be acquiring greater virulence. Many infections, however, involve several bacterial pathogens. The keys to successful outcome are early diagnosis and surgical debridement. Fluid resuscitation and administration of broad spectrum antibiotics should be initiated as soon as the diagnosis is suspected.

Anti-Bacterial Agents↗
PubMedDate not supplied

From Creutzfeldt-Jakob disease to the mad cow epidemic.

Hans-Gerhard Creutzfeldt and Alfons Jakob independently authored clinical and pathologic descriptions of a new syndrome in the 1920s. This syndrome, which subsequently came to be named after them, was characterized by dementia, motor and coordination abnormalities, a fatal course, and pathologic findings of diffuse spongiform neuronal degeneration. Although it appeared for many years to be little more than a medical curiosity, Creutzfeldt-Jakob disease attained widespread attention by its pathologic similarity to kuru and bovine spongiform encephalopathy, "mad cow disease." Because there are sporadic, familial, and iatrogenic forms of Creutzfeldt-Jakob disease, it is considered to have both genetic and infectious aspects. Although its causation has for some time been ascribed to "slow viruses," the etiology of Creutzfeldt-Jakob disease is currently thought to be due to prions, small proteinaceous infectious particles that have genetic encoding. The debate regarding whether the appearance of atypical Creutzfeldt-Jakob disease can be linked to the epidemic of "mad cow disease" is currently unresolved.

Adolescent↗
PubMedDate not supplied

Nalmefene: a long-acting opioid antagonist. Clinical applications in emergency medicine.

The use of the opioid antagonist naloxone is well known to the experienced health care provider. The availability of the longer acting opioid antagonist nalmefene has several potential benefits in clinical practice. Nalmefene has a plasma half-life of almost 11 h, compared to 60-90 min for naloxone. Nalmefene has been shown to reverse opioid intoxication for as long as 8 h, reducing the need for continuous monitoring of intoxicated patients and repeated dosing of naloxone. Single dose administration has also been used effectively in the reversal of opiate-assisted conscious sedation. In addition, this agent has been used in the treatment of diseases as diverse as interstitial cystitis and chronic alcohol dependence. However, the long duration of action enables extended withdrawal reactions in the chronically opioid-dependent patient. The prolonged opioid antagonism of nalmefene has several applications in the clinical practice of emergency medicine, and is a useful addition in certain situations to the pharmacologic armamentarium of the practicing emergency physician.

Procedural Sedation↗
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The carpal tunnel syndrome.

Chronic carpal tunnel syndrome was initially described by James Jackson Putnam in 1880. A number of medical luminaries have also contributed to our understanding of the syndrome, including Paget, Marie, Ramsay Hunt, Phalen. and Osler. Carpal tunnel syndrome is the most common peripheral compression neuropathy. Most cases are idiopathic, with nonspecific tenosynovitis leading to median nerve compression. A number of diseases and other conditions are also associated with chronic carpal tunnel. Patients characteristically complain of nocturnal paresthesias or burning pain. Motor complaints relate to thenar muscular weakness and atrophy. Bedside diagnostic tests include Tinel's and Phalen's signs, and application of pressure over the median nerve by inflating a sphygmomanometer over the wrist. Tinel's sign is the induction of paresthesias by tapping over the site of the median nerve at the wrist. In Phalen's sign, symptoms are reproduced by maximum flexion of the wrist for 60 s. The classically described patients are middle-aged women. In addition, another distinct population is receiving increased attention, the relatively young male and female workers who experience symptoms performing repetitive manual labor.

Adult↗