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Biomedical subjects

M Linzer

Publications and source records attributed to M Linzer.

At least 73 records · Page 4Linked to original sources
PubMed1988

Impact of a medical journal club on house-staff reading habits, knowledge, and critical appraisal skills. A randomized control trial.

The journal club is an established teaching modality in many house-staff training programs. To determine if a journal club improves house-staff reading habits, knowledge of epidemiology and biostatistics, and critical appraisal skills, we randomized 44 medical interns to receive either a journal club or a control seminar series. A test instrument developed by the Delphi method was administered before and after the interventions (mean, five journal club sessions). By self-report, 86% of the house staff in the journal club group improved their reading habits vs 0% in the control group. Knowledge scores increased more in the journal club group than in the control group, and a trend was found toward more knowledge gained as more sessions were attended. Ability to appraise critically a test article increased slightly in each group, but there was no significant difference between the groups. We conclude that a journal club is a powerful motivator of critical house-staff reading behavior and can help teach epidemiology and biostatistics to physicians-in-training.

Biometry↗
PubMed1987

Syncope.

The isolated syncopal episode, most commonly a benign and self-limited event, may also represent serious neurologic or cardiologic disease. In evaluating patients with syncope, the clinician must differentiate the benign from the more serious etiology. Considerable progress has been made in the past 20 years in understanding the causes of syncope and in determining prognosis. This paper reviews our current appreciation of syncope and in determining prognosis. This paper reviews our current appreciation of these issues and defines the clinical utility of diagnostic testing in patients with syncope.

Aged↗
PubMed1987

The journal club and medical education: over one hundred years of unrecorded history.

Sir William Osler organized a journal club at McGill University in 1875, and several authors suggest that journal clubs were found in certain European countries (in particular, Germany and England) prior to that time. The evolution and development of the journal club, however, has not been recorded in the medical literature. Through personal communications and interviews with senior clinicians and historians, I have traced the history of the journal club as an educational modality. In the early 1900s in Germany, journal clubs were routinely found in departments of medicine and medical schools. From 1917-1975, journal clubs evolved into a forum for continuing medical education. Recently, journal clubs have been designed to teach critical appraisal skills to physicians-in-training. Journal clubs are currently found in the fields of medicine, surgery, psychiatry, nursing, pharmacy, obstetrics and gynaecology, paediatrics and geriatric social service. This powerful educational tool has played an active role in medical education for over a century. The journal club should be more formally incorporated into the medical educational curriculum.

Education, Medical, Graduate↗
PubMed1987

Inability to predict diagnosis in febrile intravenous drug abusers.

Although hospitalization is recommended for all febrile intravenous drug abusers, this practice has not been tested and validated. To determine the distribution of disease and the predictive value of clinical information available in the emergency room for diagnosis in these patients, we prospectively evaluated the clinical and laboratory data for 87 consecutive admissions involving 75 intravenous drug abusers with temperature of 38.1 degrees C or more, emergency room physicians' diagnostic predictions, and final diagnosis. Final diagnoses were pneumonia in 38% of the patients, trivial illness (viral syndrome, pharyngitis, or pyrogen reaction) in 26%, infective endocarditis in 13%, and other conditions in 23%. Neither emergency room physicians' diagnostic predictions nor clinical data correlated with a final diagnosis of endocarditis. Although physicians' prediction of trivial illness was associated with a final diagnosis of trivial illness (p less than 0.05), 29% of these patients had a more serious final diagnosis. These data confirm the need to hospitalize all intravenous drug abusers presenting with fever at an emergency room.

Adult↗
PubMed1986

Diffuse lymphadenopathy as a manifestation of ankylosing spondylitis.

Diffuse lymphadenopathy has not been previously described in association with ankylosing spondylitis. A 22-year-old man who presented with anorexia, weight loss, shoulder pain, and diffuse lymphadenopathy is described. Lymph node biopsy showed a nonspecific pattern of reactive hyperplasia with sinus histiocytosis. Clinical evaluation disclosed active spondylitis with HLA-B27 positivity. No other cause for the lymphadenopathy was found. The association between lymphadenopathy and connective tissue diseases is discussed. Ankylosing spondylitis should be added to the differential diagnosis of patients with generalized lymphadenopathy of uncertain cause.

Adult↗
PubMed1984

Chronic pancreatitis: the diagnostic significance of pancreatic size and echo amplitude.

Pancreatic size and pancreatic echo amplitude were examined to determine their value for distinguishing chronic pancreatitis from normal. Using patients with cystic fibrosis as a model for chronic pancreatitis, a prospective study was performed comparing 16 patients with this disease and 16 normals. Absolute measurements of the pancreatic body and the ratio of pancreatic size to vertebral body size were determined. Pancreatic echo amplitude was both measured clinically from the B-scan and evaluated in a blind review by seven observers. The pancreases of cystic fibrosis could be distinguished on the basis of echo amplitude with sensitivity and specificity of 94 per cent and 100 per cent for direct B-scan echo amplitude measurements and 74 per cent and 88 per cent for reviewers. Pancreatic size was of no value as a distinguishing characteristic, probably because as the diseased pancreas increases in echo amplitude by fat and fibrous tissue replacement, it blends imperceptibly with the peripancreatic soft tissues. Measurement of pancreatic size in chronic pancreatitis is therefore inaccurate and probably overestimated.

Adolescent↗
PubMed1984

Diagnostic ultrasound: its use in the evaluation of muscle.

We describe a noninvasive quantitative way of measuring muscle with a specially-designed digital ultrasound scanner. Reliability and reproducibility of echo amplitude were determined in 16 normal male volunteers--10 runners and 6 non-runners. Echo amplitudes were recorded from the quadriceps femoris muscle. The muscle was scanned at mid-thigh in a relaxed state with 18 degrees flexion and in an isometrically contracted state with the leg in full extension. Echo amplitudes obtained in the non-runner group were: (1) mean value of the muscle in the relaxed state (174.9 +/- 30.8) and (2) mean value of the muscle in the contracted state (121.8 +/- 31.4). The difference in these values (53.1) was significant at p less than 0.05. Echo amplitudes for runners were: (1) mean value of the muscle in the relaxed state (146.6 +/- 39.2) and (2) mean value of the muscle in the contracted state (107.1 +/- 30.1). The difference in these values (39.5) was significant at p less than -0.01. The data indicate that: values of echo amplitudes are reproducible; there is a statistically significant difference in the mean amplitudes of muscle in a contracted and relaxed state; and while the difference between runner and non-runner muscle is not statistically significant (p greater than 0.1), there is a trend toward significance. Because ultrasound amplitude is a function of tissue structure, this technique may provide a noninvasive method for quantifying muscle collagen and fat.

Adipose Tissue↗