Alton I. Sutnick

Paralytic ileus simulating acute intestinal obstruction due to pentolinium tartrate (Ansolysen).

Excerpt In recent years pentolinium tartrate has become one of the most widely used drugs in the treatment of severe hypertension. The case described below illustrates dramatically a side effect of...

Pulmonary Surfactant and Atelectasis

Surface activity of atelectatic lung extracts was studied with a surface film balance. All 16 atelectatic specimens demonstrated decreased surface activity regardless of etiology. Of those 12 not associated with pneumonia, contiguous lung tissue was normally surface active. Only atelectatic portions, no matter how tiny, were inactive. To clarify factors involved with the 4 atelectatic specimens associated with pneumonia, 23 specimens of pneumonia were studied. All produced inactive extracts. Eleven of 19 contiguous sections studied were also abnormal. Into this group fell the 4 atelectatic areas. The opposite lungs, uninvolved with pneumonia, were normal. These findings suggest that a decrease in pulmonary surfactant may occur secondary to atelectasis due to noninfectious factors. A surfactant antagonist may be produced during pulmonary infection, and diffuse out into neighboring lung tissue, causing the atelectasis occasionally seen with pneumonia. This concept implies that other substances introduced into the alveoli may also result in atelectasis.

SYSTEMIC LUPUS ERYTHEMATOSUS AND HYPERTENSION WITHOUT RENAL INSUFFICIENCY

Excerpt In the evaluation of patients with hypertension, specific etiologic factors such as coarctation of the aorta, unilateral renal disease or polycystic disease of the kidneys have been sought,...

Population cancer screening.

Controlled trials to evaluate mass screening programs for cancer detection have been singularly lacking. High cost, lack of medical manpower, and low yield have contributed to this problem. A new program in cancer detection (CAN‐SCREEN) has been developed jointly by The Fox Chase Cancer Center in Philadelphia and the Preventive Medicine Institute in New York City. This program attempts to provide a quality cancer‐detection examination with increased cost effectiveness. Features include: 1) a self‐administered questionnaire on medical history, symptoms, and risk factors; 2) nonphysician examiners; 3) risk‐factor analysis with a predetermined decision logic to determine type and periodicity of examination; and 4) primary intervention (health education). This collaborative program between two institutions in two cities demonstrates the feasibility of introducing similar programs elsewhere. A data base shared by cooperating centers permits information on all patients to be used for evaluation of new techniques, end results, etc. A randomized controlled trial has been designed to evaluate the effectiveness and efficiency of the questionnaire alone and of the questionnaire and examination.

The Health Care System in India

Excerpt The people of India are an ancient people, but the nation is a relatively new, evolving, developing country, still in transformation, having become a fully independent and united country on...

The Medical Scene in Israel Today

Excerpt Israel probably has the largest number of doctors per capita of any country in the world (1:336 in 1973; second is the USSR with 1:360 in 1972). Physicians are not in great demand there as ...

EMT training for medical students

Dr. John Lumpkin (University of Chicago): The subject of integrating EMT training into the medical school curriculum has recently become controversial. How much education in EMS is necessary for the average medical student? Could EMS education somehow effect the way that they as graduate physicians interact with the EMS system? Many of us are familiar with the incident that occurred about two years ago at the American College of Gastroenterologists in Palm Springs, California. A paramedic was managing a patient in cardiac arrest via radio communication with the base station. The gastroenterologists wanted to help, but the paramedic saw them as interfering and refused to allow their involvement. The result was that some of the gastroenterologists were removed from the scene by the police, who were more afraid of the paramedic than the strangers. Another subject involves the expectations that society holds for the medical student. In many ways, for instance, the medical student is expected by family and friends to be a practitioner of medicine from the day he/she is accepted into a graduate program. Yet, the student generally has none of the practical skills necessary. Is it reasonable or appropriate within the medical school curriculum to teach the medical student how to handle these situations prior to graduation from medical school? Dr. Daniel Goodenberger (Georgetown University): Despite the fact that EMT courses at Georgetown have never been publicized, they have been going on for approximately 1.5 years. They were begun in 1968