Issues for American Internal Medicine Through the Last Century

Stevens, Rosemary

doi:10.7326/0003-4819-105-4-592

Cited by 30 publications

(6 citation statements)

References 13 publications

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“…Despite its uninspiring and confusing name, internal medicine in the USA became powerful in medical schools because of its focus on science, clinical research, and teaching. The identification of internal medicine with the AAP and the ASCI gave the field a lasting academic tone (2). The laboratory and scientific aspects of early internal medicine made the field much more than just a group of doctors who did not do surgery, obstetrics, or pediatrics, and it gave internal medicine a hospital base, such as surgery had.…”

Section: The Meaning Of "Internal Medicine"mentioning

confidence: 99%

History of Internal Medicine at Baylor University Medical Center, Part 2

Armstrong¹,

Emmett²,

Fordtran³

2004

Baylor University Medical Center Proceedings

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Section: The Meaning Of "Internal Medicine"mentioning

confidence: 99%

History of Internal Medicine at Baylor University Medical Center, Part 2

Armstrong¹,

Emmett²,

Fordtran³

2004

Baylor University Medical Center Proceedings

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“…The identification of internal medicine with the AAP and the ASCI gave the field a lasting academic tone (2). The laboratory and scientific aspects of early internal medicine made the field much more than just a group of doctors who did not do surgery, obstetrics, or pediatrics, and it gave internal medicine a hospital base, such as surgery had.…”

Section: The Meaning Of "Internal Medicine"mentioning

confidence: 99%

“…Internal medicine also became powerful as a practice specialty primarily because of the organizational success of the American College of Physicians (ACP) (2), which was formed in 1915 (8)(9)(10). It was patterned after the Royal College of Physicians of London, which was founded in 1518 by a charter granted by King Henry VIII.…”

Section: The American College Of Physiciansmentioning

confidence: 99%

The History of Internal Medicine at Baylor University Medical Center, Part 1

Fordtran

Armstrong

Emmett³

et al. 2004

Baylor University Medical Center Proceedings

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“…Physicians with a special interest in tuberculosis were one of the first to break away from the parent specialty of internal medicine and become subspecialists in 1941 11. With the development of effective antimicrobial therapy, sanatoria closed and the tuberculosis physician acquired a new body of knowledge and developed skills in pulmonary function testing, bronchoscopy, and, later, polysomnography.…”

mentioning

confidence: 99%

Pulmonary and critical care medicine: a peculiarly American hybrid?

Tobin

Hines

1999

Thorax

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The physiological consequences of altered airways structure on the function of asthmatic airways has been of interest to clinicians and physiologists since the classic study of Huber and Koessler in 1922. 1 These authors provided the first measurements of airway wall thickness in relation to their size and reported that the airway wall of patients who died of asthma was thicker than that of controls. Many have subsequently commented on this finding, 2-7 and Freedman provided an excellent review of its functional significance in 1972.8 A systematic analysis of the eVect of wall thickening on airway function by Moreno and colleagues showed that a thickening of the inner aspect of the airway wall that had little or no eVect on baseline airways resistance was capable of amplifying the eVect of smooth muscle shortening on airway calibre to account for the airways hyperresponsiveness of asthmatic subjects.9 A series of studies followed that further explored this problem using both quantitative histology and computer based models of the airways. [10][11][12][13][14][15] Wiggs et al 15 used a computer model to argue that the greatest eVect of the combination of smooth muscle shortening and wall thickening on the reduction of airway calibre is in the peripheral airways because these structures are encircled by airway smooth muscle. Yanai et al 16 subsequently investigated the site of increased resistance in human airways using direct measurements of pressure and flow to establish that the peripheral airways were the major site of lower airway obstruction in asthma.In this issue of Thorax Orsida and colleagues 17 provide information on the nature of the vascular changes in bronchial biopsy specimens, arguing that the observations made in the bronchi reflect those in the smaller airways. They compare biopsy tissue from a control group with that from two groups of asthmatic patients-one treated and the other not treated with inhaled steroids-and show an increase in the number of vessels and total area of submucosa occupied by vessels in the biopsy specimens from patients with asthma. They also found that inhaled steroids reduced the area of the submucosa occupied by vessels in the asthmatic patients without influencing the number of vessels observed.This study extends the available data on airway vasculature in asthma [18][19][20][21] and is consistent with the concept that the inflammatory response that underlies asthma increases the submucosal vascular compartment, possibly by inducing the growth of new vessels. The authors argue that these vascular changes alter airways function because they found that the change in number of vessels/mm 2 of lamina propria induced by steroids correlated with the percentage change in forced expiratory volume in one second (FEV 1 ) after bronchodilator and the airways response to inhaled methacholine. They suggest that a positive eVect of inhaled steroids may be in reducing the size of this vascular compartment, but recognise that this finding will need to be confirmed by future longi...

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Issues for American Internal Medicine Through the Last Century

Cited by 30 publications

References 13 publications

History of Internal Medicine at Baylor University Medical Center, Part 2

History of Internal Medicine at Baylor University Medical Center, Part 2

The History of Internal Medicine at Baylor University Medical Center, Part 1

Pulmonary and critical care medicine: a peculiarly American hybrid?

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