Philip A. Mackowiak

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Sinus-tract cultures were compared with cultures of operative specimens from 40 patients with chronic osteomyelitis. Thirty-five patients (87.5%) had a single pathogen isolated from their operative specimens. Only 44% of the sinus-tract cultures contained the operative pathogen. Isolation of Staphyloccus aureus from sinus tracts correlated with the presence(More)
OBJECTIVE To evaluate critically Carl Wunderlich's axioms on clinical thermometry. DESIGN Descriptive analysis of baseline oral temperature data from volunteers participating in Shigella vaccine trials conducted at the University of Maryland Center for Vaccine Development, Baltimore. SETTING Inpatient clinical research unit. PARTICIPANTS One hundred(More)
BACKGROUND In March 2011, the Institute of Medicine (IOM) issued a new set of standards for clinical practice guidelines intended to enhance the quality of guidelines being produced. To our knowledge, no systematic review of adherence to such standards has been undertaken since one published over a decade ago. METHODS Two reviewers independently screened(More)
Polymicrobial sepsis is a common and frequently fatal clinical condition that has received relatively little attention in published reports. Retrospectively, we reviewed the case records of 184 patients with polymicrobial sepsis seen at three Dallas hospitals between 1972 and 1977. Analysis of clinical data using log linear models enabled us to identify(More)
Over a century ago, Elie Metchnikoff theorized that health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt. His theory flourished for a time, then drifted to the fringe of medical practice before re-emerging in the mid-1990s as a concept worthy of mainstream medical attention.(More)
Akhenaten was one of Egypt's most controversial pharaohs, in part because of his strange appearance in images produced after he had declared Aten, the Sun-disc, his one-and-only god. Whether these were symbolic representations or realistic ones that indicate a deforming genetic disorder is the subject of continuing debate. The authors present evidence that(More)
If asked to define fever, most physicians would offer a thermal definition, such as "fever is a temperature greater than...." In offering their definition, many would ignore the importance of the anatomic site at which temperature measurements are taken, as well as the diurnal oscillations that characterize body temperature. If queried about the history of(More)
The importance of an upper limit of the febrile response has been recognized since the time of Hippocrates. Although the precise temperature defining this limit varies according to the site at which body temperature is measured, human core temperature is almost never permitted to rise above 41 degrees C-42 degrees C during fever. There are compelling(More)
The traditional clinico-pathologic conference (CPC) begins with a case presentation. Next, a clinician analyzes the clinical information, illustrating the diagnostic process and proposing one “best-fit” diagnosis for the anonymous (and often dead) patient. Finally, a pathologist presents the actual autopsy or histologic findings, either validating or(More)