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Saladin, "noble enemy" of Richard the Lionheart and victor at the battle of Hattin, died suddenly in 1193 A.D. at the age of 56. The clinical information preserved in the historical record is insufficient to render a definitive diagnosis for Saladin's final illness, and yet, it contains enough details to narrow the list of possibilities to just a few and also to critique his treatment in light of the medical concepts of his day. [ABSTRACT FROM AUTHOR]

Evidence is presented that Alexander the Great, Captain James Cook, Emily Dickinson, and Florence Nightingale each developed symptoms consistent with post-traumatic stress disorder in the aftermath of repeated potentially traumatizing events of differing character. Their case histories also varied with respect to background, premorbid personality style, risk factors, clinical presentation, and course of the illness, illustrating the pleomorphic character of the disorder, as well as the special problems in diagnosing it in historical figures. [ABSTRACT FROM AUTHOR]

Adhesive joints are an alternative method of joining elements. New adhesives achieve cohesion and adhesion strength comparable with plastics used for structural components and coatings. Bonding is faster, simpler and cheaper. For this reason, adhesive joints are increasingly replacing other types of connections. Tests show that the material properties in the cast adhesive specimens differ from the ones determined in the joint. Adhesive producers most often describe the strength of the overlap joint tested in accordance with ASTM D1002. Strength, modulus of elasticity and elongation to break tested in accordance with ASTM D638 are reported less frequently. The article presents a method for determining the mechanical properties of the adhesive in a butt joint and differences in the determined values in relation to the cast specimens on the example of methacrylic adhesive Plexus MA300. The tests were carried out for joining aluminium rod with a square cross-section of 15 mm x 15 mm and adhesive layer thickness of approximately 1 mm. The fractures of cast specimens and butt joints were analyzed.

The aim of the conducted research was to compare the functional properties and the cutting accuracy of items produced using Fiber lasers in comparison with CO2 lasers. The object of 6 mm thick sheet plates made of S235JR steel cut with the two different laser types were analyzed. The tests covered dimensional accuracy (in accordance with the PN EN 22768-fH standard) and the surface after cutting (in accordance with the PN-EN ISO 9013: 2017-04). The results of the analysis have demonstrated that for the same welding linear energy, more accurate cutting surface is obtained using Fiber laser cutting.

Abu-'Ali al-Husayn ibn Abdallah ibn-Sina (known in the West as Avicenna) is revered in much of Asia as one of history's greatest physicians. And yet, few westerners know of him, his iconic Canon of Medicine or the role he played in preserving ancient Greek medical knowledge following the sack of Rome. We briefly review Avicenna's impressive legacy and provide what to our knowledge is the first critical examination of the illness responsible for his death at age 58 years., Competing Interests: Declaration of Competing Interest The authors declare no competing interests., (Copyright © 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

George Washington's medical history has been recounted so many times and with such consistency that it seems that nothing new remains to be said about the panoply of disorders that plagued him during his life. The same can be said for the particular one that carried him off at age 67. We know that he had small pox, dysentery, recurrent attacks of malaria, and a host of other infections during his long and spectacularly productive career. His teeth were a source of unrelenting distress despite his assiduous attention to dental hygiene; and terminally, he developed a rapidly progressive upper respiratory infection, which killed him in little more than a day and a half despite the best medical care available., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Growing evidence suggests that 2-deoxy-2-[18F]fluoro-D-glucose (18FDG)-positron emission tomography/computed tomography (PET/CT) is a useful imaging technique for the evaluation of fever of unknown origin (FUO). This imaging technique allows for accurate localization of foci of hypermetabolism based on 18FDG uptake in glycolytically active cells that may represent inflammation, infection, or neoplasia. The presence of abnormal uptake can help direct further investigation that may yield a final diagnosis. A lack of abnormal uptake can be reasonably reassuring that these conditions are not present, thereby avoiding unnecessary additional testing. Insurers have not routinely covered outpatient 18FDG-PET/CT for the indication of FUO in the United States. However, data published since 2007 suggest early use in FUO diagnostic evaluations improves diagnostic efficiency and reduces costs. Clinicians and insurers should consider 18FDG-PET/CT as a useful tool when preliminary studies are unrevealing., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Although the term "fever" is used liberally in clinical publications, we provide evidence that it is rarely defined in terms of the minimum temperature used to qualify as a fever, the type of thermometer employed in measuring patients' temperatures, or the site at which temperatures are taken. We maintain that in the absence of such information, the term "fever" is meaningless., (© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

COVID-19 is not the world's first pandemic, not its worst, or likely to be its last. In fact, there have been many pandemics throughout history with lessons for the current one. The most destructive pandemic of all time, at least in terms of the number of people killed in the shortest time, was the "Spanish flu" pandemic of 1918/1919. Why did it happen? What lessons did it teach us? And could it happen again? These questions are addressed in the context of the current COVID-19 pandemic and several other nearly equally devastating pandemics of earlier times., Competing Interests: No potential conflict of interest was reported by the author., (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.)

Objectives: Fever is the single most frequently reported manifestation of COVID-19 and is a critical element of screening persons for COVID-19. The meaning of "fever" varies depending on the cutoff temperature used, the type of thermometer, the time of the day, the site of measurements, and the person's gender and race. The absence of a universally accepted definition for fever has been especially problematic during the current COVID-19 pandemic., Methods: This investigation determined the extent to which fever is defined in COVID-19 publications, with special attention to those associated with pregnancy., Results: Of 53 publications identified in which "fever" is reported as a manifestation of COVID-19 illness, none described the method used to measure patient's temperatures. Only 10 (19%) publications specified the minimum temperature used to define a fever with values that varied from a 37.3 °C (99.1 °F) to 38.1 °C (100.6 °F)., Conclusions: There is a disturbing lack of precision in defining fever in COVID-19 publications. Given the many factors influencing temperature measurements in humans, there can never be a single, universally accepted temperature cut-off defining a fever. This clinical reality should not prevent precision in reporting fever. To achieve the precision and improve scientific and clinical communication, when fever is reported in clinical investigations, at a minimum the cut-off temperature used in determining the presence of fever, the anatomical site at which temperatures are taken, and the instrument used to measure temperatures should each be described. In the absence of such information, what is meant by the term "fever" is uncertain., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)

Coronavirus disease 2019 screening can evaluate large numbers of patients while reducing healthcare exposures and limiting further spread of the virus. Temperature screening has been a focal point of case detection during the pandemic because it is one of the earliest and most frequently reported manifestations of the illness. We describe important factors to consider of screened individuals as well as the measurement process and current outcomes. Optimal temperature-based screening involves both individual and environmental factors as well as reconsideration of the current fever threshold., (© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Francisco Goya produced over 1,800 works during his long career, which earned him a reputation as one of the greatest artists of modern times. When he was 47, he developed a mysterious illness that destroyed his hearing, and for the next 35 years left him "deaf as a stump." Of the diagnoses proposed to date, Susac syndrome is the one most consistent with what little we do know of the character of that illness. If he were alive today, given the severity of his hearing loss, Goya would be treated with a cochlear implant, which might restore his ability to communicate in spoken language, though probably not to the level preceding his 1793 illness., (Copyright © 2019. Published by Elsevier Inc.)

In Christina's World, one of the most beloved works of American art, Andrew Wyeth painted Christina Olson crawling crablike across the field below her house, raised on emaciated arms, with a swollen knob for an elbow, and hands clenched and gnarled. The significance of these physical abnormalities, and the message Wyeth endeavored to convey via the portrait, are considered here in light of Christina's medical history and the disorder it most likely signifies.

Although Galileo, Fahrenheit and Celsius are the names generally associated with the origin of the thermometer and its scale, many others were involved in bringing into existence the instrument we use today to monitor body temperature. In fact, the seed from which the thermometer arose was planted long before those credited with inventing it made their contributions, and nurtured by many other investigators during its evolution and clinical application., (Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Historians have long maintained that pneumonia killed William Henry Harrison (1773-1841) just 1 month after he became the ninth president of the United States. For more than a century and a half, it has been alleged that the aged Harrison caught a fatal chill the day he was sworn into office while delivering an overly long inaugural address in wet, freezing weather without a hat, overcoat, and gloves. However, a careful review of the detailed case summary written by his personal physician suggests that enteric fever, not pneumonia per se, was the disorder that carried off "Old Tippecanoe." Two other presidents of that era, James Knox Polk and Zachary Taylor, also developed severe gastroenteritis while in office. Taylor's illness, like Harrison's, proved fatal. In all 3 cases, the illnesses were likely a consequence of the unsanitary conditions that existed in the nation's capital during most of the nineteenth century., (© The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

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. Metchnikoff also predicted the existence of bacterial translocation and anticipated theories linking chronic inflammation with the pathogenesis of atherosclerosis and other disorders of the aged.

Many have wondered what might have become of the totalitarian state Lenin founded on merciless terror, had he not died so young. He was 52 and at the height of his power when he had his first stroke. Six months later he had another and then a third stroke three months after that. He died 3 months shy of his 54th birthday with cerebral arteries so calcified that when tapped with tweezers at the time of his autopsy, they sounded like stone. The reason for his premature atherosclerosis has yet to be explained. He had a family history of cardiovascular disease and, therefore, is suspected of having had an inherited lipid disorder. Stress too might have had a role in the progression of his atherosclerosis. However, neither would explain the extent of the calcification of his cerebral arteries identified at post mortem examination. A recently described variant of the NT5E mutation might explain such calcification, as well as Lenin's family history of cardiovascular disease, and his premature cerebrovascular attacks., (Published by Elsevier Inc.)

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 130 guidelines selected at random from the National Guideline Clearinghouse (NGC) website for compliance with 18 of 25 IOM standards., Results: The overall median number (percentage) of IOM standards satisfied (out of 18) was 8 (44.4%), with an interquartile range of 6.5 (36.1%) to 9.5 (52.8%). Fewer than half of the guidelines surveyed met more than 50% of the IOM standards. Barely a third of the guidelines produced by subspecialty societies satisfied more than 50% of the IOM standards surveyed. Information on conflicts of interest (COIs) was given in fewer than half of the guidelines surveyed. Of those guidelines including such information, COIs were present in over two-thirds of committee chairpersons (71.4%) and 90.5% of co-chairpersons. Except for US government agency–produced guidelines, criteria used to select committee members and the selection process were rarely described. Committees developing guidelines rarely included an information scientist or a patient or patient representative. Non-English literature, unpublished data, and/or abstracts were rarely considered in developing guidelines; differences of opinion among committee members generally were not aired in guidelines; and benefits of recommendations were enumerated more often than potential harms. Guidelines published from 2006 through 2011 varied little with regard to average number of IOM standards satisfied., Conclusion: Analysis of a random sample of clinical practice guidelines archived on the NGC website as of June 2011 demonstrated poor compliance with IOM standards, with little if any improvement over the past 2 decades.

By the time of Hippocrates the typical paroxysmal fever patterns of tertian (every 48 hours) and quartan (every 72 hours) fevers caused by malaria were known. Through the ensuing centuries, ancient Greek, Roman, and Persian physicians made additional contributions to the understanding of fevers. By the end of that era, there was a working definition of what constitutes a fever, the distinction between fever as a symptom and fever as a disease, an elaborate classification scheme for multiple types of fever, hypotheses as to the causes of fever, and methods for diagnosing and treating fevers. Based on the definition of fever at that time, the 10th century ce Persian physician Akhawaynī created fever curves hundreds of years before they were routinely used in the clinical setting. In Hidāyat al-Muta'allimīn fī al-Tibb, Akhawaynī describes a system for fever curves and draws fever curves for tertian and quartan Fevers, as well as the double tertian, double quartan, and triple quartan fevers. In this work we examine the history of fevers in the ancient world and the first description of the fever curve.

Confederate general "Stonewall" Jackson has been called "one of the greatest military geniuses the world ever saw." However, on critical review of his command decisions during the course of 12 of the 20 battles he fought during the American Civil War, historians have rated his performance as poor. In this investigation, the authors examined the effect of sleep deprivation on Jackson's battle decisions in light of experimental data driving current calls for limiting the duty hours of physicians.

According to history books, tuberculosis was responsible for the death of Simon Bolivar at the age of 47 years in 1830. The results of an autopsy performed by Alexandre Prospère Révérend, the French physician who cared for him during the terminal phase of his illness, have long been regarded as proof of the diagnosis. On careful reanalysis of Bolivar's medical history and post mortem examination, we reach a different conclusion. On the basis of several critical clinical, epidemiological, and pathological features of his fatal disorder, we conclude that either paracoccidioidomycosis or bacterial bronchiectasis complicating chronic arsenic intoxication was more likely responsible for his death than was tuberculous "consumption."

Although body temperature is tightly regulated in humans, elevated temperatures are frequently encountered during febrile illnesses and exertional and environmental hyperthermia. Such temperature increases exert profound effects on cell signaling and gene expression patterns, which have important consequences for innate immune function and cell injury, apoptosis, and recovery. The lung offers a framework for understanding how these effects can either benefit or harm the host. We present data demonstrating that exposure to febrile-range hyperthermia (∼39.5 °C) exerts multiple biologic effects that converge on enhanced neutrophil recruitment to the lung, and describe the consequences of these effects for pathogen clearance and collateral tissue injury. We also discuss the influence of temperature on apoptosis in lung epithelium. Collectively, the data presented identify body temperature as a modifiable factor that exerts profound influence on the outcome of infection and injury.