Death of a medical colossus: The course, cause and fatal outcome of Avicenna's colic.

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.

Defining Fever.

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.

Prior pandemics. looking to the past for insight into the COVID-19 pandemic.

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.

How fever is defined in COVID-19 publications: a disturbing lack of precision.

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.

Why Temperature Screening for Coronavirus Disease 2019 With Noncontact Infrared Thermometers Does Not Work.

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.

George Washington's Recurrent Health Problems and Fatal Infection Re-examined.

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.

Imaging a Fever-Redefining the Role of 2-deoxy-2-[18F]Fluoro-D-Glucose-Positron Emission Tomography/Computed Tomography in Fever of Unknown Origin Investigations.

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.

Goya's Lost Hearing: A Twenty-First Century Perspective on Its Cause, Effects and Possible Treatment.

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.

A Patient as Art: Andrew Wyeth's Portrayal of Christina Olson's Neurologic Disorder in Christina's World.

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.

Oliver Cromwell׳s Fatal Ague.

Although many people recognize Oliver Cromwell by name, few know more than the barest details of his life or his legacy, and fewer still of the "ague" that ended his brief reign as Lord Protector of the Commonwealth of England, Scotland and Ireland and one of Britain׳s greatest generals. He died suddenly at age 59. Cromwell was the "terror of Europe" during that period. His physicians diagnosed his fatal disorder as "bastard tertian ague." A contemporary analysis of his clinical record, including one with the aid of the U.S. Department of Energy׳s supercomputer at the Oak Ridge National Laboratory in Tennessee, suggests that he died of an infection, possibly 2 infections acting in concert.

Booker T. Washington and the Secret of Hypertension in African Americans.

Booker T. Washington rose from slavery to become one of the most admired Americans of his time. He died of long-standing malignant hypertension on November 14, 1915. At that time the medical profession was just beginning to recognize the importance of hypertension as a risk factor for cardiovascular disease. In spite of intensive research fueled by ongoing speculation, why Washington might have been predisposed to the ravages of hypertension, and African Americans continue to be so predisposed, is a secret yet to be told.

Origin, Evolution and Clinical Application of the Thermometer.

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.