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Gregory W Rutecki

Publications and source records attributed to Gregory W Rutecki.

12 recordsLinked to original sources
PubMed2006

A revised timeline for biological agents: revisiting the early years of the germ theory of disease.

An agreed upon timeline for the initial, scientifically-informed use of biological agents typically begins with the Japanese Army in Manchuria and China prior to the generalized outbreak of World War II (1932 until 1945). The process included human experimentation with multiple biological agents followed by their release in combat (e.g. the plague bacillus) targeting military personnel and civilians. Two postulates are used support these dates. First, allegations of earlier bacteriological weapon experimentation and/or use represented the accidental, small scale, and sporadic dispersion of infectious agents preceding the Germ Theory of Disease. Therefore, attempts prior to the Twentieth Century were uninformed scientifically and are not considered representative. Later, as the Germ Theory was maturing, the hypothetical timeline was derived, in part retrospectively, from reputable historical sources (the Trillat Report and The League of Nations) published immediately upon the conclusion of World War I. These documents explicitly testified to the total absence of bacteriological weapons in any form (experimentation or battlefield application) directed at human subjects-in stark contrast to the utilization of chemical agents-during the course of that war. Therefore the Japanese Army in Manchuria became time zero. Recently, evidence previously hidden from outside study has surfaced demonstrating that a small group of Turkish physicians injected typhus-contaminated serum into Armenian civilians during WWI. Although controversy persists regarding primary intent-immunization, experimentation on human subjects, or the introduction of a crude biological weapon-the discovery might suggest a revision to the accepted timeline. The primitive efforts with contaminated serum that occurred during the First World War may seem trivial, especially when compared to overall fatalities during that conflict, but they did include the informed and fatal application of microbial agents. Furthermore, the actions may have influenced certain behaviors that followed in World War II.

Biological Warfare↗
PubMed2005

The influence of controllable lifestyle and sex on the specialty choices of graduating U.S. medical students, 1996-2003.

PURPOSE: To determine whether the preferences of female medical students are sufficient to explain the recent trend of U.S. medical students choosing specialties with controllable lifestyles. METHOD: Specialty choice for graduating U.S. medical students by sex was determined from the responses to the Association of American Medical Colleges' 1996-2003 Medical School Graduation Questionnaires. Using earlier research, specialties were classified as having an uncontrollable or controllable lifestyle. Log-linear models were constructed to assess the strength of association among trends in specialty choice, controllable lifestyle, and sex. RESULTS: The percentage of women choosing specialties with controllable lifestyles increased from 18% in 1996 to 36% in 2003. For men, the percentage grew from 28% to 45%. The change in preference for controllable lifestyle specialties accounted for a large proportion of the variability in specialty choices for both women and men from 1996-2003 (chi2 for changes common to women and men = 920, 1 df, p < .0001). The difference between women and men in the trend toward controllable lifestyle specialties was small relative to the common changes (chi2 for differences = 12, 1 df, p = .0005). CONCLUSION: Controllable lifestyle was strongly associated with the recent trends in specialty choice for both women and men and could not be explained solely by the specialty preferences of women.

Adult↗
PubMed2004

Primer on clinical acid-base problem solving.

Acid-base problem solving has been an integral part of medical practice in recent generations. Diseases discovered in the last 30-plus years, for example, Bartter syndrome and Gitelman syndrome, D-lactic acidosis, and bulimia nervosa, can be diagnosed according to characteristic acid-base findings. Accuracy in acid-base problem solving is a direct result of a reproducible, systematic approach to arterial pH, partial pressure of carbon dioxide, bicarbonate concentration, and electrolytes. The 'Rules of Five' is one tool that enables clinicians to determine the cause of simple and complex disorders, even triple acid-base disturbances, with consistency. In addition, other electrolyte abnormalities that accompany acid-base disorders, such as hypokalemia, can be incorporated into algorithms that complement the Rules and contribute to efficient problem solving in a wide variety of diseases. Recently urine electrolytes have also assisted clinicians in further characterizing select disturbances. Acid-base patterns, in many ways, can serve as a 'common diagnostic pathway' shared by all subspecialties in medicine. From infectious disease (eg, lactic acidemia with highly active antiviral therapy therapy) through endocrinology (eg, Conn's syndrome, high urine chloride alkalemia) to the interface between primary care and psychiatry (eg, bulimia nervosa with multiple potential acid-base disturbances), acid-base problem solving is the key to unlocking otherwise unrelated diagnoses. Inasmuch as the Rules are clinical tools, they are applied throughout this monograph to diverse pathologic conditions typical in contemporary practice.

Acid-Base Equilibrium↗
PubMed2003

Influence of controllable lifestyle on recent trends in specialty choice by US medical students.

CONTEXT: Recent specialty choices of graduating US medical students suggest that lifestyle may be an increasingly important factor in their career decision making. OBJECTIVE: To determine whether and to what degree controllable lifestyle and other specialty-related characteristics are associated with recent (1996-2002) changes in the specialty preferences of US senior medical students. DESIGN AND SETTING: Specialty preference was based on analysis of results from the National Resident Matching Program, the San Francisco Matching Program, and the American Urological Association Matching Program from 1996 to 2002. Specialty lifestyle (controllable vs uncontrollable) was classified using earlier research. Log-linear models were developed that examined specialty preference and the specialty's controllability, income, work hours, and years of graduate medical education required. MAIN OUTCOME MEASURE: Proportion of variability in specialty preference from 1996 to 2002 explained by controllable lifestyle. RESULTS: The specialty preferences of US senior medical students, as determined by the distribution of applicants across selected specialties, changed significantly from 1996 to 2002 (P<.001). In the log-linear model, controllable lifestyle explained 55% of the variability in specialty preference from 1996 to 2002 after controlling for income, work hours, and years of graduate medical education required (P<.001). CONCLUSION: Perception of controllable lifestyle accounts for most of the variability in recent changing patterns in the specialty choices of graduating US medical students.

Career Choice↗
PubMed2003

Familial Mediterranean fever, inflammation and nephrotic syndrome: fibrillary glomerulopathy and the M680I missense mutation.

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by inflammatory serositis (fever, peritonitis, synovitis and pleuritis). The gene locus responsible for FMF was identified in 1992 and localized to the short arm of chromosome 16. In 1997, a specific FMF gene locus, MEFV, was discovered to encode for a protein, pyrin that mediates inflammation. To date, more than forty missense mutations are known to exist. The diversity of mutations identified has provided insight into the variability of clinical presentation and disease progression. CASE REPORT: We report an individual heterozygous for the M680I gene mutation with a clinical diagnosis of FMF using the Tel-Hashomer criteria. Subsequently, the patient developed nephrotic syndrome with biopsy-confirmed fibrillary glomerulonephritis (FGN). Further diagnostic studies were unremarkable with clinical workup negative for amyloidosis or other secondary causes of nephrotic syndrome. DISCUSSION: Individuals with FMF are at greater risk for developing nephrotic syndrome. The most serious etiology is amyloidosis (AA variant) with renal involvement, ultimately progressing to end-stage renal disease. Other known renal diseases in the FMF population include IgA nephropathy, IgM nephropathy, Henoch-Schönlein purpura as well as polyarteritis nodosa. CONCLUSION: To our knowledge, this is the first association between FMF and the M680I mutation later complicated by nephrotic syndrome and fibrillary glomerulonephritis.

Familial Mediterranean Fever↗