Archives of Internal Medicine

Our medical research library holds 7 studies published in Archives of Internal Medicine (1971–1997). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 6 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: American Medical Assn
• Published: 1960–2012, United States
• Language: English
• ISSN: 0003-9926 (print), 1538-3679 (electronic)
• Continues: A.M.A. Archives of Internal Medicine
• Continued by: JAMA Internal Medicine
• Its record in the NLM Catalog

1990s

• The probability of malignancy in solitary pulmonary nodules. Application to small radiologically indeterminate nodules. S.J. Swensen, M.D. Silverstein, D.M. Ilstrup, et al. 1997;157(8):849-55. PubMed

  Abstract

  Background: A clinical prediction model to identify malignant nodules based on clinical data and radiological characteristics of lung nodules was derived using logistic regression from a random sample of patients (n = 419) and tested on data from a separate group of patients (n = 210).

  Objective: To use multivariate logistic regression to estimate the probability of malignancy in radiologically indeterminate solitary pulmonary nodules (SPNs) in a clinically relevant subset of patients with SPNs that measured between 4 and 30 mm in diameter.

  Patients And Methods: A retrospective cohort study at a multispecialty group practice included 629 patients (320 men, 309 women) with newly discovered (between January 1, 1984, and May 1, 1986) 4- to 30-mm radiologically indeterminate SPNs on chest radiography. Patients with a diagnosis of cancer within 5 years prior to the discovery of the nodule were excluded. Clinical data included age, sex, cigarette-smoking status, and history of extrathoracic malignant neoplasm, asbestos exposure, and chronic interstitial or obstructive lung disease; chest radiological data included the diameter, location, edge characteristics (eg, lobulation, spiculation, and shagginess), and other characteristics (eg, cavitation) of the SPNs. Predictors were identified in a random sample of two thirds of the patients and tested in the remaining one third.

  Results: Sixty-five percent of the nodules were benign, 23% were malignant, and 12% were indeterminate. Three clinical characteristics (age, cigarette-smoking status, and history of cancer [diagnosis, > or = 5 years ago]) and 3 radiological characteristics (diameter, spiculation, and upper lobe location of the SPNs) were independent predictors of malignancy. The area (+/-SE) under the evaluated receiver operating characteristic curve was 0.8328 +/- 0.0226.

  Conclusion: Three clinical and 3 radiographic characteristics predicted the malignancy in radiologically indeterminate SPNs.

• Severity of pulmonary asbestosis as classified by International Labour Organisation profusion of irregular opacities in 8749 asbestos-exposed American workers. Those who never smoked compared with those who ever smoked. K.H. Kilburn, R.H. Warshaw. 1992;152(2):325-7. PubMed

  Abstract

  The profusion of irregular opacities on chest roentgenograms by International Labour Organisation pneumoconiosis criteria was used to assess the severity of asbestosis in 8749 asbestos-exposed active and retired American workers. Seventy-eight percent had no asbestosis (category 0/0 or 0/1), 18.6% had slight asbestosis (1/0 to 1/2), 3% had moderate asbestosis (2/1 to 2/3), and 0.3% had advanced disease (3/2 or greater). Significantly more current smokers had asbestosis than did those who had never smoked, and their average profusion of opacities was higher. The mean age of current smokers with asbestosis was 60 years, whereas subjects with the disease who had never smoked had a mean age of 64 years, a significant difference. Cigarette smoking and asbestosis appear to act synergistically to produce irregular opacities on chest roentgenograms of asbestos-exposed American workers.

1980s

• Spectrum of occupational disease in an academic hospital-based referral center in Connecticut from 1979 to 1987. M.R. Cullen, M.G. Cherniack. 1989;149(7):1621-6. PubMed

  Abstract

  The inability to characterize the extent of occupational disease in the United States limits clinical diagnosis and public health interventions. We present an 8-year (1979 to 1987) experience with clinic-based reporting in Connecticut. Altogether, 3566 cases were sequentially coded for demographics, diagnoses, workplace identification, and exposures at two academic occupational medicine clinics. The lungs were the principal organs of diagnosed effect, with asbestos-related disorders predominating, whereas the urinary tract, endocrine organs, and cardiovascular systems were rarely involved. Of all diseases, 64.8% were diagnosed as chronic and irreversible. Three common disorders, lead intoxication (acute and chronic), asbestosis, and occupational asthma were selected for illustration. Patients with lead poisoning and asbestosis, although collectively numerous (40 and 504, respectively), came from a small number of worksites and industries. Occupational asthma was more variable: 141 diagnosed cases came from 56 different trades and industries and were caused by 28 recognized agents. While we recognize that clinic-based reporting suffers from obvious problems with referral bias and misclassification, our experience shows that it provides an important index of disease burden. Our data document the effects of legislation and litigation on lead poisoning and asbestosis, and correspondingly helps characterize diseases that will respond to broad intervention. On the other hand, occupational asthma is more pervasive and would require a more specialized, partially clinical approach.

• Malignant mesothelioma with occupational and environmental asbestos exposure in an Illinois community hospital. K.M. Wolf, Z.H. Piotrowski, J.D. Engel, et al. 1987;147(12):2145-9. PubMed

  Abstract

  Clinical, radiologic, pathologic, and epidemiologic data on 32 patients with diffuse malignant mesothelioma (DMM) diagnosed between 1968 and 1984 at a 427-bed community hospital in Berwyn, Ill, were reviewed. Independent pathologists' review of light microscopy, supported by electron microscopy, immunoperoxidase staining, or autopsy, confirmed 29 pleural and three peritoneal DMMs. Clinical and radiologic characteristics were similar to those in published case series. Median age at diagnosis was 67 years, and median survival after diagnosis, seven months. Fourteen patients were women. Exposure histories were obtained through 22 interviews supplemented by hospital charts and death certificates. Thirty patients (94%) had a history of asbestos exposure through work (15 [47%]) and/or residence near an asbestos facility (27 [84%]). Medical records and death certificates underreported asbestos exposure and DMM.

• Asbestos diseases and pulmonary symptoms and signs in shipyard workers and their families in Los Angeles. K.H. Kilburn, R. Warshaw, J.C. Thornton. 1986;146(11):2213-20. PubMed

  Abstract

  Families of 338 male and 81 female shipyard workers (SYW), including 280 wives, 144 daughters, and 81 sons, were examined for diseases resulting from asbestos. The workers were initially exposed to asbestos at least 20 years prior to the study date. Radiographic signs of asbestosis (using standard criteria international Labor Office 1980) were found in 64% of 288 male SYW and 21% of 71 female SYW. After excluding those with any occupational exposure to asbestos, asbestosis prevalence was 11% in wives, 8% in sons, and 2% in daughters. Asbestos disease prevalence in workers and in wives increased with the number of years from initial exposure. Male SYW who had smoked had airway obstruction without volume loss. Nonsmokers had normal pulmonary functions. In SYW households prevalences of respiratory diseases, wheezing on physical examination, and symptoms of asthma and chronic bronchitis, exceeded those in the comparison (Michigan) population, even for the younger daughters and sons. These differences, and airway obstruction and distribution defects reported earlier were not explained by cigarette smoking or by asbestos exposure. Instead, they are tentatively ascribed to long-term exposure to ambient air pollution in Los Angeles.

• Bronchoalveolar lavage in asbestosis. A.S. Rebuck, A.C. Braude. 1983;143(5):950-2. Review PubMed

  Abstract

  The interstitial lung disease associated with asbestosis is unique in that the etiological agent and its effects on the pulmonary parenchyma can be studied on a serial basis using bronchoalveolar lavage. In this way both disease activity and structural derangements can be assessed and used in the treatment of the affected individual. In this review, attention has been drawn to the cascade of inflammatory changes induced by asbestos fibers. The activated inflammatory cells are responsible for the alveolitis characteristic of this condition. Like the other forms of diffuse interstitial lung disease, it is the alveolitis that precedes and predicts eventual fibrosis.

1970s

• Lysosomes and the toxicity of particulate pollutants. A.C. Allison. 1971;128(1):131-9. Review PubMed

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