Nodules in rheumatic fever

Nodules in rheumatic fever

110 AMERICAN HEART JOURNAL A dosage of 150 grains (10 Gm.) of sodium salicylate daily is followed in most instances by a blood level of salicylate ...

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110

AMERICAN

HEART JOURNAL

A dosage of 150 grains (10 Gm.) of sodium salicylate daily is followed in most instances by a blood level of salicylate of 30 to 50 mg. per hundred cubic centimeters. When the level of salicylates in the blood falls much below these figures, one can suspect that the patient is not taking the drug. In recurrent attacks of polyeyclic rheumatic fever the sedimentation rate is little affected by the administration of salicylates. Long-continued, high dosage of salicylates is followed by a slight reduction in the hemoglobin content and erythrocyte count. The leucocyte count is unaffected by salicylates, as is the urine. AUTHOR& Bing, R. J., Thomas, C. B., and Waples, E. C.: The Circulation Hypertension, J. Clin. Investigation 24: 513, 1945.

in Experimental

Neurogenfc

The hemodynamic alterations during chronic neurogenic hypertension were studied in six unanesthetized dogs. Following the establishment of hypertension, the cardiac output rose, while the difference in the oxygen content between arterial and mixed venous blood, and the coefficient of oxygen utilization decreased. Since the heart rate increased, the systolic discharge and the right auricular pressure remained at their prehypertensive levels. The total resistance showed no change in four dogs, while it rose in the remainder of the animals. The blood flow through the kidney and the glomerual filtration rate fell in two animals and remained constant in the rest. The decline in the renal fraction and the rise in the renal vascular resistance are evidenced of renal arteriolar constriction. This takes place presumably in the afferent arterioles as the filtrate fraction remained constant. The development of neurogenic hypertension was .followed by a marked rise in the blood flow through the forelimb and a fall of the vascular resistance through the extremity. The changes described in this paper are compatible with increased sympathetic tone Differences in the vascular dynamics between neurogenic hypertension, experimental AUTAOR~ renal hypertension, and essential hypertension, are discussed. Harvey, R. A.:

Nodules in Rheumatic

Fever.

Arch. Pediat. 62: 302, 1945.

This clinico-pathologic study, made by a student in the junior class of Weetern Reserve University as a part of the requirements of the Pediatrics Department, gives a good summary of our knowledge of the clinical manifestations and the causes of subcutaneous and Aschoff’s nodules in rheumatic fever. Johnson, John J.: Some Experimental Aspects of Streptococcus Fever. Arch. Pediat. 62: 387, 1945.

Infection

and Rheumatic

In 1944 the author was able to produce a picture quite closely resembling human carditis by injecting bacteria-free filtrates of a virulent, streptococcus. Working with the same organism a year later, he was unable to reproduce these lesions. He was also unable to reproduce the picture of rheumatic. carditis by injecting horse serum as Rich and to rabbits and then, Gregory did. However, if he first gave horse serum intravenously twelve to twenty days later, introduced a sterile streptococcic filtrate, at least a mild oarditis resulted. The author concludes, therefore, that horse serum, which alone did not produce carditis, did injure the hearts in such a way that they became more susceptible to injury from a bacteria-free streptoeoccic filtrate. Arch Surg. 61: 106, Josiah C.: Surgical Therapy of the Patent Ductus Arteriorrua 1945. This report adds five more to the growing list of patients successfully operated on for this congenital lesion. One of the five patients had proved bacterial endocarditis and has remained well for two years after operation. Sulfadiazine was used for twelve days postoperatively. Trent,