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Observations on the epidemiology of streptococcal pharyngitis and the relation of streptococcal carriers to the occurrence of outbreaks
SELECTED
Hurst, A., Bassin, S., and Levine, Stenosis. Am. Rev. Tuherr. 49:
873
ABSTRACTS
I.:
Miliary
276,
1944.
Densities
Associated
With
Mitral
Chest x-ray surveys for tubcrculosit: are protlurtive of a great tileal of informaon nontuberculous conditions. Several cases of bilateral, symmetrical, diffuse, nodular, pulmonary densities assokted with rheumatic mitral st,cnosis were discovered in draftees. These miliary densities must be carefully Ilistinguishetl from similar appearing renditions, such as miliary tuberculosis, sarcoidosis, pneumonoconiosis, carcinomatosis, rtc. An explanation for the varying roentgenographie appearance has been offere~l in the light of the probable pathologic anI1 physiologic background. tion
.~IJTH~RR.
Wedum, A. G., and Wedum, B. G.: Am.
J. Dis.
Chilll.
67:
182,
Rheumatic
Infections
in Cincinnati
Hospitals.
19.U.
There was a total of 3,475 admissions of patients with rheumatic infections to all hospitals in Cincinnati for the period from Jan. 1, 1930 to Dec. 31, 1940. Analysis of the records of these admissions and comparison with similar data obtained in Philadelphia for the perioll from 1930 through 1934 revealed the following facts : The rheumatic syndrome ~a?; more nearly the same in Negroes in the two cities than it was in white persons. Negroes constituted a considerably greater proportion of the patients with rheumatit heart disease with rheumatic fever, and a somewhat smaller proportion of those with chorea than would be expected from their proportion in the population and in patients admitterl to hospitals. Choroa is more Common in Negroes than is generally realized. In white persons in Cincinnati the incidence of rheumatic fever was lower, and the acute manifest,ations were less frequent, than in Philadelphia, and both morbidity aml c.ase mortality among rllildren were lower. Among adults above the age of 35 years? the annual incidence of rheumatic heart disease per hundred thousand of population was greater in (‘incinnati; this group accounted for more of thp patients who died in Cincinnati than in Philadelphia. Adequate cqonvalescent care for white children, and caomparatively inadequate length of hospitalization for adults in Cincinnati, provide a possihlr explanation for these differences. tend to corroborate the growing conviction The data accumulate(l in thi R survey that convalescent, care, of provr~l value for children with rheumatic fever, should he given also to young adults. This c*oncaept is of major importance in handling rheumatic infections among young persons in military serricc. .21’T110RS.
Kuttner, A. G., and Krumwiede, E.: Observations on the Epidemiology of Streptococcal Pharyngitis and the Relation of Streptococcal Oarriers to the Occurrence of Outbreaks. J. (Yin. Investigation 23: 139, 1944. Major and minor outbreaks as well as sporadic cases of streptococcal pharyngitis occurring in groups of rheumatic children in a sanatorium (luring a six-year period are described. Major outbreaks were due to Group A streptococci of a single type not previously present, and were not precedrd by a rise in carrier rate. Minor outbreaks were prereded by a slow spread from carriers to other individuals without at first causing infection. Subsequently, a small number of clinical cases due to these types developed. Sporadic cases arose directly from carriers and were not preceded by a dissemination of the streptococci to healthy individuals,
874 The
AMERICAN
length
Twenty-nine months were microorganisms months. than
of the
carrier
per carriers did
state
length
of
was
the
carrier
JOURNAL
studied.
cent of the children of Group A hemolytic not spread to other
The epidemic-inducing types in ‘ ( contact ” carriers.
The tonsils.
HEART
admitted streptococci. individuals
of streptococci state
was
during the summer and fall With few exceptions, these and disappeared after a few
persisted
not
related
longer
to
the
in ‘ ‘ post-infection
presence
or
’’
absence
of
AUTHORS.
Kuttner, A. G., in the Blood Clin. Investigation
The Occurrence of Bacteriostatic Properties and Lenert, T. F.: of Patients After Recovery From Streptococcal Pharyngitis. J.
The development recovery from upper type, is reported.
23:
151, 1944.
of bacteriostatic properties in the blood of children, after respiratory infections due to Group A streptococci of a single AUTHORS.
Higgins, G. K.: The Effect of Pulmonary Heart. Am. Rev. Tuberc. 49: 255, 1944.
Tuberculosis
Upon the Weight
of the
The total heart weights of 609 carefully selected patients dying from pulmonary tuberculosis have been tabulated by age, body length, and estimated body weight. These have been compared with normal heart weights selected from the literature. Right ventricular weights above Miiller’s averages of the tuberculous pa.tients and a ventricular ratio present in 40 per cent. The right ventricle weighed left in 15 per cent of the tuberculous patients. It was not possible to determine hypertrophy and pleural adhesions, pulmonary tuberculosis.
a definite pulmonary
A definite relationship clinical duration of the
between
Left
ventricular
existed disease.
hypertrophy
was
not
were found in 23 per cent (L/R) of less than 1.3 was more than the corresponding
relationship between collapse, or the type right
noted
ventricular in
this
A theory has been presented to explain the presence trophy in some patients and its absence in others with
right ventricular and extent of the
hypertrophy
and
the
series. of right similar
ventricular tuberculous
hyperlesions. AUTHOR.
Gordan, G., Soley, M. I-I., and Chamberlain, F. L.: Electrocardiographic Associated With Hyperthyroidism. Arch. Int. Med. 73: 148, 1944.
Features
In this series of cases of hyperthyroidism the noteworthy electrocardiographic findings in order of frequency were: (1) sinus tachycasdia, (2) various abnormalities of the T waves, of which low amplitude and notching were the most common, (3) aurieular fibrillation, (4) partial auriculoventricular block, and (5) in rare instances, auricular flutter. After exclusion of other causes for electrocardiographic abnormalities, the incidence of these findings was the same for the younger (14 to 40 years of age) and for the older (41 to 75 years of age) groups of patients. After treatment of hyperthyroidism, the abnormalities tend to disappear. In the presence of hyperthyroidism, electrocardiograms must be interpreted with caution, since they may simulate those of persons with organic heart disease. AUTHORS.
Hurst, A., Bassin, S., and Levine, Stenosis. Am. Rev. Tuherr. 49:
873
ABSTRACTS
I.:
Miliary
276,
1944.
Densities
Associated
With
Mitral
Chest x-ray surveys for tubcrculosit: are protlurtive of a great tileal of informaon nontuberculous conditions. Several cases of bilateral, symmetrical, diffuse, nodular, pulmonary densities assokted with rheumatic mitral st,cnosis were discovered in draftees. These miliary densities must be carefully Ilistinguishetl from similar appearing renditions, such as miliary tuberculosis, sarcoidosis, pneumonoconiosis, carcinomatosis, rtc. An explanation for the varying roentgenographie appearance has been offere~l in the light of the probable pathologic anI1 physiologic background. tion
.~IJTH~RR.
Wedum, A. G., and Wedum, B. G.: Am.
J. Dis.
Chilll.
67:
182,
Rheumatic
Infections
in Cincinnati
Hospitals.
19.U.
There was a total of 3,475 admissions of patients with rheumatic infections to all hospitals in Cincinnati for the period from Jan. 1, 1930 to Dec. 31, 1940. Analysis of the records of these admissions and comparison with similar data obtained in Philadelphia for the perioll from 1930 through 1934 revealed the following facts : The rheumatic syndrome ~a?; more nearly the same in Negroes in the two cities than it was in white persons. Negroes constituted a considerably greater proportion of the patients with rheumatit heart disease with rheumatic fever, and a somewhat smaller proportion of those with chorea than would be expected from their proportion in the population and in patients admitterl to hospitals. Choroa is more Common in Negroes than is generally realized. In white persons in Cincinnati the incidence of rheumatic fever was lower, and the acute manifest,ations were less frequent, than in Philadelphia, and both morbidity aml c.ase mortality among rllildren were lower. Among adults above the age of 35 years? the annual incidence of rheumatic heart disease per hundred thousand of population was greater in (‘incinnati; this group accounted for more of thp patients who died in Cincinnati than in Philadelphia. Adequate cqonvalescent care for white children, and caomparatively inadequate length of hospitalization for adults in Cincinnati, provide a possihlr explanation for these differences. tend to corroborate the growing conviction The data accumulate(l in thi R survey that convalescent, care, of provr~l value for children with rheumatic fever, should he given also to young adults. This c*oncaept is of major importance in handling rheumatic infections among young persons in military serricc. .21’T110RS.
Kuttner, A. G., and Krumwiede, E.: Observations on the Epidemiology of Streptococcal Pharyngitis and the Relation of Streptococcal Oarriers to the Occurrence of Outbreaks. J. (Yin. Investigation 23: 139, 1944. Major and minor outbreaks as well as sporadic cases of streptococcal pharyngitis occurring in groups of rheumatic children in a sanatorium (luring a six-year period are described. Major outbreaks were due to Group A streptococci of a single type not previously present, and were not precedrd by a rise in carrier rate. Minor outbreaks were prereded by a slow spread from carriers to other individuals without at first causing infection. Subsequently, a small number of clinical cases due to these types developed. Sporadic cases arose directly from carriers and were not preceded by a dissemination of the streptococci to healthy individuals,
874 The
AMERICAN
length
Twenty-nine months were microorganisms months. than
of the
carrier
per carriers did
state
length
of
was
the
carrier
JOURNAL
studied.
cent of the children of Group A hemolytic not spread to other
The epidemic-inducing types in ‘ ( contact ” carriers.
The tonsils.
HEART
admitted streptococci. individuals
of streptococci state
was
during the summer and fall With few exceptions, these and disappeared after a few
persisted
not
related
longer
to
the
in ‘ ‘ post-infection
presence
or
’’
absence
of
AUTHORS.
Kuttner, A. G., in the Blood Clin. Investigation
The Occurrence of Bacteriostatic Properties and Lenert, T. F.: of Patients After Recovery From Streptococcal Pharyngitis. J.
The development recovery from upper type, is reported.
23:
151, 1944.
of bacteriostatic properties in the blood of children, after respiratory infections due to Group A streptococci of a single AUTHORS.
Higgins, G. K.: The Effect of Pulmonary Heart. Am. Rev. Tuberc. 49: 255, 1944.
Tuberculosis
Upon the Weight
of the
The total heart weights of 609 carefully selected patients dying from pulmonary tuberculosis have been tabulated by age, body length, and estimated body weight. These have been compared with normal heart weights selected from the literature. Right ventricular weights above Miiller’s averages of the tuberculous pa.tients and a ventricular ratio present in 40 per cent. The right ventricle weighed left in 15 per cent of the tuberculous patients. It was not possible to determine hypertrophy and pleural adhesions, pulmonary tuberculosis.
a definite pulmonary
A definite relationship clinical duration of the
between
Left
ventricular
existed disease.
hypertrophy
was
not
were found in 23 per cent (L/R) of less than 1.3 was more than the corresponding
relationship between collapse, or the type right
noted
ventricular in
this
A theory has been presented to explain the presence trophy in some patients and its absence in others with
right ventricular and extent of the
hypertrophy
and
the
series. of right similar
ventricular tuberculous
hyperlesions. AUTHOR.
Gordan, G., Soley, M. I-I., and Chamberlain, F. L.: Electrocardiographic Associated With Hyperthyroidism. Arch. Int. Med. 73: 148, 1944.
Features
In this series of cases of hyperthyroidism the noteworthy electrocardiographic findings in order of frequency were: (1) sinus tachycasdia, (2) various abnormalities of the T waves, of which low amplitude and notching were the most common, (3) aurieular fibrillation, (4) partial auriculoventricular block, and (5) in rare instances, auricular flutter. After exclusion of other causes for electrocardiographic abnormalities, the incidence of these findings was the same for the younger (14 to 40 years of age) and for the older (41 to 75 years of age) groups of patients. After treatment of hyperthyroidism, the abnormalities tend to disappear. In the presence of hyperthyroidism, electrocardiograms must be interpreted with caution, since they may simulate those of persons with organic heart disease. AUTHORS.