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Recurrence rates in rheumatic fever: The evaluation of etiologic concepts and consequent preventive therapy
RheuUtic Wopkins
and Gregory, J. E.: Type Produced by Hosp. 75: 115, 1944.
further Anaphylactic
x~e~me~~a~ Cardiac ~Y~eKse~s~t~~~~y~
Lesions Bull.
Of &tie Johns
Pn preceding papers we have described and illustrated cardiac lesions or? r,& rhenmatic type that were produced in animals by hypersensitive reactions to foreign protein; shown the basic identity of rheumatic pneumonitis with the pneumonitis resulting from sulfonamide hypersensitivity in nonrheumatics; and assembled evidence of a variety of other types in support of the view that human rheumatic lesions represent the results of foeal hypersensitive reactions. In the present paper further experimental cardiac hypersensitive lesions of the rheumatic type are illustrated. Studies illustrating experimental hypersensitive pneumonitis and arthritis will be presented shortly.
Wilson, M. G., and Lubschez, R.: Evaluation of Etiologic Concepts 3L A. 126: 477, 1944.
Recurrence ates in Eheumatic Fever: and Consequent PreventWe T~era~~~
The 5. A.
The expected risk for a major recurrence of rheumatic fever at specific ages from 4 to 25 years and for various patterns of disease was defined from the ansly& of the records of 499 rheumatie individuals doring 5,677 person-years of life experience. The only factors which were found to inflnence the risk of future recurrences were age and the interval of time elapsing since the la.& attack. Most published studies on the relative frequency of rheumatic fever in expenmental and control groups do not appear to meet the basic re@rements for adequate biostatistieal analysis. Final judgment as to the validity of etiolog&d concepts and consequent preventive therapy, which are based on these studies, must. be deferred. !iUTHORS.
Jones, T. X3.:
The
Diagnosis
of Rheumatic
Fever.
3, -4. N.
,1-. 626:
G31, 1.9&
For the present, it would seem advisable to limit the diagnosis of rheumatic feve: to patients with rather distinct clinical manifestations. It is s-iggested that the following constitute reasonably certain diagnostic criteria : Any combination of the major manifestations (ear&is, arthralgia, chorea, nodules, sod a verified history of previous rheumatic fever). The combination of at least one of the major manifestations with two of the minor manifestations (fever, abdominal or prec.ordial pain, eryt.hema: marginzdtum, epistaxis, pulmonary changes, and laboratory abnormalities) 1 the diagnostic significance of The presence of rheumatic heart disease increases the minor manifestations when no other cause for these manifestations exists. Small though probably insignificant errors may be found with these criteria. Numerous clinical entities as enumerated may be confused with rheumatic fever. Clinical observations and, wherever possible, specific. diagnostic tests should be applied in any diagnostic problem. AUTEOR.
avenswaay, Arie Relationship cocci: 156, 1944.
The Geographic 6.: to the Incidence of
Bacteriologic studies at eight Army from Jan. 1 to April 21, 1944, reveal
Distribution beumatic
of Fever.
Sir Force, Q &eaXaflons that Grol;p A .‘lemolytie
emoiytic StreptoJ. 8. 1%. A. 126: during the period .. streptococci iso!ated
and Gregory, J. E.: Type Produced by Hosp. 75: 115, 1944.
further Anaphylactic
x~e~me~~a~ Cardiac ~Y~eKse~s~t~~~~y~
Lesions Bull.
Of &tie Johns
Pn preceding papers we have described and illustrated cardiac lesions or? r,& rhenmatic type that were produced in animals by hypersensitive reactions to foreign protein; shown the basic identity of rheumatic pneumonitis with the pneumonitis resulting from sulfonamide hypersensitivity in nonrheumatics; and assembled evidence of a variety of other types in support of the view that human rheumatic lesions represent the results of foeal hypersensitive reactions. In the present paper further experimental cardiac hypersensitive lesions of the rheumatic type are illustrated. Studies illustrating experimental hypersensitive pneumonitis and arthritis will be presented shortly.
Wilson, M. G., and Lubschez, R.: Evaluation of Etiologic Concepts 3L A. 126: 477, 1944.
Recurrence ates in Eheumatic Fever: and Consequent PreventWe T~era~~~
The 5. A.
The expected risk for a major recurrence of rheumatic fever at specific ages from 4 to 25 years and for various patterns of disease was defined from the ansly& of the records of 499 rheumatie individuals doring 5,677 person-years of life experience. The only factors which were found to inflnence the risk of future recurrences were age and the interval of time elapsing since the la.& attack. Most published studies on the relative frequency of rheumatic fever in expenmental and control groups do not appear to meet the basic re@rements for adequate biostatistieal analysis. Final judgment as to the validity of etiolog&d concepts and consequent preventive therapy, which are based on these studies, must. be deferred. !iUTHORS.
Jones, T. X3.:
The
Diagnosis
of Rheumatic
Fever.
3, -4. N.
,1-. 626:
G31, 1.9&
For the present, it would seem advisable to limit the diagnosis of rheumatic feve: to patients with rather distinct clinical manifestations. It is s-iggested that the following constitute reasonably certain diagnostic criteria : Any combination of the major manifestations (ear&is, arthralgia, chorea, nodules, sod a verified history of previous rheumatic fever). The combination of at least one of the major manifestations with two of the minor manifestations (fever, abdominal or prec.ordial pain, eryt.hema: marginzdtum, epistaxis, pulmonary changes, and laboratory abnormalities) 1 the diagnostic significance of The presence of rheumatic heart disease increases the minor manifestations when no other cause for these manifestations exists. Small though probably insignificant errors may be found with these criteria. Numerous clinical entities as enumerated may be confused with rheumatic fever. Clinical observations and, wherever possible, specific. diagnostic tests should be applied in any diagnostic problem. AUTEOR.
avenswaay, Arie Relationship cocci: 156, 1944.
The Geographic 6.: to the Incidence of
Bacteriologic studies at eight Army from Jan. 1 to April 21, 1944, reveal
Distribution beumatic
of Fever.
Sir Force, Q &eaXaflons that Grol;p A .‘lemolytie
emoiytic StreptoJ. 8. 1%. A. 126: during the period .. streptococci iso!ated