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Studies on rheumatic fever: Observations on tonsillar carriers of hemolytic streptococci; The effect of tonsillectomy and the administration of penicillin on rheumatic and nonrheumatic fever patients
Abstracts
and Reviews
Selected Abstracts Myers, nit
J. D., and Hickam, Oxygen Consumption
J. B.: An Estimation in Heart Failure.
of the Hepatic Blood J. Clin. Investigation
Flow and Splanch27:620 (Sept.), 1948.
Thirteen patients with congestive heart failure, associated with a reduced cardiac output and increased blood volume, were studied by the hepatic vein catheterization technique. Liver blood flow was determined by the bromsulphalein method. In cardiac failure the liver gets its usual percentage (20 to 24 per cent) of the reduced total cardiac output, and thus differs from the kidney, which suffers a disproportionate reduction in blood flow. There is a compensatory increase in hepatic artiovenous oxygen difference, which under rest and fasting conditions maintains a normal splanchnic oxygen difference. There is a poor correlation between the level of hepatic blood flow and right atria1 or peripheral venous pressure. WAIFE. Nelson, H. G., Studies on Streptococci; Rheumatic 1948.
and the Personnel of United States Naval Medical Research Unit 4: Rheumatic Fever: Observations on Tonsillar Carriers of Hemolytic The Effect of Tonsillectomy and the Administration of Penicillin on and Nonrheumatic Fever Patients. J. Infect. Dis. 83:138 (Sept.-Oct.),
A study was made of the comparative incidence of Group A hemolytic streptococci obtained from cultures of the throats and excised tonsils of rheumatic and nonrheumatic fever patients who had been selected for tonsillectomy. Of the seventy-five rheumatic fever patients, twentytwo were considered to have a low-grade activity of the disease and fifty-three showed no evidence There were sixty-four nonrheumatic of activity for at least one month prior to operation. patients. Routine throat cultures prior to operation were positive for Group A hemolytic streptococci in only 2.7 per cent of the rheumatic fever patients. Positive throat cultures for Group A hemolytic streptococci were similarly found in 3.1 per cent of the nonrheumatic patients prior to tonsillectomy. Group A streptococci were found in the excised tonsillar tissue of 33.3 per cent of the rheumatic fever patients. There was no significant difference in the percentage of positive cultures recovered from patients with continuing activity, as compared with those in the inactive group. Positive cultures were obtained from the tonsils of 15.6 per cent of the nonrheumatic fever patients. Penicillin was given preoperatively to patients whose cultures yielded hemolytic streptococci. The twenty-two patients with lowPostoperative penicillin therapy was given to all patients. grade activity showed no increase in activity following tonsillectomy, and all but two of this group Of the group of fifty-three patients who had been considered became inactive within three months. inactive at the time of tonsillectomy, ten had minor manifestations of activity following operation, but all became inactive at the end of two months. The authors conclude that low-grade activity of rheumatic fever does not contraindicate tonsillectomy when combined with postoperative penicillin therapy, and that cultures from excised tonsils appear to give more accurate information as to the actual incidence of streptococcal carriers than do routine throat cultures. SCHWARTZ. 306
and Reviews
Selected Abstracts Myers, nit
J. D., and Hickam, Oxygen Consumption
J. B.: An Estimation in Heart Failure.
of the Hepatic Blood J. Clin. Investigation
Flow and Splanch27:620 (Sept.), 1948.
Thirteen patients with congestive heart failure, associated with a reduced cardiac output and increased blood volume, were studied by the hepatic vein catheterization technique. Liver blood flow was determined by the bromsulphalein method. In cardiac failure the liver gets its usual percentage (20 to 24 per cent) of the reduced total cardiac output, and thus differs from the kidney, which suffers a disproportionate reduction in blood flow. There is a compensatory increase in hepatic artiovenous oxygen difference, which under rest and fasting conditions maintains a normal splanchnic oxygen difference. There is a poor correlation between the level of hepatic blood flow and right atria1 or peripheral venous pressure. WAIFE. Nelson, H. G., Studies on Streptococci; Rheumatic 1948.
and the Personnel of United States Naval Medical Research Unit 4: Rheumatic Fever: Observations on Tonsillar Carriers of Hemolytic The Effect of Tonsillectomy and the Administration of Penicillin on and Nonrheumatic Fever Patients. J. Infect. Dis. 83:138 (Sept.-Oct.),
A study was made of the comparative incidence of Group A hemolytic streptococci obtained from cultures of the throats and excised tonsils of rheumatic and nonrheumatic fever patients who had been selected for tonsillectomy. Of the seventy-five rheumatic fever patients, twentytwo were considered to have a low-grade activity of the disease and fifty-three showed no evidence There were sixty-four nonrheumatic of activity for at least one month prior to operation. patients. Routine throat cultures prior to operation were positive for Group A hemolytic streptococci in only 2.7 per cent of the rheumatic fever patients. Positive throat cultures for Group A hemolytic streptococci were similarly found in 3.1 per cent of the nonrheumatic patients prior to tonsillectomy. Group A streptococci were found in the excised tonsillar tissue of 33.3 per cent of the rheumatic fever patients. There was no significant difference in the percentage of positive cultures recovered from patients with continuing activity, as compared with those in the inactive group. Positive cultures were obtained from the tonsils of 15.6 per cent of the nonrheumatic fever patients. Penicillin was given preoperatively to patients whose cultures yielded hemolytic streptococci. The twenty-two patients with lowPostoperative penicillin therapy was given to all patients. grade activity showed no increase in activity following tonsillectomy, and all but two of this group Of the group of fifty-three patients who had been considered became inactive within three months. inactive at the time of tonsillectomy, ten had minor manifestations of activity following operation, but all became inactive at the end of two months. The authors conclude that low-grade activity of rheumatic fever does not contraindicate tonsillectomy when combined with postoperative penicillin therapy, and that cultures from excised tonsils appear to give more accurate information as to the actual incidence of streptococcal carriers than do routine throat cultures. SCHWARTZ. 306