The Pattern of Symptoms, Pre-Treatment Interval, and Prognosis of Acute Rheumatic Fever
- ALVAN R. FEINSTEIN, M.D.;
- JUANITA G. ZAGALA, M.D.; and
- MARIO SPAGNUOLO, M.D.
- Requests for reprints should be addressed to Alvan R. Feinstein, M.D., Department of Medicine, Yale University School of Medicine, 789 Howard Avenue, New Haven 11, Connecticut.
Excerpt
In a recent re-appraisal of the clinical patterns of acute rheumatic fever (1), we decided to examine the now traditional belief that residual heart disease is prevented by early treatment. Inspected grossly, the data for first attacks of rheumatic fever showed residual heart disease in 53 (25 per cent) of 209 patients who began treatment within the first 2 weeks after onset of symptoms and in 38 (69 per cent) of 55 patients who began treatment after the first 2 weeks. This highly significant difference seemed to be a clear demonstration that early treatment was of definite value.
When the
Summario in Interlingua
Le typos de gravamine que portava 264 juveniles e adolescentes con prime attaccos de acute febre rheumatic al consulta medical esseva correlationate con le intervallo de tempore inter le prime symptoma e le comenciamento del therapia e con le incidentia de affectiones cardiac—rigorosee objectivemente evalutate—ante e post le tractamento.
Residue damnification cardiac occurreva in 25 pro cento (53) del 209 patientes qui comenciava le tractamento intra 2 septimanas post le declaration del symptomas e in 69 pro cento (38) del 55 patientes qui comenciava le tractamento post plus que 2 septimanas. Tamen, le examine additional de iste datos monstrava le sequente pertinente factos. [1] Residue morbo cardiac, non relationate con le typo o le tempore del tractamento, esseva presente in 30 patientes hospitalisate con sever carditis e esseva absente in 151 patientes qui non habeva carditis al tempore de lor hospitalisation. In le 83 patientes con leve carditis, residue morbo cardiac occurreva un pauco minus frequentemente quando le tractamento esseva initiate precocemente que quando illo esseva initiate tardivemente, sed le differentia non esseva statisticamente significative. [2] De 202 patientes presentate con patente arthritis, solmente 3 pro cento habeva sever carditis, durante que 61 pro cento non habeva carditis. De 62 patientes sin arthritis, 39 pro cento habeva sever carditis, e solmente 13 pro cento habeva nulle carditis. [3] Arthritis occurreva como gravamine de presentation in 89 pro cento del patientes tractate intra 2 septimanas sed in solmente 42 pro cento de illes tractate post plus que 2 septimanas.
Iste datos non supporta le conception traditional que le precoce tractamento de acute febre rheumatic reduce le incidentia de residue morbo cardiac. A causa del facto que arthritis usualmente provocava un prompte attention medical, le gruppo a "tractamento precoce" includeva grande numeros de patientes in qui le absentia de residue morbo cardiac esseva causate per le comportamento del morbo plus tosto que per le therapia o per le promptitude del initiation del therapia.
A parte lor signification con respecto al pathogenese e al tractamento de febre rheumatic, iste resultatos indica que le subtilitates del comportamento clinic del morbo debe esser recognoscite pertinentemente si on vole evitar erronee conclusiones a base del analyse statistic de datos concernente le therapia.
Article and Author Information
-
From Irvington House, Irvington-on-Hudson, New York, and the Department of Medicine, New York University School of Medicine, New York, New York.
-
Supported in part by grants from Parke, Davis and Company, the National Heart Institute (H 1595 C7), the American Heart Association, the New York Heart Association, and the Sullivan County Heart Chapter.
-
- Received March 1, 1962.
- Accepted June 7, 1962.
RSS Feeds









