A COMPARATIVE STUDY OF THE GEOGRAPHIC DISTRIBUTION OF RHEUMATIC FEVER, SCARLET FEVER AND ACUTE GLOMERULONEPHRITIS IN NORTH AMERICA

Objective We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. Methods A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. Results Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high ( n = 20) and low burden ( n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). Conclusions Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.

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Skin Manifestations of Internal Disorders (Dermadromes)

PEDIATRICS ◽

10.1542/peds.2.6.750 ◽

1948 ◽

Vol 2 (6) ◽

pp. 750-750

Author(s):

P. A. DI SANT' AGNESE

Keyword(s):

Rheumatic Fever ◽

Erythema Multiforme ◽

Scarlet Fever ◽

Recent Attempt ◽

Systematic Description ◽

Skin Manifestations ◽

Readable Form ◽

Skin Nodules

This book represents the most recent attempt to provide a systematic description of the skin manifestations of internal disorders. The author has coined and used throughout the volume the term "dermadrome" to designate the dermal component of a syndrome. Thus for instance the characteristic exanthem is the "dermadrome" of scarlet fever, erythema multiforme and skin nodules the "dermadromes" of rheumatic fever. The dermatologic symptoms are detailed under the heading of the various diseases. This facilitates reference within the text for those not conversant with all the intricacies of dermatologic classification. Author and publisher have done a commendable job in presenting the material in clear and readable form.

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Bacterial Aetiology of Pharyngotonsillitis in Paediatric Age Group in a Tertiary Care Hospital in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/624 ◽

2021 ◽

Vol 8 (39) ◽

pp. 3441-3447

Author(s):

Thushara Ushakumari Bhuvanendran ◽

Beena V.G.

Keyword(s):

Staphylococcus Aureus ◽

Streptococcus Pneumoniae ◽

Rheumatic Fever ◽

Streptococcus Pyogenes ◽

Acute Rheumatic Fever ◽

Bacterial Pathogens ◽

Antibiotic Sensitivity ◽

Acute Glomerulonephritis ◽

Age Group ◽

Common Organism

BACKGROUND Pharyngotonsillitis is defined as a spectrum of conditions ranging from inflammation primarily confined to the tonsils to pharyngitis implying generalized inflammation of the whole of pharynx. Children are more prone to get several episodes of pharyngotonsillitis per year during their school years. Pharyngitis caused by Streptococcus pyogenes can cause two non-suppurative complications, acute rheumatic fever and acute glomerulonephritis which is responsible for significant morbidity and mortality. The present study was conducted to identify the prevalence of bacterial pathogens causing pharyngotonsillitis and to study their antibiotic sensitivity pattern that would indicate the optimum line of treatment. METHOD A total of 200 children at the age group of 2 - 12 years who had clinical features of pharyngotonsillitis according to the inclusion criteria were recruited for this study over a period of one year. With the help of a disposable wooden spatula, pus from the pharyngo tonsillar region was collected and processed. Predominant isolates obtained were identified and antibiotic sensitivity was done. RESULTS Bacteria was isolated from 70 samples. Pharyngotonsillitis was found most prevalent at the age group of 8 – 10 years. Intake of cold food stuffs and passive smoking at home was found to have statistically significant association as risk factor for pharyngotonsillitis. Staphylococcus aureus was the most common organism isolated followed by Streptococcus pyogenes. The other organisms isolated were group G and C streptococci, Streptococcus pneumoniae, Pseudomonas aeruginosa and Klebsiella pneumonia sub species (spp) aerogenes. CONCLUSIONS Staphylococcus aureus was the most common organism isolated, followed by Streptococcus pyogenes. All the isolates of beta haemolytic streptococci were found to be sensitive to penicillin. There was increased incidence of resistance to macrolides among the gram-positive isolates except Streptococcus pneumoniae and it may be due to the wide spread use of macrolides injudiciously. All the bacterial pharyngotonsillitis cases were cured with the antibiotic given according to the sensitivity except one case. KEYWORDS Pharyngotonsillitis, Acute Rheumatic Fever, Acute Glomerulonephritis, Bacterial Pathogens, Antibiogram

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