scholarly journals Acute Rheumatic Fever: Findings of a Hospital-Based Study and an Overview of Reported Outbreaks

1990 ◽  
Vol 1 (3) ◽  
pp. 77-81 ◽  
Author(s):  
Upton D Allen ◽  
Michael Braudo ◽  
Stanley E Read
Keyword(s):  
United States ◽  
Rural Communities ◽  
Middle Class ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
The United States ◽  
White Middle Class ◽  
Time Period ◽  
Group A ◽  
Sick Children

To review the characteristics of reported outbreaks of acute rheumatic fever in the United States, and to determine if there is an increase in the incidence of acute rheumatic fever in the population served by the Hospital for Sick Children, Toronto, Ontario, the authors conducted a literature search and a retrospective review of inpatients and outpatients, satisfying the revised Jones criteria for the diagnosis of acute rheumatic fever, from 1972 to 1988. Patients satisfying the revised Jones criteria for the time period 1972–88 were included in the study. There have been eight articles reporting an increase in acute rheumatic fever in the United States. In three, the majority of children were white and from middle class suburban/rural communities in different geographic locations. Mucoid strains of group A streptococci were implicated but not confirmed as being associated with the outbreaks in three. The results of the chart review at the Hospital for Sick Children revealed that 83 cases satisfied the revised Jones criteria. The number of cases per 100,000 children (aged 18 years or less) per year, decreased progressively over the study period. Polyarthritis was the most frequently seen major criterion occurring in 73% of patients (61 of 83). The most frequently affected ethnic groups were Italians 23%, Afro-Canadians 19% and Orientals 8%. The reported outbreaks in the United States are multifocal and predominantly confined to white middle class children residing in suburban/rural communities. There was no evidence of an increase in the number of cases of acute rheumatic fever seen in the population served by the Hospital for Sick Children; there was a progressive decline in number of cases over the study period. The results facilitate the characterization of acute rheumatic fever within North America into three different patterns of occurrence.

scholarly journals The prevalence of MS in the United States

Neurology ◽  
2019 ◽  
Vol 92 (10) ◽  
pp. e1029-e1040 ◽  
Author(s):  
Mitchell T. Wallin ◽  
William J. Culpepper ◽  
Jonathan D. Campbell ◽  
Lorene M. Nelson ◽  
Annette Langer-Gould ◽  
...  
Keyword(s):  
United States ◽  
Census Data ◽  
Adult Population ◽  
The United States ◽  
Health Claims ◽  
The North ◽  
Time Period ◽  
The Us ◽  
Group A ◽  
Us Census

ObjectiveTo generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.MethodsA validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.ResultsThe estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1–310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1–451.6) for women and 159.7 (95% CI 158.7–160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.ConclusionThe estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

The Rise and Fall of Ace Records: A Case Study in the Independent Record Business

1990 ◽  
Vol 64 (3) ◽  
pp. 411-450 ◽  
Author(s):  
Donald J. Mabry
Keyword(s):  
United States ◽  
Middle Class ◽  
The United States ◽  
Record Industry ◽  
Rhythm And Blues ◽  
White Middle Class ◽  
History Of ◽  
The 1950S ◽  
Rock N Roll

The record industry in the United States was controlled until the 1950s by a half dozen major companies, which produced music directed primarily toward the white middle class. The following article uses the history of Ace Records, a small, regional, independent company, to examine the nature of the record industry in the 1950s and 1960s. The article explains the shifts in demography and technology that made possible the growth of the independents, as well as the obstacles and events that made their demise more likely. It also traces the changes that such companies, by recording and promoting rhythm and blues and early rock ‘n’ roll, introduced to the cultural mainstream.

scholarly journals Delayed Diagnosis of Acute Rheumatic Fever in a Patient with Multiple Emergency Department Visits

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Inna Kaminecki ◽  
Renuka Verma ◽  
Jacqueline Brunetto ◽  
Loyda I. Rivera
Keyword(s):  
Emergency Department ◽  
Rheumatic Fever ◽  
Health Care Providers ◽  
Acute Rheumatic Fever ◽  
Group A Streptococcus ◽  
The United States ◽  
Emergency Department Visits ◽  
Penicillin G ◽  
Care Providers ◽  
Group A

While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss followinggroup A Streptococcuspharyngitis. The patient presented to the emergency department twice with the complaints described above. On his 3rd presentation, the workup for his symptoms revealed the diagnosis of acute rheumatic fever with severe mitral and aortic valve regurgitation. The patient was treated with penicillin G benzathine and was started on glucocorticoids for severe carditis. The patient was discharged with recommendations to continue secondary prophylaxis with penicillin G benzathine every 4 weeks for the next 10 years. This case illustrates importance of primary prevention of acute rheumatic fever with adequate antibiotic treatment ofgroup A Streptococcuspharyngitis. Parents should also receive information and education that a child with a previous attack of ARF has higher risk for a recurrent attack of rheumatic fever. This can lead to development of severe rheumatic heart disease. Prevention of recurrent ARF requires continuous antimicrobial prophylaxis. Follow-up with a cardiologist every 1-2 years is essential to assess the heart for valve damage.

Resurgence of Acute Rheumatic Fever

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 585-586
Author(s):  
RAE-ELLEN W. KAVEY ◽  
EDWARD L. KAPLAN
Keyword(s):  
United States ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
The United States ◽  
Health Departments ◽  
State Health ◽  
The Past ◽  
Medical Centers ◽  
Military Populations

Between February 1987 and September 1988, there were eight published reports of outbreaks or increases of acute rheumatic fever cases in civilian as well as in military populations in the United States. This is a change from the past decade. Because rheumatic fever is no longer a reportable disease to local or state health departments, we thought it important to attempt to ascertain the extent of this middle 1980s resurgence. We contacted 56 physicians by telephone, all of them pediatric cardiologists. Essentially, all practice in large referral medical centers.

Houses Divided

2018 ◽  
Author(s):  
Lucas P. Volkman
Keyword(s):  
United States ◽  
African American ◽  
Civil War ◽  
Middle Class ◽  
Print Culture ◽  
The United States ◽  
Local Phenomenon ◽  
White Middle Class ◽  
And Gender ◽  
Border State

This work argues that congregational and local denominational schisms among Baptists, Methodists, and Presbyterians in the border state of Missouri before, during, and after the Civil War were central to the crisis of the Union, Civil War, and Reconstruction. Employing an array of approaches that examine these ecclesiastical fractures beyond the customary antebellum temporal scope of analysis, and as a local phenomenon, this study maintains that the schisms were interlinked religious, sociocultural, legal, and political developments rife with implications for the transformation of evangelicalism and the United States in that period and to the end of Reconstruction. The evangelical disruptions in Missouri were grounded in divergent moral and political understandings of slavery, abolitionism, secession, and disloyalty. Publicly articulated by factional litigation over church property and a combative evangelical print culture, the schisms were complicated by race, class, and gender dynamics that arrayed the contending interests of white middle-class women and men, rural churchgoers, and African American congregants. These ruptures forged antagonistic northern and southern evangelical worldviews that increased antebellum sectarian strife and violence, energized the notorious guerrilla conflict that gripped Missouri through the Civil War, and fueled postwar vigilantism between opponents and proponents of emancipation. As such, the schisms produced the intertwined religious, legal, and constitutional controversies that shaped pro- and antislavery evangelical contention before 1861, wartime Radical rule, and the rise and fall of Reconstruction.

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