The epidemiology and prevention of rheumatic fever. 1952.
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Biomedical subjects
Publications and source records attributed to C H Rammelkamp.
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The faculty of the Department of Medicine at Cleveland Metropolitan General Hospital has responded to the challenge of fostering general internal medicine in a graduate training program by organizing a "firm" system of medical care which has appealed to academic internists with broad interests in clinical medicine. This firm system consists of four medical teams which care for distinct patient populations, closely integrating their outpatient and inpatient care. The firms are made up of all the house staff in training in internal medicine together with senior and junior faculty members who are directors for the firms. Medical students in general medicine are also assigned to firms. This firm system is relatively simple to understand and establish and is readily applicable to other academic departments with general medical responsibilities.
The susceptibility of 55 strains of slow-growing anaerobes to eight clinically useful or potentially useful antibiotics was determined by agar dilution and disk diffusion tests. Strains of the genera Peptococcus, Peptostreptococcus, Megasphaera, Veillonella, Eubacterium, Bifidobacterium, Clostridium, and Fusobacterium were included. All strains were susceptible to chloramphenicol, but varied in their susceptibility to penicillin, lincomycin, clindamycin, tetracyclines, and vancomycin. Correlation between minimal inhibitory concentration and inhibition zone diameters was generally good. Prediction of susceptibility based on zone diameter measurements appeared satisfactory. Although routine susceptibility testing of anaerobic bacteria is not recommended, there are circumstances where such testing is relevant to the clinical situation. For those laboratories ill-equipped to do dilution tests, a disk diffusion test would give relatively accurate preliminary information. Quantitative susceptibility tests could then be done by a reference laboratory.
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A case of scarlet fever studied in 1959 and caused by Staphylococcus aureus, phage type 52/52a/80 infection of a surgical burn is reported. The literature is reviewed and data are presented which indicate the distinct antigenicity of the erythrogenic toxins of staphylococci and group A streptococci. The patient developed neutralizing antibodies to staphylococcal toxin which disappeared ten months after infection. The similarity of the rashes and desquamation of the skin of several diseases caused by staphylococci indicate at least one common toxin.