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60(5 NORTH CAROLINA MEDICAL JOURNAL December, 1953 these individuals, it seems likely that a significant number of first attacks of rheumatic fever were prevented. This method has also been employed in rheumatic patients, known to be highly susceptible to recurrences. In a small series of such patients given vigorous, early penicillin therapy for streptococcal infections, Massell found also a significant reduction of rheumatic attacks. Currently it is advocated that penicillin be given for 10 days in order to insure complete elimination of the streptococci(0). For home care the impracticalit.v of daily injections can be overcome by combinations of long-acting penicillin injections followed by oral therapy. The chief disadvantage of this method as compared with continuous prophylaxis is that one will miss the opportunity to treat a number of streptococcal infections early enough to prevent rheumatic fever. Often streptococcal invasion of the throat gives few symptoms. The physician, then, may not be called at all, or if he is, his therapy may not be given in time to prevent the trigger mechanism that touches off the rheumatic attack. Summary Several methods of protection against rheumatic fever are available (fig. 2). Penicillin may be used as a continuous prophylactic agent, probably the most effective method for the susceptible child. Sulfadiazine is useful for the same purpose. It is cheaper and possibly somewhat less effective. For the treatment of an acute streptococcal infection in a normal or rheumatic subject, early vigorous use of penicillin is the method of choice. Sulfonamides, in this situation, are ineffective. References 1. Bland, E. F., and Jones, T. D.: Rheumatic Fever and Rheumatic Heart Disease; A Twenty Year Report on 1000 Patients Followed Since Childhood, Circulation 4:836-843 (Dec.) 1951. 2. Rantz, L., Boisvert. P. J., and Spink, W. W.: Etiology and Pathogenesis of Rheumatic Fever, Arch. Int. Med. 76:131-138 (Sept.) 1945. 3. Rosenberg-, E. F., and Hench, P. S.: Recent Advances in the Treatment of Rheumatic Fever; With Special Reference to Sulfonamide Prophylaxis and Intravenous Salicylate Therapy, M. Clin. North America 30:489-509 (May) 1946. 4. Massell, B. F., Dow, J. W., and Jones, T. D.: Orallv Administered Penicillin in Patients with Rheumatic Fever, J.A.M.A. 138:1030-1036 (Dec.) 1948. 5. Kilbourne, E. D., and Loere. J. P.: Comparative Effects of Continuous and Intermittent Penicillin Therapy on the Formation of Antistreptolysin in Hemolytic Streptococcus Pharyngitis, J. C. I. 27:418-424 (July) 1948. 6. Massell, B. F., and others: Prevention of Rheumatic Fever by Prompt Penicillin Therapy of Hemolytic Streptococcic Respiratory Infections, J.A.M.A. 146:1469-1474 (Aug.) 1951. 7. Wannamaker, L. W., and others: Prophylaxis of Acute Rheumatic Fever by Treatment of the Preceding Streptococcal Infection with Various Amounts of Depot Penicillin, Am. J. Med. 10:673-695 (June) 1951. 8. Stollerman, G. H., and Rusoff, J. H.: Prophylaxis Against Group A Streptococcal Infections in Rheumatic Fever Patients, J.A.M.A. 150:1571-1575 (Dec. 20) 1952. 9. Breese, B. B., and others: Prevention of Rheumatic Fever, Modern Concepts of Cardiovascular Disease, 22:158-161 (Jan.) 1953. NUTRITION IN OBSTETRICS Richard L. Burt, Ph.D., M.D. Winston-Salem During the past quarter of a century nutrition has gained increasing recognition as a significant aspect of prenatal care. Basic studies on animals, together with a wealth of biochemical and clinical observations, have combined to focus attention on diet in pregnancy. From such studies it appears that the mother's nutritional status may profoundly influence not only the course of her pregnancy, but the health and vigor of the newborn infant as well(1). In general, good prenatal nutrition is associated with healthier mothers and better babies. Although our knowledge of human nutrition is far from complete, enough facts are available to enable us to understand the nature of the nutritional burden of gestation. On the basis of this knowledge we are able to estimate the dietary requirements of the expectant mother and to recommend dietary adjustments designed to accommodate the altered body economy of pregnancy. With this consideration in mind, it is pertinent to review briefly the biochemical and physiologic background for nutritional management in pregnancy. The Nutritional Burden of Pregnancy Nitrogen requirement Protein is essential to the fabrication of the products of conception and to the growth of maternal tissues in response to pregnancy. Available data indicate that mammary and uterine growth during pregnancy requires approximately 17 and 39 Gm. of nitrogen respectively, while the total nitrogen content of the term fetus is about 70 Gm. The placenta, membranes, and amniotic fluid contain an additional 17 to 19 Gm. of nitro- Read before the Section on Gynecology and Obstetrics, Medical Society of the State of North Carolina, Pinehurst, May 12, 1953. From the Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest College and the North Carolina Baptist Hospital, Winston-Salem.
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1953 |
Identifier | NCHH-17-014 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-014.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 596 |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1953 |
Identifier | NCHH-17-014-1056 |
Form General | Periodicals |
Page Type | all; article; article title |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolina141953medi_1056.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 14 |
Issue Number | 12 |
Page Number | 596 |
Health Discipline | Medicine |
Full Text | 60(5 NORTH CAROLINA MEDICAL JOURNAL December, 1953 these individuals, it seems likely that a significant number of first attacks of rheumatic fever were prevented. This method has also been employed in rheumatic patients, known to be highly susceptible to recurrences. In a small series of such patients given vigorous, early penicillin therapy for streptococcal infections, Massell found also a significant reduction of rheumatic attacks. Currently it is advocated that penicillin be given for 10 days in order to insure complete elimination of the streptococci(0). For home care the impracticalit.v of daily injections can be overcome by combinations of long-acting penicillin injections followed by oral therapy. The chief disadvantage of this method as compared with continuous prophylaxis is that one will miss the opportunity to treat a number of streptococcal infections early enough to prevent rheumatic fever. Often streptococcal invasion of the throat gives few symptoms. The physician, then, may not be called at all, or if he is, his therapy may not be given in time to prevent the trigger mechanism that touches off the rheumatic attack. Summary Several methods of protection against rheumatic fever are available (fig. 2). Penicillin may be used as a continuous prophylactic agent, probably the most effective method for the susceptible child. Sulfadiazine is useful for the same purpose. It is cheaper and possibly somewhat less effective. For the treatment of an acute streptococcal infection in a normal or rheumatic subject, early vigorous use of penicillin is the method of choice. Sulfonamides, in this situation, are ineffective. References 1. Bland, E. F., and Jones, T. D.: Rheumatic Fever and Rheumatic Heart Disease; A Twenty Year Report on 1000 Patients Followed Since Childhood, Circulation 4:836-843 (Dec.) 1951. 2. Rantz, L., Boisvert. P. J., and Spink, W. W.: Etiology and Pathogenesis of Rheumatic Fever, Arch. Int. Med. 76:131-138 (Sept.) 1945. 3. Rosenberg-, E. F., and Hench, P. S.: Recent Advances in the Treatment of Rheumatic Fever; With Special Reference to Sulfonamide Prophylaxis and Intravenous Salicylate Therapy, M. Clin. North America 30:489-509 (May) 1946. 4. Massell, B. F., Dow, J. W., and Jones, T. D.: Orallv Administered Penicillin in Patients with Rheumatic Fever, J.A.M.A. 138:1030-1036 (Dec.) 1948. 5. Kilbourne, E. D., and Loere. J. P.: Comparative Effects of Continuous and Intermittent Penicillin Therapy on the Formation of Antistreptolysin in Hemolytic Streptococcus Pharyngitis, J. C. I. 27:418-424 (July) 1948. 6. Massell, B. F., and others: Prevention of Rheumatic Fever by Prompt Penicillin Therapy of Hemolytic Streptococcic Respiratory Infections, J.A.M.A. 146:1469-1474 (Aug.) 1951. 7. Wannamaker, L. W., and others: Prophylaxis of Acute Rheumatic Fever by Treatment of the Preceding Streptococcal Infection with Various Amounts of Depot Penicillin, Am. J. Med. 10:673-695 (June) 1951. 8. Stollerman, G. H., and Rusoff, J. H.: Prophylaxis Against Group A Streptococcal Infections in Rheumatic Fever Patients, J.A.M.A. 150:1571-1575 (Dec. 20) 1952. 9. Breese, B. B., and others: Prevention of Rheumatic Fever, Modern Concepts of Cardiovascular Disease, 22:158-161 (Jan.) 1953. NUTRITION IN OBSTETRICS Richard L. Burt, Ph.D., M.D. Winston-Salem During the past quarter of a century nutrition has gained increasing recognition as a significant aspect of prenatal care. Basic studies on animals, together with a wealth of biochemical and clinical observations, have combined to focus attention on diet in pregnancy. From such studies it appears that the mother's nutritional status may profoundly influence not only the course of her pregnancy, but the health and vigor of the newborn infant as well(1). In general, good prenatal nutrition is associated with healthier mothers and better babies. Although our knowledge of human nutrition is far from complete, enough facts are available to enable us to understand the nature of the nutritional burden of gestation. On the basis of this knowledge we are able to estimate the dietary requirements of the expectant mother and to recommend dietary adjustments designed to accommodate the altered body economy of pregnancy. With this consideration in mind, it is pertinent to review briefly the biochemical and physiologic background for nutritional management in pregnancy. The Nutritional Burden of Pregnancy Nitrogen requirement Protein is essential to the fabrication of the products of conception and to the growth of maternal tissues in response to pregnancy. Available data indicate that mammary and uterine growth during pregnancy requires approximately 17 and 39 Gm. of nitrogen respectively, while the total nitrogen content of the term fetus is about 70 Gm. The placenta, membranes, and amniotic fluid contain an additional 17 to 19 Gm. of nitro- Read before the Section on Gynecology and Obstetrics, Medical Society of the State of North Carolina, Pinehurst, May 12, 1953. From the Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest College and the North Carolina Baptist Hospital, Winston-Salem. |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-014.pdf |
Document Sort | all; nchh-17 |
Article Title | Nutrition In Obstetrics |
Article Author | Richard L. Burt |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-014 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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