The search for host determinants of susceptibility to rheumatic fever: the missing link. T. Duckett Jones Memorial Lecture.
نویسنده
چکیده
Thirty years ago, in his presentation "The Natural History of Rheumatic Fever," Dr. T. Duckett Jones said, "It has become the order of the day to consider that both the morbidity and the mortality in rheumatic fever have decreased to such an extent as to relegate the problem to a position of unimportance. " He added, "One may wonder, and reach almost any desired conclusion, about what modifying role, if any, the biological characteristics of the streptococci may have played in the reputedly changing pattern. Others may prefer to ponder about the host factors, such as the effect of improved nutrition, improved housing, or other environmental advances. We know of no convincing study which removes these matters from conjecture."' Rheumatic fever is a challenge to physicians and scientists. Attempts to meet this challenge have brought forth new ideas regarding the clinical manifestations, epidemiology, pathogenesis, and control of this disease. Yet, despite the recognized decline in the incidence of rheumatic heart disease in the western world, it remains a serious health problem to children and young adults in developing countries. Why? Although there is no simple answer to this question, it is clear that research in rheumatic heart disease must continue. As expressed by T. Duckett Jones, "The exact incidence of the disease, or the decrease in incidence or severity, seems of less importance than the need to gain further knowledge ofhow and why human beings develop rheumatic fever."' In this presentation I will summarize our knowledge in one area of the pathogenesis of rheumatic fever. I will also dwell on the search for host determinants of
منابع مشابه
On the Evolution of Our Knowledge of Congenital Malformations of the Heart; the T. Duckett Jones Memorial Lecture.
M Y WARM association with T. Duckett Jones when he was in charge of the House of the Good Samaritan makes it a genuine pleasure to give the T. Duckett Jones Memorial Lecture. Although a year younger than I, Duckett was 4 years ahead of me in medical school and by the time I graduated he was established at the House of the Good Samaritan. Duckett offered me my first jobas a histologist to the Go...
متن کاملThe virtual disappearance of rheumatic fever in the United States: lessons in the rise and fall of disease. T. Duckett Jones memorial lecture.
I AM DEEPLY HONORED to have been invited to give the 1984 T. Duckett Jones Memorial Lecture. This year marks 40 years since Dr. Jones first published his paper entitled "The Diagnosis of Rheumatic Fever."' Jones had the foresight to recognize the importance of standardized diagnostic criteria from three points of view. He wrote: "(1) Otherwise, [without standardized criteria] the incidence of r...
متن کاملPERSPECTIVE The virtual disappearance of rheumatic fever in the United States: lessons in the rise and fall of disease
I AM DEEPLY HONORED to have been invited to give the 1984 T. Duckett Jones Memorial Lecture. This year marks 40 years since Dr. Jones first published his paper entitled "The Diagnosis of Rheumatic Fever."' Jones had the foresight to recognize the importance of standardized diagnostic criteria from three points of view. He wrote: "(1) Otherwise, [without standardized criteria] the incidence of r...
متن کاملThe virtual disappearance of rheumatic fever in the United States: lessons in the rise and fall of disease
I AM DEEPLY HONORED to have been invited to give the 1984 T. Duckett Jones Memorial Lecture. This year marks 40 years since Dr. Jones first published his paper entitled "The Diagnosis of Rheumatic Fever."' Jones had the foresight to recognize the importance of standardized diagnostic criteria from three points of view. He wrote: "(1) Otherwise, [without standardized criteria] the incidence of r...
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ورودعنوان ژورنال:
- Circulation
دوره 69 1 شماره
صفحات -
تاریخ انتشار 1984