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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
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As the name indicates, at a cartilaginous joint, the adjacent bones are united by cartilage, a tough but flexible type of connective tissue. Unlike synovial joints, these types of joints lack a joint cavity and involve bones joined together by either hyaline cartilage or fibrocartilage.
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
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[Development of quality standards for patients with rheumatoid arthritis for use in Germany].

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[Development of quality standards for patients with axial spondyloarthritis for use in Germany].

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[Quality in acute inpatient rheumatology 2021 : Current aspects of the KOBRA quality label of the Association of Rheumatological Acute Care Clinics].

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Mission statement from rheumatologists in the German Society of Rheumatology (DGRh e. V.) : We live rheumatology.

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[Long version on the S3 guidelines for axial spondyloarthritis including Bechterew's disease and early forms, Update 2019 : Evidence-based guidelines of the German Society for Rheumatology (DGRh) and participating medical scientific specialist societies and other organizations].

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[Spondyloarthritides].

M Rudwaleit1

  • 1Klinik für Innere Medizin und Rheumatologie, Klinikum Bielefeld Rosenhöhe, An der Rosenhöhe 27, 33647, Bielefeld, Deutschland. martin.rudwaleit@klinikumbielefeld.de.

Der Internist
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PubMed
Summary
This summary is machine-generated.

Spondyloarthritides (SpA) are inflammatory diseases impacting the skeleton and joints. Key factors include genetics like HLA-B27 and the IL-23/17 pathway, guiding new treatments for inflammatory back pain.

Keywords:
Anti-inflammatory agents, non-steroidalArthritis, psoriaticSacroiliitisSpondylitis, ankylosingTumor necrosis factor alpha, inhibitors

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Area of Science:

  • Rheumatology
  • Immunology
  • Genetics

Background:

  • Spondyloarthritides (SpA) encompass inflammatory rheumatic conditions affecting the axial skeleton, peripheral joints, entheses, and extraskeletal sites.
  • Current classification distinguishes between predominant axial SpA and predominant peripheral SpA, with axial SpA further categorized into radiographic and nonradiographic forms.

Purpose of the Study:

  • To summarize the understanding of Spondyloarthritides (SpA), including classification, genetic factors, pathogenesis, clinical presentation, diagnosis, and therapeutic strategies.
  • To highlight the significance of the interleukin 23/17 pathway as a therapeutic target.

Main Methods:

  • Review of current literature on Spondyloarthritides (SpA).
  • Analysis of genetic associations, particularly HLA-B27.
  • Examination of pathogenetic pathways, including the interleukin 23/17 axis.
  • Summary of diagnostic criteria and therapeutic approaches.

Main Results:

  • Genetic factors, notably HLA-B27, play a crucial role in SpA.
  • The interleukin 23/17 pathway is implicated in SpA pathogenesis, suggesting novel treatment avenues.
  • Inflammatory back pain with specific characteristics is the primary symptom of axial SpA.
  • Diagnosis relies on clinical presentation (inflammatory back pain), HLA-B27 status, and imaging findings like sacroiliitis.

Conclusions:

  • Therapeutic strategies for SpA involve physiotherapy, nonsteroidal anti-inflammatory drugs as first-line treatment, and biological agents as second-line therapy.
  • Conventional disease-modifying antirheumatic drugs demonstrate efficacy primarily in peripheral arthritis associated with SpA.