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Related Concept Videos

Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

407
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
407
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

432
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
432
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

246
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
246
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

401
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
401
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

278
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
278
Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

663
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
663

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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
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Interventions for treating tuberculous pericarditis.

Charles S Wiysonge1, Mpiko Ntsekhe, Lehana Thabane

  • 1Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, Western Cape, South Africa, 7505.

The Cochrane Database of Systematic Reviews
|September 14, 2017
PubMed
Summary
This summary is machine-generated.

Corticosteroids may reduce deaths in HIV-negative patients with tuberculous pericarditis. For HIV-positive patients, corticosteroids might decrease constriction, but evidence is limited. Further research is needed for optimal treatment strategies.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Public Health

Background:

  • Tuberculous pericarditis (TBp) is a serious condition that can lead to heart failure and death.
  • Treatment for TBp typically involves antituberculous chemotherapy, corticosteroids, drainage, and surgery.

Purpose of the Study:

  • To assess the effectiveness of various treatments for tuberculous pericarditis.
  • To evaluate the impact of corticosteroids, drainage, and other interventions on patient outcomes.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
  • Searched multiple databases including Cochrane, MEDLINE, Embase, and LILACS up to March 2017.
  • Assessed risk of bias and certainty of evidence using the GRADE approach.

Main Results:

  • In HIV-negative individuals, corticosteroids likely reduce pericarditis deaths and may decrease all-cause mortality and need for repeat pericardiocentesis.
  • In HIV-positive individuals (many not on antiretrovirals), corticosteroids may reduce constriction but have uncertain effects on death or cancer.
  • Limited evidence exists for colchicine, M. indicus pranii immunotherapy, and open surgical drainage; surgical drainage may reduce repeat pericardiocentesis in HIV-negative patients.

Conclusions:

  • Corticosteroids show potential benefit in reducing mortality for HIV-negative patients with TBp.
  • For HIV-positive patients, particularly those not on antiretroviral therapy, corticosteroids may help reduce constriction.
  • Further research is recommended to explore percutaneous drainage, pericardiectomy timing, and novel antibiotic regimens.