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Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

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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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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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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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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...
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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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Related Experiment Video

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Author Spotlight: Self-Assessment Protocol for Predicting Psoriatic Arthritis in Psoriasis Patients
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The Self-Administered Rheumatoid Arthritis Disease Activity Index (RADAI) is Less Accurate than DAS28-CRP as a

H T W Smeele1, J Naterop1, E Röder1

  • 1Erasmus University Medical Centre Rotterdam The Netherlands.

ACR Open Rheumatology
|November 29, 2019
PubMed
Summary

The Rheumatoid Arthritis Disease Activity Index (RADAI) was not validated for measuring disease activity in pregnant rheumatoid arthritis (RA) patients. The Disease Activity Score 28 (DAS28)-CRP remains the gold standard for RA disease activity assessment during pregnancy.

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Area of Science:

  • Rheumatology
  • Obstetrics
  • Immunology

Background:

  • Disease Activity Score 28 (DAS28)-CRP is a validated measure for rheumatoid arthritis (RA) disease activity in pregnancy.
  • The Rheumatoid Arthritis Disease Activity Index (RADAI) offers practical advantages for self-administration.
  • Validating RADAI for pregnancy use is crucial for improving patient monitoring and management.

Purpose of the Study:

  • To validate the RADAI as a reliable measure of disease activity in pregnant RA patients.
  • To compare RADAI's performance against the established DAS28-CRP standard.
  • To assess RADAI's utility in predicting fertility and pregnancy outcomes.

Main Methods:

  • Prospective cohort study (Pregnancy-induced Amelioration of Rheumatoid Arthritis) including 269 RA patients.
  • Comparison of RADAI and DAS28-CRP for disease course, activity states, fertility, and pregnancy outcomes.
  • Assessment of construct validity by correlating RADAI and DAS28-CRP with galactosylation of immunoglobulin G (IgG).

Main Results:

  • RADAI did not show significant agreement with DAS28-CRP in disease states (κ < 0.51).
  • DAS28-CRP, but not RADAI, predicted time to pregnancy and birthweight.
  • Both measures correlated with IgG galactosylation, but only DAS28-CRP changes correlated with IgG changes.

Conclusions:

  • RADAI cannot be validated as a disease activity measure during pregnancy.
  • DAS28-CRP remains the gold standard for assessing RA disease activity in pregnant individuals.
  • Further research may be needed to explore alternative self-administered tools for RA management during pregnancy.