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Related Concept Videos

Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

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

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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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...
265
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

145
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...
145
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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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...
150
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

273
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Bone Disorders01:29

Bone Disorders

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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
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Related Experiment Video

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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
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Frailty in Rheumatic Diseases.

Francesca Motta1,2, Antonio Sica3,4, Carlo Selmi1,2

  • 1Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center- IRCCS, Rozzano, Italy.

Frontiers in Immunology
|November 16, 2020
PubMed
Summary

Frailty, a decline in physiological function, is more common in chronic diseases, especially rheumatic diseases, due to inflammation. Maintaining muscle strength through physical activity may reverse frailty and improve patient outcomes.

Keywords:
connective tissue diseasesfrailtyfrailty indexinflammagingosteoarthritisrheumatic diseasesrheumatoid arthritisvasculitis

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Area of Science:

  • Gerontology
  • Rheumatology
  • Pathophysiology

Background:

  • Frailty is a syndrome of physiological decline, increasing vulnerability and adverse health outcomes.
  • While common in the elderly, frailty is increasingly recognized in chronic diseases, independent of age.
  • Chronic inflammation is a key pathophysiological mechanism implicated in frailty, affecting multiple body systems.

Purpose of the Study:

  • To review the current understanding of the link between frailty and rheumatic diseases.
  • To explore the role of chronic inflammation in frailty within the context of rheumatic conditions.
  • To discuss the implications of frailty for clinical decision-making and management in rheumatology.

Main Methods:

  • Literature review of studies exploring frailty in rheumatic diseases.
  • Analysis of pathophysiological mechanisms connecting inflammation, frailty, and rheumatic conditions.
  • Discussion of existing and proposed frailty assessment tools for rheumatic patients.

Main Results:

  • Frailty is more prevalent in patients with rheumatic diseases than in healthy controls, irrespective of age.
  • High disease activity in rheumatic conditions is associated with increased frailty, largely driven by chronic inflammation.
  • Frailty is dynamic and potentially reversible, with muscle strength being a significant modifiable factor.

Conclusions:

  • Frailty assessment should be integrated into rheumatology practice for improved risk stratification and personalized management.
  • Addressing the underlying rheumatic disease and promoting physical activity may prevent or mitigate frailty.
  • Developing disease-specific frailty indexes is crucial for accurate prognostic estimates and optimizing treatment strategies.