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Related Concept Videos

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...
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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...
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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 III: Medical Management01:21

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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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Genome-wide Association Studies-GWAS01:11

Genome-wide Association Studies-GWAS

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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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Factors Affecting the Risk of Infection01:26

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Rheumatoid Arthritis Disease Activity and Hospitalized Infection in a Large US Registry.

Huifeng Yun1, Lang Chen1, Jason A Roy2

  • 1University of Alabama at Birmingham, Birmingham.

Arthritis Care & Research
|July 22, 2022
PubMed
Summary
This summary is machine-generated.

Patients with rheumatoid arthritis (RA) experiencing low or moderate disease activity face a higher risk of hospitalized infections compared to those in remission. This finding holds true even after accounting for treatments and other health conditions.

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Area of Science:

  • Rheumatology
  • Infectious Disease Epidemiology

Background:

  • The relationship between rheumatoid arthritis (RA) disease activity and infection risk is complex, often obscured by treatments and comorbidities.
  • Accurate assessment of infection risk in RA patients requires accounting for dynamic disease activity and treatment changes.

Purpose of the Study:

  • To quantify the risk of hospitalized infections associated with varying levels of disease activity in rheumatoid arthritis (RA) patients.
  • To adjust for confounding factors including RA treatments and comorbidities using advanced statistical methods.

Main Methods:

  • Utilized data from the CorEvitas registry and linked Medicare claims for 3,254 RA patients (2006-2019).
  • Defined disease activity using the Clinical Disease Activity Index (CDAI).
  • Employed marginal structural models (MSMs) to estimate the effect of time-varying CDAI on hospitalized infection risk, controlling for confounders.

Main Results:

  • A total of 529 hospitalized infections were identified.
  • Crude infection incidence rates per 100 person-years were 3.8 (remission), 6.6 (low activity), and 8.0 (moderate activity).
  • Adjusted analyses showed significantly higher infection risk for low (HR 1.60) and moderate (HR 1.83) disease activity compared to remission.

Conclusions:

  • Elevated risk of hospitalized infection in RA patients with low or moderate disease activity compared to remission.
  • Findings highlight the importance of managing RA disease activity to mitigate infection risk.
  • The study successfully adjusted for complex interplay of disease activity, treatments, and confounders.