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Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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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 IV: Nursing Management01:20

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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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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

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The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response01:15

Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response

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Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
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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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Related Experiment Video

Updated: Jul 30, 2025

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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Association of Hydroxychloroquine Use with a Dose-Dependent Decrease in Mortality Risk in Patients with Elderly-Onset

Ching-Tsai Lin1,2, Wen-Nan Huang1,3, Jun-Peng Chen4

  • 1Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, 1650, Section 4, Taiwan Boulevard, Xitun Dist., Taichung, 40705, Taiwan.

Rheumatology and Therapy
|May 12, 2023
PubMed
Summary

Hydroxychloroquine treatment improves survival in elderly-onset rheumatoid arthritis (EORA) patients. Key mortality risks include older age, male sex, smoking, and malignancy, highlighting hydroxychloroquine

Keywords:
Elderly-onset rheumatoid arthritisGeriatricHydroxychloroquineMalignancyMortality risk

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Area of Science:

  • Rheumatology
  • Geriatrics
  • Clinical Epidemiology

Background:

  • Elderly-onset rheumatoid arthritis (EORA) presents a significant mortality risk.
  • The impact of disease-modifying anti-rheumatic drugs (DMARDs) on EORA-specific mortality remains unclear.
  • This study investigates mortality risk factors in EORA patients.

Purpose of the Study:

  • To identify risk factors associated with all-cause mortality in patients with EORA.
  • To evaluate the effect of hydroxychloroquine treatment on mortality in EORA.
  • To analyze the relationship between malignancy, hydroxychloroquine use, and mortality risk.

Main Methods:

  • Retrospective analysis of 980 EORA patients diagnosed over age 60.
  • Utilized multivariable Cox regression to determine hazard ratios (HR) and 95% confidence intervals (CI).
  • Employed Kaplan-Meier analysis for survival assessment.

Main Results:

  • Higher age, male sex, current smoking, and underlying malignancy were significant mortality risk factors.
  • Hydroxychloroquine treatment demonstrated a protective effect against mortality (HR 0.30, 95% CI 0.14-0.64).
  • Patients with malignancy not receiving hydroxychloroquine had the highest mortality risk.

Conclusions:

  • Hydroxychloroquine treatment is associated with improved survival in EORA patients.
  • Further prospective studies are recommended to validate these findings.
  • Understanding risk factors and treatment benefits is crucial for managing EORA mortality.