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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 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...
276
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...
289
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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Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

175
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...
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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.
GWAS does not require the identification of the target gene involved in...
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Related Experiment Video

Updated: Jan 17, 2026

Monitoring PD-1-Blocking Antibodies Bound to T Cells Derived from a Drop of Peripheral Blood
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Rheumatic Immune-Related Adverse Events: Immune Checkpoint Inhibitor Therapy and Ramifications for Health

Laura Kobashigawa1, Nicole Zagelbaum1, Katherine Ruddy1

  • 1Division of Rheumatology, University of Southern California Keck School of Medicine, Los Angeles, USA.

Cureus
|September 22, 2025
PubMed
Summary
This summary is machine-generated.

Immune checkpoint inhibitor (ICI) therapy can cause rheumatic immune-related adverse events (irAEs). Patients at a public medical center, predominantly Hispanic, had significantly lower rheumatologist referral rates for irAEs compared to a private center, raising concerns about healthcare disparities.

Keywords:
access to health carehealthcare disparityimmune checkpoint inhibitors (icis)immune-related adverse event (irae)patient referral

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Area of Science:

  • Oncology
  • Rheumatology
  • Health Services Research

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed cancer treatment but can cause immune-related adverse events (irAEs).
  • Rheumatic irAEs are a significant concern, particularly among ethnic minority populations who are underrepresented in current research.
  • Understanding disparities in the management of irAEs is crucial for equitable cancer care.

Purpose of the Study:

  • To investigate differences in rheumatic immune-related adverse events (irAEs) and rheumatologist referral rates between a public medical center serving a predominantly Hispanic population and a private medical center.
  • To compare the characteristics and management of patients experiencing rheumatic irAEs at these two distinct healthcare settings.

Main Methods:

  • A retrospective review of medical records for patients aged 18+ treated with ICIs between May 2015 and May 2021 at two medical centers (public and private).
  • Comparison of patient demographics, irAE development, and referral patterns to rheumatology between the two centers.
  • Analysis focused on identifying differences in the incidence and management of rheumatic irAEs.

Main Results:

  • Rheumatic irAEs, primarily arthritis and myositis, were observed in patients at both centers.
  • Patients at the public medical center were more likely to be Hispanic and significantly less likely to be referred to a rheumatologist compared to patients at the private medical center.
  • No significant differences in cancer outcomes were found between the institutions for patients with rheumatic irAEs.

Conclusions:

  • Lower rheumatologist referral rates for rheumatic irAEs at the public medical center suggest potential healthcare disparities.
  • Further research with diverse patient populations is needed to ensure equitable management of irAEs across different healthcare settings.
  • Addressing these disparities is essential for improving outcomes for all cancer patients receiving ICI therapy.