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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...
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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 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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Active versus Passive Immunity01:31

Active versus Passive Immunity

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Immunity, along with the ability to limit pathogen growth to prevent significant body tissue damage, can be gained either by (1) actively developing an immune response within the individual after exposure to a pathogen or after getting vaccinated or (2) passively transferring immune components from an immune individual to one who is nonimmune. Both these forms of immunity can be found naturally and in medical practices.
Active Immunity
Active immunity refers to the resistance one develops...
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The Spindle Assembly Checkpoint02:19

The Spindle Assembly Checkpoint

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The spindle assembly checkpoint is a molecular surveillance mechanism ensuring the fidelity of chromosome segregation during anaphase. The checkpoint monitors the completion of all the prerequisite steps before chromosome segregation to determine whether the segregation process should proceed or be delayed.
Many proteins function together to control the spindle assembly checkpoint. Mutations affecting these proteins may allow cells to proceed into anaphase prematurely, resulting in the...
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Induction of Experimental Autoimmune Encephalomyelitis in Mice and Evaluation of the Disease-dependent Distribution of Immune Cells in Various Tissues
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Immune Checkpoint Inhibitors Did Not Exacerbate Autoimmune Rheumatic Disease Activity in Patients With Cancer.

Ping-Han Tsai1,2,3, Chen-I Hsieh1,2,3, Yung-Chia Kuo4,5,6

  • 11Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, New Taipei City Municipal Tucheng Hospital, New Taipei City, Taiwan.

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PubMed
Summary
This summary is machine-generated.

Immune checkpoint inhibitors (ICIs) do not significantly worsen autoimmune rheumatic diseases (ARDs) in cancer patients. Real-world data shows no increased risk of ARD flare-ups or need for higher medication dosages after ICI treatment.

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Area of Science:

  • Oncology
  • Rheumatology
  • Immunology

Background:

  • The safety of immune checkpoint inhibitors (ICIs) in cancer patients with pre-existing or acquired autoimmune rheumatic diseases (ARDs) is not well-established.
  • Real-world data is needed to evaluate the impact of ICIs on patients with both cancer and ARDs.

Purpose of the Study:

  • To assess the safety of ICIs in patients with cancer and co-existing ARDs.
  • To compare ICI safety profiles in patients with and without ARDs.

Main Methods:

  • A retrospective analysis of 23,981 cancer patients from the Chang Gung Research Database (2002-2022).
  • Propensity-score matching created three groups: Cancer+ICI+ARD+ (n=303), Cancer+ICI+ARD- (n=597), and Cancer+ICI-ARD+ (n=1,212).
  • Assessed changes in steroid/DMARD dosages and laboratory markers of ARD activity before and after ICI treatment.

Main Results:

  • No significant differences in steroid dosage changes were observed between patients with and without ARDs receiving ICIs.
  • Disease-modifying antirheumatic drug (DMARD) dosages did not increase post-ICI therapy, irrespective of ARD status.
  • Laboratory parameters for ARD activity remained stable; severe or new ARDs did not significantly increase (7.26% vs 10.64%, P=.08), though skin complications like psoriasis were more frequent with ICIs.

Conclusions:

  • Immune checkpoint inhibitor (ICI) treatment does not appear to significantly elevate the risk of autoimmune rheumatic disease (ARD) flare-ups in cancer patients.
  • ICI therapy is a viable option for cancer patients with pre-existing or acquired ARDs, with manageable safety profiles.