治疗小孔古尼亚关节炎:一项对133名巴西患者的研究
José Kennedy Amaral1, Clifton O Bingham2, Peter C Taylor3
1Institute of Diagnostic Medicine of Cariri, Juazeiro do Norte, Brazil.
The American journal of tropical medicine and hygiene
|August 7, 2023
概括
奇孔尼亚关节炎 (CHIKA) 患者在用甲状腺和/或莱夫卢诺米德治疗4周后,疼痛和关节功能显著改善. 这种临床反应在治疗后至少持续了五个月.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 奇孔古尼亚热是一种全球传播者传播的病毒性疾病,引起急性症状.
- 许多患者患有慢性,残疾性关节炎,对初始的症状治疗没有反应.
- 奇孔尼亚关节炎 (CHIKA) 需要有效的治疗策略来长期管理.
研究的目的:
- 为了描述患有 chikungunya关节炎 (CHIKA) 的患者的治疗结果.
- 在CHIKA患者中评估甲状腺素和/或莱夫卢诺米德与德克萨米他联合的疗效.
主要方法:
- 133名临床和血清学诊断的CHIKA患者的回顾性审查.
- 治疗包括甲状腺素 (20毫克/周) 和/或莱夫卢诺米德 (20毫克/天) 与德克萨梅他 (0-4毫克/天) 连续4周.
- 疾病活动评分28 (DAS28) 和疼痛评分在基线和4周评估;关节计数在治疗后5个月评估.
主要成果:
- 在4周后,DAS28红细胞沉率 (ESR) 从6.0降至2.7 (P < 0.001) 和疼痛评分从81.8降至13.3 (P < 0.001) 显著降低.
- 在治疗后5个月内,疼痛,关节疼痛和胀的关节数量持续改善.
- 在4周内观察到快速的临床改善,持续5个月.
结论:
- 对CHIKA的4周治疗方案诱导了快速和持续的临床改善.
- 观察到的结果表明,甲状腺和/或莱夫卢诺米德在治疗CHIKA时具有潜在的疗效.
- 需要进一步的研究来确认治疗对这些持续结果的贡献.
相关概念视频
01:21Rheumatic Heart Disease III: Medical Management
13
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...
13
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
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...
38
01:20Rheumatic Heart Disease IV: Nursing Management
18
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...
18
01:23Rheumatic Heart Disease I: Introduction
16
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...
16