A psychiatric follow-up of children with rheumatic fever and other chronic diseases

Chorea is a rare manifestation of systemic lupus erythematosus (SLE). We report on a young patient with chorea who was diagnosed initially with rheumatic fever. Follow up and further evaluation confirmed the diagnosis of SLE and anti-phospholipid syndrome. Of special interest were the negative antiphospholipid (aPL) antibodies and the initial diagnosis of rheumatic fever which is still not uncommon problem in our region. The rarity of such presentation with joint and non specific increase of antistreptolysin O (ASO) titer might be the factors that led to an incorrect diagnosis. Early diagnosis and treatment of SLE and anti-phospholipid syndrome are very crucial and should be considered with such presentation.

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THE RHEUMATIC CHILD AND HIS WORLD

PEDIATRICS ◽

10.1542/peds.19.5.916 ◽

1957 ◽

Vol 19 (5) ◽

pp. 916-922

Author(s):

Iago Galdston

Keyword(s):

Rheumatic Fever ◽

External World ◽

The Body ◽

Statistical Analyses ◽

Review Of The Literature ◽

Question Asking ◽

Claude Bernard ◽

The World ◽

Etiologic Research

IT IS PROVERBIAL that a fool can ask more questions than a wise man can answer. It is not proverbial that for the question-asking fool there is some hope and for the others, none. Now it is my intention on this occasion to play the fool awhile, to ask a great number of questions, and I cordially invite you to join me in this game. I want to inquire into The World of the Rheumatic Child, into his internal as well as into his external world, or, as Claude Bernard has phrased it, into his milieu interieur and into his milieu exterieur. Now there is some method to my folly, and it amounts to this. We know a great deal about the disease rheumatic fever and about its devastating effects within the body of its victim. But we do not know a great deal, indeed only a very little, about the victim within whose body the disease effects its devastations. I said—we know a great deal about the disease itself. In preparation for this talk I "re-surveyed the literature" and I found it, as I have known it to be, not only enormous in quantity but most impressive in quality. It is literally studded with masterpieces of etiologic research, of clinical surveys, of pathologic studies, of follow-up surveys, of epidemiologic analyses, and of therapeutic enterprises. In my review of the literature I came upon some old and esteemed friends whose works I had witnessed "in the making," the studies, for example, of Wyckoff, and those of Alfred Cohn; Claire Ling's penetrating statistical analyses, Pearl Raymond's biologic speculations, May Wilson's classical and encyclopedic résumé of knowledge—and upon a host of others, too numerous, really, to catalogue.

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Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain

BMJ Open ◽

10.1136/bmjopen-2018-024073 ◽

2019 ◽

Vol 9 (6) ◽

pp. e024073 ◽

Cited By ~ 3

Author(s):

Maria Tellez-Plaza ◽

Laisa Briongos-Figuero ◽

Gernot Pichler ◽

Alejandro Dominguez-Lucas ◽

Fernando Simal-Blanco ◽

...

Keyword(s):

Risk Factors ◽

General Population ◽

Phase I ◽

Chronic Diseases ◽

University Hospital ◽

Phase Iii ◽

Event Data ◽

Time To Event ◽

Time To Event Data

PurposeThe Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain.ParticipantsIn 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega’s catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999–2000 of 495 phase I participants (phase II). In 2001–2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information).Findings to dateThe Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort.Future plansIn 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.

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QT dispersion in acute rheumatic fever

Cardiology in the Young ◽

10.1017/s1047951106000060 ◽

2006 ◽

Vol 16 (2) ◽

pp. 141-146 ◽

Cited By ~ 7

Author(s):

Tugcin Bora Polat ◽

Yalim Yalcin ◽

Celal Akdeniz ◽

Cenap Zeybek ◽

Abdullah Erdem ◽

...

Keyword(s):

Rheumatic Fever ◽

Acute Rheumatic Fever ◽

Qt Dispersion ◽

Control Group ◽

Healthy Children ◽

Rheumatic Carditis ◽

Normal Children ◽

A Value ◽

The Mean

Background:Disturbances of conduction are well known in the setting of acute rheumatic fever. The aim of this study is to investigate the QT dispersion as seen in the surface electrocardiogram of children with acute rheumatic fever.Methods:QT dispersion was quantitatively evaluated in 88 children with acute rheumatic fever. Patients were divided into two groups based on the absence or presence of carditis. As a control group, we studied 36 healthy children free of any disease, and matched for age with both groups. Repeat echocardiographic examinations were routinely scheduled in all patients at 3 months after the initial attack to study the evolution of valvar lesions.Results:The mean QT dispersion was significantly higher in children with rheumatic carditis. But there was no statistical difference between children without carditis and normal children. Among the children with carditis, the mean dispersion was higher in those with significant valvar regurgitation. Dispersion of greater than 55 milliseconds had a sensitivity of 85%, and specificity of 70%, in predicting rheumatic carditis, while a value of 65 milliseconds or greater had sensitivity of 81% specificity of 85% in predicting severe valvar lesions in acute rheumatic carditis. At follow-up examination, a clear reduction on the QT dispersion was the main finding, reflecting an electrophysiological improvement.Conclusions:These observations suggest that QT dispersion is increased in association with cardiac involvement in children with acute rheumatic fever.

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Automatized follow-up and alert system for patients with chronic hypertension

Health Informatics Journal ◽

10.1177/1460458219900446 ◽

2020 ◽

Vol 26 (4) ◽

pp. 2625-2636 ◽

Cited By ~ 1

Author(s):

Claudio Urrea ◽

Daniel Venegas

Keyword(s):

Blood Pressure ◽

Chronic Diseases ◽

Monitoring System ◽

Disease Status ◽

Integrated System ◽

Chronic Hypertension ◽

Alert System ◽

Telecommunication Technology ◽

Technological Advances

This article presents the development and implementation of a monitoring system for patients with chronic hypertension. Technological advances in wireless communication are increasingly used today to send and receive information through smartphones. This also applies to devices for measuring blood pressure, which can be efficiently integrated with smartphones. Telemedicine is used in a variety of health fields, and in the past 5 years, it has extended its reach to the online monitoring of patients. The objective of this study is to create an integrated system capable of conducting the follow-up, through mobile communication (smartphones), of patients with chronic diseases such as hypertension. An iHealth equipment certified by the Food and Drug Administration is used. The blood pressure values from users are uploaded via Internet and stored in an integral system for processing. The monitoring system developed not only informs users about their disease status but also sends them alerts generated during monitoring. This work uses the telecommunication technology existing through smartphones. The integrated system developed ensures the follow-up of the blood pressure of a large number of users. In addition, this system can be further applied to diseases such as diabetes and metabolic syndrome. The system developed was easy to use and efficient to monitor patients with chronic diseases such as high blood pressure.

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Acute rheumatic fever in south-east of Turkey: clinical features and epidemiological evaluation of the patients over the last 25 years

Cardiology in the Young ◽

10.1017/s1047951120001596 ◽

2020 ◽

Vol 30 (8) ◽

pp. 1086-1094

Author(s):

Sevcan Erdem ◽

Fadli Demir ◽

Mustafa Ayana ◽

Oguz Canan ◽

Yankı Kaan Okuducu ◽

...

Keyword(s):

Rheumatic Fever ◽

Medical Records ◽

Acute Rheumatic Fever ◽

Aortic Valves ◽

Cardiology Department ◽

Epidemiological Evaluation ◽

Valve Lesions ◽

Common Manifestation ◽

Important Disease

AbstractThis study evaluates clinical and epidemiological features of acute rheumatic fever using the data of last 25 years in our hospital in south-east of Turkey. The medical records of 377 patients with acute rheumatic fever admitted to Pediatric Cardiology Department of Çukurova University during 1993–2017 were retrospectively analysed. Two hundred and six patients were admitted between 1993 and 2000, 91 between 2001 and 2008, and 80 between 2009 and 2017. The largest age group (52%) were between 9 to 12 years of age and approximately two-thirds of the patients presented in the spring and winter seasons (62.8%). Among the major findings, the most common included carditis 83.6% (n = 315), arthritis at 74% (n = 279), Sydenham’s chorea at 13.5% (n = 51), and only two patients (0.5%) had erythema marginatum and two patients (0.5%) had subcutaneous nodule. Carditis was the most common manifestation observed in 315 patients (83.6%). The most commonly affected valve was the mitral valve alone (54.9%), followed by a combined mitral and aortic valves (34%) and aortic valve alone (5.7%). Of the patients with carditis, 48.6% (n = 153) had mild carditis, of which 45 had a subclinical. Sixty-two patients (19.7%) had moderate and 100 patients (31.7%) had severe carditis. At the follow-up, 2 patients died and 16 patients underwent valve surgery. Twenty-eight (7.4%) patients’ valve lesions were completely resolved. Conclusion: Although the incidence of acute rheumatic fever decreased, it still is an important disease that can cause serious increases in morbidity and mortality rates in our country.

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Mushroom consumption, biomarkers, and risk of cardiovascular disease and type 2 diabetes: a prospective cohort study of US women and men

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz057 ◽

2019 ◽

Vol 110 (3) ◽

pp. 666-674 ◽

Cited By ~ 7

Author(s):

Dong Hoon Lee ◽

Meng Yang ◽

Edward L Giovannucci ◽

Qi Sun ◽

Jorge E Chavarro

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Chronic Diseases ◽

Prospective Cohort ◽

Cox Proportional Hazards ◽

Health Study ◽

Potential Health ◽

Cardiometabolic Diseases

ABSTRACT Background Mushrooms are good dietary sources of important vitamins, minerals, and bioactive compounds which may be important in the prevention of chronic diseases. However, studies have not prospectively evaluated the potential health effects of mushrooms with respect to major cardiometabolic diseases. Objectives The aim of this study was to examine the association of mushroom consumption with major cardiometabolic diseases and mediating biomarkers in 2 large prospective US cohorts. Methods We followed 67,139 women from the Nurses’ Health Study (1986–2012) and 43,541 men from the Health Professionals Follow-up Study (1986–2012) who were free of chronic diseases. Mushroom consumption was assessed at baseline through the use of a food-frequency questionnaire. Cardiometabolic biomarkers were collected in subpopulations of the 2 cohorts. Cox proportional hazards models were used to estimate HRs and 95% CIs of cardiovascular disease (CVD), including coronary heart disease (CHD) and stroke, and type 2 diabetes (T2D), associated with mushroom consumption. Results We identified total 11,894 CVD (7,616 CHD; 4,278 stroke), and 10,206 T2D cases in >2 million person-years of follow-up. In the pooled multivariable-adjusted analysis, participants who consumed ≥5 servings of mushrooms per week had no significantly different risk of total CVD (HR: 1.02; 95% CI: 0.91, 1.14), CHD (HR: 1.00; 95% CI: 0.87, 1.16), stroke (HR: 1.05; 95% CI: 0.87, 1.25), or T2D (HR: 1.04; 95% CI: 0.93, 1.16) than participants who consumed mushrooms <1 time/mo. We consistently found no association between mushroom consumption and the aforementioned cardiometabolic diseases, in subgroups of sex, lifestyle factors, and medical conditions. Moreover, mushroom consumption was not associated with plasma biomarkers of lipids, insulin, and inflammation. Conclusions We found no association of mushroom consumption with biomarkers and risks of CVD and T2D in US adults. More large prospective cohort studies are warranted to investigate this association in other racial/ethnic groups.

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