scholarly journals Rheumatic Carditis in Children--A Follow up Study, and An Economical Evaluation : Rheumatic Heart Disease as an Economical Disease

1966 ◽  
Vol 30 (10) ◽  
pp. 1326-1331 ◽  
Author(s):  
Masahiro OSHIMA
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Rheumatic Carditis ◽  
Follow Up Study ◽  
Economical Evaluation ◽  
Rheumatic Heart

225 Rheumatic heart disease in Timor Leste school students (RHD-TL) follow-up study: assessment of secondary prophylaxis and outcomes in Timor Leste

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
A Horton ◽  
B Remenyi ◽  
K Davis ◽  
N Mock ◽  
E Paratz ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Secondary Prophylaxis ◽  
Penicillin G ◽  
School Students ◽  
Borderline Cases ◽  
Follow Up Study ◽  
Timor Leste ◽  
Rheumatic Heart

Abstract Background The Rheumatic Heart disease in Timor Leste school students (RHD-TL) study identified Timor Leste as having some of the highest rates of definite rheumatic heart disease (RHD) in the world. The RHD-TL follow-up study aimed to assess the delivery and outcomes of the secondary prophylaxis program in known patients with echocardiographic screen detected definite and borderline RHD. Methods School-students in Timor Leste where reassessed over a 3-year period since the initial study in 2016. Prospective assessments included adherence to secondary prophylaxis, complications of prophylaxis, follow-up clinical assessment and serial echocardiography. Of the 48 patients, 25 Definite and 23 Borderline, 38 (79%) of all patients, and 92% of definite RHD cases have had one or more follow-up assessments including full datasets for adherence, recurrence rates and progression of disease. Follow-up is provided by the volunteer paediatric cardiology team and rheumatic heart disease team of two NGOs in collaboration with local clinics. Results The median duration of follow-up of the 38 patients was of 1.6 years. The median age was 13 years (range 8-22) and 75% were female. Adherence rates in patients with definite RHD was on average greater than 95% during the follow-up period. Of the 23 patients with mild or moderate RHD one case with documented acute rheumatic fever (ARF) recurrence progressed whilst 8 cases improved on benzathine-penicillin G (BPG) therapy. There was no progression of the 6 borderline cases who were not prescribed BPG. Out of the 9 borderline cases in whom BPG was prescribed, one, with 67% adherence, had a documented episode of ARF leading to echocardiographic progression and moderate definite RHD. Conclusion This was the first follow-up study to look at disease natural history, both in treated and untreated groups, in Timor-Leste and brought practical insights into the efficacy of the Timor Leste RHD monitoring and prophylaxis programs. Its ongoing project will enable advocacy and quality assessment for the program as it expands. Abstract 225 Figure 1.

THE EFFECT OF INTENSIVE AND PROLONGED THERAPY WITH CORTISONE AND HYDROCORTISONE IN FIRST ATTACKS OF RHEUMATIC CARDITIS

PEDIATRICS ◽  
1955 ◽  
Vol 16 (3) ◽  
pp. 325-334
Author(s):  
Milton Markowitz ◽  
Ann G. Kuttner
Keyword(s):  
Heart Disease ◽  
Side Effects ◽  
Rheumatic Heart Disease ◽  
Inflammatory Reaction ◽  
Clinical Evidence ◽  
Large Series ◽  
Rheumatic Carditis ◽  
Prolonged Therapy ◽  
Rheumatic Heart

Forty patients (39 children and 1 adolescent) with clinical evidence of carditis during first rheumatic attacks were treated with large doses of oral cortisone or oral hydrocortisone for periods varying from 9 weeks to 12 months. Twenty-nine of these forty patients received treatment within 3 weeks of onset. After follow-up observations ranging from 6 to 22 months, 24 of the 29 patients have no evidence of heart disease. Patients with severe as well as mild carditis responded equally well. Eleven patients treated later than 3 weeks after onset did less well: only 2 have normal hearts, 8 have rheumatic heart disease and 1 patient died. The results of this study suggest that cortisone given early in the course of the rheumatic attack in doses sufficiently large to suppress the inflammatory reaction completely and continued until the disease has run its course, may reduce the incidence of residual heart disease. Further studies based on a large series of cases with adequate controls are needed to establish the value of this regimen. Eleven of the forty patients developed serious side effects. In 4 the symptoms were of sufficient severity to necessitate cessation of therapy. In the remainder the untoward reactions were controlled by reducing the dosage of the steroid.

scholarly journals Follow up study of rheumatic heart disease.

1981 ◽  
Vol 45 (12) ◽  
pp. 1426-1429
Author(s):  
MITSUO KITADA ◽  
SETSUKO NAKAJIMA ◽  
KINICHI UHEDA ◽  
KENJI YASUTAKE ◽  
TADASHI NAKAGAWA
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Follow Up Study ◽  
Rheumatic Heart

scholarly journals Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036827 ◽  
Author(s):  
Bárbara Martins Bechtlufft ◽  
Bruno Ramos Nascimento ◽  
Craig Sable ◽  
Clara Leal Fraga ◽  
Márcia Melo Barbosa ◽  
...  
Keyword(s):  
Heart Disease ◽  
Public Schools ◽  
Rheumatic Heart Disease ◽  
Heart Diseases ◽  
Diagnostic Category ◽  
Secondary Outcome ◽  
Unfavourable Outcome ◽  
History Of ◽  
Rheumatic Heart

ObjectivesEchocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5–18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.SettingPublic schools of underserved areas and private schools in Minas Gerais, southeast Brazil.ParticipantsA total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12–16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.Primary and secondary outcome measuresUnfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.ResultsAmong patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).ConclusionThe simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.

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