Rheumatic fever and rheumatic heart disease: clinical profile of 550 cases in India

Ravisha, M.S; Tullu, Milind S.; Kamat, Jaishree R.

doi:10.1016/s0188-4409(03)00072-9

Cited by 53 publications

(65 citation statements)

References 6 publications

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“…A systematic evaluation of patients care is important to defi ne further strategy for disease control and treatment. A systematic comparison of the present series with previously published series [11][12][13][14][15][16][17][18] is presented in the Table 2. Onset age was comparable.…”

Section: Discussionmentioning

confidence: 96%

“…In our series, only 58.2% had high antistreptolysin-O titres. A comparison with previous reported series described in Table 2, [11][12][13][14][15][16][17][18] in addition to a 24 comparing all Brazilian series published since the 1980's, indicated a wide variation, 48.7%-84.5%, from different studies in many parts of the country. Antistreptolysin-O rising titres in RF cases from our unit were previously examined, stressing the importance of serial determination over the fi rst two months.…”

mentioning

confidence: 78%

“…25 The tests of acute phase response indicated high erythrocyte sedimentation rate in 58.3% and C-reactive protein in 45.9%, and again a wide variation is observed in the published series. [11][12][13][14][15][16][17][18]24 It is possible that different laboratory techniques might have infl uenced these results in the same way for antistreptolysin-O, but it was not possible to reach a conclusion, due to the retrospective approach.…”

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confidence: 99%

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Apresentação e desfecho da febre reumática em uma série de casos

Carvalho¹,

Dalben²,

Corrente³

et al. 2012

Rev. Bras. Reumatol.

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Objective: To assess the clinical characteristics and outcome of a rheumatic fever case-series from a referral hospital over the last 20 years. Patients and methods: Patients under the age of 18 years, diagnosed with rheumatic fever between 1986 and 2007 were retrospectively assessed to estimate the carditis and relapse rates, by use of descriptive and survival analysis. Results: Of 178 cases identifi ed, 134 were included. During the acute phase, 66.4% had polyarthritis, 56.8% had carditis, 28.6% had chorea, 1.5% had subcutaneous nodules, and 1.5% had erythema marginatum. The association of carditis and arthritis occurred in 40%. Carditis and chorea were more frequent among female gender. High antistreptolysin-O titres were found in 58.3%, and family history of rheumatic fever, in 14.5%. Mean follow-up was 6.8 years (1.1 to 16.9). Relapse was observed in 15%, hospital admissions in 27.6%, and follow-up discontinuation in 47.4% after a mean of 5.1 years. Carditis and relapse probabilities were 17.5% and 13.2%, respectively, fi ve years after the initial attack. Conclusion: The risk of carditis and relapse of rheumatic fever was higher within the fi rst fi ve years. Follow-up discontinuation was frequent, pointing to the need of measures to improve adherence to prophylaxis and follow-up.

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Section: Discussionmentioning

confidence: 96%

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confidence: 78%

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confidence: 99%

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Apresentação e desfecho da febre reumática em uma série de casos

Carvalho¹,

Dalben²,

Corrente³

et al. 2012

Rev. Bras. Reumatol.

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“…[1][2][3][4] The compliance to different prophylactic regimens is relatively poor. 9,10 Azithromycin, with a long half-life, which can be administered once weekly was thought to improve the compliance. 14 So we decided to study the effectiveness of AZT in the secondary prophylaxis of rheumatic fever.…”

Section: Discussionmentioning

confidence: 99%

“…8 The main problem with the different regimens of secondary prophylaxis is compliance. 9,10 So, we are on the look-out for safer alternatives with improved patient compliance.…”

Section: Introductionmentioning

confidence: 99%

Once weekly azithromycin in secondary prevention of rheumatic fever

Gopal

Harikrishnan

Sivasubramonian

et al. 2012

Indian Heart Journal

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A B S T R A C TRheumatic fever and rheumatic heart disease (RHD) are still important problems in developing countries. Secondary prophylaxis which is the most cost-effective method in preventing recurrences of rheumatic fever is fraught with problems of drug compliance. The utility of 500 mg once weekly azithromycin (AZT), an orally effective long-acting antibiotic was evaluated against oral penicillin (phenoxy methyl penicillin 250 mg twice daily) in this study. Forty-eight consecutive patients (44% males, mean age 29.4 years) with established RHD were randomised into two groups-26 patients received AZT and 22 received oral penicillin. Patients were evaluated at randomisation, at 1 month, 3 months, and 6 months, clinically, serologically and by throat swab culture. End points were absence of streptococcal colonisation, infection or fever at the end of 6 months. During the study, 4 patients (15.4%) in the AZT group developed sore throat and fever, had positive throat culture and positive serology indicating streptococcal infection. None satisfied the criteria for rheumatic fever reactivation. None in the oral penicillin group developed streptococcal infection. In conclusion, weekly 500 mg of AZT is not effective in the prevention of streptococcal throat infection compared to oral penicillin therapy in adult patients with established RHD.

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