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subclinical rheumatic heart disease

Daniel Engelman, Reapi L Mataika, Joseph H Kado, Maureen Ah Kee, Susan Donath, Tom Parks, Andrew C Steer
OBJECTIVES: Echocardiographic screening for rheumatic heart disease (RHD) can detect subclinical cases, however adequate adherence to secondary antibiotic prophylaxis (SAP) is required to alter disease outcomes. We aimed to investigate the adherence to SAP among young people with RHD diagnosed through echocardiographic screening in Fiji, and to investigate factors associated with adherence. METHODS: Patients diagnosed with RHD through echocardiographic screening in Fiji from 2006 - 2014 were included...
October 12, 2016: Tropical Medicine & International Health: TM & IH
M S Sahin, M U Yalcin, D Kocyigit
INTRODUCTION: Patients with elevated anti-streptolysin O (ASO) titers (ASOT) and recurrent tonsillitis episodes are known to be at higher risk for rheumatic heart disease (RHD). However, there is no data regarding prevalence of RHD in this high risk population. In this study, we aimed to screen ambulatory patients with elevated ASOT and recurrent tonsillitis episodes using echocardiography for identification of RHD. We hypothesized that prevalence of RHD is higher in this patient group compared to general population...
October 2016: International Journal of Pediatric Otorhinolaryngology
Nikesh R Shrestha, Prahlad Karki, Rajan Mahto, Keshar Gurung, Naveen Pandey, Krishna Agrawal, Martina Rothenbühler, Philip Urban, Peter Jüni, Thomas Pilgrim
IMPORTANCE: Although rheumatic heart disease has been nearly eradicated in high-income countries, 3 in 4 children grow up in parts of the world where it is still endemic. OBJECTIVES: To determine the prevalence of clinically silent and manifest rheumatic heart disease as a function of age, sex, and socioeconomic status and to estimate age-specific incidence. DESIGN, SETTING, AND PARTICIPANTS: In this school-based cross-sectional study with cluster sampling, 26 schools in the Sunsari district in Eastern Nepal with 5467 eligible children 5 to 15 years of age were randomly selected from 595 registered schools...
April 1, 2016: JAMA Cardiology
Daniel Engelman, Joseph H Kado, Bo Reményi, Samantha M Colquhoun, Jonathan R Carapetis, Susan Donath, Nigel J Wilson, Andrew C Steer
BACKGROUND: Echocardiographic screening for rheumatic heart disease (RHD) can identify individuals with subclinical disease who could benefit from antibiotic prophylaxis. However, most settings have inadequate resources to implement conventional echocardiography and require a feasible, accurate screening method. We aimed to investigate the accuracy of screening by non-expert operators using focused cardiac ultrasound (FoCUS). METHODS: In this prospective study of diagnostic accuracy, we recruited schoolchildren aged 5 to 15 years in Fiji to undergo two blinded tests...
June 2016: Lancet Global Health
Ayşe Güler Eroğlu
In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38...
March 2016: Türk Pediatri Arşivi
Anita Saxena
Rheumatic heart disease (RHD) is estimated to affect over 20 million people worldwide, the vast majority being in developing countries. Screening for RHD has been recommended by World Health Organization (WHO) since 2004. Conventionally, auscultation has been used for diagnosing RHD. Auscultation has its limitations and may not detect mild cases. With the evolution of portable echocardiographic systems, mass screening for subclinical RHD has become possible. Portable echo has the advantage of rapid access and hence screening in schools or communities is possible...
July 2015: Translational pediatrics
Daniel Engelman, Joseph H Kado, Bo Reményi, Samantha M Colquhoun, Jonathan R Carapetis, Nigel J Wilson, Susan Donath, Andrew C Steer
BACKGROUND: Echocardiographic screening for rheumatic heart disease (RHD) has the potential to detect subclinical cases for secondary prevention, but is constrained by inadequate human resources in most settings. Training non-expert health workers to perform focused cardiac ultrasound (FoCUS) may enable screening at a population-level. We aimed to evaluate the quality and agreement of FoCUS for valvular regurgitation by briefly trained health workers. METHODS: Seven nurses participated in an eight week training program in Fiji...
2016: BMC Cardiovascular Disorders
Najwa Jawhar, Imad Chami, Zakhia Saliba, Ghassan Chehab
OBJECTIVES: The main aim of this study is to evaluate the significance of several clinical and laboratory findings presented by a large number of pediatric patients who were suspected to have acute rheumatic fever (ARF) by physicians who ordered echocardiogram for confirmation and for avoiding overuse of unnecessary antibiotics. These suspecting reasons include elevated ASO titers and recurrent tonsillitis. Another aim is to stress the role of Doppler echocardiogram in confirming the diagnosis of ARF by detecting rheumatic heart disease (RHD) in suspected cases...
October 2015: Le Journal Médical Libanais. the Lebanese Medical Journal
Bigesh Nair, Sunitha Viswanathan, A George Koshy, Prabha Nini Gupta, Namita Nair, Ashok Thakkar
Background. Early detection of subclinical rheumatic heart disease by use of echocardiography warrants timely implementation of secondary antibiotic prophylaxis and thereby prevents or retards its related complications. Objectives. The objective of this epidemiological study was to determine prevalence of RHD by echocardiography using World Heart Federation criteria in randomly selected school children of Trivandrum. Methods. This was a population-based cross-sectional screening study carried out in Trivandrum...
2015: International Journal of Rheumatology
Anirban Gupta, Rohit Bhatia, Gautam Sharma, Kameshwar Prasad, Mamta Bhushan Singh, Deepti Vibha
BACKGROUND: Studies on predictors of ischemic strokes caused by rheumatic heart disease (RHD) are sparse and extremely important for identifying high-risk cases to direct future therapeutic trials for prevention of ischemic stroke in this population. OBJECTIVE: The aim of the present study was to study the predictors of ischemic stroke in patients with RHD and to observe outcome of patients with ischemic stroke at 3 months' follow-up using modified Rankin scale...
December 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Jaanika Ilisson, Maksim Zagura, Kersti Zilmer, Erik Salum, Kaire Heilman, Anneli Piir, Vallo Tillmann, Jaak Kals, Mihkel Zilmer, Chris Pruunsild
INTRODUCTION: Juvenile idiopathic arthritis (JIA) is a frequent childhood rheumatic disease characterized by chronic inflammation. The latter has been related to impairment of arterial functional-structural properties, atherogenesis and later cardiovascular events. The objective of this study was to examine intima-media thickness (IMT) and the parameters of arterial stiffness in children with JIA at diagnosis and their correlation with JIA subtype and markers of inflammation and atherosclerosis...
2015: Arthritis Research & Therapy
Michael H Gewitz, Robert S Baltimore, Lloyd Y Tani, Craig A Sable, Stanford T Shulman, Jonathan Carapetis, Bo Remenyi, Kathryn A Taubert, Ann F Bolger, Lee Beerman, Bongani M Mayosi, Andrea Beaton, Natesa G Pandian, Edward L Kaplan
BACKGROUND: Acute rheumatic fever remains a serious healthcare concern for the majority of the world's population despite its decline in incidence in Europe and North America. The goal of this statement was to review the historic Jones criteria used to diagnose acute rheumatic fever in the context of the current epidemiology of the disease and to update those criteria to also take into account recent evidence supporting the use of Doppler echocardiography in the diagnosis of carditis as a major manifestation of acute rheumatic fever...
May 19, 2015: Circulation
Sophie Mavrogeni, George Servos, Roubini Smerla, George Markousis-Mavrogenis, Georgia Grigoriadou, Genovefa Kolovou, George Papadopoulos
Cardiac involvement in pediatric systemic autoimmune diseases has a wide spectrum of presentation ranging from asymptomatic to severe clinically overt involvement. Coronary artery disease, pericardial, myocardial, valvular and rythm disturbances are the most common causes of heart lesion in pediatric systemic autoimmune diseases and cannot be explained only by the traditional cardiovascular risk factors. Therefore, chronic inflammation has been considered as an additive causative factor of cardiac disease in these patients...
2015: Inflammation & Allergy Drug Targets
Anita Saxena, Liesl Zühlke, Nigel Wilson
The advent of portable echocardiography has led to screening for rheumatic heart disease (RHD) with high disease prevalence found in many countries. Data are presented from studies from India, Africa, and New Zealand. The natural history of subclinical echocardiographically detected RHD is the most important research question to be answered before more widespread screening is endorsed. The 2012 World Heart Federation (WHF) criteria for the echocardiographic diagnosis of RHD provide standardization of RHD diagnosis, increasing the specificity for definite RHD and raising the threshold for borderline RHD...
September 2013: Global Heart
Justin P Zachariah, Mihail Samnaliev
OBJECTIVES: To project the cost-effectiveness of population-based echo screening to prevent rheumatic heart disease (RHD) consequences. BACKGROUND: RHD is a leading cause of cardiovascular mortality and morbidity during adolescence and young adulthood in low- and middle-per capita income settings. Echocardiography-based screening approaches can dramatically expand the number of children identified at risk of progressive RHD. Cost-effectiveness analysis can inform public health agencies and payers about the net economic benefit of such large-scale population-based screening...
June 2015: Journal of Medical Economics
Janice M Beitz
Morbid obesity is a chronic disease affecting millions of Americans. The disorder is likely to increase in prevalence because currently one third of the American population is obese. Many factors are associated with morbid obesity, including psychological (eg, depression), physiological (eg, hypothyroidism) mechanisms, sleep disorders (eg, sleep apnea), drug therapy (antidepressants, antidiabetic agents, steroids), and genetics. Increasing numbers of morbidly obese patients are requiring critical care, presenting major challenges to professional staff across the disciplines...
January 2015: Ostomy/wound Management
Ganesan Karthikeyan, Ramamoorthy Ananthakrishnan, Niveditha Devasenapathy, Rajiv Narang, Rakesh Yadav, Sandeep Seth, Sandeep Singh, Kewal C Goswami, Vinay K Bahl
Stroke and systemic embolism occur frequently in patients with rheumatic mitral stenosis (MS) in sinus rhythm (SR), but the risk and predictors of embolic events in this population are not well studied. The aim of this study was to determine if transient, subclinical atrial fibrillation (AF) increases the risk of systemic embolism in patients with MS in SR. A single-center, prospective observational study of patients with rheumatic MS in SR was performed. The rate of the composite primary outcome of stroke, transient ischemic attack, or non-central nervous system embolism was determined, as well as the predictive value of Holter-detected episodes of transient (<30 seconds), subclinical AF for this outcome...
September 15, 2014: American Journal of Cardiology
Elisabetta Rossi, Anna Rita Felici, Leul Banteyrga
BACKGROUND AND AIM OF THE STUDY: In developing countries rheumatic heart disease (RHD) is still the most common acquired cardiovascular disease affecting children and young adults. The study aim was to investigate, via an echocardiographic screening, the prevalence of subclinical RHD in high-school students in Eritrea. METHODS: A total of 684 students (314 females, 370 males; mean age 16.7 years) was randomly selected from nine secondary high schools in different regions of Eritrea to assess, via clinical and echocardiographic examinations, the presence of subclinical RHD...
March 2014: Journal of Heart Valve Disease
James J Calloway, Susan M Goodman, Wesley Hollomon, Linda A Russell, Daniel Krauser
The management of perioperative cardiovascular risk in patients with rheumatoid arthritis (RA) is challenging due to the independent contribution to risk by high grade inflammatory mechanisms and the underestimation of risk by traditional cardiac risk factors alone. RA is associated with accelerated rates of subclinical atherosclerosis and markedly higher rates of both myocardial infarction and sudden cardiac death over non-RA controls. There is an absence of prospectively validated perioperative coronary heart disease (CHD) risk assessment tools for this unique patient population and available guidelines may fail to identify those patients most at risk...
July 2013: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Eli Miloslavsky, Sebastian Unizony
All primary vasculitides can target the heart, but this complication is more frequent in TAK, PAN, and EGPA. Although pericarditis is seen in virtually all forms of vasculitis, it rarely becomes a significant clinical problem. Myocarditis is more prevalent in EGPA and TAK, and coronary angiitis is most common in TAK, PAN, and BD. In addition, AI is a classic complication of TAK-induced aortitis, and intracavitary cardiac thrombus formation mainly affects patients with BD. Myocarditis, coronary arteritis, and valvular disease can lead to congestive heart failure and represent poor prognostic factors that require aggressive therapy...
February 2014: Rheumatic Diseases Clinics of North America
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