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2.
Immunol Med ; 43(2): 92-97, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32089102

RESUMO

The aim of this study was to find the correlation between severity of dry eye and rheumatoid arthritis (RA) disease activity. Forty- two RA patients with dry eye were recruited from Rheumatology Outpatient Clinic in Minia University Hospital. Assessment of RA disease activity was performed using disease activity score (DAS-28). Ocular tests include Schirmer test I, tear film break up time (TBUT) and ocular staining score (OSS) was performed by ophthalmologist to find evidence of ocular dryness. Erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti SSA/Ro and anti SSB/La was also tested. Patients with severe dry (OSS ≥ 3) underwent minor salivary gland biopsy (MSGB) as suspected to have secondary Sjögren's syndrome (SS). Of 42 RA patients, 30 had definite dry eye. DAS-28 did not show significant correlation with any of ocular tests for dryness while the duration of RA was significantly positively correlated with Schirmer test and OSS. The biopsy results of RA patients with severe dry eye show no evidence of SS. The severity of dry eye is not correlated with activity of RA but with its duration.


Assuntos
Síndromes do Olho Seco/etiologia , Febre Reumática/complicações , Adulto , Síndromes do Olho Seco/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Febre Reumática/diagnóstico , Índice de Gravidade de Doença , Fatores de Tempo
4.
J Pediatr ; 215: 187-191, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31587860

RESUMO

OBJECTIVE: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period. STUDY DESIGN: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded. RESULTS: Of 98 patients (62 boys, mean age 8.81 ± 3.04 years), 59 (60.2%) reported a positive history of pharyngotonsillitis; 48 (49%) had received antibiotic (mean duration of treatment of 5.9 ± 3.1 days), and, among these, 28 (58.3%) had carditis. Carditis was the second most frequent finding, subclinical in 27% of patients. Mitral regurgitation was present in 49 of 56 patients (87.5%) and aortic regurgitation in 36/56 (64.3%) no stenosis was documented. CONCLUSIONS: ARF is still present in high-income countries and can develop despite primary prophylaxis, especially when given for a short course. Our findings highlight the need for 10 days of antistreptococcal treatment to prevent ARF. Echocardiography is important because 27% of cases with carditis were subclinical.


Assuntos
Miocardite/diagnóstico , Miocardite/epidemiologia , Febre Reumática/diagnóstico , Adolescente , Antibacterianos/uso terapêutico , Insuficiência da Valva Aórtica/diagnóstico por imagem , Artrite/microbiologia , Bloqueio Atrioventricular/diagnóstico , Sedimentação Sanguínea , Criança , Pré-Escolar , Coreia/microbiologia , Países Desenvolvidos , Ecocardiografia Doppler em Cores , Eletrocardiografia , Eritema/microbiologia , Feminino , Hemoglobinas/análise , Humanos , Itália/epidemiologia , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Faringite/epidemiologia , Estudos Retrospectivos , Febre Reumática/tratamento farmacológico , Febre Reumática/epidemiologia , Estações do Ano , Tonsilite/epidemiologia
5.
Am J Emerg Med ; 37(11): 2118.e5-2118.e7, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31474378

RESUMO

Isolated motor disturbances in the paediatric population are uncommon presentations to the emergency department. Choreiform movements have a broad differential diagnosis and may present insidiously with progressive worsening of asymmetric clumsiness, hypotonia and dysarthria. The incidence of Sydenham's chorea (SC) caused by acute rheumatic fever (ARF) is very rare in developed countries. We report a previously healthy, vaccinated 9-year old male who presented to our ED with intermittent and progressive right sided clumsiness for four weeks. Physical examination findings showed dysdiadokinesis and dysmetric movements of the right side, which varied in intensity and were less pronounced on serial re-examination during the same ED visit. Basic bloodwork, MRI and MRA/V showed no abnormalities, and the patient was discharged home with urgent neurology follow-up. He re-presented to our ED four days later with worsening gait and inability to hold a pencil at school. He was subsequently diagnosed with chorea by the neurology team. The cause of chorea was later determined to be SC, and the patient's throat swab came back positive for group A-beta hemolytic strep (GAS) infection. We explore current literature regarding the various presentations of ARF, differential considerations in acute chorea, and diagnostic studies needed to determine the etiology of acute chorea. With the low incidence of chorea in developed nations, this diagnosis can be easily overlooked. We highlight the importance of this diagnosis, as well as primary and secondary treatment in ARF.


Assuntos
Coreia/microbiologia , Febre Reumática/diagnóstico , Criança , Coreia/diagnóstico , Humanos , Masculino , Febre Reumática/complicações
6.
Am J Trop Med Hyg ; 101(5): 1054-1057, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31516109

RESUMO

We report a case of acute rheumatic fever with severe pancarditis occurring simultaneously with probable acute post-streptococcal glomerulonephritis in a previously well, Australian Aboriginal, 29-year-old male. These autoimmune streptococcal sequelae are usually considered pathogenetically distinct, and concurrence has not previously been reported from this high-burden setting. We hypothesize that a single type of infecting group A Streptococcus (Strep A) triggered both autoimmune sequelae. Salient features included mitral and aortic regurgitation that worsened during the acute illness, painful pericarditis, and high troponin; severe acute kidney injury with oliguria, hematuria, and macroalbuminuria; reduced complement (C3); and elevated streptococcal serology. The case highlights important diagnostic and management challenges. It also illustrates the serious morbidity impact of the complications of Strep A.


Assuntos
Glomerulonefrite/etiologia , Febre Reumática/complicações , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Ceftriaxona/administração & dosagem , Ceftriaxona/uso terapêutico , Floxacilina/administração & dosagem , Floxacilina/uso terapêutico , Cardiopatias/microbiologia , Cardiopatias/patologia , Humanos , Masculino , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Febre Reumática/diagnóstico , Febre Reumática/tratamento farmacológico
7.
Pediatr Int ; 61(10): 962-966, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31332885

RESUMO

BACKGROUND: The aim of this study was to investigate of the role of oxidative stress (OS) in acute rheumatic fever (ARF) and its relationship with the progress of the disease. METHODS: Thirty patients with ARF and 31 age-sex-matched healthy children were enrolled in this study. Serum malondialdehyde (MDA), protein carbonyl (PCO), high-sensitivity C-reactive protein (hs-CRP), cytokines (tumor necrosis factor-α and interleukin-6) and total antioxidant capacity (TAC) were measured. The diagnosis of ARF was based on the Jones criteria. RESULTS: Patients with ARF had significantly higher serum MDA, PCO, hs-CRP and cytokine levels and lower TAC than healthy controls. On Pearson's correlation analysis we found that oxidative stress markers were positively correlated with hs-CRP and cytokines, while TAC was negatively correlated with MDA, PCO, hs-CRP and cytokines. The number of valves involved as well as the level of mitral valve involvement was also significantly related to the oxidative stress parameters and TAC. All oxidative stress parameters decreased significantly with anti-inflammatory therapy while TAC increased. CONCLUSION: Malondialdehyde and PCO, as biomarkers, as well as hs-CRP together with the other available diagnostic tools, can be used in the evaluation of patients with ARF.


Assuntos
Estresse Oxidativo , Febre Reumática/fisiopatologia , Biomarcadores/metabolismo , Estudos de Casos e Controles , Criança , Citocinas/metabolismo , Progressão da Doença , Feminino , Humanos , Masculino , Análise por Pareamento , Estudos Prospectivos , Febre Reumática/diagnóstico , Febre Reumática/metabolismo
8.
Cardiol Young ; 29(6): 744-748, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31198127

RESUMO

OBJECTIVES: First-degree heart block is a minor manifestation of acute rheumatic fever. Second and third degree heart block and junctional rhythms occur less commonly. We report patients presenting with these latter three electrocardiographic abnormalities and investigate their diagnostic utility. DESIGN: Patients admitted to our centre meeting the 2014 New Zealand Rheumatic Fever Guideline Diagnostic Criteria for rheumatic fever over a 5-year period from January 2010 to December 2014 were identified. Clinical, haematologic, electrocardiographic, and echocardiographic records were reviewed. Electrocardiograms (ECG) were considered abnormal if there was second- or third-degree atrioventricular block or junctional rhythms. Comparative data from patients with advanced conduction abnormalities without a diagnosis of rheumatic fever during the same time period were reviewed. RESULTS: A total of 201 patients met inclusion criteria for rheumatic fever. Of these, 17 (8.5%) had transient abnormalities of atrioventricular conduction, 5 (2.5%) with second or third-degree atrioventricular block, and 12 (6%) junctional rhythms. The remaining 173 (86%) patients had evidence of rheumatic valvulitis at presentation. Only one patient without rheumatic fever was found to have advanced conduction abnormalities over the study period, from a total of 3702 ECG. CONCLUSIONS: This large contemporary cohort of acute rheumatic fever shows that 8.5% of cases had either advanced atrioventricular block or junctional rhythms both highly suggestive of the diagnosis in our population.


Assuntos
Bloqueio Atrioventricular/etiologia , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Febre Reumática/diagnóstico , Adolescente , Bloqueio Atrioventricular/diagnóstico , Bloqueio Atrioventricular/fisiopatologia , Criança , Pré-Escolar , Ecocardiografia , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Febre Reumática/complicações
9.
Indian Pediatr ; 56(4): 311-313, 2019 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31064901

RESUMO

OBJECTIVE: To determine the diagnostic accuracy of polymerase chain reaction-based detection of sof gene compared to throat swab culture for S. pyogenes infection in patients with acute rheumatic fever and those with recurrence of rheumatic activity. METHODS: 40 patients between 3 to 18 years of age, with clinical diagnosis of acute rheumatic fever or new activity in established rheumatic heart disease were included. The amplicon of 228bp of sof gene was detected using a polymerase chain reaction-based technique and the results were compared with throat swab culture for Streptococcus pyogenes. RESULTS: 10 patients had a positive throat swab culture and 11 had sof gene detected. The sensitivity and specificity of the test was 100% and 96.7%, respectively compared to throat swab culture (P=0.001). The positive predictive value and the negative predictive value was 90.9% and 100% respectively. CONCLUSION: Polymerase chain reaction-based detection of sof gene provides an alternative to throat swab culture in diagnosing activity in Acute Rheumatic Fever or established Rheumatic heart disease.


Assuntos
Técnicas de Tipagem Bacteriana/métodos , Peptídeo Hidrolases/genética , Febre Reumática/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus pyogenes , Adolescente , Criança , Pré-Escolar , Estudos Transversais , DNA Bacteriano/análise , DNA Bacteriano/genética , Humanos , Índia , Faringe/microbiologia , Reação em Cadeia da Polimerase , Febre Reumática/microbiologia , Sensibilidade e Especificidade , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/genética , Streptococcus pyogenes/isolamento & purificação
10.
Aust N Z J Public Health ; 43(3): 288-293, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30994967

RESUMO

OBJECTIVES: We report a cluster of acute rheumatic fever (ARF) cases and the public health response in a high-burden Australian setting. METHODS: The public health unit was notified of an increase in ARF cases in a remote Australian Aboriginal community. A multi-disciplinary group coordinated the response. Household contacts were screened for ARF or group A Streptococcus (GAS) infection by questionnaire and swab collection, offered an echocardiogram if aged 5-20 years, and intramuscular benzathine benzylpenicillin if aged over one year or if less than one year with impetigo. RESULTS: Fifteen definite and seven probable ARF cases were diagnosed in the community in July-December 2014 (all-age incidence of definite ARF: 1,473/100,000). The public health response identified two additional cases of ARF. A total of 81 contacts were screened; GAS was detected in 3/76 (4%) throat swabs and 11/24 (46%) skin swabs. Molecular typing revealed high GAS strain diversity. CONCLUSIONS: The incidence of ARF during this cluster was very high. Carriage and infection with GAS was observed, but no outbreak strain identified. Implications for public health: A national public health guideline has since been developed that includes advice on the investigation of an ARF outbreak/cluster. Sustained efforts with strong community engagement are required to tackle high ARF rates.


Assuntos
Notificação de Doenças , Grupo com Ancestrais Oceânicos , Vigilância da População/métodos , Febre Reumática/diagnóstico , Infecções Estreptocócicas/diagnóstico , Doença Aguda , Adolescente , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Austrália/epidemiologia , Criança , Pré-Escolar , Ecocardiografia , Feminino , Humanos , Incidência , Masculino , Penicilina G Benzatina/administração & dosagem , Penicilina G Benzatina/uso terapêutico , Febre Reumática/tratamento farmacológico , Febre Reumática/epidemiologia , Cardiopatia Reumática/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Streptococcus/isolamento & purificação , Adulto Jovem
12.
Aust N Z J Public Health ; 43(3): 294-299, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30908804

RESUMO

OBJECTIVE: Rheumatic fever (RF) recurrence prevention requires secondary prophylaxis for at least ten years. However, recurrences of rheumatic fever (RRF) persist disproportionately affecting Maori and Pacific youth. Reasons for recurrence rates are not well understood and commonly attributed to patient non-adherence. This research explored Maori and Pacific family experiences of RRF to better understand barriers to accessing secondary prophylaxis to inform health service improvements. METHODS: Participants were Maori and Pacific patients who had RRF or unexpected rheumatic heart disease and their family; and health professionals working in RF contexts. Kaupapa Maori, Talanga and Kakala Pacific qualitative methodologies were employed. Data were thematically analysed using a general inductive approach. RESULTS: Data collection included 38 interviews with patients and families (n=80), six focus group interviews and nine interviews with health providers (n=33) from seven geographic regions. Three key themes were identified where mismatches occurred between services and community needs: 1. Model of delivery; 2. Interpersonal approaches to care; and 3. Adolescent care. Conclusions and Public health implications: Successful RRF prevention requires interventions to address structural causes of inequity, appropriate clinical guidelines and quality health services. Service-delivery models should provide regular prophylaxis in an accessible manner through culturally-safe, community-based, age-appropriate care.


Assuntos
Atitude Frente a Saúde/etnologia , Assistência à Saúde/métodos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde do Indígena/organização & administração , Grupo com Ancestrais Oceânicos/psicologia , Febre Reumática/prevenção & controle , Cardiopatia Reumática/prevenção & controle , Prevenção Secundária , Adolescente , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Nova Zelândia/epidemiologia , Pesquisa Qualitativa , Febre Reumática/diagnóstico , Febre Reumática/etnologia , Cardiopatia Reumática/diagnóstico
13.
Int J Med Inform ; 123: 68-75, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30654905

RESUMO

BACKGROUND: Acute rheumatic fever (ARF) is an important disease that is frequently seen in Turkey, it is necessary to develop solutions to cure the disease. It is believed that new data analysis methods may be applied to this disease, and this may be useful to discover previously unrecognized patterns. Data mining of existing records and data repositories may improve knowledge on the diagnosis and management of ARF. In this regard, we planned to make a contribution to the development of new solutions by approaching the problem from a different standpoint. OBJECTIVES: The aim of this study is to analyse the effects of ARF undergone during childhood on the basis of cardiac diseases by using data mining methods. MATERIALS AND METHODS: Classification methods of data mining were used, and experiments were conducted on five algorithms. The records of the patients diagnosed with ARF were analysed by setting models with naive Bayes classifier, decision trees (CART, C4.5, C5.0, C5.0 boosted) and random forest algorithms. The performances of the algorithms that were derived were then compared. Among model performance evaluation techniques, the hold-out, cross-validation and bootstrap methods were tested in diverse ways in an applied manner. Within the scope of the research, the dataset comprising records of 297 patients was utilised in cooperation with Istanbul Medeniyet University Göztepe Training and Research Hospital's Pediatric Cardiology Clinic (Istanbul Medeniyet Üniversitesi Göztepe Egitim ve Arastirma Hastanesi Çocuk Kardiyolojisi Klinigi). Data analysis was carried out with the data of the remaining 201 patients following pre-processing. RESULTS: The results that were obtained from different algorithms were compared based on the model performance evaluation criteria. The best result was shown under the CART model by using the hold-out technique (80% training, 20% testing). According to this model, the importance values of the predictive attributes were listed, and it was found that the "teleNormal" and "cardiomegaly" attributes were not required for ARF diagnosis and treatment. In compliance with this result, it was thought that it should not be necessary for patients have a chest x-ray which is needed for diagnosis of "teleNormal" and "cardiomegaly". This will help reduce costs and thus contribute to the health economy while preventing patients from having unnecessary x-rays. DISCUSSION AND CONCLUSION: The results of this study showed that data mining techniques may be used to analyse diseases such as ARF. The important attributes that affect the disease were obtained in accordance with the results. The results of the best model (CART) may be broadened in numerous ways and provide information for both experienced and inexperienced physicians. This study is considered to be significant as it helps data mining methods become more prevalently used for data analysis in fields of medicine and healthcare.


Assuntos
Algoritmos , Mineração de Dados/métodos , Árvores de Decisões , Cardiopatias/fisiopatologia , Febre Reumática/diagnóstico , Adolescente , Teorema de Bayes , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Febre Reumática/epidemiologia
14.
Georgian Med News ; (297): 88-94, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-32011302

RESUMO

The purpose of the work is to analyze the evolution of the clinical course, diagnosis, treatment and prevention of acute rheumatic fever (ARF) and chronic rheumatic heart disease (RHD), antibiotic therapy of streptococcal infection, using modern analysis of modern literature and our own observations. Diagnostic criteria for the disease were revised. Improving the capabilities of echocardiography can improve the prognosis of the disease through the early use of treatment and prevention. The level of ORL / RHD correlates with the economic development of countries. Mutation of the etiological factor of rheumatism - ß-HSA, the formation of antibiotic resistance, increased migration, tourist activity in countries with high morbidity due to ß-HSA can lead to new outbreaks of this infection. Prevention ARF/RHD is multistage. Thus, using the experience of healthcare in different countries, new approaches to prevention can improve disease control.


Assuntos
Febre Reumática , Cardiopatia Reumática , Infecções Estreptocócicas , Antibacterianos/uso terapêutico , Humanos , Febre Reumática/diagnóstico , Febre Reumática/prevenção & controle , Febre Reumática/terapia , Cardiopatia Reumática/diagnóstico , Cardiopatia Reumática/prevenção & controle , Cardiopatia Reumática/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico
15.
Perm J ; 232019.
Artigo em Inglês | MEDLINE | ID: mdl-31926573

RESUMO

Poststreptococcal reactive arthritis (PSRA) is associated with prior group A ß-hemolytic streptococcal infection and has a reported annual incidence of 1 to 2 cases per 100,000 persons, approximately twice that of acute rheumatic fever (ARF) in the US. Children who present with reactive arthritis are not uncommon in a busy general pediatric practice in the US, whereas children who present with ARF are very rare. Distinguishing PSRA from ARF can be challenging because the symptoms and signs are similar, but the diseases differ in long-term therapy, follow-up evaluation, and prognosis. We review the diagnostic criteria for PSRA, the pertinent features of the 2015 ARF diagnostic guideline from the American Heart Association, and the major characteristics that differentiate PSRA from ARF.


Assuntos
Febre Reumática/diagnóstico , Febre Reumática/etiologia , Infecções Estreptocócicas/complicações , Doença Aguda , Anti-Inflamatórios não Esteroides/uso terapêutico , Ecocardiografia Doppler , Humanos , Miocardite/etiologia , Miocardite/fisiopatologia , Febre Reumática/diagnóstico por imagem , Febre Reumática/tratamento farmacológico , Fatores de Risco , Estados Unidos
16.
Turk J Pediatr ; 61(5): 810-814, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32105019

RESUMO

Bagrul D. Syncope due to acute rheumatic fever with pacemakerlike syndrome. Turk J Pediatr 2019; 61: 810-814. The prolongation in the PR interval on the electrocardiogram is one of the minor criteria of Jones. Abnormal increases in the PR interval lead to hemodynamic impairments caused by atrioventricular asynchrony and is called pseudo-pacemaker or pacemaker-like syndrome in the literature. A 13-yearold boy who had polyarthralgia for six weeks was referred to the emergency room because of syncope while exerting effort. In the electrocardiography, the P wave was regularly seen at the onset of the T wave immediately after the QRS wave with extremely prolonged PR interval and mild tachycardia. Also, 24 hours rhythm Holter recording showed atrioventricular dissociation. The echocardiography revealed findings of severe carditis. Diagnosis of acute rheumatic fever accompanying pacemaker-like syndrome was made. Although the recommendation for marked first-degree atrioventricular block that causes hemodynamic impairment is pacemaker implantation, a significant improvement in the PR prolongation was observed in the short term with anti-inflammatory treatment because the impairment of conduction in the patient was due to inflammation. The pacemaker-like syndrome in a child is being reported for the first time in the literature.


Assuntos
Arritmias Cardíacas/etiologia , Febre Reumática/complicações , Febre Reumática/diagnóstico , Síncope/etiologia , Adolescente , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Ecocardiografia , Eletrocardiografia , Frequência Cardíaca , Humanos , Masculino , Marca-Passo Artificial , Febre Reumática/terapia , Síncope/diagnóstico , Síncope/terapia , Síndrome
17.
Clin Med (Lond) ; 18(5): 400-402, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30287435

RESUMO

We present the case of a 41-year-old Australian woman with a 3-day history of fevers and migratory polyarthritis. Three weeks prior she had been treated by her GP with phenoxymethylpenicillin for acute tonsillitis. Examination confirmed synovitis. Systemic assessment including cardiovascular, neurological and skin examination was unremarkable. Abnormal investigations included a leucocytosis with neutrophilia, C-reactive peptide of 116 mg/L, erythrocyte sedimentation rate of 103 mm/hour and acute transaminitis. The antistreptolysin O titre was 304 IU, which increased to 1,250 IU after 2 weeks. Troponin T, electrocardiogram and echocardiography were all normal. The patient was treated for acute rheumatic fever with corticosteroids and a 10-day course of cephalexin. After 8 weeks, she made a full recovery and had normalised inflammatory markers and liver biochemistry. She was then commenced on monthly prophylactic intramuscular benzathine penicillin. This case study aims to raise awareness of the presentation, diagnosis and management of acute rheumatic fever.


Assuntos
Febre Reumática , Adulto , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Artrite/diagnóstico , Artrite/tratamento farmacológico , Artrite/etiologia , Feminino , Febre/etiologia , Humanos , Febre Reumática/diagnóstico , Febre Reumática/tratamento farmacológico , Febre Reumática/etiologia , Tonsilite/complicações , Tonsilite/tratamento farmacológico
19.
Pediatr Clin North Am ; 65(4): 623-638, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30031490

RESUMO

This article focuses on creating an orderly approach to history taking, examination, and ordering appropriate investigations when caring for a child with joint complaints. It classifies complaints as those with and without pain, swelling, or fever and of short or long duration. It recommends an approach to the physical examination and both suggests and discourages various laboratory and imaging studies.


Assuntos
Artralgia/etiologia , Artrite/diagnóstico , Adolescente , Artralgia/diagnóstico , Artralgia/diagnóstico por imagem , Artralgia/terapia , Artrite/complicações , Criança , Pré-Escolar , Diagnóstico Diferencial , Humanos , Anamnese , Medição da Dor , Febre Reumática/complicações , Febre Reumática/diagnóstico , Índice de Gravidade de Doença
20.
Pediatr Emerg Care ; 34(6): 436-440, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29851920

RESUMO

The Jones criteria of 2 major criteria or 1 major plus 2 minor criteria that have been classically used to establish the diagnosis have been significantly modified in 2015 by the American Heart Association. The criteria now include the utilization of echocardiography and Doppler color flow mapping as diagnostic tools for carditis, along with defining criteria in relation to overall population risk, delineating low- versus moderate-high risk populations. Monoarthritis and polyarthralgia are now major criteria for moderate- to high-risk groups.


Assuntos
Febre Reumática/diagnóstico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Criança , Diagnóstico Diferencial , Humanos , Masculino , Penicilinas/uso terapêutico , Febre Reumática/terapia
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