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Rheumatic fever. Acute Rheumatic Fever and Rheumatic Heart Disease - adamos.ro

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Although the prevention of rheumatic fever and the management of recurrences is well established, the optimal management of active rheumatic carditis is still unclear.

This is an rheumatic fever of a review published in and previously updated in OBJECTIVE To assess the effects of anti-inflammatory agents such as aspirin, corticosteroids, immunoglobulin and pentoxifylline for preventing or reducing further heart valve damage in patients with acute rheumatic fever. No language restrictions were applied.

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The presence of cardiac disease one year after treatment was the major outcome criteria selected. Risk of bias was assessed using methodology outlined in the Cochrane handbook.

PSEUDOTUMOR CEREBRI FOLLOWING ACUTE RHEUMATIC FEVER

Eight randomised controlled trials involving people were included. Several steroidal agents corticotrophin, cortisone, hydrocortisone, dexamethasone and prednisone, and intravenous immunoglobulin were compared to aspirin, placebo or no treatment in the various studies.

Although prevention of rheumatic fever and management of recurrences have been well established, optimal management of active rheumatic carditis remains unclear.

Six of the trials were conducted between andone study was done inand the final study was published in Overall there was no significant difference in the risk of cardiac disease rheumatic fever one year between the corticosteroid-treated and aspirin-treated groups six studies, participants, relative risk 0. Similarly, use of prednisone two studies, participants, relative risk 1.

Adverse events were not rheumatic fever in five studies.

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The three studies reporting on adverse events all reported substantial adverse events. However, all results should be interpreted with caution due to the age rheumatic fever the studies and to substantial risk of bias.

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The antiquity of most of the trials restricted adequate statistical analysis of the data and acceptable assessment of clinical outcomes by current standards. Additionally there was substantial risk of bias, so results should be viewed rheumatic fever caution.

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New randomised controlled trials in patients with acute rheumatic fever to assess the effects of corticosteroids such as oral prednisone and intravenous methylprednisolone, and other new anti-inflammatory agents are warranted. Advances in echocardiography will allow for more objective and precise assessments of cardiac outcomes.

Rheumatic heart disease