Follow-up of rheumatic carditis treated with steroids
Cardiology in the Young,  Clinical Article

Herdy GVH et al. – Many critically ill patients who complied with secondary prophylaxis were left with minor injuries, whereas those who neglected it or abandoned it had serious sequelae. The rate of abandonment and loss to follow–up was very high. Many cases (49%) were re–hospitalised because of carditis recurrence.

Methods
  • This is a retrospective analysis of the outcome of 242 patients with severe rheumatic carditis after discharge from two public hospitals in Niteroi, Brazil.
  • The authors followed up 118 patients for 4 years or more, with an average of 7.7 years.
  • They were treated with antibiotics to accomplish bacterial eradication and either intravenous methylprednisolone – 40 cases – or oral prednisone – 78 patients – to treat carditis.
  • They were followed up in outpatient clinic.

Results
  • Cardiac failure was categorised as classes III and IV according to the New York Heart Association classification.
  • In the intravenous corticosteroid group, 21 cases (52.5%) had isolated mitral valve regurgitation, 12 (30%) had mitral plus aortic involvement, and seven (17.5%) had aortic lesion only. In the oral prednisone group, 45 (58%) had mitral valve regurgitation only, 27 (34%) had mitral plus aortic involvement, and six (8%) had aortic lesion only.
  • A total of 28 children were in their first disease attack, of whom 19 (68%) had a rupture of chordae tendineae.
  • A total of 58 patients (49%) sustained recurrence of carditis because of neglected secondary prophylaxis.
  • In all, 19 cases (16%) underwent cardiac surgery – valve replacement or valvuloplasty.
  • In 33% of the cases, the outcome was favourable – asymptomatic at follow–up.
  • The overall mortality rate was 6.8%.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Pharmacy

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Pharmacy Articles

1 Precautionary labelling of foods for allergen content: Are we ready for a global framework? Full Text World Allergy Organization Journal, May 8, 2014    Free full text    Review Article

2 A pilot study to assess feasibility of value based pricing in Cyprus through pharmacoeconomic modelling and assessment of its operational framework: Sorafenib for second line renal cell cancer Full Text Cost Effectiveness and Resource Allocation, May 5, 2014    Free full text

3 New cholesterol guideline: LDL goals take backseat to statins Full Text American Pharmacists Association News, November 15, 2013    Free full text    Clinical Guideline

4 Adverse effects of nonsteroidal antiinflammatory drugs: An update of gastrointestinal, cardiovascular and renal complications Full Text Journal of Pharmacy and Pharmaceutical Sciences, January 3, 2014    Free full text    Clinical Article

5 Bedtime aspirin may be more beneficial for heart patients Full Text Pharmacy Times, December 2, 2013    Free full text    Clinical Article

6 Are chromium supplements helpful in lowering blood sugar levels? Full Text EurekAlert!, April 10, 2014    Free full text

7 Diuretics in the treatment of hypertension. Part 2: loop diuretics and potassium-sparing agents Expert Opinion on Pharmacotherapy, March 17, 2014    Review Article

8 Beyond statins: new lipid lowering strategies to reduce cardiovascular risk Current Atherosclerosis Reports, May 21, 2014    Review Article    Clinical Article

9 Efficacy and tolerability of carbamazepine for the treatment of painful diabetic neuropathy in adults: a 12-week, open-label, multicenter study Full Text International Journal of General Medicine, July 21, 2014    Free full text    Clinical Article

10 Unexpected results in cancer drug trial Full Text EurekAlert!, April 9, 2014    Free full text

11 Use of proton pump inhibitors for the provision of stress ulcer prophylaxis: Clinical and economic consequences PharmacoEconomics, February 11, 2014    Clinical Article

12 Cost-effectiveness of cranberries vs antibiotics to prevent urinary tract infections in premenopausal women: a randomized clinical trial PLOS ONE, April 15, 2014    Review Article

13 HPV eradicated by AHCC supplement, preclinical study suggests Full Text EurekAlert!, March 24, 2014    Free full text

14 A systematic review: Can one prescribe carbapenems to patients with IgE-mediated allergy to penicillins or cephalosporins? Clinical Infectious Diseases, July 25, 2014    Clinical Article

15 Vancomycin, metronidazole, or tolevamer for clostridium difficile infection: Results from two multinational, randomized, controlled trials Clinical Infectious Diseases, June 6, 2014    Clinical Article

16 Prescribing of high-dose acetaminophen products discouraged Full Text U.S. Pharmacist, March 11, 2014    Free full text    Clinical Article

17 Impact of a new method of warfarin management on patient satisfaction, time, and cost Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, August 23, 2013    Clinical Article

18 Clever chemistry improves a new class of antibiotics Full Text EurekAlert!, January 20, 2014    Free full text

19 Beta-blockers in heart failure with preserved ejection fraction: A meta-analysis Heart Failure Reviews, July 28, 2014    Evidence Based Medicine    Review Article    Clinical Article

20 Beta-lactam allergy: Clinical implications and costs Full Text Clinical and Molecular Allergy , December 4, 2013    Free full text    Clinical Article

Indexed Journals in Pharmacy: Expert Opinion in Pharmacotherapy, Formulary, U.S.Pharmacistmore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close