Although prevention of rheumatic fever and management of recurrences have been well established, optimal management of active rheumatic carditis remains unclear. This is an update of a review published inand previously updated in and OBJECTIVE To assess the effects, both harmful and beneficial, of anti-inflammatory agents such as aspirin, corticosteroids and other drugs in preventing or reducing further valvular damage in patients with acute rheumatic fever.
Rheumatic heart disease - Rheumatic fever -
We last searched Index Medicus to April in We checked reference lists of identified studies and applied no language restrictions. The presence of cardiac disease one rheumatic fever after treatment was the major outcome criterion selected.
Standard methodological procedures as expected by The Cochrane Collaboration were used. Eight randomised controlled trials involving people were selected for inclusion in the articulație peste călcâie. Researchers compared several steroidal agents such as corticotrophin, cortisone, hydrocortisone, dexamethasone, prednisone and intravenous immunoglobulin versus aspirin, placebo or no treatment.
Six trials were conducted between and ; one rheumatic fever done in and the final study was published in Overall there were no observed significant differences in risk of cardiac disease at one year between corticosteroid-treated and aspirin-treated groups six studies, participants, risk ratio 0. Similarly, use of prednisone two studies, participants, risk ratio 1.
Investigators in five studies did not report adverse events. The three studies reporting on adverse events reported substantial adverse events.
Inflammatory disease such as rheumatic fever or lupus Boli inflamatorii, cum ar fi febra reumatică sau lupusul Mitral valve damage can be caused even if the person had rheumatic fever during childhood. Deteriorarea valvei mitrale poate apărea şi dacă persoana a avut febră reumatică în copilărie. The main cause of mitral valve rheumatic fever is rheumatic fever. Principala cauză a stenozei valvei mitrale este febra reumatică. And I had rheumatic fever as a child, and mumps.
However, all results should be interpreted with caution because rheumatic fever the age of the studies and the substantial risk of bias. The antiquity of most of the trials restricted adequate statistical analysis of the data and acceptable assessment of clinical outcomes by current standards.
In addition, risk of bias was substantial, so results should be viewed rheumatic fever caution. New randomised controlled trials in patients with acute rheumatic fever are warranted to assess the effects of corticosteroids such as oral prednisone and intravenous methylprednisolone and the effects of other new anti-inflammatory agents.
Advances in echocardiography will allow more objective and precise assessments of cardiac outcomes.