| 词汇 | example_english_rheumatic-fever |
| 释义 | Examples of rheumatic feverThese examples are from corpora and from sources on the web. Any opinions in the examples do not represent the opinion of the Cambridge Dictionary editors or of Cambridge University Press or its licensors. Relation of the rheumaticfever recurrence rate per streptococcal infection to preexisting clinical features of the patients. In the author's opinion this syndrome is nothing more than good old-fashioned rheumaticfever. In this review, therefore, we discuss our experience acquired in the clinical aspects of rheumaticfever. It is not yet clear whether these putative markers are genetic or induced by streptococcal infection as part of the pathogenesis of acute rheumaticfever. The cumulative incidence of acute rheumaticfever estimates the proportion of susceptible individuals in endemically exposed populations. The other manifestations of acute rheumaticfever besides carditis usually disappear without sequels. Because of the severe cardiac impairment produced by the disease, all efforts to include prophylaxis for rheumaticfever in public health programs are justified. In addition, mitral plus either aortic or tricuspid lesions are usually secondary to rheumaticfever. Susceptibility to rheumaticfever have been ascertained because of the poor quality of records in earlier years. These two categories often reach significant proportions, being several times the registered rates for acute rheumaticfever and chronic rheumatic heart disease. With such high rates of streptococcal acquisition it is possible that most susceptible people will eventually develop rheumaticfever. The rates for acute rheumaticfever are very low in relation to the expected figures considering their proportion of poverty. Of these, 8,100 were attributed to acute rheumaticfever and 61,002 to chronic disease, totalling 69,102 (or 1.08% of all deaths due to cardiovascular disease). Cardiac failure, acute rheumaticfever and thromboembolic disease were the most common causes of death in these young patients. It is conceivable that these features represent the early cardiac morphologic changes encountered in acute rheumaticfever. The analysis of the results of our study showed that the profile of the acute phase of rheumaticfever remained unaltered. My purpose, therefore, is to review the medical treatment of acute episodes of rheumaticfever. Similarly, controversy still exists about both the advantages and the limitations of both medical and surgical therapy of rheumaticfever and rheumatic heart disease. It is of note that, although streptococcal infections are very frequent, only a few individuals develop rheumaticfever. In the absence of primary prevention, the best chance for preventing chronic carditis is to recognize thefirstepisode of acute rheumaticfever and institute secondary prophylaxis. It is mandatory to observe a correct anticoagulation and a correct prophylaxis of rheumaticfever and bacterial endocarditis. Note that the rate of recurrence fell sharply after 2-3 years of the last episode of acute rheumaticfever. Nineteen patients (12.2%) had a history of less than six months duration, and 39 patients (25%) did not recall any illness suggesting rheumaticfever. All had acute rheumaticfever, characterized by the presence of migratory polyarthritis and carditis. The recognition of the need to understand more completely the pathogenesis of the cardiac involvement of rheumaticfever is thoughtfully addressed. All efforts should be made during follow-up to reduce complications by means of appropriate anticoagulation and correct prophylaxis for bacterial endocarditis and rheumaticfever. Even the strongest advocates32'33 of this improperly identified syndrome suggest its management be identical to that of rheumaticfever, so why the new name? It is quite correct to delay treatment until one can clearly establish or rule out the presence of active rheumaticfever. A plot showing recurrences of acute rheumaticfever during the period of follow-up. When carditis was moderate to severe, as was the case with recurrent acute rheumaticfever, then the chances of improvement during long-term follow-up were low. Aortic incompetence had preexisted but followed recurrent attacks of rheumaticfever in four of the nine. Thus, as is true with acute rheumaticfever, clinical judgment will still be required to make the diagnosis in atypical settings. The primary aim is to prevent the initial attack of rheumaticfever through the correct treatment of the streptococcal infection. Five year follow-up on patients with rheumaticfever treated by bed rest, steroids or salicylates. On the other hand, some diagnostic doubts could remain in patients with borderline manifestations of acute rheumaticfever. The rates for all cardiovascular diseases are relatively high, but with low rates for acute rheumaticfever and middle rates for rheumatic heart disease. The skin manifestations by themselves essentially never establish the diagnosis of rheumaticfever. Rupture of the tendinous cords in severe acute rheumaticfever is probably not very rare, but this finding has rarely been corroborated. From then on, penicillin has been the drug of choice for treatment of streptococcal infection, and rheumaticfever is no exception. The rates for acute rheumaticfever, and for rheumatic heart disease in particular, are, in general, very low. Furthermore, antibiotics such as penicillin for primary and secondary prevention of rheumaticfever are also often in short supply. The rise and fall (and rise?) of rheumaticfever. In developing countries, in contrast, the profile of rheumaticfever has not shown any great changes. We wondered whether the cumulative incidence of acute rheumaticfever in this population may offer insights into the population susceptibility to rheumaticfever. The low proportion of older cases with a history of documented acute rheumaticfever also suggests poor medical documentation in past years. The high incidence of episodes of acute rheumaticfever in our patients is noteworthy. The dominant clinical picture of rheumaticfever was carditis, which was found either alone or in combination with other clinical features. Yet, the capability of echocardiography to diagnose acute rheumaticfever has not been fully appreciated. In acute rheumaticfever with carditis, pancarditis is the rule. Despite knowledge of the streptococcal origin of acute rheumaticfever, diagnostic criteria are still used to make the diagnosis. The treatment of choice for patients presenting with acute rheumaticfever is, of course, medical treatment. Secondary prevention of recurrent attacks of rheumaticfever by continuous administration of penicillin is very effective as a public health program. At least two specific types of difficulty exist, however, in obtaining epidemiological information on rheumaticfever in developing countries. Because of the causal relationship between streptococcal pharyngitis and rheumaticfever, it is hardly surprising that the epidemiology of the two disease is closely related. The association of two major manifestations, or presence of one major and two minor manifestation, is taken to indicate a high probability of rheumaticfever. Appropriate anticoagulation and correct prophylaxis of rheumaticfever and bacterial endocarditis is mandatory. This reflects in part the reality that all acute rheumaticfever does not progress to rheumatic heart disease. In conclusion, the epidemiological evidence suggests that less than 5-6 % of people can develop acute rheumaticfever after relevant streptococcal exposure. Years ago, a similar controversy surrounded the use of corticosteroids as opposed to aspirin for the treatment of acute rheumaticfever. Rheumaticfever: the interplay between host, genetics and microbe. Those with moderate to severe carditis with resultant cardiomegaly, due to recurrent acute episodes of rheumaticfever, are unlikely to improve with secondary prophylaxis or medical management. Rheumaticfever: the interplay between host, genetics, and microbe. Epidemiology of rheumaticfever in the developing world. This notion is strongly supported by the success of prophylaxis with sulphonamides and penicillin in reducing the incidence of rheumaticfever and in normalizing serological tests. Nowadays, increasing knowledge in immunological research has emphasized the importance of these mechanisms in the etiology of acute rheumaticfever, reinforcing the importance of the immunosuppressive action of corticosteroids. All of these topics, important as they may be, pale into insignificance when set against the impact worldwide of acute rheumaticfever and its subsequent chronic effect upon the heart. After the establishment of the referral clinic for rheumaticfever, health assistance to patients has been improved, and has included patients with chorea and arthritis but without cardiac symptoms. Decades after the realization that prompt antibiotic therapy of the preceding streptococcal infection can essentially eliminate the threat of rheumaticfever, major questions remain unanswered about this problem. Rheumaticfever occurs most frequently among children and adolescents between 5 and 15 years, coinciding with the age distribution of the highest prevalence of streptococcal infections. Due to improved medical care and general prosperity in industrialized western countries, the incidence of acute rheumaticfever and the consecutive rheumatic heart disease has decreased considerably. Rheumaticfever: the way it was. All patients with congenital lesions, and 1,835 (78%) of those with isolated rheumatic disease, had at least one well characterized episode of carditis secondary to acute rheumaticfever. At our institution, all patients with a possible episode of acute rheumaticfever are evaluated according to a protocol which includes a complete clinical and laboratory workup. Freezing a positive culture from an index case of rheumaticfever is not routine, but should be considered for possible follow up epidemiological and investigative studies. The answers to such questions will only be obtained by undertaking long-term clinical and epidemiological studies combined with supporting programs to achieve a better control of rheumaticfever. In the overall sample, the age of onset of rheumaticfever ranged from 2.6 to 14.0 years, with a median of 9.0 and a mean of 8.5 + 2.5 years. Retrospective evaluation of the medical records during the period of study demonstrated that 427 acute attacks of rheumaticfever occurred in the group of 226 patients. Since the diagnosis of this entity itself is exceedingly rare in childhood, the existence of rheumaticfever can be accepted with chorea as the only manifestation. On the other hand, the apparent increase in rheumaticfever incidence may be due in part to better ascertainment following improvements in medical care in the 1970s. Early ambulation in the treatment of acute rheumaticfever. Rheumaticfever and rheumatic heart disease in the 1970s. The duration from the onset of symptoms of acute rheumaticfever was determined from the earliest data of onset of complaints to the date of presentation. These examples are from corpora and from sources on the web. Any opinions in the examples do not represent the opinion of the Cambridge Dictionary editors or of Cambridge University Press or its licensors. |
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