Rheumatic fever is an inflammatory disease that occurs as a delayed response to a streptococcal infection. It commonly affects school-aged children and causes inflammation in the heart, joints, nervous system and other tissues. While rates have declined in developed nations, it remains an issue in developing countries. Medical management focuses on eradicating the infection with antibiotics, managing cardiac symptoms, and promoting comfort. Nursing care involves monitoring for symptoms, administering medications, maintaining nutrition and hydration, managing pain and activity levels.
Rheumatic fever (acute rheumatic fever) is a disease that can affect the heart, joints, brain, and skin. Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly. Early diagnosis of these infections and treatment with antibiotics are key to preventing rheumatic fever.
Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain.[1] The disease typically develops two to four weeks after a streptococcal throat infection.[2] Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum.[1] The heart is involved in about half of the cases.[1] Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.[1]
Case study- An 11 year old Polynesian male presents with fever up to 39 degrees (102 degrees F), joint pain and swelling, along with shortness of breath. The fever comes and goes at random times of the day. The symptoms have been present now for 4 days.
Acute meningoencephalitis Powerpoint presentation.
It comprises of acute meningitis and acute encephalitis, their clinical features, physical assesment, diagnosis and treatment.
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Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
Rheumatic fever (acute rheumatic fever) is a disease that can affect the heart, joints, brain, and skin. Rheumatic fever can develop if strep throat and scarlet fever infections are not treated properly. Early diagnosis of these infections and treatment with antibiotics are key to preventing rheumatic fever.
Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain.[1] The disease typically develops two to four weeks after a streptococcal throat infection.[2] Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum.[1] The heart is involved in about half of the cases.[1] Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.[1]
Case study- An 11 year old Polynesian male presents with fever up to 39 degrees (102 degrees F), joint pain and swelling, along with shortness of breath. The fever comes and goes at random times of the day. The symptoms have been present now for 4 days.
Acute meningoencephalitis Powerpoint presentation.
It comprises of acute meningitis and acute encephalitis, their clinical features, physical assesment, diagnosis and treatment.
THIS SLIDE IS PREPARED BY SURESH KUMAR FOR MY STUDENT SUPPORT SYSTEM TO WATCH THIS VIDEO VISIT YOUTUBE CHANNEL- Important links-
youtube channel
https://www.youtube.com/c/MYSTUDENTSUPPORTSYSTEM
facebook profile- https://www.facebook.com/suresh.kr.lrhs/
FACEBOOK PAGE- https://www.facebook.com/My-Student-Support-System-101733164924592
facebook group NURSING NOTES- https://www.facebook.com/groups/241390897133057/
FOR MAKING EASY NOTES YOU CAN ALSO VISIT MY BLOG –
BLOGGER- https://mynursingstudents.blogspot.com/
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Twitter- https://twitter.com/student_system?s=08
#glomerulonephritis,#congenitalanomalies,#childhealthnursing#anm,#gnm,#bscnursing
Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever. The heart valve damage may start shortly after untreated or under-treated streptococcal infection such as strep throat or scarlet fever.
Rheumatic fever is quite common in developing countries and it has well known cardiac complications. So it's very important to know rheumatic fever, hopefully, this presentation will fill the needs. If you think it's helpful then share it.
Acute Rheumatic Fever and Rheumatic Heart Disease, are two common conditions in children between 3-15 years of age following a Group B Streptococcal throat infection. We discuss these two conditions in the slides above, as well as their management.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
2. Rheumatic fever
• Rheumatic fever is a diffuse inflammatory
disease.
• It is a delayed response to an infection by
group A beta-hemolytic streptococci
• Acute rheumatic fever, which occurs most
often in school-age children.
3. Epidemiological Data
• The incidence of ARF has declined markedly in the
past 50 years in both the United States and
Western Europe.
• In developing countries, the magnitude of ARF is
enormous.
• Recent estimates suggest that 33.4 million people
worldwide have rheumatic heart disease and that
300,000-500,000 new cases of rheumatic fever
(approximately 60% of whom will develop
rheumatic heart disease) occur annually, with
230,000 deaths resulting from its complications.
4. Contd.
• Almost all of this toll occurs in the developing
world.
• The incidence rate of rheumatic fever is as
high as 50 cases per 100,000 children in many
areas.
• Rheumatic fever in the 21st century appears
to be largely a disease of crowding and
poverty.
5. Contd.
• About 60% of the approximately 470,000
patients diagnosed with ARF annually
eventually develop carditis, joining the
approximately 33 million worldwide with
rheumatic heart disease.
• ARF is most common among children aged 5-
15 years.
6. Etiology of the rheumatic fever
• Rheumatic fever develops in relatively small
percentage of people (3%)
• Once rheumatic fever is acquired, the person
becomes more susceptible than the general
population to recurrent infection
7. Contd.
• The Streptococcus is spread by direct contact
with oral or respiratory secretions
• Although the bacteria are the causative
agents, risk factors also present:
– Malnutrition
– Overcrowding
– Lower socioeconomic status ( poverty )
– Poor hygiene
8. Contd..
• As many as 39% of patients with rheumatic
fever develop various degrees of rheumatic
heart disease associated with valvular
insufficiency, heart failure, and death
• The disease also affects all bony joints
producing polyarthritis
9. Contd.
• Rheumatic fever can usually be prevented if
appropriate antibiotic therapy for group A
beta-hemolytic streptococcal infection is
initiated within the first 9 days.
10. Pathophysiology
Presence of group A beta hemolytic streptococcal
infection more than 9 days
Proliferative, inflammatory exudative inflammatory
process in the heart, joint, nervous system, etc.
Abnormal and humoral and cell mediated response
to streptococcal cell membrane cell
11. contd
Permanent and severe heart damage
Rheumatic and myocarditis develop which temporary
weakness the contractile power of the heart
Pericardium also affected and rheumatic pericarditis
occur
Rheumatic endocarditis result in permanent and
crippling side effect
14. Contd.
• Fever: with a temperature of 100.4 C or
higher, alternates with normal temperature.
• Weakness, malaise, weight loss, and anorexia
probably develop as a result of fever and pain
15. Contd.
• Arthritis. It most often affects the larger
joints, such as the ankles, knees, elbows,
shoulder, and wrists.
• The arthritis may or may not be symmetrical.
Joint manifestations may last hours or days
16. Contd.
• Carditis, murmur, cardiomegaly, pericarditis that
produces a significant friction rub, and heart.
• Chest pain due to pericardial inflammation may
be present.
• Sometimes there is myocardial involvement that
produces atrioventricular (AV)conduction defect
17. Contd.
• Subcutaneous nodules are small, painless,
firm nodules that adhere loosely to the
tendon sheaths, especially in knees, knuckles,
and elbows.
• They are usually evident only during the first
week or so and, generally, only in children
18. Contd.
• Erythema marginatum is an unusual rash seen
primarily on the trunk.
• The lesions are crescent-shaped and have
clear centers.
19. Contd.
• Chorea, a CNS disorder, is manifested by
sudden, irregular, aimless, involuntary
movements.
• Chorea disappears without treatment and
produces no permanent sequel.
• Abdominal pain: varies in site and severity.
The pain may be related to engorgement of
the liver.
24. Contd.
• Evidence of previous group A streptococcal
infection + Throat culture or rapid
streptococcal antigen test
• ↑ streptococcal antibody titer
• Throat swab culture: positive indicates RF
25. Contd.
• Anti-streptolysin O titre: Serological changes may
indicate a recent streptococcal infection.
• Sometimes anti-streptokinase titre, are
performed.
• WBC count: is elevated in RF
• ESR: elevated
• C-reactive protein: elevated
• Cardiac investigation, e.g. ECG, echocardiogram
26. Medical Management
The goals of medical management include
1. eradicating infection,
2. maximizing cardiac output, and
3. promoting comfort
27. Eradicate Infection
• This can be accomplished with oral administration
of penicillin.
• For penicillin-allergic clients, the physician usually
prescribes erythromycin/sulfonamide (e.g.
sulfadiazine).
28. Contd.
• Phenoxymethylpenicillin 500mg four times
daily for 1 week
• The client typically takes prophylactic agents
for rheumatic fever for 5 years after the initial
attack.
• After 5 years recurrences are rare.
• who have had rheumatic fever remain
vulnerable to bacterial endocarditis.
29. Contd.
• In addition, the antibiotics is taken to prevent
RF recurrence.
• They must be referred for evaluation for
possible prophylactic medications before and
after any surgical procedure or dental work
30. Maximize Cardiac Output
• Corticosteroids are used to treat carditis,
especially if heart failure is evident.
• If heart failure develops, treatment, including
cardiac glycosides and diuretics, is effective.
31. Nursing Management
Assessment:
• Baseline subjective and objective data
gathering
• Assess vital signs to reveal fever, tachycardia,
and blood pressure
• Auscultate heart sounds for presence of a
friction rub, and palpate peripheral pulse
32. Contd.
• Baseline ECG
• Assess baseline nutritional and hydration data
• Assess psychological data on the client’s
feelings regarding restrictions of activity,
support systems, coping strategies, level of
discomfort, and knowledge
33. CONTD.
Prednisolone:
• 60-120mg in four divided doses each day until
the clinical syndrome is improved and the ESR
has fallen to normal.
• Steroids are then tapered off over 2-4 weeks
34. Nursing Diagnosis
1. Promote Comfort
• Clients with arthritic manifestations obtain clinical
relief with salicylates.
• These drugs can result in misdiagnosis, a firm
diagnosis should be in place before administration
of salicylates.
• High-dose salicylate (preferably acetylsalicylate,
i.e. aspirin)
35. Bed rest
Best rest until:
• Temp. remains normal without use of salicylates
• Resting pulse remains under 100 BPM
• ECG tracings show no signs of myocardial damage
• ESR returns to normal
• Pericardial friction rub is not present
• Once ambulatory the client must not overdo.
36. Contd.
• Diagnosis: Activity Intolerance related to reduced
cardiac reserve and enforced bed rest.
• Outcomes: The client will progress toward an
optimal level of physical activity tolerance, based on
underlying cardiovascular status and psychosocial
readiness, as evidenced by ability to
(
37. contd
1) pace activity,
(2) verbalize improvement in fatigue,
(3) express acceptance of any imposed activity
restrictions,
(4) steadily increase activity level to include
climbing one flight of stairs without chest pain
or without ECG changes, while heart rate
remains under 90 BPM.
•
38. contd
Diagnosis: Pain related to the inflammatory
response in the joints.
Outcomes: the client will experience increased
comfort, as evidence by
(1) reports of restful sleep and reduced
discomfort,
(2) expression of joint pain relief,
(3) reduced use of pain medications, and
(4) a relaxed body posture and calm facial
expression
39. Interventions:
• Obtain a clear description of the pain or
discomfort.
• Identify the source of greatest discomfort as a
focus for intervention.
• Administer analgesics as needed.
• Balance rest and activity according to the
degree of pain and activity tolerance
40. Contd.
Diagnosis: Altered nutrition: less than body
requirements, related to fever, inflammation,
anorexia, and fatigue
Outcomes: The client will maintain or restore
adequate nutritional balance, as evidenced by
(1) resumption of body weight before the illness or no
further weight loss,
(2) consumption of 75% or more of each meal served,
(3) normal serum albumin or pre-albumin, and
(4) a positive nitrogen balance.
41. Interventions:
• A high-protein, high-carbohydrate diet helps
maintain adequate nutrition in the presence of
fever and infection.
• Hyper-metabolic states (fever and infection) can
induce a catabolic state, thus delaying healing.
Vitamin and mineral supplements may also
benefit the client.
42. Contd.
• Oral hygiene every 4 hours, small attractive
meal servings, and foods that are not overly
rich, sweet, or greasy stimulate the appetite.
• Adequate fluids intake
• Sodium and fluids must be restricted