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Management & Prevention of Rheumatic Heart Disease

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Adam Trblco

on 11 October 2012

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Transcript of Management & Prevention of Rheumatic Heart Disease

Caroline Green
Rebecca Howells
Adam Trebilco Management & Prevention
of Rheumatic Heart Disease caused by acute rheumatic fever
autoimmune reaction to group
A streptococcol infection
antibodies react with tissue glycoproteins in heart, joints, skin and nervous system what is it? - definition
- guidelines
- examples of the evidence
- quality of the evidence
- clinicians practice
- & barriers group A
streptococcal pharangitis mitral & aortic stenosis mitral & aortic regurgitation Aschoff bodies this is rheumatic heart disease endocarditis
myocarditis
fibrous pericarditis
ventricular hypertrophy
atrial hypertrophy
atrial fibrillation
pulmonary hypertension
pulmonary oedema
mitral & aortic stenosis
mitral & aortic regurgitation who has rheumatic heart disease? rare in wealthy countries
primarily in developing countries
indigenous populations more commonly affected
due to poor hygiene and health care access mortality is 23 times higher in Aboriginals youth is highly susceptible preventable 15.6 million
people globally 230,000
deaths
annually 2% of
Aboriginal population in NT evidence? examples clinicians... barriers? questions? there is a large amount of evidence available concerning ARF/RHD
while in a few areas, the available evidence of poor quality or is too old to meet current standards, most is good quality, high level evidence. difficult to ascertain
after introduction of register-based control programs, recurrence rates reduced and prophylaxis adherence improved.
we can assume that the improvement in outcomes is related to reasonable levels of adherence by clinicians. strategies for preventing RHD is not adequately implemented in populations with high risk of the disease
inconsistencies of management in RHD, resulting in inappropriate management
limited access to healthcare services for populations experiencing the highest rate of RHD systematic review on penicillin for secondary prevention for prevention of RHD.
randomised controlled trials assessing the effects of anti-inflammatory agents for preventing or reducing further heart valve damage in patients.
randomised controlled trial to investigate RF prevention by treating streptococcal pharyngitis in school- and/or community-based programs.
the Challenge of Acute Rheumatic Fever Diagnosis in a High-Incidence Population: A Prospective Study and Proposed Guidelines for Diagnosis in Australia's Northern Territory
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