Talk:Rheumatic fever

message: Carditis is the inflammation of all three layers of the heart - pericardium, myocardium and endocardium, and it is a common finding in Rheumatic Fever.--82.24.195.140 11:53, 18 July 2006 (UTC)
thread_title: Carditis

message: Diagnostic approach is probably useful to add, e.g. echocardiography, acute and convalescent antistreptolysin titres. Do we still use digoxin for congestive heart failure? JFW | T@lk 06:20, 1 January 2006 (UTC)
replies: text: Good point. I never use digoxin on new patients, but it is mentioned in all the rheumatic fever articles. --DocJohnny 06:50, 1 January 2006 (UTC)
thread_title:  ASOT 

message: Nice work. I don't recognize anything wrong. Two questions arose in my own mind as I read it:
*First paragraph on incidence seems confusing to me: statistical whipsaw. Each sentence seems to void the previous one. I would recommend a clearer statement of when rheumatic fever was at its height, what the approximate incidence was then, what the approximate incidence is now, whether there are major regional variations (Europe vs NA vs underdeveloped countries), whether antibiotic use in last 50 years was responsible for decreased incidence, and whether currently the incidence seems to be still diminishing or re-increasing.
*Clarify carditis. How is carditis different from myocarditis? Does it simply mean "myocarditis and/or pericarditis" or something more distinct? I think myocarditis is by far the more familiar term if they are synonymous. alteripse 19:36, 1 January 2006 (UTC)
thread_title: critique

message: There appears to be a conflict between the entries for the two articles.
Under scarlet fever it says: "Antibiotic treatment is usually given. It has however never been shown to reduce the chance that rheumatic fever develops.
Under rheumatic fever it says: "The rate of development of rheumatic fever in individuals with untreated strep infection is estimated to be 3%. The rate of development is far lower in individuals who have received antibiotic treatment."
Speleothing 21:16, 1 October 2007 (UTC)
thread_title:  Scarlet Fever vs. Rheumatic Fever 

message: Just undid a few bits in the pathophysiology bit which were highly dubious and unsourced. Hope that's ok.
19th October 2007  —Preceding unsigned comment added by 89.168.30.147 (talk) 23:47, 18 October 2007 (UTC)
thread_title: Changes

message: I added an image of S. pyrogenes to the infobox.  Please let me know if anybody thinks it's a poor choice.  Rex Manning (talk) 20:40, 6 February 2009 (UTC)
replies: text:  It's better than nothing, but it would be nice to see an actual photoJohnfravolda (talk) 03:52, 24 September 2009 (UTC)
thread_title:  Image 

message: Can someone put an image of swelling of how sever it can be? Also it would be good if there is marking on the image of the heart with comparison with normal heart.  —Preceding unsigned comment added by 61.8.134.131 (talk) 06:55, 10 August 2009 (UTC)
thread_title:  Need images of swelling and detail image of heart 

message: The introduction says the disease can involve the brain, but there is no mention of the brain in the body of the article.  —Preceding unsigned comment added by 89.100.82.102 (talk) 10:37, 4 June 2010 (UTC)
replies: text: Sydenham's Chorea IS the brain-involvement part of the disease, but the article doesn't make that point clear to the casual reader. Wordreader (talk) 23:00, 2 September 2011 (UTC)
thread_title: No Brainer

message: I thought I had a good handle on Reyes Syndrome before I started to look into it today, checking on the age at risk.
Risk age varies between the following websites. Use of aspirin in children varies, too.
NOTE: Any emphasis given below is my own addition.
* National Reye's Syndrome Foundation [risk age varies within this document]
"What is the Role of Asprin?"
http://reyessyndrome.org/aspirin.html 
paragraph 2 - . . .aspirin not be given to children under 19 years of age during episodes of fever-causing illnesses.
paragraph 5 - Teenagers and adults are especially at risk of developing Reye's Syndrome due to self-medication. Too often, teenagers are ingesting aspirin-type products without parental knowledge. 
* MedlinePlus [U.S. National Library of Medicine at the National Institutes of Health - it takes a more casual approach on risk age]
"Reye Syndrome"
http://www.nlm.nih.gov/medlineplus/ency/article/001565.htm
Causes, incidence, and risk factors
Reye syndrome is most often seen in children ages 4 - 12. Most cases that occur with chickenpox are in children ages 5 - 9. Cases that occur with the flu (influenzae type B) are usually in children ages 10 - 14.
Prevention
Never give a child [definition of a child?] aspirin unless told to do so by your doctor.
* Aspirin Foundation [probably European, definitely industry, site - that doesn't mean the information is wrong, just that they have a financial stake; DO give for Kawasaki's Disease]
"Asprin and Reye Syndrome"
http://www.aspirin-foundation.com/suitability/backgrounder.html 
In the UK, for example, it may not be given to children and adolescents under 16 years old except for a specific medical indication such as Kawasaki's disease, preventing clotting after cardiac surgery or reducing the risk of stroke. Some European countries also make an exception for the treatment of mild to moderate pain in children provided they do not have fever or a viral illness.
* American Liver Foundation [gives two age variations in the documents]
"Reye Syndrome"
http://www.liverfoundation.org/abouttheliver/info/reye/
Who is at risk for Reye syndrome?
Reye syndrome occurs most commonly in children between the ages of 4 and 12, although it can occur at any age.
What is the best way to prevent Reye syndrome?
Unless specifically instructed to do so by your child's doctor, do not give aspirin to anyone younger than 19.
* Medscape Today [DON'T give for Kawasaki Disease]
"Use of Aspirin in Children with Cardiac Disease: Reye's Syndrome" 
http://www.medscape.com/viewarticle/555392_8
paragraph 1 - The routine use of aspirin as an OTC antipyretic and analgesic is no longer recommended in children because of the potential association with Reye's syndrome. 
paragraph 3 - On December 28, 1982, the FDA first proposed a requirement for OTC and prescription salicylate-containing products to carry a warning against use for the treatment of flu or chickenpox in children under 16 years of age. . .
paragraph 5 - In 2005, Wei and colleagues described a 10 month-old child receiving high-dose aspirin after the diagnosis of Kawasaki disease. . .  [description of the symptoms]. . . A liver biopsy revealed findings consistent with Reye's syndrome. He recovered without sequelae.
* Medscape Reference
"Reye Syndrome"
http://emedicine.medscape.com/article/803683-overview#showall 
Age
The peak ages are 5-14 years, with a median of 6 years and a mean of 7 years.
Reye syndrome rarely occurs in newborns or in children older than 18 years.
In African Americans, 67% of patients are younger than 1 year compared with only 12% in white patients.'''
* Centers for Disease Control and Prevention
"Caring for Someone Sick at Home: Medicine Safety and Children"
http://www.cdc.gov/h1n1flu/homecare/medsafetychildren.htm
Warning
Think your child age 18 or younger might have the flu?
Never give them aspirin or products with aspirin in them.
Check all medicine labels to make sure they do not contain aspirin, also called salicylate. Although it mostly affects people age 18 or younger, Reye’s Syndrome can strike anyone who takes aspirin products when they have the flu.
* National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm 
"NINDS Reye's Syndrome Information Page"
What is Reye's Syndrome?
Reye's syndrome (RS) is primarily a children's disease, although it can occur at any age.
SUMMARY 1: Aspirin can be given to children sick with Kawasaki Disease except when it can't.
SUMMARY 2: The risk age for the development of Reye Syndrome is: a child; 5-9 years; adolescents; 4-12 years; 5-14 years; 10-14 years; teenagers; under 16 years; newborns-18 years and younger; under 19 years; adults; anyone at any age.
SUMMARY 3: There are 3 spelling variations that I've found: REYE Syndrome, REYES Syndrome, REYE'S Syndrome. Take your pick?
Thanks, Wordreader (talk) 00:42, 16 June 2012 (UTC)
thread_title:  Regarding Reyes Syndrome. . . 

message: The Prevention section only mentions prophylaxis for endocarditis, but the same reference also mentions other conditions that I have added:
Quote: You can help reduce the risk for this problem by keeping teeth clean and cavities filled. In the past, the American Heart Association recommended that people with rheumatic heart disease take a dose of antibiotics before certain dental or surgical procedures. However, our association does not suggest this type of preventive treatment any longer for people with rheumatic heart disease unless they have a history of endocarditis, an artificial heart valve, certain congenital heart defects, or have had a heart transplant and have heart valve problems.
The last point/s confuses me, though. Since there's no Harvard comma, does "a heart transplant and have heart valve problems" mean that you get prophylaxis if you've had "a heart transplant ACCOMPANIED BY valve problems" or "a heart transplant, and [as a separate issue] have heart valve problems"? Thank you, Wordreader (talk) 02:09, 14 August 2014 (UTC)
thread_title:  American Heart Association antibiotic prophylaxis recommendations 

message: ... in Circulation doi:10.1161/CIRCULATIONAHA.114.009857 JFW | T@lk 21:49, 9 December 2014 (UTC)
replies: text: Now in the Lancet doi:10.1016/S0140-6736(18)30999-1 JFW | T@lk 08:59, 15 July 2018 (UTC)
thread_title:  Review 

message: The main image on this page is traumatizing to me (other images are perhaps as bad, but I didn't continue). Is Wikipedia a medical resource or a general encyclopedia? For most of us non-medical people who would like general information (and perhaps a bit more sometimes), images like this are really terrible to see. What about young children who see these things? We try to protect young people from "seeing too much too early". Is that what we are doing here? Something to think about. I suggest changing the images to those that are more suited for the general population, particularly the first image (since many of us just read the introductions). Thanks for reading this. - David  — Preceding unsigned comment added by 2A01:CB08:8660:A600:25E0:3C14:9C9F:E61B (talk) 10:03, 20 October 2020 (UTC)
thread_title:  Images are too much!