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83-574: Marantic vegetations are often associated with previous rheumatic fever . Other risk factors include: The disease affects the valves with following predilection: mitral valve > aortic valve > tricuspid valve > pulmonary valve Grossly, vegetations form along lines of valve closure and are generally symmetric with a smooth or verrucoid (warty) texture. Histologically , lesions are composed of fibrin (eosinophilic) and platelets but, unlike bacterial etiologies, contain little evidence of PMNs , microorganisms or inflammation . Due to

166-533: A cell-mediated immunity reaction as these lesions predominantly contain T-helper cells and macrophages . In rheumatic fever, these lesions can be found in any layer of the heart causing different types of carditis . The inflammation may cause a serofibrinous pericardial exudate described as "bread-and-butter" pericarditis , which usually resolves without sequelae. Involvement of the endocardium typically results in fibrinoid necrosis and wart formation along

249-500: A streptococcal throat infection . Signs and symptoms include fever , multiple painful joints , involuntary muscle movements , and occasionally a characteristic non- itchy rash known as erythema marginatum . The heart is involved in about half of the cases. 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

332-462: A throat infection . Symptoms include: fever, painful joints with those joints affected changing with time, involuntary muscle movements , and occasionally a characteristic non-itchy rash known as erythema marginatum . The heart is involved in about half of the cases. Damage to the heart valves usually occurs only after several attacks but may occasionally occur after a single case of RF. The damaged valves may result in heart failure and also increase

415-793: A virulence factor that is highly antigenic . The antibodies which the immune system generates against the M protein may cross-react with heart muscle cell protein myosin , heart muscle glycogen and smooth muscle cells of arteries, inducing cytokine release and tissue destruction. However, the only proven cross-reaction is with perivascular connective tissue . This inflammation occurs through direct attachment of complement and Fc receptor -mediated recruitment of neutrophils and macrophages. Characteristic Aschoff bodies , composed of swollen eosinophilic collagen surrounded by lymphocytes and macrophages can be seen on light microscopy. The larger macrophages may become Anitschkow cells or Aschoff giant cells . Rheumatic valvular lesions may also involve

498-461: A French physician, said that these revivals make up "the whole history of internal medicine." According to Aristotle 's testimony, Hippocrates was known as "The Great Hippocrates". Concerning his disposition, Hippocrates was first portrayed as a "kind, dignified, old country doctor" and later as "stern and forbidding". He is certainly considered wise, of very great intellect and especially as very practical. Francis Adams describes him as "strictly

581-502: A discipline distinct from other fields with which it had traditionally been associated ( theurgy and philosophy ), thus establishing medicine as a profession. However, the achievements of the writers of the Hippocratic Corpus , the practitioners of Hippocratic medicine, and the actions of Hippocrates himself were often conflated; thus very little is known about what Hippocrates actually thought, wrote, and did. Hippocrates

664-422: A fixed time after the contraction of a disease. If a crisis occurred on a day far from a critical day , a relapse might be expected. Galen believed that this idea originated with Hippocrates, though it is possible that it predated him. Hippocratic medicine was humble and passive. The therapeutic approach was based on "the healing power of nature" ( Latin : vis medicatrix naturae ). According to this doctrine,

747-526: A hot iron. Other treatments such as applying various salves are suggested as well. Today, "treatment [for hemorrhoids] still includes burning, strangling, and excising." Also, some of the fundamental concepts of proctoscopy outlined in the Corpus are still in use. For example, the uses of the rectal speculum , a common medical device, are discussed in the Hippocratic Corpus. This constitutes

830-679: A later physician, Polybus was Hippocrates's true successor, while Thessalus and Draco each had a son named Hippocrates (Hippocrates III and IV). Soranus said that Hippocrates learned medicine from his father and grandfather ( Hippocrates I ), and studied other subjects with Democritus and Gorgias . Hippocrates was probably trained at the asklepieion of Kos, and took lessons from the Thracian physician Herodicus of Selymbria . Plato mentions Hippocrates in two of his dialogues: in Protagoras , Plato describes Hippocrates as "Hippocrates of Kos,

913-500: A librarian in Alexandria . The volumes were probably produced by his students and followers. The Hippocratic Corpus contains textbooks, lectures, research, notes and philosophical essays on various subjects in medicine, in no particular order. These works were written for different audiences, both specialists and laymen, and were sometimes written from opposing viewpoints; significant contradictions can be found between works in

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996-426: A life-threatening type II hypersensitivity reaction . Usually, self reactive B cells remain anergic in the periphery without T cell co-stimulation. During a streptococcal infection, mature antigen-presenting cells such as B cells present the bacterial antigen to CD4+T cells which differentiate into helper T 2 cells . Helper T 2 cells subsequently activate the B cells to become plasma cells and induce

1079-544: A long time. The centuries after Hippocrates's death were marked as much by retrograde movement as by further advancement. For instance, "after the Hippocratic period, the practice of taking clinical case-histories died out," according to Fielding Garrison . After Hippocrates, another significant physician was Galen , a Greek who lived from AD 129 to AD 200. Galen perpetuated the tradition of Hippocratic medicine, making some advancements, but also some regressions. In

1162-463: A moderate or high risk. Minor criteria Rheumatic fever can be prevented by effectively and promptly treating strep throat with antibiotics. Globally, rheumatic fever is seen in populations that are socioeconomically disadvantaged and with limited access to health care. Overcrowding and exposure to domestic air pollution have been cited as associated risk factors. In those who have previously had rheumatic fever, antibiotics may be used in

1245-582: A preceding streptococcal infection include: recent scarlet fever , raised antistreptolysin O or other streptococcal antibody titre, or positive throat culture. The last revision of 2015 suggested variable diagnostic criteria in low-risk and high-risk populations to avoid overdiagnosis in the first category and underdiagnosis in the last one. Low-risk populations were defined as those with acute rheumatic fever annual incidence ≤2 per 100 000 school-aged children or all-age rheumatic heart disease prevalence of ≤1 per 1000. All other populations were categorised as having

1328-640: A preventative manner as secondary prophylaxis . Antibiotic prophylaxis after an episode of acute rheumatic fever is recommended owing to the high likelihood of recurrence. Streptococcal pharyngitis may occur asymptomatically and rheumatic fever may recur even after a treated infection. The American Heart Association recommends, based on low quality evidence but with high predicted efficacy, that people with mitral stenosis due to rheumatic heart disease receive prophylactic antibiotics for 10 years or until age 40, whichever would be longer. The AHA also supports good dental hygiene in people with RHD, and antibiotics for

1411-410: A subsequent untreated infection is substantially greater (about 50%). The rate of development is far lower in individuals who have received antibiotic treatment. Persons who have had a case of rheumatic fever have a tendency to develop flare-ups with repeated strep infections. The recurrence of rheumatic fever is relatively common in the absence of maintenance of low dose antibiotics, especially during

1494-404: Is a priority to prevent complications and progression. However, spontaneous regression is more likely in borderline RHD than in definite cases, and its natural history may vary between populations. Echocardiographic screening among children and timely initiation of secondary antibiotic prophylaxis in children with evidence of early stages of rheumatic heart disease may be effective to reduce

1577-404: Is also known as Hippocratic fingers. Hippocratic succussion is the internal splashing noise of hydropneumothorax or pyopneumothorax . Hippocratic bench (a device which uses tension to aid in setting bones) and Hippocratic cap-shaped bandage are two devices named after Hippocrates. Hippocratic Corpus and Hippocratic Oath are also his namesakes. Risus sardonicus , a sustained spasming of

1660-768: Is an effort of the Carnegie Mellon School of Computer Science and Shadyside Medical Center , "to develop advanced planning, simulation, and execution technologies for the next generation of computer-assisted surgical robots." Both the Canadian Hippocratic Registry and American Hippocratic Registry are organizations of physicians who uphold the principles of the original Hippocratic Oath as inviolable through changing social times. Hippocrates's legendary genealogy traces his paternal heritage directly to Asklepius and his maternal ancestry to Heracles . According to Tzetzes's Chiliades ,

1743-481: Is caused by its destructive effects on cardiac valve tissue. The complicated pathogenesis of RHD is not fully understood, though it has been observed to use molecular mimicry via group A streptococci carbohydrates and genetic predisposition involving HLA Class II genes that trigger autoimmune reactions . Molecular mimicry occurs when epitopes are shared between host antigens and Streptococcus antigens. This causes an autoimmune reaction against native tissues in

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1826-490: Is commonly portrayed as the paragon of the ancient physician and credited with coining the Hippocratic Oath , which is still relevant and in use today. He is also credited with greatly advancing the systematic study of clinical medicine , summing up the medical knowledge of previous schools, and prescribing practices for physicians through the Hippocratic Corpus and other works. Historians agree that Hippocrates

1909-878: Is controversial and based on dated literature. Corticosteroids may be considered, especially in people with allergies to NSAIDs or severe disease, although use of steroids may cause tissue atrophy, which could present challenges during future cardiac surgery for valve repair. Some patients develop significant carditis which manifests as congestive heart failure . This requires the usual treatment for heart failure: ACE inhibitors , diuretics , beta blockers , and digoxin . Unlike typical heart failure, rheumatic heart failure responds well to corticosteroids. About 33 million people are affected by rheumatic heart disease with an additional 47 million having asymptomatic damage to their heart valves. As of 2010 globally it resulted in 345,000 deaths, down from 463,000 in 1990. In Western countries, rheumatic fever has become fairly rare since

1992-554: Is mentioned in passing in the writings of two contemporaries: in Plato 's dialogues Protagoras and Phaedrus , and in Aristotle 's Politics , all of which date from the 4th century BC. Soranus wrote that Hippocrates's father was Heraclides , a physician, and his mother was Praxitela, daughter of Tizane. The two sons of Hippocrates, Thessalus and Draco , and his son-in-law, Polybus , were his students. According to Galen ,

2075-535: Is most often associated with RHD, and its combination with certain DQ alleles is seemingly associated with the development of valvular lesions. The mechanism by which MHC class II molecules increase a host's susceptibility to autoimmune reactions in RHD is unknown, but it is likely related to the role HLA molecules play in presenting antigens to T cell receptors, thus triggering an immune response. Also found on human chromosome 6

2158-498: Is probably the most famous document of the Hippocratic Corpus. Recently, the authenticity of the document's author has come under scrutiny. While the Oath is rarely used in its original form today, it serves as a foundation for other, similar oaths and laws that define good medical practice and morals. Such derivatives are regularly taken by modern medical graduates about to enter medical practice. Although Hippocrates neither founded

2241-405: Is required. Otherwise complications are treated as usual. Rheumatic fever occurs in about 325,000 children each year and about 33.4 million people currently have rheumatic heart disease. Those who develop RF are most often between the ages of 5 and 14, with 20% of first-time attacks occurring in adults. The disease is most common in the developing world and among indigenous peoples in

2324-426: Is said to have measured a patient's pulse when taking a case history to discover whether the patient was lying. Hippocrates extended clinical observations into family history and environment. "To him medicine owes the art of clinical inspection and observation." Hippocrates and his followers were the first to describe many diseases and medical conditions. He is given credit for the first description of clubbing of

2407-724: Is the cytokine TNF-α which is also associated with RHD. High expression levels of TNF-α may exacerbate valvular tissue inflammation, because as this cytokine circulates in the bloodstream, it triggers the activation of multiple pathways that stimulate further pro-inflammatory cytokine secretion. Mannose-binding lectin (MBL) is an inflammatory protein involved in pathogen recognition. Different variants of MBL2 gene regions are associated with RHD. RHD-induced mitral valve stenosis has been associated with MBL2 alleles encoding for high production of MBL. Aortic valve regurgitation in RHD patients has been associated with different MBL2 alleles that encode for low production of MBL. In addition,

2490-400: Is to feed your sickness". However, potent drugs were used on certain occasions. This passive approach was very successful in treating relatively simple ailments such as broken bones, which required traction to stretch the skeletal system and relieve pressure on the injured area. The Hippocratic bench and other devices were used to this end. In Hippocrates's time it was thought that fever

2573-654: The American Heart Association in collaboration with other groups. According to revised Jones criteria, the diagnosis of rheumatic fever can be made when two of the major criteria, or one major criterion plus two minor criteria, are present along with evidence of streptococcal infection: elevated or rising antistreptolysin O titre or anti-DNase B . A recurrent episode can be diagnosed when three minor criteria are present. Exceptions are chorea and indolent carditis , each of which by itself can indicate rheumatic fever. An April 2013 review article in

Nonbacterial thrombotic endocarditis - Misplaced Pages Continue

2656-670: The Asclepiad "; while in Phaedrus , Plato suggests that "Hippocrates the Asclepiad" thought that a complete knowledge of the nature of the body was necessary for medicine. Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly , Thrace , and the Sea of Marmara . Several different accounts of his death exist. He died, probably in Larissa , at

2739-580: The French doctor M. S. Houdart called the Hippocratic treatment a "meditation upon death". If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live. Analogies have been drawn between Thucydides' historical method and the Hippocratic method, in particular the notion of "human nature" as a way of explaining foreseeable repetitions for future usefulness, for other times or for other cases. An important concept in Hippocratic medicine

2822-564: The Indian Journal of Medical Research stated that echocardiographic and Doppler (E & D) studies, despite some reservations about their utility, have identified a massive burden of rheumatic heart disease, which suggests the inadequacy of the 1992 Jones' criteria. E & D studies have identified subclinical carditis in patients with rheumatic fever, as well as in follow-ups of rheumatic heart disease patients who initially presented as having isolated cases of Sydenham's chorea. Signs of

2905-465: The Indian subcontinent , and North Africa . Rheumatic fever primarily affects children between ages 5 and 17 years and occurs approximately 20 days after strep throat. In up to a third of cases, the underlying strep infection may not have caused any symptoms. The rate of development of rheumatic fever in individuals with untreated strep infection is estimated to be 3%. The incidence of recurrence with

2988-609: The Knidian and Koan on how to deal with disease. The Knidian school of medicine focused on diagnosis. Medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans. The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms. The Hippocratic school or Koan school achieved greater success by applying general diagnoses and passive treatments. Its focus

3071-657: The Middle Ages , the Islamic world adopted Hippocratic methods and developed new medical technologies. After the European Renaissance , Hippocratic methods were revived in western Europe and even further expanded in the 19th century. Notable among those who employed Hippocrates's rigorous clinical techniques were Thomas Sydenham , William Heberden , Jean-Martin Charcot and William Osler . Henri Huchard ,

3154-705: The Saint Catherine's Monastery in South Sinai , they found a manuscript which contains a medical recipe of Hippocrates. The manuscript also contains three recipes with pictures of herbs that were created by an anonymous scribe. The Hippocratic Corpus (Latin: Corpus Hippocraticum ) is a collection of around seventy early medical works collected in Alexandrian Greece . It is written in Ionic Greek . The question of whether Hippocrates himself

3237-479: The developed world . In 2015 it resulted in 319,400 deaths down from 374,000 deaths in 1990. Most deaths occur in the developing world where as many as 12.5% of people affected may die each year. Descriptions of the condition are believed to date back to at least the 5th century BCE in the writings of Hippocrates . The disease is so named because its symptoms are similar to those of some rheumatic disorders . The disease typically develops two to four weeks after

3320-633: The 1960s, probably due to the widespread use of antibiotics to treat streptococcus infections. While it has been far less common in the United States since the beginning of the 20th century, there have been a few outbreaks since the 1980s. The disease is most common among Indigenous Australians (particularly in central and northern Australia), Māori , and Pacific Islanders , and is also common in Sub-Saharan Africa , Latin America ,

3403-504: The Corpus. Among the treatises of the Corpus are The Hippocratic Oath ; The Book of Prognostics ; On Regimen in Acute Diseases ; Aphorisms ; On Airs, Waters and Places ; Instruments of Reduction ; On The Sacred Disease ; etc. The Hippocratic Oath, a seminal document on the ethics of medical practice, was attributed to Hippocrates in antiquity although new information shows it may have been written after his death. This

Nonbacterial thrombotic endocarditis - Misplaced Pages Continue

3486-483: The age of 83, 85 or 90, though some say he lived to be well over 100. It is thus with regard to the disease called Sacred : it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder... Hippocrates is credited as the first person to believe that diseases were caused naturally, not because of superstition and gods. He

3569-420: The ailments of the human rectum and the treatment thereof, despite the school's poor theory of medicine. Hemorrhoids , for instance, though believed to be caused by an excess of bile and phlegm, were treated by Hippocratic physicians in relatively advanced ways. Cautery and excision are described in the Hippocratic Corpus, in addition to the preferred methods: ligating the hemorrhoids and drying them with

3652-488: The allele IGHV4-61, located on chromosome 14, which helps code for the immunoglobulin heavy chain (IgH) is linked to greater susceptibility to RHD because it may affect protein structure of the IgH. Other genes are also being investigated to better understand the complexity of autoimmune reactions that occur in RHD. The original method of diagnosing rheumatic heart disease was through heart auscultation, specifically listening for

3735-448: The bacteria than others. Other risk factors include malnutrition and poverty. Diagnosis of RF is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection. Treating people who have strep throat with antibiotics , such as penicillin , decreases the risk of developing rheumatic fever. In order to avoid antibiotic misuse this often involves testing people with sore throats for

3818-619: The best thing that physicians could do was to evaluate an illness and predict its likely progression based upon data collected in detailed case histories. Hippocratic medicine was notable for its strict professionalism, discipline, and rigorous practice. The Hippocratic work On the Physician recommends that physicians always be well-kempt, honest, calm, understanding, and serious. The Hippocratic physician paid careful attention to all aspects of his practice: he followed detailed specifications for "lighting, personnel, instruments, positioning of

3901-494: The body contains within itself the power to re-balance the four humours and heal itself ( physis ). Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed "rest and immobilization [were] of capital importance". In general, the Hippocratic medicine was very kind to the patient; treatment was gentle, and emphasized keeping the patient clean and sterile. For example, only clean water or wine were ever used on wounds, though "dry" treatment

3984-659: The burden of rheumatic heart disease in endemic regions. The efficacy of treating latent RHD in populations with high prevalence is balanced by the potential development of antibiotic resistance , which might be offset through use of narrow-spectrum antibiotics like benzathine benzapenicillin. Public health research is ongoing to determine if screening is beneficial and cost effective. Hippocrates Hippocrates of Kos ( / h ɪ ˈ p ɒ k r ə t iː z / , ‹See Tfd› Greek : Ἱπποκράτης ὁ Κῷος , translit.   Hippokrátēs ho Kôios ; c.  460  – c.  370 BC ), also known as Hippocrates II ,

4067-718: The development of rheumatic fever. Some suggest the use of benzathine benzylpenicillin . Monthly injections of long-acting penicillin must be given for a period of five years in patients having one attack of rheumatic fever. If there is evidence of carditis, the length of therapy may be up to 40 years. Another important cornerstone in treating rheumatic fever includes the continual use of low-dose antibiotics (such as penicillin , sulfadiazine , or erythromycin ) to prevent recurrence. Aspirin at high doses has historically been used for treatment of rheumatic fever. However, due to side effects like gastritis and salicylate poisoning , necessitating serum monitoring of salicylate levels, and

4150-513: The earliest recorded reference to endoscopy . Hippocrates often used lifestyle modifications such as diet and exercise to treat diseases such as diabetes , what is today called lifestyle medicine . Two popular but likely misquoted attributions to Hippocrates are "Let food be your medicine, and medicine be your food" and "Walking is man's best medicine". Both appear to be misquotations, and their exact origins remain unknown. In 2017, researchers claimed that, while conducting restorations on

4233-409: The exemplar of that flexible, critical, well-poised attitude of mind, ever on the lookout for sources of error, which is the very essence of the scientific spirit." "His figure... stands for all time as that of the ideal physician," according to A Short History of Medicine , inspiring the medical profession since his death. The Travels of Sir John Mandeville reports (incorrectly) that Hippocrates

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4316-672: The face muscles may also be termed the Hippocratic Smile. The most severe form of hair loss and baldness is called the Hippocratic form. In the modern age, a lunar crater has been named Hippocrates . The Hippocratic Museum , a museum on the Greek island of Kos is dedicated to him. The Hippocrates Project is a program of the New York University Medical Center to enhance education through use of technology. Project Hippocrates (an acronym of "High Performance Computing for Robot-Assisted Surgery")

4399-804: The fingers, an important diagnostic sign in chronic lung disease, lung cancer and cyanotic heart disease . For this reason, clubbed fingers are sometimes referred to as "Hippocratic fingers". Hippocrates was also the first physician to describe Hippocratic face in Prognosis . Shakespeare famously alludes to this description when writing of Falstaff 's death in Act II, Scene iii. of Henry V . Hippocrates began to categorize illnesses as acute , chronic , endemic and epidemic , and use terms such as, "exacerbation, relapse , resolution, crisis, paroxysm , peak, and convalescence ." Another of Hippocrates's major contributions may be found in his descriptions of

4482-485: The first three to five years after the first episode. Recurrent bouts of rheumatic fever can lead to valvular heart disease . Heart complications may be long-term and severe, particularly if valves are involved. In countries in Southeast-Asia, sub-Saharan Africa, and Oceania, the percentage of people with rheumatic heart disease detected by listening to the heart was 2.9 per 1000 children and by echocardiography it

4565-636: The heart that are incorrectly recognized as "foreign" due to the cross-reactivity of antibodies generated as a result of epitope sharing. The valvular endothelium is a prominent site of lymphocyte-induced damage. CD4 + T cells are the major effectors of heart tissue autoimmune reactions in RHD. Normally, T cell activation is triggered by the presentation of bacterial antigens. In RHD, molecular mimicry results in incorrect T cell activation, and these T lymphocytes can go on to activate B cells , which will begin to produce self-antigen-specific antibodies. This leads to an immune response attack mounted against tissues in

4648-477: The heart that have been misidentified as pathogens. Rheumatic valves display increased expression of VCAM-1 , a protein that mediates the adhesion of lymphocytes. Self-antigen-specific antibodies generated via molecular mimicry between human proteins and streptococcal antigens up-regulate VCAM-1 after binding to the valvular endothelium. This leads to the inflammation and valve scarring observed in rheumatic valvulitis, mainly due to CD4+ T cell infiltration. While

4731-421: The hideous dragon; they die soon thereafter. This is a version of the legend of Melusine . Some clinical symptoms and signs have been named after Hippocrates as he is believed to be the first person to describe them. Hippocratic face is the change produced in the countenance by death, or long sickness, excessive evacuations, excessive hunger, and the like. Clubbing , a deformity of the fingers and fingernails,

4814-437: The infection; however, testing might not be available in the developing world . Other preventive measures include improved sanitation . In those with rheumatic fever and rheumatic heart disease, prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or valve repair

4897-418: The lines of closure of the left-sided heart valves. Warty projections arise from the deposition, while subendocardial lesions may induce irregular thickenings called MacCallum plaques . Chronic rheumatic heart disease (RHD) is characterized by repeated inflammation with fibrinous repair. The cardinal anatomic changes of the valve include leaflet thickening, commissural fusion, and shortening and thickening of

4980-530: The mechanisms of genetic predisposition remain unclear, a few genetic factors have been found to increase susceptibility to autoimmune reactions in RHD. The dominant contributors are a component of MHC class II molecules, found on lymphocytes and antigen-presenting cells, specifically the DR and DQ alleles on human chromosome 6 . Certain allele combinations appear to increase RHD autoimmune susceptibility. Human leukocyte antigen (HLA) class II allele DR7 ( HLA-DR7 )

5063-428: The non-invasive nature of NBTE, clinical examination may or may not reveal a new murmur . An embolic stroke may be the first feature to suggest diagnosis of NBTE. An echocardiogram is essential for visualization of the mass. Rheumatic fever Rheumatic fever ( RF ) is an inflammatory disease that can involve the heart , joints , skin , and brain . The disease typically develops two to four weeks after

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5146-576: The patient, and techniques of bandaging and splinting" in the ancient operating room . He even kept his fingernails to a precise length. The Hippocratic school gave importance to the clinical doctrines of observation and documentation. These doctrines dictate that physicians record their findings and their medicinal methods in a very clear and objective manner, so that these records may be passed down and employed by other physicians. Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions. He

5229-521: The physician of experience and common sense." His image as the wise, old doctor is reinforced by busts of him, which wear large beards on a wrinkled face. Many physicians of the time wore their hair in the style of Jove and Asklepius . Accordingly, the busts of Hippocrates that have been found could be only altered versions of portraits of these deities. Hippocrates and the beliefs that he embodied are considered medical ideals. Fielding Garrison , an authority on medical history, stated, "He is, above all,

5312-473: The prevention of infective endocarditis during dental procedures are recommended in high-risk patients. No vaccines are currently available to protect against S. pyogenes infection, although research is underway to develop one. Difficulties in developing a vaccine include the wide variety of strains of S. pyogenes present in the environment and the large amount of time and number of people that will be needed for appropriate trials for safety and efficacy of

5395-445: The production of antibodies against the cell wall of Streptococcus. However the antibodies may also react against the myocardium and joints, producing the symptoms of rheumatic fever. S. pyogenes is a species of aerobic , cocci , gram-positive bacteria that are non-motile, non- spore forming , and forms chains and large colonies . S. pyogenes has a cell wall composed of branched polymers which sometimes contain M protein ,

5478-463: The risk of Reye syndrome , a serious and potentially deadly condition that may arise in children treated with aspirin or aspirin-containing products, alternatives to aspirin have been sought, especially in children. While evidence suggests that treatment of rheumatic fever–associated arthritis with naproxen may be equally effective as with aspirin, its role in managing carditis has not been established. Management of carditis in acute rheumatic fever

5561-402: The risk of atrial fibrillation and infection of the valves . Rheumatic fever is a systemic disease affecting the connective tissue around arterioles , and can occur after an untreated strep throat infection, specifically due to group A streptococcus (GAS), Streptococcus pyogenes . The similarity between antigens of Streptococcus pyogenes and multiple cardiac proteins can cause

5644-413: The school of medicine named after him, nor wrote most of the treatises attributed to him, he is traditionally regarded as the "Father of Medicine". His contributions revolutionized the practice of medicine; but after his death the advancement stalled. So revered was Hippocrates that his teachings were largely taken as too great to be improved upon and no significant advancements of his methods were made for

5727-453: The sound of blood regurgitation from possibly dysfunctional valves. However, studies have shown that echocardiography is much more efficient in detecting RHD due to its high sensitivity. An echocardiogram has the ability to detect signs of RHD before the development of more obvious symptoms such as tissue scarring and stenosis. Modified Jones criteria were first published in 1944 by T. Duckett Jones , MD. They have been periodically revised by

5810-468: The symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema , i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day students of pulmonary medicine and surgery. Hippocrates was the first documented chest surgeon and his findings and techniques, while crude, such as the use of lead pipes to drain chest wall abscess, are still valid. The Hippocratic school of medicine described well

5893-563: The tendinous cords. It is caused by an autoimmune reaction to Group A β-hemolytic streptococci (GAS) that results in valvular damage. Fibrosis and scarring of valve leaflets, commissures and cusps leads to abnormalities that can result in valve stenosis or regurgitation. The inflammation caused by rheumatic fever, usually during childhood, is referred to as rheumatic valvulitis. About half of patients with rheumatic fever develop inflammation involving valvular endothelium . The majority of morbidity and mortality associated with rheumatic fever

5976-464: The vaccine. The management of rheumatic fever is directed toward the reduction of inflammation with anti-inflammatory medications such as aspirin or corticosteroids . Individuals with positive cultures for strep throat should also be treated with antibiotics . People with positive cultures for Streptococcus pyogenes should be treated with penicillin as long as allergy is not present. The use of antibiotics will not alter cardiac involvement in

6059-416: The valves . Rheumatic fever may occur following an infection of the throat by the bacterium Streptococcus pyogenes . If the infection is left untreated, rheumatic fever occurs in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Due to their genetics, some people are more likely to get the disease when exposed to

6142-512: Was 12.9 per 1000 children. To assist in the identification of RHD in low resource settings and where prevalence of GAS infections is high, the World Heart Federation has developed criteria for RHD diagnosis using echocardiography, supported by clinical history if available. The WHF additionally defines criteria for use in people younger than age 20 to diagnose "borderline" RHD, as identification of cases of RHD among children

6225-525: Was a Greek physician and philosopher of the classical period who is considered one of the most outstanding figures in the history of medicine . He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, and the (however misguided) formulation of humoral theory . The Hippocratic school of medicine revolutionized ancient Greek medicine , establishing it as

6308-410: Was a disease in and of itself. Hippocrates treated patients with fever by starving them out, believing that 'starving' the fever was a way to neutralize the disease. He may therefore have been the originator of the idea " Feed a cold, starve a fever ". One of the strengths of Hippocratic medicine was its emphasis on prognosis . At Hippocrates's time, medicinal therapy was quite immature, and often

6391-573: Was acknowledged by the disciples of Pythagoras for allying philosophy and medicine. He separated the discipline of medicine from religion, believing and arguing that disease was not a punishment inflicted by the gods but rather the product of environmental factors , diet, and living habits. There is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus. However, Hippocrates did hold many convictions that were based on incorrect anatomy and physiology , such as Humorism . Ancient Greek schools of medicine were split into

6474-476: Was born around the year 460 BC on the Greek island of Kos ; other biographical information, however, is likely to be untrue. Soranus of Ephesus , a 2nd-century Greek physician , was Hippocrates's first biographer and is the source of most personal information about him. Later biographies are in the Suda of the 10th century AD, and in the works of John Tzetzes , which date from the 12th century AD. Hippocrates

6557-536: Was on patient care and prognosis , not diagnosis. It could effectively treat diseases and allowed for a great development in clinical practice. Hippocratic medicine and its philosophy are far removed from modern medicine, in which the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school. This shift in medical thought since Hippocrates's day has generated serious criticism of their denunciations; for example,

6640-403: Was preferable. Soothing balms were sometimes employed. Hippocrates was reluctant to administer drugs and engage in specialized treatment that might prove to be wrongly chosen; generalized therapy followed a generalized diagnosis. Some of the generalized treatments he prescribed are fasting and the consumption of a mix of honey and vinegar. Hippocrates once said that "to eat when you are sick,

6723-403: Was that of a crisis , a point in the progression of disease at which either the illness would begin to triumph and the patient would succumb to death, or the opposite would occur and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days , which were supposed to be

6806-511: Was the author of any of the treatises in the corpus has not been conclusively answered, but modern debate revolves around only a few of the treatises seen as potentially authored by him. Because of the variety of subjects, writing styles and apparent date of construction, the Hippocratic Corpus could not have been written by one person (Ermerins numbers the authors at nineteen). The corpus came to be known by his name because of his fame; possibly all medical works were classified under 'Hippocrates' by

6889-431: Was the ruler of the islands of "Kos and Lango" [sic], and recounts a legend about Hippocrates's daughter. She was transformed into a hundred-foot long dragon by the goddess Diana , and is the "lady of the manor" of an old castle. She emerges three times a year, and will be turned back into a woman if a knight kisses her, making the knight into her consort and ruler of the islands. Various knights try, but flee when they see

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