{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:48:55Z","timestamp":1771307335975,"version":"3.50.1"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2017,10,25]],"date-time":"2017-10-25T00:00:00Z","timestamp":1508889600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>The aim of the present study was to describe the clinical course, laboratory tests, and the cardiac involvement in rheumatic carditis patients in functional class III and IV, submitted to pulse therapy combined with oral prednisone.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 120 patients with severe carditis due to acute rheumatic fever were treatment with three cycles of pulse therapy combined with oral corticosteroids. The patients were followed up from the hospital admission until the end of the treatment and returned after 30, 60, and 90 days to control. The patients were evaluated by clinical, laboratory, and transthoracic echocardiogram.<\/jats:p><\/jats:sec>Results<\/jats:title>In total, 23 (19.2%) patients at first attack of rheumatic fever and 97 (80.8%) with recurrent carditis were evaluated. Cardiac surgery was performed in 8 (6.6%) patients. The patients showed improved laboratory and radiological parameters (p<0.001) and were discharged, 74 (61.7%) in functional class I and 46 (38.3%) in functional class II. Hospitalisation time ranged from 21 to 176 days, with a mean of 69.1 days. Reduction of left atrium and ventricle diameters was observed, measured by means of transthoracic echocardiography, at hospital admission and discharge (p<0.001). None of the patients experienced rebound.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The pulse therapy was effective in controlling severe rheumatic carditis and the oral corticosteroid prevented rebound episodes. Prolonged hospital stay was required for the clinical stabilisation of patients and to avoid the interruption of medication.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951117002062","type":"journal-article","created":{"date-parts":[[2017,10,25]],"date-time":"2017-10-25T08:06:20Z","timestamp":1508918780000},"page":"309-314","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Pulse therapy combined with oral corticosteroids in the management of severe rheumatic carditis and rebound"],"prefix":"10.1017","volume":"28","author":[{"given":"Renato P. A.","family":"Torres","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00f4mulo F. A.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael A.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ros\u00e2ngela S. L. A.","family":"Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2017,10,25]]},"reference":[{"key":"S1047951117002062_ref24","first-page":"73","article-title":"Estudo de 500 casos de febre reum\u00e1tica na cidade de Curitiba","volume":"19","author":"Torres","year":"2000","journal-title":"Divulga\u00e7\u00e3o em Sa\u00fade para Debate"},{"key":"S1047951117002062_ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s002469910017"},{"key":"S1047951117002062_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpn.2011.12.005"},{"key":"S1047951117002062_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.04.059"},{"key":"S1047951117002062_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2005.08.028"},{"key":"S1047951117002062_ref16","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.32.3.457"},{"key":"S1047951117002062_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951102000264"},{"key":"S1047951117002062_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-200X.1996.tb03430.x"},{"key":"S1047951117002062_ref10","first-page":"1","article-title":"Rheumatic fever","volume":"11","author":"Markowitz","year":"1972","journal-title":"Major Probl Clin Pediatr"},{"key":"S1047951117002062_ref7","first-page":"643","article-title":"Rheumatic fever and rheumatic heart disease: the last 50 years","volume":"137","author":"Kumar","year":"2013","journal-title":"Indian J Med Res"},{"key":"S1047951117002062_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114002212"},{"key":"S1047951117002062_ref4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2002.00772.x"},{"key":"S1047951117002062_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(05)70267-X"},{"key":"S1047951117002062_ref1","unstructured":"WHO. Rheumatic fever and rheumatic heart disease: report of a WHO expert consultation on rheumatic fever and rheumatic heart disease. World Health Organization. Geneva, 2001, Oct 29\u2013Nov 1. Geneva: WHO, 2004."},{"key":"S1047951117002062_ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5240.1628"},{"key":"S1047951117002062_ref12","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X1999000500007"},{"key":"S1047951117002062_ref2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000205"},{"key":"S1047951117002062_ref6","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2010.0162"},{"key":"S1047951117002062_ref9","first-page":"97","article-title":"High-dose intravenous methylprednisolone (pulsetherapy): possible therapeutic solution for active rheumatic fever with severe carditis","volume":"43","author":"Couto","year":"1984","journal-title":"Arq Bras Cardiol"},{"key":"S1047951117002062_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(57)92104-9"},{"key":"S1047951117002062_ref11","first-page":"377","article-title":"Pulse therapy (high venous of venous methylprednisolone) in children with rheumatic carditis. Prospective study of 40 episodes","volume":"60","author":"Herdy","year":"1993","journal-title":"Arq Bras Cardiol"},{"key":"S1047951117002062_ref15","first-page":"177","article-title":"Salicylates in rheumatic fever: an attempt to assess their value","volume":"23","author":"Ilingworth","year":"1954","journal-title":"Q J Med"},{"key":"S1047951117002062_ref5","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.29.6.813"},{"key":"S1047951117002062_ref8","first-page":"1","article-title":"Anti-inflammatory treatment for carditis in acute rheumatic fever","volume":"5","author":"Cilliers","year":"2015","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951117002062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,15]],"date-time":"2019-04-15T20:15:15Z","timestamp":1555359315000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951117002062\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,25]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["S1047951117002062"],"URL":"https:\/\/doi.org\/10.1017\/s1047951117002062","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,25]]},"assertion":[{"value":"\u00a9 Cambridge University Press 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}