[The risk factors for unfavorable outcomes in rheumatism].

A prospective study was made of environmental factors effects on unfavorable cardial and cerebral outcomes of rheumatic fever (RF) assessed functionally, biochemically and psychologically. Some of RF predisposing factors (female sex, frequent nasopharyngeal infections, poor housing and occupational conditions) negatively affect outcomes of primary RF and contribute to emergence of valvular disease. The initial attack of activity I or III degree, pronounced carditis, active rheumatic process at discharge, recurrences, absence of year-round prophylaxis allow prognostication of valvular heart disease. The majority of the factors promoting valvular and circulatory disorders also contribute to the onset of psychic abnormalities, astheno-organic syndrome, in particular.