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https://www.readbyqxmd.com/read/27899517/endovascular-management-of-cerebral-septic-embolism-three-recent-cases-and-review-of-the-literature
#1
Eugene L Scharf, Tia Chakraborty, Alejandro Rabinstein, Amrendra S Miranpuri
Endovascular management of acute ischemic stroke secondary to septic emboli from bacterial endocarditis is case-specific and outside established guidelines. We report three new cases of an acute ischemic stroke secondary to septic embolus from two different centers. All cases reported here were large vessel occlusions of the middle cerebral artery in anticoagulated patients. In one case the embolus was noted to be firm and aspiration thrombectomy was attempted in lieu of stent retrieval. Thrombolysis in Cerebral Ischemia (TICI) 3 recanalization was achieved and the patient experienced a good outcome with resolution of deficits...
November 29, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27822623/-esc-and-aha-guidelines-2015-on-endocarditis-in-competition-or-synchrony
#2
Bernhard Maisch
In the 2015 guidelines of the European Society of Cardiology (ESC) and the American Heart Association (AHA) on infective endocarditis, the diagnostics are based on the modified Duke criteria. The diagnosis can be confirmed by a combination of micro-organisms demonstrated in culture or in situ, with the detection of valvular lesions or abscess formation by an imaging modality using echocardiography, positron emission tomography computed tomography (PET/CT), cardio-CT or nuclear medical methods. The management should be further improved by an interdisciplinary endocarditis team in a specifically designated reference center...
December 2016: Herz
https://www.readbyqxmd.com/read/27816113/temporal-trends-in-the-prevalence-of-infective-endocarditis-in-germany-between-2005-and-2014
#3
Karsten Keller, Ralph S von Bardeleben, Mir A Ostad, Lukas Hobohm, Thomas Munzel, Stavros Konstantinides, Mareike Lankeit
Infective endocarditis (IE) is a potentially life-threatening disease. Little is known about temporal trends in its prevalence in Germany. In 2009, recommendations for antibiotic prophylaxis were deescalated in the revised European Society of Cardiology guideline to include only patients at high risk of IE. We selected patients with the discharge diagnosis of IE based on the International Classification of Diseases code I33 in the nationwide database of the Federal Statistical Office of Germany. We identified 94,364 patients with a diagnosis of IE from January 2005 to December 2014...
October 8, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27777297/surgical-management-of-infective-endocarditis-complicated-by-embolic-stroke-practical-recommendations-for-clinicians
#4
Bobby Yanagawa, Gosta B Pettersson, Gilbert Habib, Marc Ruel, Gustavo Saposnik, David A Latter, Subodh Verma
There has been an overall improvement in surgical mortality for patients with infective endocarditis (IE), presumably because of improved diagnosis and management, centered around a more aggressive early surgical approach. Surgery is currently performed in approximately half of all cases of IE. Improved survival in surgery-treated patients is correlated with a reduction in heart failure and the prevention of embolic sequelae. It is reported that between 20% and 40% of patients with IE present with stroke or other neurological conditions...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27721936/role-of-radionuclide-imaging-for-diagnosis-of-device-and-prosthetic-valve-infections
#5
Jean-François Sarrazin, François Philippon, Mikaël Trottier, Michel Tessier
Cardiovascular implantable electronic device (CIED) infection and prosthetic valve endocarditis (PVE) remain a diagnostic challenge. Cardiac imaging plays an important role in the diagnosis and management of patients with CIED infection or PVE. Over the past few years, cardiac radionuclide imaging has gained a key role in the diagnosis of these patients, and in assessing the need for surgery, mainly in the most difficult cases. Both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and radiolabelled white blood cell single-photon emission computed tomography/computed tomography (WBC SPECT/CT) have been studied in these situations...
September 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27687628/-which-patients-with-infective-endocarditis-require-emergency-surgery
#6
François Delahaye
Half of patients with infectious endocarditis have surgery during the active phase of infective endocarditis (before the end of antibiotic therapy). The American Heart Association and the European Society of Cardiology, independently from each other, have published guidelines in September 2015. As regards surgical indications, these guidelines are similar. The surgical indication must be a common decision of a multidisciplinary team of experts in cardiology, cardiac surgery, imaging and infectious diseases...
September 26, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27680224/a-case-of-cefepime-encephalopathy-being-difficult-to-distinguish-from-non-convulsive-status-epilepticus-during-the-treatment-of-bacterial-meningitis
#7
Yusuke Toda, Mineo Yamazaki, Tomohiro Ota, Yosuke Fujisawa, Kazumi Kimura
A 64-year-old man with fever, appetite loss, and pain in the back of the neck visited our hospital. We diagnosed him as having bacterial meningitis because of pleocytosis of the cerebrospinal fluid, and started treatment with antibiotics. Multiple cerebral infarcts were found on brain MRI. We suspected that the origin of the bacterial meningitis was infective endocarditis, and administered Cefepime and Gentamicin according to the guidelines for treatment of infective endocarditis. Three days later, he became drowsy and had myoclonus and flapping of the extremities...
September 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27648311/ultrasound-assisted-catheter-directed-thrombolysis-in-the-management-of-a-right-atrial-thrombus-a-new-weapon-in-the-armamentarium
#8
Mohamed Shokr, Ramanjit Kaur, Kevin Belgrave, Arshad Javed, Mahir Elder, Shaun Cardozo, Luis Afonso, Amir Kaki
Catheter related thrombosis (CRT) is a commonly encountered entity fraught with substantial risk for mortality secondary to various complications including pulmonary embolism (PE), tricuspid regurgitation, endocarditis, right sided heart failure, and cardiogenic and septic shock. CRT carries a mortality rate of 18% in hemodialysis patients and more than 40% in nonhemodialysis patients. Management strategies include systemic anticoagulation, systemic thrombolysis, surgical evacuation, and percutaneous retrieval with no established guidelines...
2016: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27642739/-an-unexpected-cause-of-dyspnea-and-degradation-of-performance
#9
Peter Seizer, Michaela Rockenstiehl, Suzanne Fateh-Moghadam, Susanne Haen, Ferruh Artunc, Martin R Müller, Azadeh Ebrahimi, Reimer Riessen, Meinrad Gawaz, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: A 55-year old man suffers from progressive, distinctive dyspnoea and physical weakness since 5 days. Due to ST-segment changes in the ECG and a positive troponin-test, the primary care physician initiates an hospitalization. INVESTIGATIONS: After admission, the laboratory tests confirm the elevated troponin-values, and show additionally elevated pro-brain-natriuric-peptide-values. The coronary angiography presents a highly reduced left ventricular function, an aortic insufficiency III° and a coronary heart disease...
September 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27642299/myocardial-infarction-and-aortic-root-mycotic-aneurysm-complicating-aortic-valve-endocarditis-utility-of-cardiac-ct
#10
Aimee E Moores, Michael S Cahill, Todd C Villines
Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27621836/international-guideline-changes-and-the-incidence-of-infective-endocarditis-a-systematic-review
#11
Omeair Khan, Ahmed Mohamed Abdel Shafi, Adam Timmis
The objective of this study was to determine the impact on incident infective endocarditis (IE) of guideline recommendations to restrict indications for antibiotic prophylaxis. We conducted a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. PubMed and EMBASE databases were searched for articles published between 2007 and 2015 using mesh terms relevant to the research question. Included were English language articles published after 2009 that provided estimates of IE incidence before-and-after major international guideline changes...
2016: Open Heart
https://www.readbyqxmd.com/read/27621607/managing-infective-endocarditis-in-the-elderly-new-issues-for-an-old-disease
#12
Emmanuel Forestier, Thibaut Fraisse, Claire Roubaud-Baudron, Christine Selton-Suty, Leonardo Pagani
The incidence of infective endocarditis (IE) rises in industrialized countries. Older people are more affected by this severe disease, notably because of the increasing number of invasive procedures and intracardiac devices implanted in these patients. Peculiar clinical and echocardiographic features, microorganisms involved, and prognosis of IE in elderly have been underlined in several studies. Additionally, elderly population appears quite heterogeneous, from healthy people without past medical history to patients with multiple diseases or who are even bedridden...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27555973/the-association-of-streptococcus-gallolyticus-subspecies-pasteurianus-bacteremia-with-the-detection-of-premalignant-and-malignant-colonic-lesions
#13
Gaurav Chand, Leonid Shamban, Adam Forman, Prabhat Sinha
Streptococcus gallolyticus subspecies (subsp.) gallolyticus (formerly bovis biotype I) bacteremia has been associated with colonic adenocarcinoma. The bovis species underwent reclassification in 2003. Subtypes of gallolyticus are associated with colonic malignancy but are less frequent, resulting in less awareness. A 71-year-old male admitted with worsening lower back pain and fevers. Initial vital signs and laboratory data were within normal limits. MRI revealed lumbosacral osteomyelitis and antibiotics were initiated...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27540996/international-expert-consensus-on-sutureless-and-rapid-deployment-valves-in-aortic-valve-replacement-using-minimally-invasive-approaches
#14
Mattia Glauber, Simon C Moten, Eugenio Quaini, Marco Solinas, Thierry A Folliguet, Bart Meuris, Antonio Miceli, Peter J Oberwalder, Manfredo Rambaldini, Kevin H T Teoh, Gopal Bhatnagar, Michael A Borger, Denis Bouchard, Olivier Bouchot, Stephen C Clark, Otto E Dapunt, Matteo Ferrarini, Theodor J M Fischlein, Guenther Laufer, Carmelo Mignosa, Russell Millner, Philippe Noirhomme, Steffen Pfeiffer, Xavier Ruyra-Baliarda, Malakh Lal Shrestha, Rakesh M Suri, Giovanni Troise, Borut Gersak
OBJECTIVE: To define the benefit of sutureless and rapid deployment valves in current minimally invasive approaches in isolated aortic valve replacement. METHODS: A panel of 28 international experts with expertise in both minimally invasive aortic valve replacement and rapid deployment valves was constituted. After thorough literature review, the experts rated evidence-based recommendations in a modified Delphi approach. RESULTS: No guideline could be retrieved...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27540221/development-of-a-once-daily-gentamicin-regimen-for-paediatric-surgery-patients
#15
Sumayya Kasuji, Prady Gadaria
AIM: Intravenous gentamicin is given as a 5 day course to paediatric patients who have undergone abdominal surgery. There was an impression that the multiple daily dosing regimen in use at the time (2.5 mg/kg three times a day) did not provide therapeutic levels in this patient cohort therefore the aim was to develop a dosing regimen that did. METHOD: A retrospective audit of pre- and post-dose gentamicin levels in patients on a multiple daily dose regimen was undertaken...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27514339/a-change-in-the-nice-guidelines-on-antibiotic-prophylaxis
#16
M H Thornhill, M Dayer, P B Lockhart, M McGurk, D Shanson, B Prendergast, J B Chambers
Since 2008, NICE clinical guidelines have stated: 'Antibiotic prophylaxis against infective endocarditis is not recommended for people undergoing dental procedures'. This put UK guidance at odds with guidance in the rest of the world, where antibiotic prophylaxis is recommended for patients at high-risk of infective endocarditis undergoing invasive dental procedures. Many dentists also felt this wording prohibited the use of antibiotic prophylaxis, regardless of the wishes of the patient or their personal risk of infective endocarditis and made it difficult for them to use their clinical judgment to deliver individualised care in the best interests of their patients...
August 12, 2016: British Dental Journal
https://www.readbyqxmd.com/read/27484973/preoperative-hemoglobin-level-the-best-predictor-of-transfusion-of-packed-red-cells
#17
Wiebe J de Boer, Cornelis Visser, Yuri M Ganushchak
Blood transfusions could have serious consequences for patients. A reduction in the transfusion rate could be accomplished by an optimized blood management. Clear guidelines and awareness among all employees at a single institution have resulted in a reduction in transfusion rates in recent years. Identification of the group of patients who still received a blood transfusion in recent years could result in a further reduction. This study enrolled 4022 patients undergoing cardiothoracic surgery between 2008 and 2013...
July 8, 2016: Perfusion
https://www.readbyqxmd.com/read/27418041/trends-in-infective-endocarditis-hospitalisations-at-united-states-children-s-hospitals-from-2003-to-2014-impact-of-the-2007-american-heart-association-antibiotic-prophylaxis-guidelines
#18
Katherine E Bates, Matthew Hall, Samir S Shah, Kevin D Hill, Sara K Pasquali
OBJECTIVE: National organisations in several countries have recently released more restrictive guidelines for infective endocarditis prophylaxis, including the American Heart Association 2007 guidelines. Initial studies demonstrated no change in infective endocarditis rates over time; however, a recent United Kingdom study suggested an increase; current paediatric trends are unknown. METHODS: Children (5 years of age. Interrupted time series analysis was used to evaluate rates over time indexed to total hospitalisations...
July 15, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27368014/infective-endocarditis-in-hypertrophic-cardiomyopathy-a-multicenter-prospective-cohort-study
#19
Fernando Dominguez, Antonio Ramos, Emilio Bouza, Patricia Muñoz, Maricela C Valerio, M Carmen Fariñas, José Ramón de Berrazueta, Jesús Zarauza, Juan Manuel Pericás Pulido, Juan Carlos Paré, Arístides de Alarcón, Dolores Sousa, Isabel Rodriguez Bailón, Miguel Montejo-Baranda, Mariam Noureddine, Elisa García Vázquez, Pablo Garcia-Pavia
Infective endocarditis (IE) complicating hypertrophic cardiomyopathy (HCM) is a poorly known entity. Although current guidelines do not recommend IE antibiotic prophylaxis (IEAP) in HCM, controversy remains.This study sought to describe the clinical course of a large series of IE HCM and to compare IE in HCM patients with IE patients with and without an indication for IEAP.Data from the GAMES IE registry involving 27 Spanish hospitals were analyzed. From January 2008 to December 2013, 2000 consecutive IE patients were prospectively included in the registry...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27349588/-aftercare-of-patients-after-mitraclip%C3%A2-implantation
#20
A Schlitt, E Lubos, M Guha, C Hegeler-Molkewehrum, M Sudau, H Schmidt
Many patients with moderate to severe mitral regurgitation cannot be subjected to surgical therapy due to their multimorbidity. For these patients, MitraClip® implantation is a therapeutic alternative.The aim of this article is to present recommendations for treatment after a MitraClip® procedure. For this purpose, a selective literature review has been carried out based on the current literature, notably on national and international guidelines.After a MitraClip® procedure, rehabilitation is indicated because of the underlying heart failure as well as the treatment of a heart valve...
June 27, 2016: Herz
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