Managing Infective Endocarditis: What Lies Behind the High Mortality Rate and What Can We Do About it?

2020 ◽  
Vol 29 (6) ◽  
pp. 812-813
Author(s):  
Andrew Cochrane ◽  
William Shi
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
High Mortality

Infective endocarditis

2020 ◽  
pp. 115-128
Keyword(s):  
At Risk ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
High Mortality ◽  
Clinical Management ◽  
Valve Disease ◽  
Educational Issues ◽  
The Uk

Infective endocarditis (IE) is a condition that most commonly occurs in patients with pre-existing valve disease. It affects one in 30 000 people in the UK and is associated with a high mortality rate (15–30% in hospital mortality). Nurses working in the cardiac arena should be aware of those patients who are at risk of developing IE and its clinical management. This chapter covers the aetiology, diagnosis, complications, treatment, nursing considerations, and specific educational issues that are relevant to the overall management and prevention of IE.

Emamectin benzoate is a safe and effective anthelmintic against coelomic nematode Philometra rubra in striped bass Morone saxatilis

2020 ◽  
Vol 142 ◽  
pp. 47-53
Author(s):  
K Béland ◽  
G Séguin ◽  
S Lair
Keyword(s):  
Mortality Rate ◽  
Striped Bass ◽  
High Mortality ◽  
Morone Saxatilis ◽  
Treatment Results ◽  
Emamectin Benzoate ◽  
Once Daily ◽  
Fish Hatchery ◽  
Parasitic Burden

An unusually high mortality rate due to verminous (Philometra rubra) coelomitis was documented in wild-hatched striped bass Morone saxatilis raised in a fish hatchery as part of a stock restoration program. To decrease the parasitic burden and therefore potentially minimize mortality, the effectiveness of 2 different anthelmintics was evaluated. Two trials were conducted on wild-collected fingerlings naturally infected by P. rubra. In 2006, 144 yearling fish were randomly assigned to 4 experimental groups: (1) levamisole (Levasol®) at 2 mg l-1 via immersion for 8 h once weekly for 3 wk; (2) levamisole at a dose of 2.5 mg kg-1 biomass via feed once daily for 7 d; (3) emamectin benzoate (Slice®) at a dose of 0.05 mg kg-1 biomass via feed once daily for 7 d; and (4) control. Emamectin successfully eliminated live nematodes in 84.9% of the fish, whereas the administration of levamisole, either via immersion or feed, was not successful in significantly reducing the number of live P. rubra. In 2007, the administration of the same dosage of emamectin to approximately 1000 naturally infected yearling striped bass was associated with a 100% mortality rate of P. rubra in the 30 fish randomly examined 5 wk after the beginning of the treatment. Results of these trials indicate that, at the dosage used, the administration of emamectin at the end of the summer is safe for striped bass yearlings and considerably reduces the prevalence and intensity of the infection by this parasite.

Inovasi Teknologi Pembuatan Pakan Udang dengan Penambahan Tepung Kopasanda (Chromolaena odorata L.) di Desa Tamangapa Kecamatan Ma’rang Kab. Pangkep

2019 ◽  
Vol 3 (2) ◽  
pp. 140
Author(s):  
Harlina Harlina ◽  
Hadijah Hadijah ◽  
Kamaruddin Kamaruddin ◽  
Ernaningsih Ernaningsih
Keyword(s):  
Mortality Rate ◽  
Community Service ◽  
High Mortality ◽  
Raw Materials ◽  
Development Program ◽  
Chromolaena Odorata ◽  
Farmed Fish ◽  
Counseling Training ◽  
Shrimp Feed ◽  
Simple Technology

Tamangapa village, Ma’rang district is part of the community development program conducted by Universitas Muslim Indonesia in Pangkajene Kepulauan regency. The local shrimp farmers of Tamangapa village have been facing major issue due to expensive artificial feed and high mortality rate. In order to solve the needs of feed and high mortality rate for farmed fish or shrimp, the source of the natural ingredients using kopasanda leaves Chromolaena odorata L is required. The use of a natural ingredient is also used to prevent the vibriosis using simple technology such as the utilization of local raw materials which is affordable and locally available. The present community service aimed to provide the proper knowledge and skills to members of the fish/shrimp farmer’s group through counseling, training and mentoring. This community service program encouraged the local farmers to be able to utilize the local raw materials as a source of shrimp feed, use the feed pellet machine, and packaging leading to independent feed production. The participatory training method, lectures, forum group discussions, and practices of making shrimp feed and packaging were applied. The Implementation of the Community Partnership Program of Shrimp and Fish Cultivation Groups is independently able to produce organic fish or shrimp feed for farmer’s group leading to higher productivity of aquaculture.

Candida albicans endocarditis involving a normal native aortic valve in an immunocompetent patient

2020 ◽  
Vol 13 (11) ◽  
pp. e236902
Author(s):  
Taha Sheikh ◽  
Jeremy C Tomcho ◽  
Mohammed T Awad ◽  
Syeda Ramsha Zaidi
Keyword(s):  
Candida Albicans ◽  
Mortality Rate ◽  
Aortic Valve ◽  
High Mortality ◽  
Treatment Options ◽  
Immunocompetent Patient ◽  
Fungal Endocarditis ◽  
Appropriate Treatment ◽  
Mechanical Valves ◽  
Serious Infection

Fungal endocarditis, specifically from Candida species, is a rare but serious infection with a high mortality rate. Most cases occur in bioprosthetic or mechanical valves and are uncommon in native, structurally normal valves. When Candida endocarditis is detected and appropriate treatment is initiated earlier, there is an improvement in mortality. While the recommendation is usually to treat with a combination of surgery and antifungal medications, patient comorbidities may limit treatment options.

scholarly journals 1186. Cefazolin inoculum effect predicts reduced susceptibility to other antibiotics and patient outcomes in MSSA endovascular infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S617-S617
Author(s):  
Dan Smelter ◽  
Sue McCrone ◽  
Warren Rose
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
Patient Outcomes ◽  
Treatment Options ◽  
Fold Increase ◽  
Specific Mechanism ◽  
Research Support ◽  
High Burden ◽  
Low Toxicity ◽  
Inoculum Effect

Abstract Background MSSA Infective endocarditis (IE) is inherently a high-burden infection with up to a 30% mortality rate. Cefazolin is an appealing treatment option for IE with low toxicity and a favorable dosing scheme. However, cefazolin has been associated with treatment failure in IE, attributed to an inoculum effect. The specific mechanism underlying the cefazolin inoculum effect (CIE) remains undetermined, but CIE has been linked to both blaZ expression and agr dysfunction. This study aims to determine whether CIE is linked to reduced susceptibility to other antibiotics and worse outcomes regardless of therapy in MSSA endovascular infections. Methods Sixty-four MSSA strains were collected from patients with endovascular infections not treated with cefazolin. To determine CIE phenotype, strains were cultured and MICs assayed for cefazolin, nafcillin, and vancomycin at 107 CFU/mL for high-inocula (HI) and 105 CFU/mL for standard-inocula (SI). This study defined CIE as a ≥ 4-fold increase in MIC at HI compared to SI, with at least an MIC of 4 mg/L at HI. Nitrocefin disks identified blaZ expression, and beta lysin disks were used to determine hemolysin type and agr function. Patient outcomes of mortality and bacteremia duration were assessed across cohorts. Results Twenty-four strains exhibit a CIE (38%), with 10 strains having an MIC of ≥ 32mg/L at HI. Nafcillin and vancomycin also had an inoculum effect, uncoupled from the CIE and occurring at a lower frequency and amplitude at HI. Presence of CIE had a greater association with blaZ expression (71% vs 25%) than agr dysfunction (38% vs 20%). 50% (9/18) of CIE infections were cleared within 48 hours while 77% (20/26) of CIE-negative infections were cleared within 48 hours (P=0.106). However, presence of CIE was not associated with increased mortality (25% CIE-positive vs 35%; P=0.578) Conclusion Previous studies for CIE failed to enrich for isolates from endovascular sources, where inocula are known to be high. This study presents one of the largest endovascular source cohorts for CIE evaluation. It identifies that CIE prevalence (38%) is higher than reports from diverse infection sources (10-36%). CIE appears to predict bacteremia duration with other MSSA treatment options, suggesting mechanisms independent of blaZ and agr function for this phenomenon. Disclosures Warren Rose, PharmD, MPH, Merck (Grant/Research Support)Paratek (Grant/Research Support)

scholarly journals Bowel necrosis in patient with severe case of COVID-19: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Ardian Soeselo ◽  
Wirawan Hambali ◽  
Sandy Theresia
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Critically Ill ◽  
High Mortality ◽  
Severe Case ◽  
Bowel Necrosis ◽  
Case Presentation ◽  
Gastrointestinal Manifestations ◽  
Emergent Laparotomy

Abstract Background In patients who are critically ill with COVID-19, multiple extrapulmonary manifestations of the disease have been observed, including gastrointestinal manifestations. Case presentation We present a case of a 65 year old man with severe COVID-19 pneumonia that developed hypercoagulation and peritonitis. Emergent laparotomy was performed and we found bowel necrosis in two sites. Conclusions Although rare, the presentation of COVID-19 with bowel necrosis requires emergency treatments, and it has high mortality rate.

SARS-CoV-2 and Tissue Damage: Current Insights and Biomaterial-based Therapeutic Strategies

2021 ◽  
Author(s):  
Himadri Roy ◽  
Rupali Singh ◽  
Deepa Ghosh
Keyword(s):  
Mortality Rate ◽  
High Mortality ◽  
Tissue Damage ◽  
Therapeutic Strategies ◽  
The World ◽  
Rapid Transmission

The effect of SARS-CoV-2 infection on humanity has gained worldwide attention and importance due to its rapid transmission, lack of treatment and high mortality rate. While scientists across the world...

scholarly journals Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

2021 ◽  
Author(s):  
Anna Bläckberg ◽  
Christian Morenius ◽  
Lars Olaison ◽  
Andreas Berge ◽  
Magnus Rasmussen
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Haemophilus Influenzae ◽  
Comparative Study ◽  
Clinical Characteristics ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Common Cause ◽  
Prosthetic Valves

AbstractInfective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.

Modern imagine methods in diagnostics of acute pancreatitis in clinical practice

2020 ◽  
pp. 14-25
Author(s):  
G. R. Ahunova ◽  
R. R. Ahunova
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Mortality Rate ◽  
High Mortality ◽  
Surgical Pathology ◽  
Diagnostic Radiology ◽  
Common Disease ◽  
Review Of The Literature ◽  
Abdominal Organs ◽  
Comprehensive Examination

Acute pancreatitis is one of the most frequent and formidable diseases, and rates as one of the most common disease in the structure of acute surgical pathology of the abdominal organs. In the last decade, there has been an increase in the proportion of necrotic forms of the disease with damage to various departments of the retroperitoneal space and a stably high mortality rate. The diagnostics problem of acute pancreatitis is still relevant due to difficulties that persist despite the possibility of a comprehensive examination of patients upon admission to the hospital and during treatment. This article presents a review of the literature, reflecting the state of the problem and aspects of diagnostic radiology of acute pancreatitis.

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