Valid Comparison of Infective Endocarditis (IE) Risk Constellations: Current Data

2021 ◽  
Author(s):  
R. Eyermann
Keyword(s):  
Infective Endocarditis ◽  
Current Data ◽  
Valid Comparison

Cerebrovascular Complication and Valve Surgery in Infective Endocarditis

2021 ◽  
Author(s):  
Cory J. Rice ◽  
Shivakrishna Kovi ◽  
Dolora R. Wisco
Keyword(s):  
Ischemic Stroke ◽  
Infective Endocarditis ◽  
Neurological Complication ◽  
Current Data ◽  
Valve Surgery ◽  
Cerebrovascular Event ◽  
Replacement Surgery ◽  
Risks And Benefits ◽  
Cerebrovascular Complication ◽  
Cerebrovascular Complications

AbstractInfective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. However, in circumstances when an indication for valve surgery to treat IE is present, the benefits of early surgical treatment may outweigh the potential neurologic deterioration. Furthermore, valve surgery has been associated with lower in-hospital mortality than medical therapy with intravenous antibiotics alone. Early valve surgery can be performed within 7 days of transient ischemic attack or asymptomatic stroke when medically indicated. Timing of valve surgery for IE after symptomatic medium or large symptomatic ischemic stroke or ICH remains challenging, and current data in the literature are conflicting about the risks and benefits. A delay of 2 to 4 weeks from the time of the cerebrovascular event is often recommended, balancing the risks and benefits of surgery. The range of timing of valve surgery varies depending on the clinical scenario, and is best determined by a multidisciplinary decision between cardiothoracic surgeons, cardiologists, infectious disease experts, and vascular neurologists in an experienced referral center.

Increased risk of infective endocarditis after traumatic skin wound

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318632
Author(s):  
Hiroyuki Ohbe ◽  
Masao Iwagami ◽  
Yusuke Sasabuchi ◽  
Hideo Yasunaga
Keyword(s):  
Risk Factor ◽  
Infective Endocarditis ◽  
Case Series ◽  
Baseline Period ◽  
Skin Wound ◽  
Current Data ◽  
Infectious Endocarditis ◽  
Skin Wounds ◽  
Increased Risk ◽  
Rate Ratios

ObjectiveCurrent data suggest that a history of traumatic open skin wounds may be a risk factor for infectious endocarditis, with limited evidence. We tested the hypothesis that traumatic skin wound is a risk factor for infectious endocarditis.MethodsUsing the Japan Medical Data Center (JMDC) database (4 650 927 people aged 20–64 years, 2012–2018) and the Kumamoto database (493 414 people aged ≥65 years, 2012–2017), we conducted nested case–control and self-controlled case series (SCCS) analyses.ResultsIn the JMDC database, 544 cases hospitalised for infective endocarditis (IE) were matched with 2091 controls; 2.8% of cases and 0.5% of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.31 (95% CI 1.74 to 10.7). In the Kumamoto database, 4.0% (27/670) of cases and 1.1% (29/2581) of controls were exposed to traumatic skin wounds in the previous 1–4 weeks, with an adjusted OR of 4.15 (95% CI 2.04 to 8.46). In the SCCS, the incidence rate ratios for IE were 2.61 (95% CI 1.67 to 4.09), 1.73 (95% CI 1.01 to 2.94), 1.19 (95% CI 0.63 to 2.27) and 1.52 (95% CI 0.82 to 2.74) for the Kumamoto database and 3.78 (95% CI 2.07 to 6.92), 1.58 (95% CI 0.64 to 3.89), 1.60 (95% CI 0.65 to 3.94) and 1.29 (95% CI 0.47 to 3.53) for the JMDC database at 1–4, 5–8, 9–12 and 13–16 weeks after traumatic skin wound, respectively, compared with the baseline period.ConclusionsThis study suggests that traumatic skin wound is a risk factor for IE 1–4 weeks after the wound.

scholarly journals Infective Endocarditis: Updated Guidelines

2010 ◽  
Vol 21 (2) ◽  
pp. 74-77 ◽  
Author(s):  
U Allen
Keyword(s):  
Infective Endocarditis ◽  
Daily Living ◽  
American Heart ◽  
Heart Association ◽  
Current Data ◽  
Adverse Outcomes ◽  
Target Groups ◽  
Endocarditis Prophylaxis ◽  
Dental Procedures ◽  
Hygiene Measures

The most recent revision of the American Heart Association guidelines on infective endocarditis prophylaxis occurred in 2007. These revisions were based on the fact that current data have brought into question the benefit of previous recommendations for infective endocarditis prophylaxis. It was noted that the bacteremia that occurs following dental procedures represents only a fraction of the episodes of bacteremia that occur with activities of daily living (such as chewing, brushing teeth and other oral hygiene measures). The target groups and the procedures for which prophylaxis is reasonable have been significantly reduced in number. The focus is now on patients who are most likely to have adverse outcomes from infectious endocarditis. The present article is targeted at practicing Canadian physicians and provides the rationale for the current recommendations. In addition to a summary of the indications for prophylaxis, information is provided on the conditions for which prophylaxis is not recommended.

Successful Entrepreneurship as Developmental Outcome

2011 ◽  
Vol 16 (3) ◽  
pp. 174-186 ◽  
Author(s):  
Martin Obschonka ◽  
Rainer K. Silbereisen ◽  
Eva Schmitt-Rodermund
Keyword(s):  
Big Five ◽  
Role Models ◽  
Structural Equation ◽  
Current Data ◽  
Equation Modeling ◽  
Authoritative Parenting ◽  
Venture Creation ◽  
Entrepreneurial Success ◽  
Entrepreneurial Skills ◽  
Age Appropriate

Applying a lifespan approach of human development, this study examined pathways to entrepreneurial success by analyzing retrospective and current data. Along the lines of McClelland’s ideas of early entrepreneurship development and Rauch and Frese’s Giessen-Amsterdam model on venture success, we investigated the roles of founders’ adolescent years (early role models, authoritative parenting, and early entrepreneurial competence), personality traits (Big Five pattern), and entrepreneurial skills and growth goals during venture creation. Findings were derived from structural equation modeling studying two comparable samples of founders (N = 531) and nascent founders (N = 100) from Germany. Across both samples, reports on age-appropriate entrepreneurial competence in adolescence and an entrepreneurial Big Five profile predicted entrepreneurial skills during venture creation, which in turn predicted founders’ setting of ambitious growth goals and entrepreneurial success. Early entrepreneurial competence was related to the availability of entrepreneurial role models and authoritative parenting during adolescence as well as to an entrepreneurial Big Five profile. In line with prospective reports on early precursors of entrepreneurship, the findings illuminate the development of entrepreneurship in general and entrepreneurial success in particular over the lifespan, especially with regard to factors relevant in the adolescent years and the interplay with personality across different developmental periods.

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