P2754Streptococcal infective endocarditis: distribution of species and their prognosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Chamat ◽  
A Dahl ◽  
C Hassager ◽  
M Arpi ◽  
L Oestergaard ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Electronic Device ◽  
Species Level ◽  
University Hospital ◽  
Heart Valve Disease ◽  
Significant Difference ◽  
Streptococcal Species ◽  
Species Groups ◽  
One Year ◽  
The One

Abstract Background Infective endocarditis (IE) is frequently caused by streptococcal species. However, there is limited knowledge about the relationship between different streptococcal species and IE, and their associated outcomes. Purpose To examine the prevalence of streptococci at species level in IE, and to relate these different species to outcomes. Methods From 2002–2012 we prospectively collected consecutive patients with IE admitted to two tertiary heart centres covering a catchment area of 2.4 million people. The registry comprises 915 IE patients, 366 (40%) with streptococcal IE. Based on phylogenetic relationship, streptococcal species were classified into seven main groups: Mitis, Bovis, Mutans, Anginosus, Salivarius, Pyogenic and Nutritionally Variant Streptococcus (NVS). Classification at species level was not possible in 51 patients, who were excluded. Complications and prognosis of streptococcal IE were compared between the subgroups, and at species level. Results We included 315 patients with streptococcal IE. Mean age was 63 (IQR 52–76) years, and most were men (67%). A total of 115 patients (37%) had a previous heart valve disease, 58 (18%) had a prosthetic valve, 22 (7%) had previously had IE and 29 (9%) had a cardiac electronic device. With 148 episodes (47%) the Mitis group was the most common cause of IE. Other frequent groups were the Pyogenic group and the Bovis group, accounting for 66 (21%) and 51 (16%) of the cases, respectively. Surgery was carried out in 55% (n=173) of all cases. Patients infected with S. pneumoniae or S. agalactiae had a significantly higher rate of surgery, 72.2% (n=13) and 71.9% (n=23) respectively, whereas the Bovis group had a significantly lower rate, 35.5% (n=18) (p=0.048). The aortic valve was infected in 137 patients (43.5%), mitral valve in 105 patients (33.3%) and both valves were infected in 53 patients (16.8%). Twenty patients (6.3%) had right-sided IE, including pacemaker lead IE. There was no significant difference between the species subgroups regarding type of infected valve. Embolization and osteitis were observed in 76 (24.1%) and 30 (9.5%) patients, respectively. There was no significant difference between the species groups, as was the case with mortality: 23 patients (7.3%) died in-hospital and the one-year mortality was 16% (n=50). Distribution of streptococcal IE Conclusion Species of the Mitis group were the most frequent Streptococci causing IE. Patients infected with S. pneumonia or S. agalactiae had significantly higher rate of surgery, and patients infected with S. bovis group had lower rate of surgery. There was no significant difference in rate of complications such as abscesses, embolization, osteitis or mortality between the streptococcal species. Acknowledgement/Funding Supported by grants from Herlev-Gentofte University Hospital Research Foundation

scholarly journals Prosthetic-joint Infections: Mortality Over The Last 10 Years

2019 ◽  
Vol 4 (4) ◽  
pp. 198-202 ◽  
Author(s):  
Arnaud Fischbacher ◽  
Olivier Borens
Keyword(s):  
Surgical Treatment ◽  
University Hospital ◽  
Cumulative Mortality ◽  
Risk Of Death ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Significant Difference ◽  
One Year ◽  
The One

Abstract. Background: There is a constant increase of joint arthroplasties to improve the quality of life of an ever-aging population. Although prosthetic-joint infections are rare, with an incidence of 1-2%, they represent a serious complication in terms of morbidity and mortality. Infection related mortality is known to be approaching 8% at one year. The aim of this retrospective study is to reassess the one and two-year mortality over the last ten years.Methods: Patients treated for prosthetic joint infection at the University Hospital of Lausanne (Switzerland) between 2006 and 2016 were included. The one and two-year cumulative mortality depending on sex, age, type of prosthesis, infecting organism and type of surgical treatment were computed.Results: 363 patients (60% hips, 40% knees) were identified with a median age of 70 years. The one-year cumulative mortality was 5.5% and it was 7.3% after two years. No difference was seen between hip and knee prostheses, but the mortality was higher in men than in women and increased with age. Furthermore, there was a significant difference depending of the germ with enterococci infections associated with a higher risk of death. Finally, patients treated with a one-stage or two-stage exchange had a lower mortality than those treated with debridement and retention.Conclusion: The mortality is still high and differs according to sex, age, infecting organism and type of surgical treatment. There is a need of studies to improve the management of patients at risk of increased mortality.

scholarly journals One-Year Clinical Evaluation of the Bonding Effectiveness of a One-Step, Self-Etch Adhesive in Noncarious Cervical Lesion Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Babacar Faye ◽  
Mouhamed Sarr ◽  
Khaly Bane ◽  
Adjaratou Wakha Aidara ◽  
Seydina Ousmane Niang ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Retention Rate ◽  
Recall Rate ◽  
Acid Etching ◽  
Significant Difference ◽  
Usphs Criteria ◽  
One Step ◽  
One Year ◽  
The One ◽  
Self Etch

This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching.

scholarly journals An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programme in Nigeria

2020 ◽  
Author(s):  
Ogochukwu Kelechi Onyeso ◽  
Joseph O Umunnah ◽  
Charles Ikechukwu Ezema ◽  
Joseph A Balogun ◽  
Chigozie Uchenwoke ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Economic Cost ◽  
Educational Programme ◽  
Medical Rehabilitation ◽  
Musculoskeletal Imaging ◽  
Significant Difference ◽  
Level Of Training ◽  
One Year ◽  
The One ◽  
Training Programmes

Abstract Background: Previous studies have shown that deficiency in training may lead to inappropriate utilisation of diagnostic imaging among healthcare professionals, thus, raising concerns about patient safety and economic cost. This study aimed to evaluate the nature and level of musculoskeletal imaging (MI) training received by physiotherapists who graduated from Nigerian universities and completed the one-year mandatory internship. Methods: An online version of the Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), which was previously validated, was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board’s (MRTBN). Data were obtained on demographics, nature, and level of training on various MI modalities using the PMIPQ. Descriptive statistics, Friedman’s ANOVA, and Kruskal-Wallis tests were used for the data analysis at P ≤ 0.05. Results: The results showed that only 10.0% of the respondents had a standalone undergraduate course in MI, 92.8% did not have any MI clinical posting exposure during the internship, and 67.3% had never attended any MI workshop. There was a significant difference in the level of training received across various MI modalities [χ2 (15) = 1285.899; P = 0.001]. However, there was no significant difference in the level of MI training across the institutions (P = 0.36). The study participants with Doctor of Physiotherapy (DPT) education were better trained in MI than their counterparts with a bachelor’s degree (P = 0.047). Conclusions: The self-reported level of MI training among the respondents was deficient, but the knowledge of X-ray was significantly higher than other MI modalities. Based on the overall findings in this study, we recommend that diagnostic imaging contents be introduced early in the current and future physiotherapy training programmes.

Aspects of Lactation in the Platypus, Ornithorhynchus anatinus (Monotremata), in Waters of Eastern New South Wales.

1983 ◽  
Vol 31 (6) ◽  
pp. 881 ◽  
Author(s):  
TR Grant ◽  
M Griffiths ◽  
RMC Leckie
Keyword(s):  
New South ◽  
New South Wales ◽  
Young Leave ◽  
South Wales ◽  
Ornithorhynchus Anatinus ◽  
Significant Difference ◽  
Lactating Females ◽  
One Year ◽  
The One ◽  
First Time

Female platypuses captured in waters of eastern New South Wales were found to be lactating between the months of October and March. Lactating females were most numerous in December, accounting for 64% of females captured. Non-lactating females were taken in all months, indicating that not all females breed successfully every year. There was no significant difference between the fatty acid complement of milk taken from a platypus lactating very late in the season and those of others sampled in December at the peak of the lactation season. Some evidence exists that females do not become reproductive until at least their second year of life. Some females were found lactating in consecutive years, and others lactated one year and not in the one following. Animals of over 9 years of age are known to breed. Most juveniles were captured in February, March and April, and it is suggested that the young leave the breeding burrows for the first time in late January through to March, and become independent from their mothers, who are ceasing lactation at that time.

Correlation Between MRI Findings and Clinical Impairment In Patients With Shoulder Adhesive Capsulitis: A Prospective Study

2020 ◽  
Author(s):  
Romain GILLET ◽  
Francois ZHU ◽  
Pierre PADOIN ◽  
Gabriella HOSSU ◽  
Aymeric RAUCH ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Adhesive Capsulitis ◽  
Mri Findings ◽  
Significant Difference ◽  
Clinical Impairment ◽  
Pain Duration ◽  
One Year ◽  
The One ◽  
A Prospective Study

Abstract Objectives: MRI diagnostic criteria of shoulder adhesive capsulitis (AC) are widely used, but there is little information available on the association between MRI findings and clinical impairment. The aim of our study was to determine the correlation of MRI findings with the Constant-Murlay Score (CMS), pain duration, and symptoms at the one-year follow-up in AC patients. Methods: MRI of 132 patients with a clinical diagnosis of shoulder AC were prospectively studied. A radiologist examined all patients and completed the CMS just prior to MRI. Pain duration was assessed. The signal intensity and the maximal thickness of the inferior glenohumeral (IGHL) and coracohumeral (CHL) ligaments were measured by two radiologists. Medical record analysis was performed in a sub-group of 49 patients to assess correlation approximately one year after the MRI examination. Results: There was a significant difference in mean pain duration score (3.8 ± 1.2 versus 3.2 ± 0.9 and 3.8 ± 1.2 versus 3.2 ± 0.9 respectively for readers 1 and 2) and in mean mobility scores (15.7 ± 8 points versus 19.6 ± 10.1 points and 15.8 ± 8.2 points versus 19.4 ± 10 points respectively for readers 1 and 2) in patients with a high IGHL signal compared to those with a low signal (P < .05). IGHL was thicker in patients with clinical improvement at one-year follow-up compared to those presenting clinical stability or worsening (P < .05). Conclusion: In shoulder AC patients, the degree of signal intensity at the IGHL was inversely related to shoulder pain duration and range of motion, and a thickened IGHL indicated a favorable outcome at one-year follow-up.

scholarly journals Survival following orbital exenteration at a tertiary brazilian hospital

2016 ◽  
Vol 43 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Juliana Mika Kato ◽  
Fabricio Lopes da Fonseca ◽  
Suzana Matayoshi
Keyword(s):  
Survival Rates ◽  
Histological Diagnosis ◽  
Years Of Life Lost ◽  
Orbital Exenteration ◽  
Tertiary Referral Hospital ◽  
Average Survival ◽  
Significant Difference ◽  
The Face ◽  
One Year ◽  
The One

Objective: to analyze the epidemiology, clinical features and survival rate of patients undergoing orbital exenteration (OE) in a tertiary referral hospital. Methods : we conducted a retrospective study of all patients undergoing OE at the Hospital das Clínicas, FMUSP between January 2007 and December 2012. We collected data records related to gender, age, origin, length of stay, duration of the disease, other treatments related to the disease, number of procedures outside of the face related to the disease, follow-up and histological diagnosis. Results : we treated 37 patients in the study period. The average survival in one year was 70%, in two years, 66.1%, and 58.3% in three years. There was no significant difference in the one-year survival related to histological diagnosis (p=0.15), days of hospitalization (p=0.17), gender (p=0.43), origin (p=0.78), disease duration (p=0.27) or the number of operations for the tumor (p=0.31). Mortality was higher in elderly patients (p=0.02). The average years of life lost was 33.9 in patients under 60 years, 14.7 in patients in the 61-80 years range and 11.3 in patients over 80 years. Conclusion : the present series of cases is significant in terms of prevalence of orbital exenteration; on the other hand, it shows one of the lowest survival rates in the literature. This suggests an urgent need for improved health care conditions to prevent deforming, radical resections.

scholarly journals BLOOD PRESSURE TRENDS PRECEDING DEMENTIA: A STUDY OF HEART FAILURE PATIENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S959-S959
Author(s):  
Connor Wilson ◽  
Amanda Pangle ◽  
Jeanne Wei ◽  
Gohar Azhar
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Systolic Pressure ◽  
Dementia Diagnosis ◽  
Retrospective Case ◽  
Significant Difference ◽  
Diagnosis Of Dementia ◽  
Blood Pressures ◽  
One Year ◽  
The One

Abstract Blood pressure and perfusion of the brain are central components of neurological health that are often influenced by heart failure. This retrospective case-control study analyzed blood pressure changes preceding the diagnosis of dementia in patients over the age of 60. Blood pressures were obtained from the date of dementia diagnosis, and then one year and five years before diagnosis. Study “controls” were age-matched patients without dementia, using the mean age of dementia diagnosis as the first data point. Over the five-year period preceding diagnosis, 67.2% with dementia showed decreasing systolic pressure compared to 46.6% of patients without dementia. Similarly, 62.7% with dementia showed a decreasing systolic pressure over the one-year period, compared to 50.0% of those without dementia. Additionally, there was a significant difference (p &lt; 0.001) in the dementia rates between African American and Caucasian subgroups (55.0% African Americans vs. 31.0% Caucasians). Patients with dementia were more likely to have decreasing blood pressure trends than age-matched patients without dementia and appeared to have significantly lower blood pressures one year before the diagnosis. It is crucial that providers are cognizant of these trends and risk factors for dementia as they manage blood pressures in geriatric patients.

scholarly journals The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions

2015 ◽  
Vol 48 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Pedro Marinho Lopes ◽  
Luís Sepúlveda ◽  
Rui Ramos ◽  
Pedro Sousa
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Transrectal Ultrasound ◽  
High Rate ◽  
Prostate Biopsies ◽  
Specificity And Sensitivity ◽  
Significant Difference ◽  
Sextant Biopsy ◽  
One Year ◽  
The One

Objective: The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies. Materials and Methods: Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done. Results: In a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%). The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032). No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172). Conclusion: The high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule).

scholarly journals Short-Term Change in Occlusal Function after Using Mandibular Advancement Appliance for Snoring: A Pilot Study

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Hiroshi Ueda ◽  
Genki Watanabe ◽  
Atsushi Horihata ◽  
Myongsun Koh ◽  
Kazuo Tanne
Keyword(s):  
University Hospital ◽  
Mandibular Advancement ◽  
Short Term ◽  
Occlusal Contact ◽  
Short Term Change ◽  
Term Change ◽  
Significant Difference ◽  
The One ◽  
Mandibular Advancement Appliance ◽  
Adult Volunteers

The main aim was to evaluate the influence on occlusal contact area (OCA), maximum bite force (MBF), center of occlusal load (COL), and tooth pain after the nocturnal use of different mandibular advance appliances (MAAs) for snoring. Subjects were consisted of ten adult volunteers with mild snoring in Hiroshima University Hospital. Recordings of occlusal function were performed six times for two hours, that is, immediately and 5, 15, 30, 60, and 120 minutes after the nocturnal use of MAA. The subjects continuously scored their pain intensity on a 10 cm visual analogue scale (VAS) when MBF was measured. Comparing two MAAs, OCA and MBF were significantly larger in two-piece MAA than in one-piece MAA five minutes after removing the appliance. Significant difference in COL and VAS score compared to baseline disappeared more quickly with two-piece MAA than with one-piece MAA. In conclusion, it is shown that two-piece MAA could be superior to the one-piece one in terms of the degree side effect on occlusal function.

scholarly journals Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis

2020 ◽  
Author(s):  
Carmen Hidalgo Tenorio ◽  
Juan Gálvez ◽  
Francisco Javier Martínez-Marcos ◽  
Antonio Plata-Ciezar ◽  
Javier De La Torre-Lima ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Methicillin Resistance ◽  
Diagnostic Delay ◽  
Invasive Procedure ◽  
Study Objective ◽  
Infection Focus ◽  
History Of ◽  
One Year ◽  
The One ◽  
Related Mortality

Abstract Background: S. aureus(SA) infective endocarditis (IE)has a very high mortality, attributed to the age and comorbidities of patients, inadequate or delayed antibiotic treatment, and methicillin resistance, among other causes. The main study objective was to analyze epidemiological and clinical differences between IE by methicillin-resistantversusmethicillin-susceptible SA (MRSA vs. MSSA) and to examine prognostic factors for SA endocarditis, including methicillin resistance and vancomycin minimum inhibitory concentration (MIC) values >1 ug/mL to MRSA. Methods: Patients with SA endocarditis were consecutively and prospectively recruited from the Andalusia endocarditis cohort between 1984 and January 2017. Results: We studied 437 patients with SA endocarditis, which was MRSA in 13.5% of cases. A greater likelihood of history of COPD (OR 3.19; 95% CI 1.41-7.23), invasive procedures, or recognized infection focus in the three months before IE onset (OR 2.9; 95% CI 1.14-7.65) and of diagnostic delay (OR 3.94; 95% CI 1.64-9.5) was observed in patients with MRSA versusMSSA endocarditis. The one-year mortality rate due to SA endocarditis was 44.3% and associated with decade of endocarditis onset (1985-1999) (OR 8.391; 95% CI (2.82-24.9); 2000-2009 (OR 6.4; 95% CI 2.92-14.06); active neoplasm (OR 6.63; 95% CI 1.7-25.5) and sepsis (OR 2.28; 95% CI 1.053-4.9). Methicillin resistance was not associated with higher IE-related mortality (49.7 vs. 43.1%; p= 0.32). Conclusion:MRSA IE is associated with COPD, previous invasive procedure or recognized infection focus, and nosocomial or healthcare-related origin.Methicillin resistance does not appear to be a decisive prognostic factor for SA IE.

Sign in / Sign up

Export Citation Format

Share Document