scholarly journals Characteristics of infective endocarditis in a cancer population

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001664
Author(s):  
Cullen Grable ◽  
Syed Yusuf ◽  
Juhee Song ◽  
George M Viola ◽  
Owais Ulhaq ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Mortality Data ◽  
Limited Information ◽  
Tertiary Care Centre ◽  
Indwelling Catheters ◽  
Patients With Cancer ◽  
Duke Criteria ◽  
Immunocompromised State

BackgroundInfective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE.ObjectivesLimited information exists about IE in patients with cancer. We aimed to evaluate the characteristics of patients with cancer and IE at our tertiary care centre, including a comparison of the microorganisms implicated and their association with mortality.MethodsA retrospective chart review of patients with cancer who had echocardiography for suspicion of endocarditis was conducted. A total of 56 patients with a confirmed diagnosis of cancer and endocarditis, based on the modified Duke criteria, were included in the study. Baseline demographics, risk factors for developing IE, echocardiography findings, microbiology and mortality data were analysed.ResultsFollowing the findings of vegetations by echocardiography, the median survival time was 8.5 months. Staphylococcus aureus was the most common organism identified as causing endocarditis. The mitral and aortic valves were the most commonly involved sites of endocarditis. Patients with S. aureus endocarditis (SAE) had a significantly poorer survival when compared with patients without SAE (p=0.0217) over the 12-month period from diagnosis of endocarditis.ConclusionsOverall survival of patients with cancer and endocarditis is poor, with a worse outcome in patients with SAE.

scholarly journals Contemporary Pattern of Pediatric Infective Endocarditis from Tertiary Care Centre of Northern India: A Single Centre Experience

2021 ◽  
Vol 11 (01) ◽  
pp. e250-e254
Author(s):  
Dinesh Kumar ◽  
Shikha Garg ◽  
Dheeraj D. Bhatt
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Rheumatic Heart Disease ◽  
Tertiary Care ◽  
North India ◽  
Normal Heart ◽  
Tertiary Care Centre ◽  
Duke Criteria ◽  
Culture Negative ◽  
Rheumatic Heart

AbstractWith an increasing number of children with congenital heart disease (CHD) undergoing corrective treatments, improved pediatric intensive care, better antimicrobial treatments, and a relative decrease in rheumatic heart disease over the years, the epidemiology of pediatric infective endocarditis in India may be undergoing a change. The study was done in the department of pediatrics of a tertiary care teaching hospital of North India. A retrospective analysis of case records of children (<12 years) admitted with a diagnosis of infective endocarditis (IE) from January 2013 to April 2019 was performed. Modified Duke's criteria were used to diagnose IE. There were 21 children diagnosed with infective endocarditis during this period. The mean age at presentation was 70 months (range: 2.5–144 months). CHD (n = 13/21, 61.9%) was the most common predisposing condition. A total of 28% (6/21) patients had no preexisting structural heart disease. Nine percent (2/21) had rheumatic heart disease. Staphylococcus aureus was the most common etiological agent in those with a structurally normal heart. Most patients had blood culture–negative infective endocarditis (n = 12, 57.1%). Only one patient fulfilled Duke's major microbiological criteria. Six patients (28.57%) died during the hospital stay. Increasingly younger children are being diagnosed with infective endocarditis in India and a significant number of them are in the setting of a structurally normal heart. In view of high percentage of culture-negative endocarditis, the Duke criteria may need to be revised to retain their sensitivity in such settings.

scholarly journals Are patients with cancer with sepsis and bacteraemia at a higher risk of mortality? A retrospective chart review of patients presenting to a tertiary care centre in Lebanon

BMJ Open ◽  
2017 ◽  
Vol 7 (3) ◽  
pp. e013502 ◽  
Author(s):  
Gilbert Abou Dagher ◽  
Christopher El Khuri ◽  
Ahel Al-Hajj Chehadeh ◽  
Ali Chami ◽  
Rana Bachir ◽  
...  
Keyword(s):  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Patients With Cancer ◽  
Risk Of Mortality

Characterization, epidemiological profile and risk factors for clinical outcome of infective endocarditis from a tertiary care centre in Turkey

2019 ◽  
Vol 51 (10) ◽  
pp. 738-744 ◽  
Author(s):  
Hicaz Zencirkiran Agus ◽  
Serkan Kahraman ◽  
Cagdas Arslan ◽  
Gamze Babur Guler ◽  
Ali Kemal Kalkan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Clinical Outcome ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Epidemiological Profile

scholarly journals Prevalence of surgical site infection in general surgery in a tertiary care centre in India

2017 ◽  
Vol 4 (9) ◽  
pp. 3101 ◽  
Author(s):  
Ansul Kumar ◽  
Arpita Rai
Keyword(s):  
Surgical Site Infection ◽  
General Surgery ◽  
Surgical Procedure ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Exploratory Laparotomy ◽  
Site Infection ◽  
Tertiary Care Centre ◽  
One Year

Background: Surgical site infection (SSI) can be defined as an infection that is present up to 30 days after a surgical procedure if no implants are placed and up to one year if an implantable device was placed in the patient. SSI is a significant problem associated with major surgeries and is the 3rd most frequently reported nosocomial infection. This study aims to study the prevalence of SSI in the Department of Surgery, Rajendra Institute of Medical Sciences (RIMS), Ranchi.Methods: A retrospective study was undertaken at the Department of General Surgery for a period of one year. Retrospective chart review was conducted from the hospital database. The rate of SSI was studied in relation to its type, the type of surgical procedure and elective vs emergency surgeries.Results: The present study revealed 12.5% prevalence of SSI in Department of General Surgery, RIMS. Among the 3 types, superficial incision SSI was most prevalent followed by deep incisional SSI and finally by organ/space SSI. The surgical procedure most commonly associated with SSI was exploratory laparotomy. An alarming 17.7% of SSI was associated with emergency surgeries as compared to 12.5% of elective surgeries.Conclusions: The consequences of SSIs greatly impact patients and the healthcare systems. Prevention of SSI requires a multifaceted approach targeting pre-, intra-, and postoperative factors. It is imperative that facilities have open-minded management teams, regulatory agencies and medical associations that want to provide the foundation required to generate a culture of patient safety in our health care systems.

scholarly journals Challenges and perceptions of cancer patients attending a tertiary care center during COVID 19 Pandemic Era: Patient’s Perspective

2020 ◽  
Vol 11 (6) ◽  
pp. 15-20
Author(s):  
Yashna Gupta ◽  
Laxman Pandey ◽  
Pankaj Kumar Garg ◽  
Amit Sehrawat ◽  
Sweety Gupta ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Patient’S Perspective ◽  
Hospital Patients ◽  
Anticancer Treatment ◽  
The Government ◽  
Immunocompromised State

Background: Patients with cancer are more susceptible to acquire SARS-Cov-2 infection due to their immunocompromised state related to the disease and anticancer treatment. There is a lack of literature assessing the patient’s perspective of the present crisis and its impact on their treatment. Aims and Objective: The present study aimed to address the challenges and sufferings faced by patients with cancer during their treatment in the current COVID-19 pandemic era. Materials and Methods: A single-institute, cross-sectional questionnaire-based observational study was conducted in a tertiary care teaching hospital. Patients attending the Oncology outpatient department were enrolled in the study. Results: One hundred patients (64 males, 36 females) with a mean age of 47.17 years (range-24-71) participated in the study. The majority of patients (89%) were aware of the COVID 19 symptoms and did not confuse them with cancer symptoms. Most of them were aware of preventive measures like frequent hand washing, sanitizer usage, and face masks to reduce the risk of infection. Almost half of them encountered difficulties in commuting to the Hospital. Most (83%) of them were worried about treatment delay and disease progression due to the COVID-19 pandemic. Almost half of the patients (54%) were fearful of acquiring the infection from the radiotherapy machine and immobilizing devices. Two-third of the patients (64%) were afraid to carry the virus back to their homes. Awareness regarding our Hospital’s teleconsultation facility was limited among patients. Conclusion: The present study underscores the success of ongoing COVID-19 awareness programs run by the government. However, there is an urgent need to address the various challenges encountered by patients with cancer. The strengthening of telemedicine facilities may reduce the in-person visits made by the patients.

Evaluation of conventional troponin I testing for the detection of myocardial dysfunction in children

2020 ◽  
Author(s):  
Eimear McGovern ◽  
Christine Voss ◽  
Nicole M Hemphill ◽  
Shubhayan Sanatani ◽  
Vilte Barakauskas ◽  
...  
Keyword(s):  
Predictive Value ◽  
Myocardial Injury ◽  
Troponin I ◽  
Myocardial Dysfunction ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Primary Objective ◽  
Healthy Children ◽  
Clinical Predictors ◽  
Tertiary Care Centre

Abstract Objectives Troponin is a marker of myocardial injury but is not well studied in children. Our primary objective was to ascertain the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of conventional troponin I for the detection of acute myocardial dysfunction in previously healthy children. Our secondary objective was to identify clinical predictors of myocardial dysfunction in the setting of elevated troponin. Study Design This was a retrospective chart review in a single, paediatric, tertiary care centre of troponin tests performed in all admitted children over a 4-year period. Demographics, symptoms, signs, chest x-ray, ECG, and echocardiogram abnormalities were documented. Myocardial dysfunction was presumed to be absent when the patient had a normal cardiac assessment, with or without echocardiography, and did not re-present. Results From January 2014 through December 2017, 566 patients had troponin tested as a screen for myocardial injury. Troponin was positive in 38 of 566 cases (6.7%). Myocardial dysfunction was detected in 9 of 566 cases (1.6%). Troponin was elevated in six of nine cases of myocardial dysfunction. The sensitivity of conventional troponin I for detecting acute myocardial dysfunction was 66% (95% confidence interval [CI] 30 to 93%). The specificity was 94% (95% CI 92 to 96%). PPV was 16% (95% CI 6 to 31%) and NPV 99% (95% CI 98 to 100%). An abnormal ECG was more prevalent in patients with a true positive versus a false-positive troponin result (P=0.03). Conclusion Troponin testing identified few cases of myocardial dysfunction. We found the test to have only 66% sensitivity. Troponin testing as a screen for myocardial injury in children has limited utility.

Epidemiology, Molecular Mycology, and Environmental Sources ofFusariumInfection in Patients with Cancer

2002 ◽  
Vol 23 (9) ◽  
pp. 532-537 ◽  
Author(s):  
Issam Raad ◽  
Jeffrey Tarrand ◽  
Hend Hanna ◽  
Maher Albitar ◽  
Erle Janssen ◽  
...  
Keyword(s):  
Dna Analysis ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Uninfected Control ◽  
Cancer Center ◽  
Retrospective Case ◽  
Patients With Cancer ◽  
Random Amplification ◽  
Immunocompromised Status ◽  
Control Study

Objective:To investigate the epidemiology and environmental sources of Fusarium infections in patients with cancer.Design:Retrospective case-control study conducted following surveillance environmental cultures and DNA analysis of isolated organisms.Setting:A tertiary-care, university cancer center.Methods:In 1996 and 1997, environmental cultures were performed on air samples and water systems. A retrospective chart review was performed for 70 patients with cancer identified with fusariosis between 1987 and 1997. Patients with fusariosis were compared with 49 uninfected control patients who occupied hospital rooms with positive environmental cultures for Fusarium. With the use of random amplification of polymorphic DNA organisms isolated from infected patients were compared with environmental organisms.Results:Most of the patients with Fusarium (40, 57%) were infected on or within 3 days of admission, indicating community rather than nosocomial acquisition. Patients were comparable in terms of underlying immunocompromised status to 49 uninfected control patients. However, the duration from admission to infection in the patients with fusariosis tended to be shorter than the duration from admission to discharge in the exposed control patients (P= .06). Water cultured from the hospital tanks and from sinks and water fountains was negative for Fusarium. With the use of polymerase chain reaction, environmental isolates did not match clinical ones. Quantitative air sampling showed that the quantitative outdoor Fusarium levels were eightfold higher than the indoor levels. During the rainy summer season, outdoor air concentrations of Fusarium were at their highest, coinciding with the peak incidence of fusariosis at our center.Conclusion:The most likely source of fusariosis was the external environment rather than nosocomial sources, such as water.

scholarly journals Impact of Systematic Whole-body 18F-Fluorodeoxyglucose PET/CT on the Management of Patients Suspected of Infective Endocarditis: The Prospective Multicenter TEPvENDO Study

2020 ◽  
Author(s):  
Xavier Duval ◽  
Vincent Le Moing ◽  
Sarah Tubiana ◽  
Marina Esposito-Farèse ◽  
Emila Ilic-Habensus ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Fdg Pet ◽  
Tertiary Care ◽  
Management Plan ◽  
Whole Body ◽  
Duke Criteria ◽  
Pet Ct ◽  
18F Fdg ◽  
Duke Classification ◽  
Fdg Pet Ct

Abstract Background Diagnostic and patients’ management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients. Methods In sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients’ management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients’ management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established. Results Among the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P &lt; .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients’ managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32–48), which was most likely to occur in those with a noncontributing echocardiography (P &lt; .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV. Conclusions Systematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients. ClinicalTrial.gov identification number NCT02287792.

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