Risk of embolization, Biology

Assignment Help:

Systemic embolization occurs in 22 per cent to 50 per cent of cases of IE. Emboli often involve major arterial beds, including lungs, coronary arteries, spleen, bowel, and extremities. Up to 65 per cent of embolic events involve the central nervous system, and 90 per cent of central nervous system emboli lodge in the distribution of the middle cerebral artery. The highest incidence of embolic complications is seen with aortic- and mitral-valve infections and in IE due to S aureus and Candida species and HACEK and Abiotrophia organisms. Emboli can occur before diagnosis, during therapy, or after therapy is completed, although most emboli occur within the first 2 to 4 weeks of antimicrobial therapy. The rate of embolic events drops dramatically during the first 2 weeks of successful antibiotic therapy, from 13 to .2 embolic events per 1000 patient-days. In general, mitral vegetations, regardless of size, are associated with higher rates of embolization (25 per cent) than aortic vegetations (10 per cent). The highest embolic rate (37 per cent) has been seen in the subset of patients with mitral vegetations attached to the anterior rather than the posterior mitral leaflet and with vegetation size > 1 cm in diameter. Staphylococcal or fungal IE appears to carry a high risk of embolization, i.e., independent of vegetation size. Large vegetations independently predict embolic events only in the setting of streptococcal IE. The embolic event rate among patients with IE and increasing vegetation size was twice that of patients with static or decreasing vegetation size over 4 to 8 weeks of therapy.  The indications for surgery for persistent vegetation after systemic embolization are:

1) Anterior mitral leaflet vegetation, particularly with size  > 10 mm

2) One or more embolic events during first 2 weeks of antimicrobial therapy

3) Two or more embolic events during or after antimicrobial therapy

4) Increase in vegetation size after 4 weeks of antimicrobial therapy


Related Discussions:- Risk of embolization

Swine fever, S w i n e fever It is also known as hog cholera and re...

S w i n e fever It is also known as hog cholera and results in high fever and prostration. E t iology : Pestivirus belonging to family Togaviridae is responsi

Explain an overview of water soluble vitamins, Explain An Overview of Wate...

Explain An Overview of Water Soluble Vitamins? Vitamins, we already know, are classified by the materials in which they will dissolve. Fat-soluble vitamins -vitamin A, D, E a

Cartilage occur in a joint and what it its function, Where does cartilage o...

Where does cartilage occur in a joint and what it its function? Cartilage might be found covering the surface of bones where they meet in a movable joint. Cartilage decreases f

Poisoning, Poisoning: Poisoning  is a common medical emergency  in chi...

Poisoning: Poisoning  is a common medical emergency  in childhood. In children under 5 years of  age essentially all poisoning are accidental. Nearly 75 per  cent  of  all poi

What is iris coloboma, What is Iris Coloboma Coloboma is a congenital a...

What is Iris Coloboma Coloboma is a congenital abnormality due to non-fusion of the embryonic choroidal fissure. It can affect any part of the eye and may involve the optic ner

State the concept of finger tapping, State the concept of Finger Tapping ...

State the concept of Finger Tapping The subject is asked to tap his or her extended index finger on a typewriter key attached to a mechanical counter. Several series of 10-seco

Adults with infective endocarditis, Mitral valve prolapse (MVP) has emerged...

Mitral valve prolapse (MVP) has emerged as a prominent, predisposing structural cardiac abnormality and in adults accounts for 7 to 30 per cent of NVE in cases not related to drug

How the arrangement of cells helps with tissue functioning, Distinguish bet...

Distinguish between epithelial and connective tissues with respect to their cell arrangement? PROVIDE a specific example( for both tissue types) of how the arrangement of cells hel

Explain the communication process, Q. Explain the communication process? ...

Q. Explain the communication process? Communication is a process by which information is exchanged between individuals through a common system of symbols, signs, or behavior. C

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd