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

Define promoting food security to control under nutrition, Define Promoting...

Define Promoting food security to control under nutrition? Public distribution of food grains through a network of ration shops, particularly to reach the population below the

Explain point mutations gene, Explain Point Mutations gene? Mutations ...

Explain Point Mutations gene? Mutations involving single genes occur by addition, substitution, or deletion of a single base in DNA. Such mutations, called point mutations, ca

Write short notes on urine, Write short notes on Urine? The concentrate...

Write short notes on Urine? The concentrated filtrate produced by the kidney is called urine, and is composed mainly of water, urea, toxins, and mineral salts. Urine from the c

Cytological approach, Write an essay on cytological approach in taxonomy.

Write an essay on cytological approach in taxonomy.

Explain about selection of healing abutment, Selection of healing abutment ...

Selection of healing abutment It is done depending upon the tissue thickness. Tissue thickness can be measured similar to ridge mapping or sounding procedure, wherein after an

What is cytogenetics, What is Cytogenetics? Before the advent of modern...

What is Cytogenetics? Before the advent of modern technology, the American biologists Thomas Hunt Morgan, G.W. Beadle, H. Sturtevant, Barbara McClintock, and others contributed

Explain the absorption of itraconazole capsules, Explain The absorption of ...

Explain The absorption of itraconazole capsules It is decreased with concurrent use of drugs that reduce gastric acidity, such as antacids, H2-receptor blockers, proton pump in

Can you explain puffeelfish poisoning, Q. Can you explain Puffeelfish poiso...

Q. Can you explain Puffeelfish poisoning? Tetrodotoxin (TTX) causes pufferfish (tetrodon) poisoning, also known as blowfish poisoning or fugu. How does a pufferfish look l

Prevention of iron deficient anaemia, Prevention   You as nurse needs t...

Prevention   You as nurse needs to ensure that iron supplementation  is given to children who are at risk for iron deficiency.  Iron supplementation  should start between 4 and

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