Dental Issues Like Gum Disease

Dental Issues Like Gum Disease
Dental issues, like gum disease, do more than just affect your oral health. In fact, research shows
that heart disease and stroke are often associated with gum disease, and while no clear cause–and–
effect relationship has been proven by doctors just yet, studies show that gum disease directly
increases the risk of developing serious heart conditions. For this reason, the dentists at Kenton
Dental Care, Kenton, Ohio's leading center for family dentistry, say that routine dental exams along
with good oral hygiene habits are essential to fighting off gum disease and keeping your heart
healthy.
Gum disease, also known as periodontal disease, is a common condition among adults in the U.S.
and is the infection of the mouth's gum tissue, usually
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Infective Endocarditis Case Study
Lorma Colleges
City of San Fernando 2500 La Union
College of Nursing
NCM 103 First Semester School Year 2013 – 2014
Case Study: Management of Patients With Dysrhythmias and Conduction Problems
Abby, is 21 years of age and is a female patient who received a permanent atrial–ventricular
pacemaker for the diagnosis of sick sinus rhythm, a disorder that leads to periods of tachycardia and
periods of extreme bradycardia or sinus arrest. The nurse received the end–of–shift report and
arrives at Ms. Abby's's room where she assesses the patient's incision dressing on the upper left
chest and it is dry. The patient's left arm is edematous and ecchymotic and twice the size of the other
... Show more content on Helpwriting.net ...
Jeffa Hextee Jeco had her tongue and nose pierced 6 weeks ago. The drug screen is negative. She
presents with tricuspid insufficiency murmur grade II, and a temperature of 104°F. The patient
complains of extreme fatigue, and anorexia. The echocardiogram reveals vegetations on the
tricuspid valve.
1. What risk factors predisposed Ms. Waters to develop infective endocarditis? 2. Explain the
pathophysiology of infective endocarditis as it relates to this case. 3. What additional clinical
manifestations should the nurse include in the assessment of the patient? 4. What medical
management should the nurse anticipate for the patient? 5. What nursing management should be
provided for the patient and family?
Case Study: Management of Patients With Complications From Heart Disease
James Hitler is 72 years of age and is a male patient who is admitted with the diagnosis of acute
pulmonary edema secondary to acute left ventricular heart failure. The patient has a history of
coronary artery disease that has been treated medically. The patient is anxious, pale, cold, clammy,
and dyspneic. The vital signs are: BP 88/50, P 110, R 32, and T 97°F. There are bubbling crackles
and wheezing throughout the lung fields and the patient is raising frothy

Aortic Regurgitation Essay
AORTIC REGURGITATION
Aortic regurgitation(AR) refers to the failure of incompetent aortic valve to prevent the flow of
blood from aorta back to the left ventricle.
HEMODYNAMICS:
The backward leak of blood from the aorta to left ventricle during diastole increases left ventricular
volume. The left ventricle accommodates extra volume of blood by increasing ventricular size. This
regurgitation leads to impaired forward systemic blood flow reducing cardiac output. Left ventricle
increases ejection during early part of systole to compensate this. In increased regurgitation, left
ventricular pressure increases, which may leads to increased left atrial pressure and pulmonary
congestion.
CLINICAL FEATURES:
 Asymptomatic in mild form.
 Palpitation, dyspnea on ... Show more content on Helpwriting.net ...
 High pitched decrescendo diastolic murmur.
DIAGNOSIS:
 ECG: Normal or left ventricular hypertrophy, diastolic overloading pattern of left ventricle.
 Chest X–ray: Enlargement of left ventricle.
 Echocardiography: Dilated aorta, enlargement of left ventricle.
 Droppler study determine the severity of AR.
TREATMENT:
 Calcium channel blockers.
 Prevention of infective endocarditis.
 Surgery: Aortic valve replacement by homograft or prosthetic valve.
AORTIC STENOSIS:
Aortic stenosis results due to narrowing of aortic valve or adjacent part of aorta. This leads to a
development of pressure gradient between left ventricle and aorta increasing the left ventricular
pressure and hypertrophy. It is very rare in children.
CLINICAL FEATURES:
Classical triad of exertional dyspnea, exertional angina and exertional syncope.
Fatigue, exercise intolerance.
Pulsus parvus et tardus (slow rising pulse).
Narrow pulse pressure.
Ejection systolic murmur.
DIAGNOSIS:

ECG: Left ventricular hypertrophy.
Chest X–ray: Cardiomegaly in case of CCF.
Echocardiography: Identify site of

Treatment Of Intravenous Drug Use
Abstract
Intravenous drug use is a dangerous, yet increasing activity around the world. Persons who inject
themselves with illicit drugs are at risk for several complications such as infection caused by
contaminated needles. These infections can be serious and often lead to hospitalization as well as
other health–related complications. A situation that often arises is determining the best type of
treatment for IV drug users who are being discharged from the hospital. Physicians and pharmacists
are commonly faced with choosing outpatient IV antibiotic therapy versus oral antibiotics when
treating infections caused by IV drug use. This presents an ethical dilemma, particularly concerning
the ethical principles of beneficence and ... Show more content on Helpwriting.net ...
Unfortunately, the trend in intravenous drug use has increased in recent years. Results from the 2013
National Survey on Drug Use and Health show that of individuals aged 12 or older in America,
current users of cocaine and heroin were approximately 1.5 million and 289,000 respectively
(Substance Abuse and Mental Health Services Administration, 2014). As the number of intravenous
drug users continues to rise, so does the risk of dangerous and potentially fatal complications that
are associated with illicit drug use. In this population, death rates are higher due to overdose, AIDs–
related mortality, and other blood–borne viruses (Mathers et al., 2013). Mortality rates remain high
even though precautions have been taken to reduce them. According to Lavender & McCarron
(2013), "Mortality in injecting drug users is up to 22 times higher than for the age–adjusted
population, despite increased provision of needle and syringe programs, reduced needle and syringe
sharing, and higher uptake of hepatitis B vaccination" (p. 511).
In addition to higher rates of mortality, intravenous drug users are at increased risk of infection.
Mertz, et al. (2008) stated, "Malnutrition, immunodeficiency, homelessness, and needle–sharing
contribute to a high infection rate in these patients" (p. 2). Common infections range from simple
cutaneous abscesses and cellulitis to more serious infections such as

Cardiovascular Disease Analysis
It is generally known that cardiovascular diseases (CVDs) rank as the first cause of death globally.
In 2012, around 17.5 million people died from CVDs representing 31% of total deaths, with about
7.4 million attributed to coronary heart disease and about 6.7 million to stroke. More than 75% of
these deaths occur in low– and middle–income countries(1).
HIV, on the other hand, constitutes another major global public health issue. It is estimated that, so
far, more than 34 million people have died from the disease(2,3). In 2014, 1.2 (980.000–1.6 million)
million deaths were attributed to HIV–related causes(2). The most HIV–affected region is Sub–
Saharan Africa, accounting for almost 70% of the global total of new HIV cases(2,4). In 2014, 25.8
... Show more content on Helpwriting.net ...
Coronary artery disease (CAD), pulmonary hypertension, myocardial diseases, endocardial disease,
arrhythmias, pericardial disease and cardiac tumors are conditions that may be encountered in HIV
positive patients(5). The presence of these conditions is related to geography, access to highly active
anti–retroviral therapy (HAART) and to the degree of immunosuppression. In Sub–Saharan Africa,
where access to HAART is limited and tuberculosis is endemic, the dominant forms of HIV–
associated heart disease are cardiomyopathy and pericardial tuberculosis(4). In developed countries,
where HAART is widely available and tuberculosis is uncommon, CAD is the primary cause of
disability and death in these patients(4). Lipodystrophy and metabolic syndrome are also mainly
present in developed regions(4). Rheumatic valvular heart disease remains prevalent in Africa,
however there is no evidence of increase in cases of infective endocarditis associated with HIV, as it
has been noticed in Spain, France and North America(4). This pattern might be related to the higher
prevalence of intravenous drug use (IDU) among HIV infected people in developed countries
compared to

Calcific Aortic Valve Essay
The heart valves physiological purpose is to maintain unidirectional, non–obstacle flow of blood and
mitral and aortic valves are in charge of pumping the blood, experiencing intense pressure, and
supporting higher biomechanical stress than pulmonary and tricuspid. 5 Therefore, they are more
affected by pathologies and degenerative processes while alterations in pulmonary or tricuspid
valves are less common and mainly related with genetic or fetal defects.
Diseases of native aortic valves have been linked to mechanical factors, for example, the sclerotic
lesions that occur in calcific aortic valve disease occur preferentially in the subendothelial space on
the aortic side of the leaflet, a region that is exposed to low shear stress and disturbed ... Show more
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7 Calcific aortic valve stenosis is the most common valvular pathology requiring valve replacement
and showing some evidence of aortic valve thickening known as valvular sclerosis.
Recent studies demonstrate convincingly that aortic sclerosis is not a passive, unregulated process,
but rather is an active cell–mediated process involving chronic inflammation and active calcification
11 because relies on the activation of pro–osteogenic signaling cascades, such as bone
morphogenetic protein and Wnt/b–catenin, for the induction and progression of disease (leads to
valvular calcification)
Valvular heart disease (VHD) is a major health problem that results in substantial morbidity and
death worldwide. In developing countries, VHD is primarily caused by the persistent burden of
rheumatic fever rather than degenerative pathology, and tends to affect younger individuals. 7
Several drugs can be used as short–term therapies to improve the health and condition of patients
with severe valvular pathologies, however in most cases the best option for correcting the problem is
to proceed with valve repair surgery and/or

Dental Clearance Research Paper
Healthcare teams often work together to augment the oral health of patients prior to cardiac surgery.
This is commonly referred to as dental clearance prior to cardiac surgeries in this essay; I will focus
on the rationale behind dental clearance for patients undergoing cardiac valve replacement. Dental
clearance is the process when the patients who are referred from the cardiac surgery division, are
assessed by the dental team for dental and oral concerns. And based on the finding the dentist might
recommend a treatment plan before clearing the patient. These might include but not limited to,
tooth extractions, dental hygiene, periodontal evaluation, fillings and oral surgery procedures.
According to the AHA(American Heart Association ) guidelines

Symptoms And Treatment Of Hospital Survivors
During the study period from 2006 to 2014, three hundred sixty patients with a definitive infective
endocarditis diagnosis were included. The mean age of the patients was 53 ± 13 (range 18–94). Two
hundred thirteen (59%) patients were male and one hundred forty seven were female. 80 of the 362
patients died during hospitalization and in– hospital mortality rate was 22% for the entire study. A
total of 295 (83%) of the patients were African American. 76patients had a previous episode of IE
(21%). At admission, the difference in the acute physiology (P=0.000) and chronic health points
(P=0.020), with similar age showed that the total APACHE II score had a significant difference
between in–hospital survivors versus deaths (P =0.001). The mean duration of hospital stay was
(24+–17) days (range of 2–112 days) with the mean length of stay in ICU (9+–14). During
hospitalization, 132 (37%) patients used vasopressor agents and 162(45.5) patients were on
mechanical ventilation. Clinical evaluation showed the most common symptom was fever (72%)
throughout hospitalization. Other manifestations were dyspnea (56%), edema (46%), chills (35%),
chest pain (32%), delirium (18%), headache (18%), sweating (16%), back pain (25%), weight loss
(10%), hemoptysis (5%) and abdominal pain (30 %). Physical examination revealed a new or
worsening murmur in 210 (60%) patients, skin lesions in 65(18.5 %), conjunctival hemorrhage in 9
(1%) and splenomegaly in 11(3%). Other classic signs of IE included

Prosthetic Valve Endocarditis
We read with great interest the paper by Richard van Valen and his colleagues that evaluated patients
with prosthetic valve endocarditis (PVE) due to opportunistic bacterial pathogen Propionibacterium
acnes (P. acnes). The authors should be congratulated for publishing the largest single–centre series
to date on the topic, as thus far the literature was dominated by single case reports. We would like to
add some thoughts on the microbiological aspects of PVE caused by this facultative anaerobic
species.
Diagnosis of PVE caused by this microorganism is often delayed due to oligosymptomatic and
nonspecific presentation, hence microbiological confirmation is pivotal for adjusting treatment.
Unfortunately, aside for establishing positivity of blood and/or tissue cultures, there is no further
elaboration on the microbiological techniques employed to diagnose P. acnes in this study, probably
due to its retrospective design. It would also be interesting to know the incidence of neurologic
symptoms in this case series of 13 patients, as these are more commonly observed in P. acnes PVE
than in any other type of infective endocarditis (x). ... Show more content on Helpwriting.net ...
acnes (up to two weeks). Recently it was shown that a technique that couples polymerase chain
reaction (PCR) with an an electrospray ionization mass spectrometry can be applied to heart valves
and prosthetic material to diagnose P. acnes with increased sensitivty and speed when compared to
culture methods (x). Still, one has to bear in mind the expensive equipment and cost–effectiveness
issues of implementing such technology in the diagnostic

Endocarditis Research Paper
VSD is a benign cardiac lesion the prognosis of which can be severely compromised with the
occurrence of infective endocarditis. Surgical repair reduces the risk but does not entirely excludes it
due to development of minor complications Right sided endocarditis is mainly a disease of
intravenous drug abusers. It can also occur in nondrug addicts. The incidence of right sided infective
endocarditis ranges from 5–10% in different series.. The majority of cases involve the tricuspid
valve [1]. Isolated pulmonary valve endocarditis is rare. It is assumed that its rarity is due to the low
pressure gradients within the right heart, the low prevalence of congenital malformations, the lower
oxygen content of venous blood, and the differences in the ... Show more content on Helpwriting.net
...
In our case, the patient responded to antibiotics and became asymptomatic within 4 weeks of
appropriate antibiotics, even though echocardiography showed only mild decrease in the size of
vegetation. As she was asymptomatic and inflammatory markerswere normalized, we did not
consider the option of surgery and put the patient on regular follow up. A review of the
publisheddata indicated that the role of surgery in isolated pulmonic valveendocarditis is unclear.
Recurrent pulmonary emboli are not anindication for surgery, which is only needed if fever persists
despite3 weeks of appropriate antibiotic treatment in the absence of a pulmonary abscess [6].
Surgical options include debridement ofthe infected area, vegetation excision with either valve
preservation or valve repair or valve replacement

Study Population And Clinical Data
STUDY POPULATION AND CLINICAL DATA
This study is a retrospective chart review of 360 patients with definite or possible Infective
Endocarditis according to modified Duke Criteria [1–2] who were admitted to Detroit Receiving
Hospital and Harper University Hospital in Detroit from 2006 to 2014. Both hospitals are teaching
hospitals in Detroit, Michigan. For a patient with repeated episodes of Infective Endocarditis, one
episode was only included at our institutions. Clinical, microbiological, and echocardiographic data
of all patients with definite IE were collected using a standard data collection form.
Analysis of Data
Analysis of data was conducted using the SPSS software system version 22. In table 1, bivariate
analysis was used to compare IE patients who died during admission versus those who survived to
hospital discharge.
Continuous variables were expressed as means ± standard deviation (SD) and binary regression
analysis was used to examine the associations between a continuous variable and a categorical
variable with two categories. Categorical variables were presented numbers (percentage) and the
association between them analyzed using The Chi–square test. Variables that achieved a P value less
than 0.10 in the bivariable analysis were included in the multivariable logistic regression model to
adjust the effects of any possible confounding variable. The independent predictors of the mortality
were selected using a backward stepwise.
RESULTS
During the study

La Insuficiencia Cardiaca ( Ic )
Insuficiencia cardíaca
La insuficiencia cardíaca (IC) es la incapacidad del corazón de bombear sangre en los volúmenes
más adecuados para satisfacer las demás del metabolismo; si lo logra, lo hace a expensas de una
disminución crónica de la presión de llenado de los ventrículos cardíacos.
La IC es un síndrome que resulta de trastornos, bien sean estructurales o funciones, que interfieren
con la función cardíaca. No debe confundirse con la perdida de latidos, lo cual se cesa, con el
subsecuente colapso hemodinámico, que lleva a la muerte. Debido a que no todos los pacientes
cursan con sobre carga de volumen en el momento de la evaluación por sobre el más anticuado
término insuficiencia cardiaca por sobre el más anticuado término insuficiencia cardíaca congestiva.
Epidemiología
La prevalencia de la insuficiencia cardiaca es elevada en países industrializados, debido a la mayor
edad de la población, la insuficiencia de hipertensión arterial y una mejoría en la sobrevida de las
enfermedades de la arteria coronaria, especialmente seguido de un infarto al miocardio. La tasa total
estimada gira entre 3 y 20 casos por cada mil habitante en personas mayores de 65 años, sube entre
30 y 130 por cada mil personas de esa edad, la tasa mortalidad de la IC en un año del diagnóstico es
de 35–45%.
La IC es una enfermedad común, costosa, incapacitante y potencialmente mortal. En los países
desarrollados, alrededor del 2% de los adultos sufren de insuficiencia cardíaca, pero aumenta en

Is Septic Arthritis A Potential Emergency? With...
Garcia–Arias et el argue Septic Arthritis is a potential emergency "with significant mortality and
morbidity".
The crew was called to an 80 year old lady with possible Septic Arthritis, who had a home visit by
GP this am, suffering with severe, constant pain and progressive swelling of the left knee, over past
two days. The GP would like her transported to Accident and Emergency for investigations re any
systemic infection or within the knee and other joints.
The crew entered the patients' house to find her in bed unable to weight bear. Her left knee appeared
red, swollen, and the skin was tight; it felt hot, was very tender to touch and the movement was
limited with minimal range of motion. She was also experiencing left hip ... Show more content on
Helpwriting.net ...
He is concerned she has Septic Arthritis following Endocarditis four months ago.
Other notable past history included Endocarditis four months ago, treated in hospital with IV
antibiotics; Type II Insulin dependent diabetes mellitus for eighteen years; Chronic Osteoarthritis for
more than twenty years; the stress of the death of her partner two months ago and a lack of family
supports nearby; and > 20 years ago Right Breast cancer & subsequent right mastectomy; lung
cancer with left partial pneumonectomy (previous smoker) and a laminectomy for scoliosis when 17
years old.
This patient has an extensive allergy list including Morphine, Penicillin, Cefaclor, Sulfonamides,
and Duloxetine; and her regular medications include Desvenlafaxine succinate (an extended release
anti depressant) 25mg mane; Celecoxib (Celebrex) 100mg mane; Insulin glargine (Lantus)
24units/mane; and Temazepam 20mg nocte
Acute septic arthritis is an infection within a joint. The infective agent can enter into the joint
through the blood supply, from a traumatic injury to the joint or from a previous infection (where
resistant organisms have survived treatment). The most common risk factors for joint infection is
generalised sepsis and penetrating trauma . Others include age older than eighty years (most cases of
septic arthritis occur in the elderly, >65 years = 12% of the population ); Diabetes; Rheumatoid
arthritis, Osteoarthritis or other

Clinical Overview Template ( Dental Pain )
CLINICAL OVERVIEW TEMPLATE (Dental Pain)
TERMINOLOGY
CLINICAL CLARIFICATION o Pain arising from the vicinity of the teeth1 CLASSIFICATION o
No formal classification exists, but may be categorized based on cause of pain2 o Tooth
 Dental caries
 Pulpitis
Reversible
Irreversible
 Trauma
 Cracked tooth syndrome
 Alveolar osteitis o Peridontium
 Dental hypersensitivity
 Pericoronitis
 Periodontal disease DIAGNOSIS CLINICAL PRESENTATION History
 Symptoms vary based on origin of pain2
 Dental caries
Pain generally localized, intermittent, moderate intensity, and dull.
May be aggravated by hot, cold, and/or sweet foods
 Pulpitis
Reversible o Pain generally localized, intermittent, severe intensity, and throbbing. o May ... Show
more content on Helpwriting.net ...
s
Pain at location of partially erupted tooth (most commonly 3rd molar), continuous, moderate to
severe intensity, and aching/throbbing
Aggravated by biting
 Periodontal disease
Pain localized to one or more affected teeth, dull ache, low intensity
Aggravated by eating
 Alveolar osteitis
Pain localized to tooth socket and sharp, deep ache
Typically occurs 4–5 days post–extraction Physical Examination2
 Surface of the gingiva may appear red, smooth, and shiny
 Gingiva may be receded in patients with dental hypersensitivity
 Tooth decay may be present if cause of pain is due to dental caries or reversible pulpitis

 Patient may have facial swelling
 Patients with pericoronitis have an impacted tooth surrounded by red gingiva
 Tooth may be mobile upon percussion in patients with irreversible pulpitis or periodontal disease
 Patients with alveolar osteitis have loss of clot and exposed bone CAUSES AND RISK
FACTORS Causes2
 Dental caries
 Pulpitis
Reversible
Irreversible
 Cracked tooth syndrome
 Dentinal hypersensitivity
 Pericoronitis
 Periodontal disease
 Alveolar osteitis Risk factors and/or associations Age
Adults age ≥65 years tend to have higher rates of periodontal disease than younger age groups3 Sex
Periodontal disease is more common in men vs women3 Genetics
Not applicable Ethnicity/race
Non–Hispanic blacks, Hispanics, American Indians, and Alaskan Natives tend to have the poorest
oral health relative to other racial

Heart Valve Infection
What is Heart Valve Infection in Cats?
The heart wall is composed of three separate layers: the inner endocardium, the middle myocardium
and the outer epicardium. When the endocardium becomes infected, infective endocarditis results,
causing infection in the inner heart wall and one or more heart valves. Any generalized infection can
cause an infection in this portion of the heart.
Though the condition is rare in cats, the complications of it can lead to heart failure and death.
Prompt treatment of the underlying infection is necessary in order to save the cat's heart and life.
Symptoms of Heart Valve Infection in Cats
Symptoms can differ in type and intensity depending on the site of the initial infection, the health of
the heart and complications ... Show more content on Helpwriting.net ...
An echocardiogram (ECG), which is an ultrasound of the heart, will be performed. The
echocardiogram can show the veterinarian any inflammation that may be present as a result of the
infection and show how the heart is functioning. As blood cultures are only positive in 50 to 90
percent of cases, the ECG is the most important diagnostic tool in heart valve infection cases. An
electrocardiogram (EKG) may also be done. An EKG shows the electrical activity in the heart and
can show any skipped heart beats or palpitations that are occurring.
Treatment of Heart Valve Infection in Cats
Fluid Therapy
Cats who have been diagnosed with infective endocarditis will need to be hospitalized for treatment.
Fluids will be administered intravenously to prevent dehydration and ensure that the other organs
have the fluids necessary to function properly. The veterinarian will monitor the fluid's effect on the
other organs, such as the kidneys and lungs, if the heart isn't pumping properly.
Antibiotic Therapy
Antibiotics will need to be given for approximately 12 weeks in order to clear the underlying
infection that caused the infective endocarditis. A generalized antibiotic will be given until the blood
culture has identified the infectious organism and the proper antibiotic to treat

Heart Valve Diseases: A Case Study
Heart valves are tissue paper thin membranes attached to the heart wall that constantly open and
close to regulate blood flow. The heart has 4 valves: Mitral and tricuspid valve, which control blood
flow from the atria to the ventricles and aortic and pulmonary valve, which control blood flow out of
the ventricles. A normal, healthy heart valve minimizes any obstruction and allows blood to flow
smoothly and freely in one direction. It closes completely and quickly, not allowing any blood to
flow back through the valve. (Rongrong et al, 2016).
Heart valve diseases occur when one or more of the heart valves is damaged. The causes include
degenerative valve disease, calcification due to aging, coronary artery disease, rheumatic fever,
congenital ... Show more content on Helpwriting.net ...
The current general recommendation for patients older than 60 to 65 years is a bioprosthetic valve
and for patients less than 60 to 65 years is a mechanical valve. Patients older than 65 years typically
do not outlive the life expectancy of a tissue valve. Therefore, implanting a tissue valve in an elderly
patients can avoid anticoagulation and risk for bleeding. . Patients younger than 50 years are more
likely to experience structural valve deterioration and a need for reoperation; so mechanical valves
are generally recommended for younger patients. (Tilquist and Maddox

Curricular Infection: A Case Study
TREATMENT GOALS o Maintain clinical stability until patient receives definitive treatment by a
specialist o Refer patient to appropriate specialist depending on severity of condition and presence
of comorbidities DISPOSITION
Admission criteria o Admission to the hospital is recommended for patients with:8 o Severely
immunocompromised status o Poorly controlled diabetes mellitus o Tuberculosis o Severe viral
infections o Severe vesiculobullous disorders
Criteria for ICU admission o Patients with life–threatening emergencies from spread of infection to
the cervical or fascial spaces in the head:2,8
 Compromised airway
 Significant facial swelling or trismus
 Signs of systemic infection or sepsis Recommendations for specialist referral ... Show more
content on Helpwriting.net ...
12 Bard–Parker knife and drained of pus and bacteria Indication
 Small to moderate abscess that is palpable Contraindications
 Extremely large abscess that would require extensive debridement and irrigation
 Deep abscesses that are difficult to access without more invasive surgery Interpretation of results
 Reduction of swelling and pain indicates successful procedure; however, prompt dental
consultation recommended for definitive treatment Co–morbidities
 Antibiotic prophylaxis recommended 1 hr before dental procedure that involves manipulation of
the gingiva, periapical region of teeth, or perforation of the oral mucosa in the patients with:14
Prosthetic cardiac valve
History of infective endocarditis
Congenital heart disease
Unrepaired cyanotic congenital heart disease
Repaired congenital heart disease with defects at the site
Cardiac transplantation recipients with history of cardiac valvulopathy
 Patients who have hypertension or congestive heart failure should not take NSAIDs for pain
relief12 Special

The Alchemist Personal Statement
Personal statement: These highly inspirational words from my favorite book "The Alchemist "have
always been great source of motivation for me, "When you really want something, all the universe
conspires in helping you to achieve it". I am from a small village in Sindh Pakistan. I completed my
preliminary schooling at a government school in my village then my parents sent me to city for
further education. It was a drastic change in my life and I faced many difficulties. I was living away
from my home, parents and siblings in Larkana city for my education. I facedfinancial and
emotional hardships throughout my teenage years. Something that was most comforting in the midst
of all the adversities I was facing was my dream, my passion, my enthusiasm ... Show more content
on Helpwriting.net ...
Teaching was the most gratifying, pleasant and effortless experience for me. My teaching enhanced
my confidence, wisdom, communication and leadership skills substantially. My students always
admired my interactive and creative ways of delivering core anatomy concepts to them. I happily
helped and facilitated them in the best way I could. I hope to polish my teaching skills further during
my residency by creating awareness among my patients by explaining them the pathophysiology,
management, long term prognosis and complications of their disease process in an easy and
comprehensible way, and also by guiding and educating my junior residents and students so we can
effectively work as a team to bring about constructive changes in our working environment and to
make it an enjoyable learning experienceI have a passion of taking up challenges and surpassing my
own capabilities to accomplish success in adverse circumstances. I have lived a life full of struggles
but my determination, conviction and faith never declined. I became more zealous and hardworking
with time. . I aspire to become a competent and successful physician in the future and most
importantly, a good human being and a valuable asset to the

Myocardial Infarction: Heart Attack
Myocardial infarction, commonly referred to as "Heart attack" refers to the death of cardiac muscle
as a result of prolonged severe ischemia.
Myocardial ischemia is brought about by a number of mechanisms. It can occur due to diminished
coronary blood flow precedent to coronary artery disease or relatively severe hypovolemic shock.
Increased myocardial demand due to exercises or emotions can also result in myocardial ischemia.
Another mechanism is when there is hypertrophy of the heart without simultaneous increase of
coronary blood flow that may occur in conditions such as hypertension or valvular heart disease.
Myocardial infarction in most cases is usually experienced in the setting of coronary artery disease.
A sequence of events is followed

Systolic Murmur Research Paper
A murmur is a series of vibrations of variable duration that is able to hear with a stethoscope at the
chest wall during a heart auscultation, that emanates from the heart or great vessels. A systolic
murmur is a murmur that begins during or after the first heart sound and ends before or during the
second heart sound. Certain clinical features common to all murmurs must be defined in the patient
with a systolic murmur. These characteristics are intensity (loudness), frequency (pitch), quality,
duration, configuration, primary location (point of maximum intensity), and site(s) of radiation.
Localizing their point of maximum intensity may aid greatly in determining their site of evolution.
Not all heart murmurs radiate; however, when it occurs,

Psychiatric Mental Health Nurses: A Case Study
The average salary for APRNs in Ohio is 96,520 dollars (Bureau of Labor Statistics [BLS], 2015).
Psychiatric–mental health nurse practitioner makes an average salary of 89,903 dollars
("Indeed.com," 2017). This figure does not include the benefit and other miscellaneous cost
associated with hiring new employment such are training cost, physical, and drug screening.
The return of investment for every dollar spend is four to seven dollars saving reduced drug–related
crime, criminal justice costs, and theft (NIDA, 2012, p. 11). Related to healthcare cost, it is
estimated 12 dollars return for every dollar spent (NIDA, 2012, p. 11). These benefits are improved
society and not directly benefit RHH.
RHH personality needs to see direct bereft to invest on this epidemic. The direct benefit includes
cost reduction, increase patients satisfaction, and employee satisfaction. These benefits will be
discussed below as follows.
The chance of patients with heroin addiction not having health insurance is about 60% (CDC, 2015).
It is mostly likely RHH is not get reimbursed for the treatment. In 2013, the cost of valve
replacement surgery was more than 150,000 US dollars (Benjamin et al., 2017). This figure does not
include other costs such as post–surgery follow–ups, complications, and additional treatment for a
deterioration of ventricular function or ... Show more content on Helpwriting.net ...
If psychiatric–mental health nurse practitioner established treatment plans with clear expectation,
both party will know the plan and will have a goal to achieve. There will be minimal disagreement
since the limits are set and expectations are clearly stated upon admission. The patients also get a
treatment that geared toward accomplishing absences. In general, the patients and caregivers
relationship will be improved which ultimately increase

Infective Endocarditis Case Study
Since it has been determined by researchers that causative agents of infective endocarditis play a
major role in treatment, it is important to know what exact causes those are. In a study by Zauner et
al. (2013), "IE–causing pathogens were Staphylococcus aureus, viridans streptococci, enterococci,
streptococci, coagulase–negative staphylococci, and miscellaneous pathogens" (637). Depending
upon the organism that infects the heart, there are different outcomes. For example, those infected
by staphylococcus aureus suffered noticeably higher sepsis rates, or severe blood infections. S.
aureus also tended to cause more cases of emboli activity, or blockages in the bloodstream. In
contrast, other organisms affected the body differntly. On ... Show more content on Helpwriting.net
...
For many patients, surgery is performed on the damaged valves. Surgery types differ for each
individual depending upon which valves were affected, how severely they were infected, and if
valves had previously been replaced artificially. Before surgery, patients must undergo a series of
strenuous tests and careful assessments to be sure he or she qualifies for surgery. In a particular
study, several patients were able to undergo valve replacement surgery. In a specific study, following
surgery, patients spent time in a rehabilitation center and had frequent, regular check–ups with the
health care team. Thankfully, 90% of patients that survived the surgery had significant
improvements. Limited functioning was only prevalent in 10% of the post–surgery group. In total,
there were 80 people in the study, and ten of them died. Few passed away before and during surgery,
while 7 of them died within one month after surgery (Rostagno et al., 2011). Factors that were
related to death were: old age, lack of function in the left ventricle, and intense body wide infection.
Overall, it has been concluded that the survival rate after surgery is rather high (70–85%) with a low
chance of recurrence (Rostagno et al.,

Bodily Piercing and Tattooing
Bodily piercing and tattooing are regarded to some as art or adornment, to others, a purposeful
religious sentiment. Many individuals fail to entirely consider the fulminant risks associated with
penetrating subcutaneous tissue with foreign bodies. The human body is composed of complex
systems and mechanisms, which interact in order to maintain homeostasis. When deviancy disrupts
the bodily chemical reactions, the internal processes operating to uphold optimal living conditions
will be altered. The human body requires tight limitations of cell, tissue, organ, and organ system
activity in order to function properly. As humans, bodily piercings are considered foreign, unfamiliar
objects to our anatomy. Correspondingly, our bodies have been known to, at times reject these
piercings potentially resulting in medical ailments. In healthcare, providers are increasingly faced
with treating complications related to body piercing. (Ramman ) Ear and nose piercing are the
earliest documented styles of piercings dating from 1500 BC. African and American cultures
discovered oral piercings, including those of the lip and tongue. While the nipple and genital
piercings have been said to derive from ancient Indians. The contemporary way of life brought
about different styles and methods of piercing, such as surface piercing. The investigation of the
impact on health care providers and practice of bodily piercing has been researched and is
continuing to be examined currently. The hazardous

Infective Endocarditis Research
Infective endocarditis has been around for many centuries. A man named Lazaire Riviere, while
performing an autopsy, first discovered infective endocarditis in 1674 (Brusch, 2015). Since the first
findings documented were after death, there was still much research to do in this area of
cardiovascular science. William Olser was the first person to compile an in–depth explanation of
infective endocarditis in English in the year of 1885. Furthermore, in 1966, the first modern–times
symposium of infective endocarditis was developed as a series of journal articles by authors Lerner
and Weinstein, which was published in the New England Journal of Medicine (Brusch, 2015).
Although the understanding and research of this disease is well understood ... Show more content on
Helpwriting.net ...
In other words, would it be useful to diagnose infective endocarditis with the help of advanced
imaging tools to closely examine how the tissues and organs appear? Patients that were gram–
positive for certain bacteria were included in the study, and there were 72 people that underwent the
F–FDG PET/CT. Results were evaluated and determined by nuclear medicine physicians. Overall,
the study yielded that the sensitivity for diagnosing those with infective endocarditis using F–FDG
PET/CT was low; it was only 39%. Due to the low sensitivity, the value of using F–FDG PET/CT as
diagnostic criteria for those with infective endocarditis was deemed not satisfactory (Kouijzer et al.,
2013). Still, another study took a deeper look into ways of diagnosing infective endocarditis.
An additional study investigated the usefulness of histopathological findings in the diagnosis of
infective endocarditis. Histopathology is the study of tissues viewed under a microscope to
determine manifestations of disease. In countries outside of the United States, histopathological
findings are the gold standard in confirming infective endocarditis in humans. Researchers intended
to challenge this idea and see if histopathological findings really are the best form of diagnosing
infective endocarditis, and if those findings can stand by

Listeriaia Meningitis Research Paper
Listeriosis is predominantly a food–borne illness caused by the ubiquitous Gram–positive bacterium
Listeria monocytogenes, initially recognized as a foodborne pathogen in the early 1980s. People
most prone to the disease are pregnant women, newborns, elderly, and those with HIV or other
diseases that compromise immunity. Listeria infections are associated with a high mortality rate,
thus effective treatment and prevention are essential. Antimicrobial therapy Successful treatment of
listeriosis with ampicillin or penicillin as a monotherapy has been reported in the medical literature.
Nevertheless, since in vitro tolerance or even resistance to penicillin alone has been described, and
there are a plethora of studies showing in vitro synergy ... Show more content on Helpwriting.net ...
The bacteriemic and meningitic forms of listeriosis can be cured, but serious complications can
ensue despite prompt antimicrobial therapy. After the infection of central nervous systems, sequelae
such as strabismus, hydrocephalus and retardation may arise. Hence the best approach is to prevent
listeroisis from the get–go. General recommendations for prevention are the same as for other
foodborne infections, and include thorough cooking of raw food from animal sources, careful
washing of raw vegetables before cooking, the avoidance of unpasteurized milk, as well as adequate
hand hygiene. Those at increased risk of acquiring listeriosis should refrain from eating soft cheeses,
refrigerated pâtes, refrigerated smoked seafood, meat spreads, luncheon meats and deli meats
(unless they are cooked until steaming hot). Cross–contamination of other foods, utensils and food
preparation surfaces with fluids from hot dog packages should be

Explain What Is The Standard Regimen For Premedication
JOURNAL QUESTION (please include question prior to answering) What conditions require
preventative antibiotics (premedication) prior to dental treatment? What is the standard regimen for
premedication? According with the new guidelines of the AHA, the conditions that require
preventive antibiotics (premedication) prior to dental treatment are artificial heart valves, a history
of infective endocarditis, serious congenital heart conditions, and a cardiac transplant that develops
a problem in a heart valve. For patients that present one or more of these conditions the standard
regimen for premedication is 2 grams of amoxicillin orally, 30 to 60 minutes before procedure; and
for patients allergic to amoxicillin, 600 mg of clindamycin 30 to 60

Case Study Infective Endocarditis
Case Study #3
Management of Patients with Structural, Infectious, and Inflammatory Cardiac Disorders
Ariane Waters is 21 years of age and is a female patient who is admitted to the hospital with the
diagnosis of infective endocarditis. Ariane had her tongue and nose pierced 6 weeks ago. The drug
screen is negative. She presents with tricuspid insufficiency murmur grade II, and a temperature of
104°F. The patient complains of extreme fatigue, and anorexia. The echocardiogram reveals
vegetations on the tricuspid valve.
What risk factors predisposed Ms. Waters to develop infective endocarditis?
Body piercings can be major risk factors for infected endocarditis, especially the tongue piercing
since the oral cavity is a main port of ... Show more content on Helpwriting.net ...
Blood cultures should be negative, VS should be within normal limits and the patient should not be
showing s/s of heart failure at the time of discharge. Proper home care teachings will be provided.
What nursing management should be provided for the patient and family?
The patient and her family should be taught to monitor for s/s of heart failure (stated above). They
should be able to check for heart murmurs and assess VS for sign of infection–especially
temperature. She will need adequate rest. The patient and her family should both be educated on
aseptic technique to prevent an opportunity for more organisms to enter her body, especially during
treatment. Teaching should also include how to administer IV antibiotics safely and care of the
infusion site. The patient should be informed on proper oral care –such as brushing twice per day
with a soft tooth brush staying away from devices that could contain

Infective Endocarditis Case Summary
The patient, a 21–year–old female with infective endocarditis secondary to infective embolism. The
patient with cerebrovascular accident was a transfer towards tertiary hospital and rehabilitation
center. On admission she presents with dense left hemiplegia with minimal active movement at left
upper and lower limb.
Decreased sensation and hemi–inattention to left side. Bed mobility was very limited due to
hemiparesis and patient required full facilitation to roll and sit up. Patient initially appeared to have
mild cognitive deficit in terms of memory recall and planning. Patient also experienced difficult in
swallowing. She has a weight of 70kg with no allergies. Drug and treatment was antibiotics
intravenous penicillin units 6 hourly for 4 weeks. Gentamycin 160mg intravenously 12hourly for 7
days and continue with rehabilitation. ... Show more content on Helpwriting.net ...
Pain in right arm and left shoulder. During clinical presentation patient was not distressed or
anything blood pressure 114/76 mmHg, heart rate 96 beats per minute, respiratory rate 20 beats per
minute and saturation of 100%. General signs were pallor, weight loss, fever (Hammer & McPhee,
2014, pp. 69–72). Patient reports a history of difficult with regular bowel movements, which has
been an ongoing issue during her hospital stay.
The increase mobility (patient getting out of bed and moving around in wheelchair) there has been
an improvement. Initially patient's endurance was very poor, she could tolerate 15–20minutes of
treatment before tiring. Patient made some improvement with occupational therapist, she had a
wheelchair, thin positioner and a tray table. She is able to transfer her wheelchair with minimal
facilitation. Her wheelchair mobility is still limited because of difficult self–propelling with her right
arm and leg, but she is

Mitral Critical And Methods : Case Study
CLINICAL MATERIAL AND METHODS Patients The study population comprised of 135
symptomatic adult patients (aged 18 to 62 years) of severe rheumatic mitral stenosis, with or without
associated mitral regurgitation. Patients with concomitant moderate to severe aortic valve disease
were excluded from the study. Among the 135 study patients, 45 had evidence of severe
calcification of the mitral valve (Wilkins calcium score 3 or 4), 45 had mild to moderate
calcification (Wilkins calcium score 1 or 2) and 45 had no evidence of calcification (Wilkins
calcium score 0). A group of 45 healthy subjects served as control. Patients with chronic liver or
kidney disease (serum creatinine level >1.5 mg/dl),endocrine disorders affecting calcium
metabolism ... Show more content on Helpwriting.net ...
The left ventricular dimension and left atrial diameter were measured using two–dimensional
echocardiography in the parasternal long–axis view, and the left ventricular ejection fraction (LVEF)
was calculated using the biplane method. The pulmonary artery systolic pressure (PASP) was
estimated using the tricuspid regurgitation jet and the simplified Bernoulli equation(5b). Wilkins
calcium score system was assessed individually in all subjects to determine the severity of mitral
valve calcification (5c). Laboratory Measurements Baseline laboratory tests such as hemogram,
renal function, liver function and estimations of serum calcium/phosphorus were conducted in all
patients (blood samples were drawn from an antecubital vein using a 19–G needle, after an
overnight fast) on the same day, using commercially available methods and kits. For the assessment
of sclerostin, the serum was separated by centrifugation and stored as aliquots at –70°C until taken
for analysis. Serum sclerostin levels Serum sclerostin levels were measured in all four groups (i.e.,
severely calcified, mild to moderate calcified, non–calcified and controls) using a commercially
available human sclerostin ELISA kit (SEC864Hu, Cloud clone corporation, Houston, USA), which
is a sandwich enzyme immunoassay for the quantitative measurement of human sclerostin.
Histopathology Histopathological

Orthostatic Hypotension Case Study Essay
Case Study
Julia Atungsiri
Purdue University Global
Case study
1. What is the significance of the orthostatic hypotension, tachycardia, abdominal tenderness,
hematuria, joint pain, and petechiae? What is splinter hemorrhages and what is their significance?
Orthostatic hypotension is the reduction of the systolic pressure of at least 20mmHG or the dropping
of diastolic pressure of at least 10mmHg within three minutes of standing as compared to baseline as
such, the body is often unable compensate for the changes in the blood pressure values (Fournier et
al., 2016). The fall in the blood pressure is attributes to the fact that a small amount of blood collects
in the leg veins when a person stands as a result of gravity hence reducing ... Show more content on
Helpwriting.net ...
What are the major causes of infections?
References
Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., ... &
Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and
management of complications: a scientific statement for healthcare professionals from the American
Heart Association. Circulation, 132(15), 1435–1486.
Fournier, P. E., Watt, G., Newton, P. N., Lamas, C. C., Tattevin, P., & Raoult, D. (2016). Blood
culture–negative endocarditis. In Infective Endocarditis (pp. 245–258). Springer, Cham.
Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic
approach (p. 1056). Lippincott Williams & Wilkins.
Pettersson, G. B., Coselli, J. S., Hussain, S. T., Griffin, B., Blackstone, E. H., Gordon, S. M., ... &
Woc–Colburn, L. E. (2017). 2016 The American Association for Thoracic Surgery (AATS)
consensus guidelines: surgical treatment of infective endocarditis: executive summary. The Journal
of Thoracic and Cardiovascular Surgery, 153(6), 1241–1258.
Thuny, F. (2016). Diagnostic Criteria for Infective Endocarditis. In Infective Endocarditis (pp. 81–
86). Springer,

Oral Hygiene And Oral Health
The oral cavity is more often than not viewed as a separate entity than the rest of the body. This is a
mistake due to the overriding effect the mouth has on the rest of the body. This view needs to cease
immediately due to the fact that oral health affects what people eat, their quality of life, and their
speech.1 Oral health also plays an important role with chronic diseases. Unfortunately, oral health
has not been a priority among many healthcare professionals, and this has lead to millions of
patients suffering from toothaches and over poor oral hygiene.2
Health policies should be dicussed to involove oral health using sociodental approaches to finding
out the needs and the practical risk factor approach for oral cavity health ... Show more content on
Helpwriting.net ...
There are few efficient dental care systems to cope with their problems, and where there are, the cost
is beyond most people's means. Many people have untreated carries yet healthcare workers continue
to loverlook this and focu on other parts of the body making oral health an afterthought.
Oral health affects people not just physically but also psychologically and it really influences how
they grow up in life.1 Denta caries takes away from people's quality of life. Pain, discomfort,
disfigurement, acute and chronic infections, and eating and sleep disruption as well as higher risk of
hospitalization, sre all in play when oral health is not tended to properly. With children, nutrition,
and weight gain are affected by propoer oral health care. Children will develop toothaces, which
leads to less eating, which leads to unhealthy habits for growing chilfredn. Poor helath care is like a
chain reaction of bad descisions. Poor oral health can also lead to poor sleeping habits which
decreases hemoglobin and a depressed erthyroctyre count. 3
In Brazil, in 2009, ninety per cent of pre–adolescents reported an issue related to oral health4. The
prevalence of dental pain was up to around thirty four percent among Brazilian teenagers. In the
United States, dental issues led to over 117,000 hours of school lost per 100,000 children.

The Common Urinary Tract Infection
Bacterial urinary tract infections represent the most common type of nosocomial infections. Often,
the ability of bacteria to both establish and maintain these infections are directly related to biofilm
formation on indwelling devices or within the urinary tract itself (30). Enterococci (especially E.
faecalis) are one of the main causative agents of urinary tract infection and Catheter–associated
urinary tract infections (CAUTIs) besides gram–negative pathogens (31, 32). In these infections
Biofilm provides a favorable milieu for microbial survival within the host as the organisms are
shielded from the host immune response, as well as antibiotics and antimicrobial agents (33, 34).
Several studies conducted to introduce main virulence genes of enterococci that are associated with
biofilm formation in these bacteria (11, 13,–17), but virulence mechanism and related genes for
biofilm formation are not well understood (35). In this study we investigated biofilm formation of
clinical enterococci isolates isolated from Urinary tract infections. These strains were characterized
for presence of adhesions and secretory virulence factors. Isolates had diverse presence of virulence
from lack to highest amount of virulence genes. Several previous studies investigated relation of
virulence genes and biofilm formation, especially presence of esp and gel. Enterococci esp has been
implicated as a contributing factor in colonization and persistence of infection within the urinary
tract

NICE Review Essay
Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of
infective endocarditis: before and after study: A Review Thornhill et al.'s article on the cessation of
antibiotic prophylaxis and its impact on infective endocarditis examined, both, prescriptions for
antibiotics of a standard premedication dose (3g amoxicillin or 600mg clindamycin) and diagnoses
or deaths due to infective endocarditis between January 2000 and April 2010. The time frame
chosen for this study was critical due to the release of updated NICE guidelines, stating providers
should cease use of any antibiotic prophylaxis for dental and other medical procedures. By
examining the time surrounding the NICE guidelines, the researchers hoped to evaluate any
relationship between premedicative prescriptions and incidents of infective endocarditis. They
hypothesized that in order to see evidence that the NICE guidelines were valid, there would be
minimal to no change in rate of infective endocarditis after the NICE guidelines became effective
compared to before, even though the amount of prescription decreased. The researchers felt that this
study was necessary due to the limited large–scale studies relating to recent changes in ... Show
more content on Helpwriting.net ...
The two most significant weakness related to the lack of specificity in etiological origin of the
endocarditis, and an expanded discussion in relevance of results. The researchers explained that due
to gathering their data from hospitals there was often a lack in specificity of microorganism
identification in the codes submitted. More importantly, the researchers largely discussed the
limitations in their study, rather than discussing the uses and significance of the article. While it is
good to identify possible sources of error, the researchers overly focused on this, decreasing the
confidence for readers in their

Infective Endocarditis
Infective endocarditis is the inflammation of the damaged parts of the heart due to an infection
usually from elsewhere in the body. In this disease the endocardium (the inner lining of the heart) is
inflamed and can lead to damaged heart valves and to other life–threatening complications. William
Osler was the first one to recognize this disease and gave a name to it in 1885 in his Gulstonian
lectures.
When a patient's heart has a defect or a part that is not as strong as the rest then that part is
susceptible to infective endocarditis. This tends to come from blood flowing from a higher pressure
area in the heart to a lower pressured area. This causes an 'indention' in the heart's endocardium that
collects deposits. When patients have bacteremia, the presence of infectious bacteria in the blood,
the bacteria often fall into these 'indentions' and start to collect. Once they have started to collect
they will multiply and are called vegetation.
Once vegetation happens there is an increased risk of having an abnormal alignment in the valve
that the vegetation is around. This can cause a decreased blood flow or even a blocked valve. This
may cause emboli to escape from the heart and head to other sections of the body (i.e. the lungs or
the brain) depending which valve is being effected. Different ways that the bacteria can get in the
blood are: dental procedures, skin rashes, infections, abscesses, invasive procedures, and surgeries.
The nursing process should be

##anine Esterification Of Manotoxins : A Case Study
Two of the characterized mutants are affected in the major autolysin (atlE) and in D–alanine
esterification of teichoic acids (dltA). It is known formally as staphylococcal scalded skin syndrome.
The genetic and molecular basis of biofilm formation in staphylococci is multifaceted. The disease
occurs predominantly in children but can occur in anyone. Before antibiotics were available, about
80% of people with S. The enterotoxins and TSST–1 are associated with toxic shock syndrome.
Skin infections and superficial infections, in general, are readily cured with antibiotics. Previous
Next:
What is the prognosis for staph infections?The prognosis or outcome of staph infections depends
upon the type of infection that is present as well as ... Show more content on Helpwriting.net ...
This allows blister formation and sloughing of the top layer of skin. The gene for PVL was found in
the minority of both groups. Coagulase–negative staphylococci, particularly S epidermidis, produce
an exopolysaccharide (slime) that promotes foreign–body adherence and resistance to phagocytosis.
In a study of 42 S lugdunensis isolates, most isolates were able to form at least a weak biofilm, but
the amount of biofilm formed by isolates was heterogeneous with poor correlation between clinical
severity of disease and degree of biofilm formation. ica expression is modulated by various
environmental conditions, appears to be controlled by SigB and can be turned on and off by
insertion sequence (IS) elements. aureus sepsis died from complications of the condition. It is
necessary to treat scalded skin syndrome with intravenous antibiotics and to protect the skin from
allowing dehydration to occur if large areas peel off. PVL is associated with necrotic skin and lung
infections and has been shown to be a major virulence factor for pneumonia and osteomyelitis.
Proteins have been identified that are also involved in biofilm formation, such as the accumulation–
associated protein (AAP), the clumping factor A (ClfA), the staphylococcal surface protein (SSP1)
and the biofilm–associated protein (Bap).

Pros And Cons Of Dental Care In Hong Kong
1) Please discuss how dental health service are provided to the people of Hong Kong and critically
appraise the pros and cons of dental care in Hong Kong. In Hong Kong, the dental service is
provided to the citizens in two ways: The Governmental service and the Non–governmental service.
Overall, the private practitioners account for the majority of dental service. There are four
components of the Governmental service: First, it is the Oral–Health–Education–Unit, which
promotes awareness of oral health and the practices of ora hygiene. Second, it is the School–Dental–
Care–Service which provides the primary school kids the preventive and basic dental care. Third, it
is the Government–Dental–Clinics, which provides the civil servants and their relatives the dental
service. Also it provides all ... Show more content on Helpwriting.net ...
As a result, a person may not feel being well in terms of social and mental health. 3) How does the
dental care team carry out infection control in the dental clinic? For Hand hygiene, the dental care
team requires all visitors to wash hand with Hibiscrub. As for dentist themselves, no rings or
decorations are allowed so as to reduce the colonization of bacteria on hands. They are required to
wash hand at least 3 times during each session. When performing service, there should only be a
one–direction hand movement along the 3 zones, from clean to working to dirty zone, in order to
prevent contamination of sterile instruments. For Immunization, the dental care team needs to have
vaccination for diseases such as hepatitis B and Influenza because some patients may not reveal the
truth that they have those diseases. For Medical history, the dental care team takes medical history
of patients and the record should be updated each time so that the dentist can stay alert to the
medical problems and avoid adverse effect to both the patients and the

Essay On Infective Endocarditis
National statistics of maintaining a lifestyle of poor diet, little exercise, and frequent drug use are
steadily climbing. Increases in lipid and cholesterol intake, as well as decreases in regular physical
activity is causing an increase in obesity and disease with widely known effects. 1 These behaviors
are deeply rooted in the cause of heart diseases. It has been shown through animal testing that a high
lipid, calcium, and carbohydrate increases the incidence of aortic valve hardening, thickening, and
lipidemic lesion formation. 2 Obesity is alarmingly prevalent in children at or below the age of five.
In fact, the World Health Organization (WHO) approximates that 18 million children in this age
group are overweight with high risk of becoming ... Show more content on Helpwriting.net ...
Infective endocarditis is an infection of microorganisms, whether it be bacterial or viral, which form
colonies within the endothelial lining of the heart tissue. This initiates an immune response that
causes the infected sites to grow. Figure 1 8 shows vegetations on the aortic valve which prevent it
from functioning properly. Without the ability to fully seal during diastole, blood is pulled back
through the aortic valve from the aorta. This disrupts the pressure in the left ventricle in such a way
that creates unnecessary stress on the muscle. Infective endocarditis that is present on the right side
of the heart (including the aortic valve) is of highest incidence within the population of recreational
intravenous drug users at 46% – 78% of reported cases. 9 The risk of infective endocarditis causing
vegetation on and around the aortic valve increases after valve replacement surgery. A study done in
Australia observed 2443 aortic valve replacement surgeries, taking into consideration their pre–and–
post–operation condition. Of said patients, 3.7% developed infective endocarditis. All valve
prostheses were either of allograft (human), xenograft (porcine, bovine, or equine), or mechanical
design (composite synthetics), the xenograft being the most popular.

Causes And Treatment Of Infective Endocarditis
Before discussing Infective Endocarditis, it's imperative to understand where the endocardium is
along with its function because endocarditis affects this area of the heart. The Endocardium is the
innermost layer of heart tissue that lines the cavities and valves of the heart and is composed of
loose epithelial and connective tissue. The endocardium regulates contractions of the heart and helps
regulate the composition of the blood that feeds the tissues of the heart (Kenney, 2015). Infective
Endocarditis, IE, is an infection of the endocardium that generally occurs when bacteria or germs
from another part of the body, such as the mouth, spread through the bloodstream and attach to
damaged areas in the heart (Endocarditis Definition, 2015). Individuals that have an increased risk
of developing Endocarditis include:
Those with Pacemakers or Implantable Cardioverter–Defibrillator (ICD)
Individuals with existing conditions of the heart valves
HIV (What Increases Your Risk of Endocarditis?, 2015).
Diabetes Mellitus and long term hemodialysis (Infective endocarditis in adults, 2001).
According to the American Heart Association, endocarditis affects twice as many men as women
and eight times as many older men as older woman. More than a quarter of all cases occur in
individuals that are older than 60 years of age (Heart Valves and Infective Endocarditis, 2014). In
the United States alone, national data indicated that in 2009 there were up to 28,000 hospital

Chronic Hepatitis C Case Study
Chronic hepatitis C (HCV) is a common infection in injecting drug users and the prevalence of HCV
infection in this subpopulation is up to 60% (ROUX). Patients with infective endocarditis (IE) are at
higher risk of developing neurological complications such as cardioembolic stroke. In 10–50% of
patients with IE in the left heart, it may cause stroke, usually in the first two weeks of illness.
(GRECU) According to the latest recommendations the IE is diagnosed on the basics of
transthoracic and transesophageal echocardiography (HORSTKOTTE) but doubts of IE can be set
on the basis of Doppler ultrasonography of the carotid arteries and observed changes in blood flow
through the arteries that can indicate changes in the valves that may exist within

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