Infective endocarditis is an infection of the heart valves or endocardium. It has variable presentations ranging from acute and rapidly progressive to subacute and indolent. Key diagnostic criteria include identifying the infecting pathogen through blood cultures or other tests and detecting valvular vegetations or complications through echocardiography. Complications can involve the heart, brain, kidneys and other organs due to septic emboli. Treatment involves antibiotics and may require cardiac surgery.
A powerpoint presentation about infective Endocarditis, with the most recent updates from the most reliable sources. I highlighted an introduction, pathology, approach to disease & different management plans in this presentation. 2018. Please don't forget to give me credit to my work.
Diagnosis and Management of Infective Endocarditis
Modified Dukes Criteria
Imaging Modalities
Standard Treatment Guidelines
Organism Specific Antibiotic coverage
This document discusses infective endocarditis (IE), including its changing epidemiology, pathogenesis, clinical manifestations, diagnosis, complications, and management. Some key points:
- The median age of IE patients has increased to over 60 years old. Rheumatic heart disease is less common while intracardiac devices and nosocomial sources have risen.
- Vegetations form from platelet-fibrin deposition on damaged heart valves, allowing bacterial colonization and abscess formation.
- Echocardiography is important for diagnosis. Findings include vegetations, abscesses, and valve dysfunction. Blood cultures help identify causative organisms.
- Complications include heart failure, embolization, and periannular
This document provides an overview of infective endocarditis, including its definition, epidemiology, anatomy, pathogenesis, classification, etiology, risk factors, clinical manifestations, diagnosis, management, and complications. Infective endocarditis is a bacterial or fungal infection of the heart valves or endocardium. It most commonly affects the mitral valve and is usually caused by streptococci, staphylococci, or enterococci. It can be acute or subacute and is diagnosed using the modified Duke criteria.
Infective endocarditis is an infection of the heart valves or inner lining of the heart that is usually caused by bacteria entering the bloodstream. It can cause inflammation of the heart valves and formation of vegetations, which can lead to heart failure, embolic episodes, or death if not treated properly with antibiotics and sometimes surgery. The document discusses the definition, causes, clinical presentation, diagnosis, and treatment of infective endocarditis.
Infective endocarditis is a condition where the inner lining of the heart (endocardium) becomes infected by bacteria or other microorganisms. It typically occurs where there is pre-existing heart valve damage. The infection can cause heart valve damage and formation of clumps (vegetations) that can break off and spread through the bloodstream (embolize). Presentation depends on the causative organism and can range from non-specific fever to new heart murmurs or signs of embolization. Diagnosis is based on blood cultures and echocardiography, while treatment involves prolonged antibiotic therapy and may require heart valve replacement surgery. Risk factors include rheumatic or congenital heart disease, prosthetic heart
Infective Endocarditis - Indications of SurgeryZryanMejio1
Infective endocarditis is an infection of the heart valves or endocardium. Surgery is indicated for infective endocarditis in cases of heart failure refractory to medical management, persistent sepsis despite antibiotics, recurrent emboli, valve dehiscence, or abscesses. Diagnosis involves blood cultures, echocardiography, and clinical presentation. Treatment consists of antibiotics targeting the causative organism along with management of complications. Complete removal of infected devices is usually required for device-related infective endocarditis.
A powerpoint presentation about infective Endocarditis, with the most recent updates from the most reliable sources. I highlighted an introduction, pathology, approach to disease & different management plans in this presentation. 2018. Please don't forget to give me credit to my work.
Diagnosis and Management of Infective Endocarditis
Modified Dukes Criteria
Imaging Modalities
Standard Treatment Guidelines
Organism Specific Antibiotic coverage
This document discusses infective endocarditis (IE), including its changing epidemiology, pathogenesis, clinical manifestations, diagnosis, complications, and management. Some key points:
- The median age of IE patients has increased to over 60 years old. Rheumatic heart disease is less common while intracardiac devices and nosocomial sources have risen.
- Vegetations form from platelet-fibrin deposition on damaged heart valves, allowing bacterial colonization and abscess formation.
- Echocardiography is important for diagnosis. Findings include vegetations, abscesses, and valve dysfunction. Blood cultures help identify causative organisms.
- Complications include heart failure, embolization, and periannular
This document provides an overview of infective endocarditis, including its definition, epidemiology, anatomy, pathogenesis, classification, etiology, risk factors, clinical manifestations, diagnosis, management, and complications. Infective endocarditis is a bacterial or fungal infection of the heart valves or endocardium. It most commonly affects the mitral valve and is usually caused by streptococci, staphylococci, or enterococci. It can be acute or subacute and is diagnosed using the modified Duke criteria.
Infective endocarditis is an infection of the heart valves or inner lining of the heart that is usually caused by bacteria entering the bloodstream. It can cause inflammation of the heart valves and formation of vegetations, which can lead to heart failure, embolic episodes, or death if not treated properly with antibiotics and sometimes surgery. The document discusses the definition, causes, clinical presentation, diagnosis, and treatment of infective endocarditis.
Infective endocarditis is a condition where the inner lining of the heart (endocardium) becomes infected by bacteria or other microorganisms. It typically occurs where there is pre-existing heart valve damage. The infection can cause heart valve damage and formation of clumps (vegetations) that can break off and spread through the bloodstream (embolize). Presentation depends on the causative organism and can range from non-specific fever to new heart murmurs or signs of embolization. Diagnosis is based on blood cultures and echocardiography, while treatment involves prolonged antibiotic therapy and may require heart valve replacement surgery. Risk factors include rheumatic or congenital heart disease, prosthetic heart
Infective Endocarditis - Indications of SurgeryZryanMejio1
Infective endocarditis is an infection of the heart valves or endocardium. Surgery is indicated for infective endocarditis in cases of heart failure refractory to medical management, persistent sepsis despite antibiotics, recurrent emboli, valve dehiscence, or abscesses. Diagnosis involves blood cultures, echocardiography, and clinical presentation. Treatment consists of antibiotics targeting the causative organism along with management of complications. Complete removal of infected devices is usually required for device-related infective endocarditis.
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Infective Endocarditis is a microbial infection of the heart valves or inner lining of the heart. It is most commonly caused by bacteria and can lead to the formation of vegetations on the heart valves. The diagnosis is based on the modified Duke criteria which incorporates blood culture results, echocardiography findings and clinical features such as fever, heart murmur and embolic phenomena. Early diagnosis is important to guide treatment, which typically involves prolonged intravenous antibiotics.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
This document discusses a case of infective endocarditis in a 6-year-old female child presenting with fatigue, joint pain, fast breathing, and other symptoms. After examination and testing, vegetative mass was discovered on the septal tricuspid valve. The child was diagnosed with tricuspid valve infective endocarditis. The document then provides definitions, classifications, clinical features, diagnostic criteria, management guidelines, and complications of infective endocarditis in children. It emphasizes the importance of blood cultures, echocardiography, and long-term antibiotic treatment along with monitoring for complications like embolism.
This document outlines a lecture on pediatric infective endocarditis. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, differential diagnosis, and management of IE in children. Some key points include: congenital heart disease is the most common risk factor; viridans streptococci and staphylococci are frequent causes; clinical features can include fever, heart failure, and neurological symptoms; and diagnosis involves considering other conditions like sepsis, myocarditis, or rheumatologic disorders.
Infective endocarditis is a microbial infection of the heart valves or intracardiac devices. It is classified as either acute or subacute based on clinical presentation. Acute IE is caused by pyogenic bacteria and results in sepsis, while subacute IE is usually caused by Streptococcus viridans. Diagnosis relies on the modified Duke criteria and blood cultures, while echocardiography can identify valvular vegetations. Common manifestations include fever, heart murmurs, embolic phenomena, and immunological findings such as Roth spots.
This document discusses infective endocarditis (IE), a serious infection of the heart valves or inner lining of the heart. It provides details on the epidemiology, symptoms, physical exam findings, causative organisms, risk factors, diagnostic criteria (Modified Duke Criteria), investigations including echocardiography and blood cultures, and treatment approach for IE. Staphylococcus aureus is a leading cause worldwide and viridans group streptococci are common causes after dental procedures. Diagnosis relies on modified Duke criteria incorporating positive blood cultures, echocardiogram findings, and clinical features.
This document provides an overview of infective endocarditis. It begins with definitions and epidemiology. Risk factors include age over 60, injection drug use, poor dental health, male sex, and underlying heart conditions. Common causative organisms are staphylococci, streptococci, and enterococci. Diagnosis is based on the modified Duke criteria using blood cultures, echocardiography, and clinical features. Treatment involves antibiotic therapy for 4-6 weeks based on identified organisms, with a focus on obtaining negative follow up blood cultures. Prognosis depends on the causative organism and underlying heart condition.
This document discusses infective endocarditis (IE), including:
- IE is caused by microbial infection of the heart endothelium or foreign bodies like prosthetic valves. It is life-threatening but uncommon. Morbidity and mortality remain high despite advances.
- Incidence is estimated at 1.7-6.2 per 100,000 patient-years in Western countries and 17,000 cases per year in India, often affecting younger patients with rheumatic or congenital heart disease.
- Staphylococcus aureus is the most common cause in developed nations while viridans group streptococci are common in developing countries. Multidrug resistance is a growing problem.
- Diagnosis
This document provides information about infective endocarditis:
- Infective endocarditis involves infection of the heart valves and inner lining of the heart. Common causes are bacteria entering the bloodstream from dental, respiratory, or other procedures.
- The infection can cause growths (vegetations) on the heart valves that can break off and block blood vessels in the brain, lungs, kidneys or other organs.
- Risk factors include previous heart damage, dental and surgical procedures, and some reproductive or congenital conditions. Investigations include blood tests, cultures, ECG and echocardiography. Complications may require surgery to repair or replace damaged valves.
Endocarditis presentation to internal medicine2019hospital
This document discusses infective endocarditis, including its definition, classification, common sites of involvement, risk factors, general lesions, mortality rates, and Osler's nodes and Janeway lesions as associated findings on physical examination. Key points covered include that infective endocarditis is an infection of the endocardial surface, most commonly involving the heart valves. It can be classified as acute or subacute/chronic based on temporal factors and severity. Overall mortality is around 40% usually due to heart failure from valve dysfunction. Having a prosthetic valve or previous endocarditis are major risk factors.
Infective endocarditis is a serious infection of the heart valves, usually caused by bacteria entering the bloodstream and adhering to previously damaged valves. It can occur in patients with normal or abnormal heart anatomy. Viridans streptococci and Staphylococcus aureus are common causes. It may present with nonspecific symptoms like fever or with signs of complications. Diagnosis involves blood cultures, echocardiogram, and applying the Duke criteria. Treatment is antibiotics with possible surgery. Prevention focuses on antibiotic prophylaxis before procedures for high-risk patients.
This document discusses endocarditis and its association with stroke. There are two main types of endocarditis - infective endocarditis, caused by bacterial infection of the heart valves, and nonbacterial thrombotic endocarditis (NBTE), associated with cancer and lupus. Infective endocarditis carries risks of neurologic complications including ischemic or hemorrhagic stroke. Larger vegetations, location on the mitral valve, and certain organisms increase embolism risks. Treatment involves antibiotics but anticoagulation is generally not recommended due to bleeding risks. Neurologic complications influence management decisions.
This document discusses infective endocarditis, including its definitions, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Some key points include:
- It involves microbial infection of the heart valves and is usually caused by bacteria like streptococci, staphylococci, and enterococci.
- Common symptoms include fever and heart murmur. Potential complications include heart failure, embolisms, and metastatic abscesses.
- Diagnosis involves blood cultures, echocardiography, and published clinical criteria.
- Treatment involves antibiotics tailored to the infecting organism, with surgery for complications or high-risk cases.
- Prevention focuses on antibiotic prophylaxis for high-risk
This document discusses endocarditis, an inflammation of the inner lining of the heart. It defines endocarditis and describes its epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis using the Duke's criteria, approach, treatment with antibiotics and sometimes surgery, and prophylaxis. For the presented case of a 26-year-old IV drug user with fever and murmur, the recommended workup includes blood cultures, CBC, electrolytes, urine analysis, EKG, CT chest, and transthoracic echocardiogram along with IV fluids, antibiotics, and consulting infectious disease and cardiology specialists.
This document provides an overview of infective endocarditis. It discusses the epidemiology, etiologies, pathogenesis, clinical manifestations, diagnosis, complications and treatment of the condition. Some key points include:
- Infective endocarditis is an infection of the heart valves or endocardium that often involves vegetation formation. It is usually caused by bacteria and has significant morbidity and mortality.
- Native or prosthetic heart valves are most commonly infected. Streptococci and Staphylococcus aureus are leading causes.
- Symptoms can include fever, heart murmur, embolic phenomena. Diagnosis involves blood cultures, echocardiogram and applying the Duke criteria.
- Complications
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
This document provides an overview of infective endocarditis, including its definition, pathogenesis, epidemiology, clinical presentation, diagnosis, and treatment. It defines infective endocarditis as a microbial infection of the heart valves or endocardium. It discusses the typical pathogens involved and describes the formation of vegetations on heart valves. It also outlines the diagnostic criteria, including blood cultures and echocardiography. Treatment involves prolonged antibiotic therapy tailored to the causative organism, and may require surgery in cases of heart failure or uncontrolled infection.
Infective Endocarditis is a microbial infection of the heart valves or inner lining of the heart. It is most commonly caused by bacteria and can lead to the formation of vegetations on the heart valves. The diagnosis is based on the modified Duke criteria which incorporates blood culture results, echocardiography findings and clinical features such as fever, heart murmur and embolic phenomena. Early diagnosis is important to guide treatment, which typically involves prolonged intravenous antibiotics.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
Infective endocarditis is a microbial infection of the heart valves or endocardium. It is characterized by the formation of vegetations composed of platelets, fibrin, microorganisms, and inflammatory cells. It occurs more commonly in males and the elderly. Streptococci and Staphylococcus aureus are the most common causes. Diagnosis involves blood cultures, echocardiography, and applying the Duke criteria. Complications include embolisms, heart failure, and metastatic infections. Treatment involves prolonged antibiotic therapy targeted to the infecting organism. Surgery may be needed for complications or uncontrolled infection. Antibiotic prophylaxis is now restricted to highest risk patients undergoing highest risk procedures.
This document discusses a case of infective endocarditis in a 6-year-old female child presenting with fatigue, joint pain, fast breathing, and other symptoms. After examination and testing, vegetative mass was discovered on the septal tricuspid valve. The child was diagnosed with tricuspid valve infective endocarditis. The document then provides definitions, classifications, clinical features, diagnostic criteria, management guidelines, and complications of infective endocarditis in children. It emphasizes the importance of blood cultures, echocardiography, and long-term antibiotic treatment along with monitoring for complications like embolism.
This document outlines a lecture on pediatric infective endocarditis. It discusses the epidemiology, etiology, pathogenesis, clinical manifestations, differential diagnosis, and management of IE in children. Some key points include: congenital heart disease is the most common risk factor; viridans streptococci and staphylococci are frequent causes; clinical features can include fever, heart failure, and neurological symptoms; and diagnosis involves considering other conditions like sepsis, myocarditis, or rheumatologic disorders.
Infective endocarditis is a microbial infection of the heart valves or intracardiac devices. It is classified as either acute or subacute based on clinical presentation. Acute IE is caused by pyogenic bacteria and results in sepsis, while subacute IE is usually caused by Streptococcus viridans. Diagnosis relies on the modified Duke criteria and blood cultures, while echocardiography can identify valvular vegetations. Common manifestations include fever, heart murmurs, embolic phenomena, and immunological findings such as Roth spots.
This document discusses infective endocarditis (IE), a serious infection of the heart valves or inner lining of the heart. It provides details on the epidemiology, symptoms, physical exam findings, causative organisms, risk factors, diagnostic criteria (Modified Duke Criteria), investigations including echocardiography and blood cultures, and treatment approach for IE. Staphylococcus aureus is a leading cause worldwide and viridans group streptococci are common causes after dental procedures. Diagnosis relies on modified Duke criteria incorporating positive blood cultures, echocardiogram findings, and clinical features.
This document provides an overview of infective endocarditis. It begins with definitions and epidemiology. Risk factors include age over 60, injection drug use, poor dental health, male sex, and underlying heart conditions. Common causative organisms are staphylococci, streptococci, and enterococci. Diagnosis is based on the modified Duke criteria using blood cultures, echocardiography, and clinical features. Treatment involves antibiotic therapy for 4-6 weeks based on identified organisms, with a focus on obtaining negative follow up blood cultures. Prognosis depends on the causative organism and underlying heart condition.
This document discusses infective endocarditis (IE), including:
- IE is caused by microbial infection of the heart endothelium or foreign bodies like prosthetic valves. It is life-threatening but uncommon. Morbidity and mortality remain high despite advances.
- Incidence is estimated at 1.7-6.2 per 100,000 patient-years in Western countries and 17,000 cases per year in India, often affecting younger patients with rheumatic or congenital heart disease.
- Staphylococcus aureus is the most common cause in developed nations while viridans group streptococci are common in developing countries. Multidrug resistance is a growing problem.
- Diagnosis
This document provides information about infective endocarditis:
- Infective endocarditis involves infection of the heart valves and inner lining of the heart. Common causes are bacteria entering the bloodstream from dental, respiratory, or other procedures.
- The infection can cause growths (vegetations) on the heart valves that can break off and block blood vessels in the brain, lungs, kidneys or other organs.
- Risk factors include previous heart damage, dental and surgical procedures, and some reproductive or congenital conditions. Investigations include blood tests, cultures, ECG and echocardiography. Complications may require surgery to repair or replace damaged valves.
Endocarditis presentation to internal medicine2019hospital
This document discusses infective endocarditis, including its definition, classification, common sites of involvement, risk factors, general lesions, mortality rates, and Osler's nodes and Janeway lesions as associated findings on physical examination. Key points covered include that infective endocarditis is an infection of the endocardial surface, most commonly involving the heart valves. It can be classified as acute or subacute/chronic based on temporal factors and severity. Overall mortality is around 40% usually due to heart failure from valve dysfunction. Having a prosthetic valve or previous endocarditis are major risk factors.
Infective endocarditis is a serious infection of the heart valves, usually caused by bacteria entering the bloodstream and adhering to previously damaged valves. It can occur in patients with normal or abnormal heart anatomy. Viridans streptococci and Staphylococcus aureus are common causes. It may present with nonspecific symptoms like fever or with signs of complications. Diagnosis involves blood cultures, echocardiogram, and applying the Duke criteria. Treatment is antibiotics with possible surgery. Prevention focuses on antibiotic prophylaxis before procedures for high-risk patients.
This document discusses endocarditis and its association with stroke. There are two main types of endocarditis - infective endocarditis, caused by bacterial infection of the heart valves, and nonbacterial thrombotic endocarditis (NBTE), associated with cancer and lupus. Infective endocarditis carries risks of neurologic complications including ischemic or hemorrhagic stroke. Larger vegetations, location on the mitral valve, and certain organisms increase embolism risks. Treatment involves antibiotics but anticoagulation is generally not recommended due to bleeding risks. Neurologic complications influence management decisions.
This document discusses infective endocarditis, including its definitions, epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. Some key points include:
- It involves microbial infection of the heart valves and is usually caused by bacteria like streptococci, staphylococci, and enterococci.
- Common symptoms include fever and heart murmur. Potential complications include heart failure, embolisms, and metastatic abscesses.
- Diagnosis involves blood cultures, echocardiography, and published clinical criteria.
- Treatment involves antibiotics tailored to the infecting organism, with surgery for complications or high-risk cases.
- Prevention focuses on antibiotic prophylaxis for high-risk
This document discusses endocarditis, an inflammation of the inner lining of the heart. It defines endocarditis and describes its epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis using the Duke's criteria, approach, treatment with antibiotics and sometimes surgery, and prophylaxis. For the presented case of a 26-year-old IV drug user with fever and murmur, the recommended workup includes blood cultures, CBC, electrolytes, urine analysis, EKG, CT chest, and transthoracic echocardiogram along with IV fluids, antibiotics, and consulting infectious disease and cardiology specialists.
This document provides an overview of infective endocarditis. It discusses the epidemiology, etiologies, pathogenesis, clinical manifestations, diagnosis, complications and treatment of the condition. Some key points include:
- Infective endocarditis is an infection of the heart valves or endocardium that often involves vegetation formation. It is usually caused by bacteria and has significant morbidity and mortality.
- Native or prosthetic heart valves are most commonly infected. Streptococci and Staphylococcus aureus are leading causes.
- Symptoms can include fever, heart murmur, embolic phenomena. Diagnosis involves blood cultures, echocardiogram and applying the Duke criteria.
- Complications
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. The prototypic lesion of infective
endocarditis, the vegetation is a mass of
platelets, fibrin, microorganisms, and scant
inflammatory cells.
3.
4. Acute endocarditis is a hectically febrile illness that rapidly
damages cardiac structures, seeds extracardiac sites, and, if untreated,
progresses to death within weeks.
Subacute endocarditis follows an indolent course; causes
structural cardiac damage only slowly, if at all; rarely metastasizes; and
is gradually progressive unless complicated by a major embolic event or a
ruptured mycotic aneurysm
5. EARLY PVE -PVE arising within 2 months of valve
LATE PVE— The portals of entry and organisms causing cases
beginning >12 months after surgery.
Delayed-onset nosocomial infection PVE due to
CoNS that presents 2–12 months after surgery often represents.
6. Involves the device or the endothelium at points
of device contact.
Occasionally, there is concurrent aortic or mitral
valve infection.
One-third of cases of CIED endocarditis present
within 3 months after device implantation or
manipulation,
one-third present at 4–12 months, and one-third
present at >1 year. S. aureus and CoNS, both of
which are often resistant to methicillin, cause the
majority of cases
7. Community-associated IE develops in the absence
of recent contact with a health care setting, with diagnosis
established within 48 hours of hospital admission.
Health care-associated IE develops in the context
of recent contact with a health care setting, with onset of
symptoms ≥48 hours after hospitalization
8. Between 2000 and 2011, the incidence of IE
in the United States increased from 11 per
100,000 population to 15 per 100,000
population
9. Patient factors
Age >60 years
Male sex — Men predominate in most case series of IE;
male-to-female ratios range from 3:2 to 9:1.
Injection drug use
Poor dentition or dental infection
10. Comorbid conditions
Structural heart disease — Approximately three-fourths of
patients with IE have a pre-existing structural cardiac abnormality at the time
that endocarditis develops
Congenital heart disease
History of infective endocarditis
Indwelling intravascular device
Nosocomial endocarditis - a diagnosis of IE made more than 72
hours after admission in patients with no evidence of IE on admission or
IE that develops within 60 days of a previous hospital admission during
which there was risk for bacteremia or IE
11. Cardiac implantable electronic device
Chronic hemodialysis
HIV infection
Cardiac bypass surgery
12. Tricuspid or Pulmonic valve.
Isolated right-sided IE - 10 percent .
Concomitant left-sided and right-sided IE-- 13
percent of all IE cases .
Risk factors for right-sided IE include
1. injection drug use,
2. presence of a cardiac implantable electronic device
(CIED) or other intravascular device, and
3. presence of an underlying right-sided cardiac anomaly.
13. The undamaged endothelium is resistant to infection by most bacteria and to
thrombus formation.
Endothelial injury (e.g., at the site of impact of high-velocity blood jets or on the
low-pressure side of a cardiac structural lesion) allows either direct infection by
virulent organisms or the development of a platelet–fibrin thrombus—a condition
called nonbacterial thrombotic endocarditis (NBTE).
This thrombus serves as a site of bacterial attachment during transient bacteremia.
The cardiac conditions most commonly resulting in NBTE are MR, AS, AR, VSD, and
complex CHD.
NBTE also arises as a result of a hypercoagulable state; this phenomenon gives rise
to marantic endocarditis (uninfected vegetations seen in patients with malignancy
and chronic diseases) and to bland vegetations complicating systemic lupus
erythematosus and antiphospholipid antibody syndrome.
14. Organisms that cause endocarditis enter the
bloodstream from mucosal surfaces, the skin,
or sites of focal infection.
Except for more virulent bacteria (e.g., S.
aureus) that can adhere directly to intact
endothelium or exposed subendothelial
tissue, microorganisms in the blood adhere
at sites of NBTE.
15.
16. The clinical manifestations of infective
endocarditis (IE) are variable.
IE may present as an acute, rapidly
progressive infection or as a subacute or
chronic disease with low-grade fever and
nonspecific symptoms
17. Fever most common symptom of IE (up to 90
percent of patients); it is often associated with
chills, anorexia, and weight loss.
Patients with IE typically have continuous
bacteremia, regardless of whether fever is
present.
Other common symptoms of IE include malaise,
headache, myalgias, arthralgias, night sweats,
abdominal pain, and dyspnea .
Patients with IE associated with dental infection
may report tooth pain or related symptoms.
18. Cardiac murmurs are observed in
approximately 85 percent of patients.
Supportive signs include splenomegaly and
cutaneous manifestations such as petechiae
or splinter hemorrhages.
19. Petechiae are observed in 20 to 40 percent of
patients; they may be present on the skin
(usually on the extremities) or on mucous
membranes such as the palate or
conjunctivae (picture 1).
20. Splinter hemorrhages consist of nonblanching
linear reddish-brown lesions under the nail
bed .
21. ●Janeway lesions – Nontender erythematous
macules on the palms and soles
22. ●Osler nodes – Tender subcutaneous
violaceous nodules mostly on the pads of the
fingers and toes, which may also occur on
the thenar and hypothenar eminences
23. Janeway lesions more common in acute than subacute IE.
Histologically, they reflect microabscesses with neutrophil
infiltration of capillaries.
Osler nodes and Roth spots occur most frequently in the setting
of a protracted time course of endocarditis.
They probably represent the sequelae of vascular occlusion by
microthrombi leading to localized immune-mediated vasculitis.
Roth spots (also described as Litten spots) occur in 2 percent of
patients with IE .
Osler nodes were commonly observed among patients with IE in
the preantibiotic era, but are now uncommon since IE is
frequently diagnosed and treated before their development.
24. IE is associated with a broad array of systemic
complications due to septic embolization, which may
be associated with localized thrombosis, bleeding,
infection, and/or development of immune reactions.
Cardiac complications (up to 50 percent of patients) –
Valvular insufficiency, heart failure, and others.
Neurologic complications (up to 40 percent of
patients) – Embolic stroke, intracerebral hemorrhage,
brain abscess, and others.
25. Septic emboli (up to 25 percent of patients) – Infarction of
kidneys, spleen, and other organs. In patients with concomitant
right-sided endocarditis, septic pulmonary emboli may be seen
26. Metastatic infection (such as vertebral
osteomyelitis, septic arthritis, splenic or
psoas abscess).
Systemic immune reaction (eg,
glomerulonephritis)
27.
28. Signs of new regurgitant murmurs or heart
failure,
Chest examination
1. Crackles,
2. Consolidation, or
3. Diminished breath sounds), and
4. Evaluation for evidence of septic emboli
with special attention to the fundi,
conjunctivae, skin, and digits.
29. Evaluation for bone or joint abnormalities
focal back discomfort, suggesting vertebral
osteomyelitis, discitis, and/or epidural
abscess),
Abdominal pain
(particularly left upper quadrant pain, which
may reflect splenic infarction), and
costovertebral angle tenderness (which may
reflect renal infarction or psoas abscess).
Neurologic examination
30. Routine laboratory findings relatively
nonspecific;
Elevated ESR, CRP, NCNC ANEMIA and positive
RA.
Hyperglobulinemia, cryoglobulinemia, circulating
immune complexes, hypocomplementemia, and
false-positive serologic tests for syphilis occur in
some patients.
Urinalysis microscopic hematuria, proteinuria,
and/or pyuria.
The presence of red blood cell casts on urinalysis
is generally indicative of glomerulonephritis,
which is a minor diagnostic criterion for IE
32. 1. Identification of the infecting pathogen by
blood culture, serologic testing, or
molecular testing
(1) Cardiac imaging to identify a valvular
vegetation, paravalvular abscess, or other
structural complication of infection.
The accepted criteria for diagnosis of IE are
the modified Duke criteria,
35. Blood cultures and Echocardiography:
At least 3 sets of blood cultures separate
venipuncture sites (ideally spaced over 30 to
60 minutes) prior to initiation of antibiotic
therapy.
The decision to start or withhold antibiotic
therapy prior to a microbiologic diagnosis
must be individualized.
36. Serologic tests can be used to implicate
organisms that are difficult to recover by
blood culture: Brucella, Bartonella,
Legionella, Chlamydia psittaci, and C.
burnetii.
37. Echocardiography standard imaging modality for
evaluation of cardiac valves.
FDG PET/CT an adjunctive imaging modality.
Transesophageal echocardiography (TEE) has
higher sensitivity than TTE and is better for detection of
cardiac complications such as abscess, leaflet perforation,
and pseudoaneurysm.
FDG PET/CT diagnostic tool for IE, which can identify
infection of native valves and paravalvular areas, as well
as extracardiac sites of infection.
38.
39.
40. 2 clinical categories:
Presence of bacteremia in the absence of
valvular vegetation
Presence of valvular vegetation(s) in the
absence of bacteremia.
Patients with bacteremia in the absence of
evidence for valvular vegetation should be
evaluated for alternative causes of
bacteremia (which may coexist with IE),
including: