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The interactions between the human host and selected microorganisms that culminate in IE involve the vascular endothelium, hemostatic mechanisms, the host immune system, gross anatomic abnormalities in the heart, surface properties of microorganisms, and peripheral events that initiate bacteremia. Endothelial damage results in platelet-fibrin deposition, which in turn is more receptive to colonization by bacteria than is the intact endothelium. It is hypothesized that platelet-fibrin deposition occurs spontaneously in persons vulnerable to endocarditis and that these deposits, called nonbacterial thrombotic endocarditis (NBTE) are the sites at which micro organisms adhere during bacteremia to initiate IE. Bacteremia is the initiating event that ultimately converts NBTE to IE. Bacteremia rates are highest for events that traumatize the oral mucosa, particularly the gingiva, and progressively decrease with procedures involving the genitourinary tract and the gastrointestinal tract.
The platelet-thrombin deposits are found at the valve closure-contact line on the atrial surfaces of the mitral and tricuspid valves and on the ventricular surfaces of the aortic and pulmonic valves, the sites of infected vegetations in patients with IE. Three hemodynamic circumstances may injure the endothelium, initiating NBTE: (1) a high velocity jet impacting endothelium (2) flow from a high to a low pressure chamber and (3) flow across a narrow orifice at high velocity. Flow through a narrowed orifice, as a consequence of venturi's effect, deposits bacteria maximally at the low-pressure sink immediately beyond an orifice or at the site where a jet stream impacts a surface.
To cause IE, the organism must be able to persist and propagate on the endothelium. This requires resistance to host defenses. The complement-mediated bactericidal activity of serum limits the ability of susceptible aerobic gram-negative bacilli to cause IE. Those organisms that most frequently cause endocarditis adhere more vigorously in vitro to cardiac valves than do organisms that rarely cause IE.
Decreasing power is available in a cell both as NADPH and NADH but these have quite distinct roles. NADH is oxidized by the respiratory chain to produce ATP by oxidative phosphoryl
Q. How does synaptic transmission between neurons take place? The propagation of the action potential along the axon reaches the region immediately anterior to the presynaptic
Handling : The desire for survival is same whether in animals or human beings. You may be aware of the ability of even tiny animals to scratch and bite. So we won't say any more o
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Explain Avoidance of Shock in Nutritional Care? Loss of plasma proteins lead to decrease in blood volume (hypovolemia) and lowered red blood cell volume causing a potential dan
Which term is used to describe the process whereby a catheter is inserted into an individual's heart, a radio-opaque medium is injected & x-ray images are made. Procedure is use
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Pericardiocentesis It is removal of fluid form the pericardial sac. It is a specialized procedure done n ICU or cardiac cath lab or OT. A 16 or 18 gauge needle is inserted
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