Risk of embolization, Biology

Assignment Help:

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

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

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

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

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


Related Discussions:- Risk of embolization

Biodiversity, composition of aquatic animals what are their groupings

composition of aquatic animals what are their groupings

Functions of insulin, FUNCTION S - (a) It is antagonistic to glucagon....

FUNCTION S - (a) It is antagonistic to glucagon. Insulin decreases the level of glucose in the blood. It acts by increasing the rate at which glucose is transported out of the

Define characteristics of phylum nematode, Review of Characteristics of Phy...

Review of Characteristics of Phylum Nematode and Its Position in Animal Classification? Nematodes may be free-living or parasites of plants or animals. however, all nematode

Explain how inhibition might contribute, We now understand that mutations t...

We now understand that mutations that cause the inhibition of apoptosis are found in tumors. Because proliferation itself is not induced by the inhibition of apoptosis, explain how

Advantages and disadvantages of tissue valves, Advantages of Tissue Valv ...

Advantages of Tissue Valv es   Need for anticoagulation therapy is only for a short duration in xenograft and only there is rare need for anticoagulation therapy in au

Mode of nutrition, What is the mode of nutrition of Ascaris?

What is the mode of nutrition of Ascaris?

Nutrition, how do carnivorous feed

how do carnivorous feed

Main species of taenias that cause human diseases, Q. What are the two main...

Q. What are the two main species of taenias that cause human diseases? The two chief species of taenias that cause disease in humans are Taenia solium, or the pork tapeworm, an

Standardisation research of luria nebraska, Standardisation Research of Lur...

Standardisation Research of Luria Nebraska There are published manuals for the Luria Nebraska that define the battery in detail and provide information pertinent to validity,

Lampbrush chromosomes, LAMPBRUS H CHROMOSOMES Discovered by Rucker...

LAMPBRUS H CHROMOSOMES Discovered by Ruckert . Lampbrush Chromosomes were seen in Oocytes of several different animals like shark, amphibians, reptiles and birds. (Most

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

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

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