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

What are the types of reproduction that occur in fungi, What are the types ...

What are the types of reproduction that occur in fungi? In fungi there are asexual and sexual reproduction. Fungi replicate asexually by fragmentation, gemmation and sporulatio

Formula concentration and supplementation - calorie density, Define Formula...

Define Formula Concentration and Supplementation - Calorie Density? Formula Concentration can be done by decreasing the amount or water added in the mixing of the formula. Sta

State the phases of soil genesis, State the phases of soil genesis Soil...

State the phases of soil genesis Soil genesis embodies two distinct phases. One is weathering that involves disintegration and decomposition of rocks and minerals, the other is

Accuracy of stress echocardiography, Q. Define Accuracy of Stress Echocardi...

Q. Define Accuracy of Stress Echocardiography? The accuracy of stress echo tests for the detection of coronary artery disease is expressed as the sensitivity and specificity of

Excretory organ and waste product, name the excretory ogran and waste produ...

name the excretory ogran and waste product formed in various types of animals

What is the importance of vitamin D, Importance of vitamin D Vitamin D ...

Importance of vitamin D Vitamin D is mainly involved in the  calcium and phosphate metabolism. It usually promotes absorption of calcium and inorganic phosphate from the intest

What is menu planning, What is Menu Planning? Any individual who carrie...

What is Menu Planning? Any individual who carries the responsibility of providing meals has to take decisions regarding what to serve, how much to serve, how much to spend, whe

Name the alloys which are commonly used, Name the alloys which are commonly...

Name the alloys which are commonly used The most commonly used alloys are Ti-6Al-4V and Ti-6Al-4V extra low interstitial (ELI). Commercially pure Titanium comes in different gr

What are the typical fauna of the temperate forests, What are the typical v...

What are the typical vegetation and the typical fauna of the temperate forests? In the temperate forest deciduous trees predominate. Mammals are originated in great number, as

How does temperature affect the action of enzymes, How does temperature aff...

How does temperature affect the action of enzymes upon their substrates? There are explained temperature ranges under which enzymes operate and there is a specific temperature

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