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Related Concept Videos

Endocarditis I: Introduction01:25

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Endocarditis III: Medical Management01:18

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Endocarditis IV: Nursing Management01:29

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic01:26

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Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
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Pericarditis I: Introduction01:22

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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
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Temporal association between invasive procedures and infective endocarditis.

Martin H Thornhill1,2, Annabel Crum3, Richard Campbell3

  • 1Department of Oral & Maxillofacial Medicine, Surgery and Pathology, The University of Sheffield School of Clinical Dentistry, Sheffield, UK m.thornhill@sheffield.ac.uk.

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Infective endocarditis (IE) risk increases after certain invasive procedures (IPs), including dental work and endoscopies. This finding suggests current antibiotic prophylaxis guidelines for high-risk patients may need re-evaluation.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Procedures

Background:

  • Antibiotic prophylaxis is recommended for high-risk patients undergoing specific invasive procedures (IPs) to prevent infective endocarditis (IE).
  • Current guidelines have limited data supporting prophylaxis for most IPs, except for invasive dental procedures.
  • Recommendations for antibiotic prophylaxis for IE have been revised, focusing primarily on dental procedures.

Purpose of the Study:

  • To investigate the association between specific invasive procedures (IPs) and the subsequent risk of infective endocarditis (IE).
  • To provide data for re-evaluating current antibiotic prophylaxis recommendations for IE prevention in high-risk individuals.

Main Methods:

  • A retrospective analysis of 14,731 IE hospital admissions in England (April 2010–March 2016).
  • Medical records were reviewed to identify IPs performed within 15 months prior to IE admission.
  • The incidence of IPs in the 3 months before IE was compared to the preceding 12 months to assess the odds of IE following procedures.

Main Results:

  • Increased odds of IE were observed following permanent pacemaker/defibrillator implantation (OR 1.54), dental extractions (OR 2.14), upper/lower gastrointestinal endoscopy (OR 1.58/1.66), and bone marrow biopsy (OR 1.76).
  • Bronchoscopy (OR 1.33) and blood transfusions/exchanges (OR 1.2) were also associated with a higher risk of IE.
  • Statistical significance (p<0.05) was found for most identified associations.

Conclusions:

  • A significant association exists between specific invasive procedures and subsequent infective endocarditis.
  • Procedures like pacemaker implantation, dental extractions, endoscopies, and bronchoscopies are linked to increased IE risk.
  • Current antibiotic prophylaxis guidelines for IE prevention in high-risk patients warrant re-evaluation based on these findings.