Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antibodies against the adherence protein of Mycoplasma pneumoniae are regularly found in patients with M. pneumoniae infection. Therefore, this 168-kilodalton (kDa) protein was used as an antigen in a dot-ELISA for serological diagnosis of M. pneumoniae disease. M. pneumoniae proteins were separated by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), gels were stained with Coomassie Blue, and the 168-kDa protein band was cut out and eluted using a special electroelution device. Isolated proteins or sonicated whole-cell antigens, respectively, were immobilized on a 96-well filtration plate with a nitrocellulose bottom (dot-ELISA). The test procedure was performed as in conventional ELISA tests, using alkaline phosphatase-labeled antihuman IgM or IgG antibodies, respectively, to detect antigen-antibody complexes. All results were confirmed by immunoblotting. The dot-ELISA using the 168-kDa antigen proved to be sensitive and specific. The specificity was tested on 53 sera of M. pneumoniae infections and on 490 serum specimens of patients with other respiratory diseases due to other pathogens, or with clinical conditions such as pancreatitis, meningitis or endocarditis. With regard to IgM antibodies, no false-positive reactions were found in non-M. pneumoniae diseases against the 168-kDa antigen, but there were such reactions against other M. pneumoniae proteins in immunoblots.
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PMID:Use of adherence protein of Mycoplasma pneumoniae as antigen for enzyme-linked immunosorbent assay (ELISA). 311 34

Regimens for endocarditis caused by these bacteria are generally based on high dosage of a beta-lactam antibiotic, penicillin in the case of streptococci and a penicillinase-resistant penicillin for Staphylococcus aureus, with vancomycin substituted for beta-lactam resistant staphylococci, including coagulase-negative staphylococci. The addition of other antimicrobial agents, such as aminoglycosides (or, in the case of staphylococci, sodium fusidate or rifampicin) may increase bactericidal efficiency, or allow shorter courses, but problems of toxicity or emergence of resistance may occur. Optimal regimens are discussed, and newer agents of possible usefulness are reviewed.
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PMID:Antibiotic therapy of nonenterococcal streptococcal and staphylococcal endocarditis: current regimens and some future considerations. 329 Jan 87

Strains of coagulase-negative staphylococci were tested for in vivo resistance in a rabbit model of prophylaxis of endocarditis. Regimens of nafcillin, cefazolin, cefamandole, and vancomycin were compared for efficacy in the prevention of infection caused by two methicillin-resistant strains and a susceptible strain. For the two resistant strains, vancomycin was the most effective drug tested. All regimens were effective against the susceptible strain. The two strains for which prophylaxis with beta-lactam antibiotics failed produced a beta-lactam antibiotic-inducible penicillin-binding protein (PBP) that comigrated in sodium dodecyl sulfate-polyacrylamide gels with the low-affinity PBP 2a that is associated with methicillin resistance in strains of Staphylococcus aureus. Like PBP 2a, this PBP had low binding affinity for beta-lactam antibiotics. Peptide maps after either V8 protease or chymotrypsin digestion of radiolabeled PBP 2a or silver-stained preparations were virtually identical to one another and to maps of PBP 2a from a heterogeneous and a homogeneous strain of S. aureus. Methicillin resistance in coagulase-negative staphylococci and therapeutic failure with beta-lactam antibiotics in vivo is associated with production of PBP 2a, which appears to be highly conserved structurally among different species of staphylococci.
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PMID:Coagulase-negative staphylococci resistant to beta-lactam antibiotics in vivo produce penicillin-binding protein 2a. 343 2

Acinetobacter spp. are uncommon etiologic agents of prosthetic valve endocarditis. Two patients with Acinetobacter calcoaceticus subsp. lwoffi prosthetic valve endocarditis are described. The patients were successfully treated with antibiotics (cefotaxime sodium and gentamicin sulfate); thus, we suggest medical treatment rather than early valve replacement in this particular type of infection.
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PMID:Prosthetic valve endocarditis caused by Acinetobacter calcoaceticus subsp. lwoffi. 358 34

The clinical course, prognostic factors, and management of 50 cases of late prosthetic valve endocarditis, occurring more than two months after valve replacement, were reviewed. Twenty nine cases that presented from 1971 to 1980 were compared with 21 cases that presented from 1981 to 1985. Apart from an appreciable decrease in the frequency of neurological complications between the first period (38%) and the second period (10%) no differences in clinical or bacteriological features were seen. Seventeen (59%) of the 29 cases in the earlier period and four (19%) of the 21 cases in the later period died. The rationale for antimicrobial treatment was similar during both periods. Cardiac surgery was performed in eight of 29 cases between 1971 and 1980 and in 11 of 21 between 1981 and 1985; the mean (SD) time between diagnosis of endocarditis and operation was 28 (19) days and 43 (44) days respectively. Six of the eight cases operated on in the first period died as did two of the 11 operated on in the second period. Twenty seven of the 29 cases presenting between 1971 and 1980 were treated with anticoagulants--either warfarin (15 of 27) or heparin sodium (12 of 27). Sixteen of the 21 cases presenting later were given anticoagulants and 15 of these cases were given heparin sodium. Control of anticoagulation was inadequate in nine of the 27 cases treated with anticoagulants during the first period and in only two of 16 treated during the second period. During the first treatment period neurological complications were more frequent when control of anticoagulation was inadequate.
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PMID:Fifty cases of late prosthetic valve endocarditis: improvement in prognosis over a 15 year period. 362 Feb 45

Cefamandole nafate and cephalothin sodium were administered as prophylaxis in a randomized, prospective study to 80 consecutive patients undergoing open heart surgery. The two groups matched well in age, sex, and type of operation. Postoperative infection developed in 2 of 40 patients (5%) in the cefamandole-treated group and in 11 of 40 patients (27.5%) in the cephalothin-treated group (p less than 0.01). The two patients in the former group had respiratory tract infections. There were no instance of endocarditis, mediastinitis or bacteraemia in any of the two groups. Both antibiotics were well tolerated with no adverse reactions. Cefamandole appears to be an effective and preferable prophylactic antibiotic for use during cardiac surgery.
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PMID:Comparative study of cefamandole versus cephalothin as antibiotic prophylaxis for open heart surgery. 369 8

Some particular features of the cardiomyopathies (CM) observed in the tropics, especially in Africa, are emphasized in this study. Chronic parietal endocarditis is excluded from the CM group. The author presents facts that justify the linking of that affection to endocardial diseases. Myocardiopathies are acute ailments presenting with congestive lesions, reversible under etiological therapy. Anemic and beri-beri myocardiopathies are not unusual in the tropics and present a hyperkinetic syndrome before the stage of advanced cardiac insufficiency. Infectious or parasitic myocarditis seem frequent in the tropics. The author recalls the characteristics of the myocarditis in the human african trypanosomiasis which he opposes, particularly, to the american trypanosomiasis. The reality of bilharzial myocarditis is more debatable while bilharzial pulmonary hypertension is well documented. Chronic congestive CM presents a few specific characteristics in the tropics. The features, well described in temperate regions, are found in the tropics with a particularly unfortunate prognosis. Some alcoholic myocardiopathies have been observed. The rare occurrence of hypertrophic CM in the tropics results, seemingly, from a lack of exploratory means. The author studies briefly a recent series of 31 cases in Abidjan. Post-partum myocardiopathy seems to be the clinical appearance of a latent myocardial insufficiency of the normal post-partum in women presenting with associated risks factors (anemia, malnutrition, overwork, excessive sodium intake, etc.). An early diagnosis enables a cure only by resting, but it is sometimes necessary to associate a medical treatment. Death by embolism or the passing to chronicity are however possible. Drepanocytic CM is debatable and in many cases, seems hardly differentiated from anemic myocardiopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cardiomyopathies in tropical areas]. 377 21

Between November, 1978, and December, 1983, 736 patients had valve replacement with the St. Jude Medical valve prosthesis. There were 478 patients with aortic valve replacement (AVR), 188 with mitral valve replacement (MVR), 63 with double valve replacement, and 7 with tricuspid valve replacement (they were not included in this study). The mean age at the time of operation was 46.7 years for patients having AVR and 48.6 years for those having MVR and AVR + MVR. Follow-up totaled 1,116 patient-years (range, 4 to 82 months). Early (30-day) mortality was lowest for isolated MVR (2.3%) and AVR (3.7%), and increased with reoperation or when associated procedures were combined with valve replacement. Patients undergoing reoperation or having associated procedures made up 49% of the AVR and 54% of the MVR groups. All patients were advised of the need for long-term anticoagulation with warfarin sodium. Nine patients (7 with AVR, 1 with MVR, 1 with AVR + MVR) had suspected or confirmed episodes of systemic thromboembolism, a linearized incidence of 0.99% per patient-year for AVR, 0.36% per patient-year for MVR, and 0.98% per patient-year for AVR + MVR. Eight patients with AVR underwent reoperation for prosthetic valve endocarditis (5 of the 8 patients had endocarditis prior to initial valve replacement). There were no instances of structural valve failure. There were 37 late deaths. Actuarial survival at 5 years (excluding early mortality, 95% confidence limits) was 89.8% for AVR, 84.8% for MVR, and 95.2% for AVR + MVR.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Durability and low thrombogenicity of the St. Jude Medical valve at 5-year follow-up. 377 1

Infective endocarditis remains a serious illness with a high mortality. In more than 75% of 417 patients, the infection was due to gram-positive microorganisms. The non-drug-addicted patients (33%) were elderly and debilitated with advanced illness that preceded the endocarditis. The drug-addicted patients (67%) were young and were infected with multiple kinds of microorganisms. The blood cultures grew strains of Staphylococcus aureus resistant to methicillin sodium and nafcillin sodium in a majority of patients. Gram-negative microorganisms and fungi were cultured almost exclusively from samples from the drug-addicted patients. The high mortality among the non-drug-addicted patients (28%) was related to their advanced age and debilitating illness. The high mortality among the drug-addicted patients (21%) was related to the complex bacteriology of their infections and the severe anatomical disruption of the valvular complexes of the heart. When cured of their disease after treatment with intravenously administered antibiotics or a valve procedure or both, their long-term survival was related to whether or not they abstained from their habit. If the patient abstained from the use of drugs, the chances of survival were good; if not, death invariably ensued. This experience strongly supports our contention that if a patient returns to the use of drugs and reinfects the valve after initial cure, a second valve operation is contraindicated.
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PMID:Management of infective endocarditis: seventeen years' experience. 381 2

To explore the possibility that Streptococcus sanguis aggregation of platelet-rich plasma (PRP) might be mediated by soluble agents, we tested cell-free S. sanguis supernatant for aggregation activity. The supernatant of untreated S. sanguis was without measurable PRP aggregation activity. In contrast, the cell-free supernatant of ATP-incubated S. sanguis produced an immediate wave of PRP aggregation. The supernatant with PRP aggregating activity contained insufficient protease to produce a response. The response increased with the time of incubation with ATP. Active supernatant was desalted and chromatographed on nucleotide-calibrated columns of Dowex 1-X8. An active ADP function was identified. The activity was insensitive to dicyclohexylcarbodiimide, but was sensitive to both Ca2+ and Ca2+-Mg2+ chelating agents, cold (4 degrees C), heat (80 degrees C), pH (optimum between pH 7 and 8), apyrase, and sodium molybdate. In addition, preincubation of PRP with adenosine inhibited activity. Strains of viridans streptococci were screened for activity. Aggregation-promoting strains showed two times more activity than did other strains. Although it was not vigorously excluded that the ADP was discharged from the microbes, the existence of an exogenous ATPase on S. sanguis was strongly suggested. The expression of the activity was associated with the lag time to onset of PRP aggregation with intact S. sanguis. This activity could, therefore, be a synergistic promoter of PRP aggregation and an additional virulence factor in endocarditis.
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PMID:ADP-like platelet aggregation activity generated by viridans streptococci incubated with exogenous ATP. 621 55


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