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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a retrospective study, 29 patients at least 20 years of age with known aortic stenosis are reported who had the peak systolic gradient (PSG) measured on at least two occasions without an intervening surgical procedure or episode of endocarditis. In these 29 patients, there were 31 intervals available for evaluation with a mean follow-up time of 43.5 months (1 week to 120 months). In 16 of the 31 intervals, the PSG increased by 50% or more and in 15, it did not. In the group where the PSG increased, the average rate of increase was 1.3 mm. Hg/month with the most rapid gradient increase at 3.8 mm. Hg/month. Progression to high gradient was correlated with the development of angina pectoris or left ventricular hypertrophy by voltage and ST-T wave changes. In this study, other symptoms were not helpful in predicting an increase in severity. It is still recommended, however, that any patient with aortic stenosis and the development of symptoms of congestive heart failure or exertional syncope should be suspected of having progressed to severe aortic stenosis and should be restudied.
Am Heart J 1979 Dec
PMID:Rate of progression of severity of valvular aortic stenosis in the adult. 49 18

In a 54-month retrospective review, we compared the clinical features of 26 narcotic addicts with staphylococcal endocarditis (group 1) and ten other addicts with nonstaphylococcal endocarditis (group 2). The admission temperature and the respiratory rate of patients in group 1 were significantly higher (P less thn .05 and less than .02 respectively) than those of patients in group 2. Group 1 also differed from group 2 in the following variables: (1) bilateral multiple pulmonary infiltrates in 46% vs none in group 2; (2) greater incidence of symptoms referable to the central nervous system (50% vs none in group 2); and (3) gastrointestinal symptoms of vomiting, diarrhea, or constipation in 62% vs 10% in group 2. Serious cardiovascular, renal, and other complications were more frequent in staphylococcal endocarditis. Tricuspid regurgitation occurred with equal frequency in both groups and was of no value in differentiating staphylococcal from nonstaphylococcal endocarditis.
South Med J 1979 Dec
PMID:Comparison of staphylococcal and nonstaphylococcal endocarditis in narcotic addicts. 51 66

Review of porcine valve xenografts in 68 patients over a 32-month period disclosed seven episodes of endocarditis in six patients, an attack rate of 10%. Four patients died as a result of the infections. The presence of Staphylococcus epidermidis in every case was most striking as was the preponderance of methicillin sodium resistance. The clustering of cases within a restricted time period, and the absence of subsequent cases, suggests the strong possibility of a nosocomial occurrence.
Arch Intern Med 1979 Dec
PMID:Endocarditis associated with porcine valve xenografts. 51 18

The anesthetic management of a woman with Eisenmenger's syndrome undergoing abdominal hysterectomy with general anesthesia is described. Proper anesthetic management of patients with this syndrome depends on a knowledge of the pathophysiologic process and associated complications. The potential problems of systemic hypotension, pulmonary embolism and infective endocarditis are outlined. Sudden death is a common and pregnancy is a major hazard.
Can Med Assoc J 1977 Dec 17
PMID:General anesthesia in Eisenmenger's syndrome. 58 42

Among 373 patients with porcine xenografts, there were 27 instances of exposure of the xenograft to bloodstream or endocardial infection in 22 patients. Nine patients underwent 10 separate insertions of xenografts for active infective endocarditis. There were no early infections or valve failures. Three patients returned with a late prosthetic valve endocarditis (PVE) due to a new infection. There were 6 instances of bacteremia early after xenograft valve insertion with no early infection, no valve dysfunction, and 1 instance of late PVE. Eleven patients had PVE on a porcine xenograft. Blood cultures in the 10 patients treated with antibiotics promptly became negative. There were 3 valve-related deaths: 2 from valve incompetence and 1 from mitral and aortic xenograft stenosis. Our experience suggests that the Hancock porcine xenograft is: (1) as resistant to infection as are rigid prostheses in active infective endocarditis; (2) resistant to early postoperative bacteremias; and (3) easier to sterilize than rigid prostheses and more durable than other tissue valves in the face of PVE.
Ann Thorac Surg 1977 Dec
PMID:Bacteremia, endocarditis, and the Hancock valve. 59 63

We recently treated two narcotic addicts with bacterial endocarditis who developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This prompted a retrospective review of blood chemistry studies in all narcotic addicts admitted to our hospital over a 30-month period because of a clinical suspicion of bacterial endocarditis. Patients with culture-positive endocarditis (group 1) had significantly lower plasma osmolality, sodium, calcium and albumin values (P less than .02, .001, .005, and .005 respectively) than addicts without endocarditis (group 2). More than 90% of those in group 1 had hyponatremia, and 48% had plasma hypoosmolality. These findings may be of value in the initial evaluation of ill narcotic addicts for hospitalization.
South Med J 1978 Dec
PMID:Blood chemistry abnormalities in bacterial endocarditis of narcotic addicts. 72 31

A case of left-ventricular-right-atrial septal defect secundary to blunt chest trauma is described. The etiology of this type of septal defect, e. g. congenital, following aortic and mitral valve replacement, endocarditis and trauma, is discussed. Early defect closure is recommended in the presence of significant shunt volume.
Thoraxchir Vask Chir 1978 Dec
PMID:[Isolated left ventricular--right atrial shunt after blunt chest trauma (author's transl)]. 75 Dec 80

The abilities of 14 strains of aerobic gram-positive cocci and gram-negative bacilli to adhere in vitro to human or canine aortic valve leaflets were compared. 2-mm sections of excised valve leaflets were obtained by punch biopsy and were incubated under standardized conditions in suspensions of bacteria. Valve sections were subsequently washed and homogenized, and quantitative techniques were used to determine the proportions of bacteria from the initial suspensions that had adhered to the valve sections. Comparable results were obtained when these adherence ratios were determined by two independent methods based either on measurements of bacterial viability or of radioactivity in 51Cr-labeled bacteria. For each bacterial strain, the adherence ratio was constant over a wide range of concentrations of bacteria in the incubation medium. Strains of enterococci, viridans streptococci, coagulase-positive and coagulase-negative staphylococci and Pseudomonas aeruginosa (adherence ratios 0.003-0.017) were found to adhere more readily to valve sections than strains of Escherichia coli and Klebsiella pneumoniae (adherence ratios 0.00002-0.00004). The organisms that most frequently cause bacterial endocarditis were found to adhere best to heart valves in vitro, suggesting that the ability to adhere to valvular endothelium may be an important or essential charcteristic of bacteria that cause endocarditis in man.
J Clin Invest 1975 Dec
PMID:Adherence of bacteria to heart valves in vitro. 81 87

Endocarditis of the tricuspid valve due to Pseudomonas aeruginosa in a heroin addict failed to respond to therapy with gentamicin, carbenicillin, and amikacin. Clinical and bacteriologic cure was achieved with oral administration of a trimethoprim-sulfamethoxazole mixture plus parenteral therapy with colistin. In vitro synergism was demonstrated for the three drugs at concentrations achievable in the serum. Therapy for endocarditis due to Pseudomonas continues to be a major problem; however, the successful treatment of this patient warrants consideration for instituting therapy with a trimethoprim-sulfamethoxazole misture plus colistin in individuals with this infection who fail to respond to standard therapeutic regimens for severe infections with Pseudomonas.
Chest 1977 Dec
PMID:Endocarditis due to Pseudomonas aeruginosa in a heroin addict. Successful treatment with trimethoprim-Sulfamethoxazole mixture plus colistin. 92 22

This study follows the clinical course of 22 patients in the active phase of infective endocarditis who inderwent valve replacement at North Carolina Memorial Hospital between March, 1966, and March, 1976. At the time of operation, there was gross valve tissue destruction in 16 patients, verrucae in nine, ruptured chordae tendineae in five, and myocardial or annular abscess formation in five. Four patients survived less than 6 months after the initial operation. One survived almost 3 years before dying of recurrent carcinoma of the lung. The remaining 17 patients have been followed an average of 4.6 years. Major postoperative complications were as follows: paravalvular problem, five patients; congestive heart failure, seven patients; complete heart block, three patients; systemic arterial emboli, four patients. These complications often were associated with the preoperative presence of annular or myocardial abscess. Thus it appears that postoperative complications often result from annular structural deficiencies rather than being directly related to active infection.
J Thorac Cardiovasc Surg 1977 Dec
PMID:The long-term outlook for valve replacement in active endocarditis. 92 13


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