Infective Endocarditis: Spike in N.C. Linked to Opioid Epidemic (CME/CE)

(MedPage Today) --'Alarming'increase prompts call to improve the related'cascade of care '
Source: MedPage Today Public Health - Category: American Health Source Type: news

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By MICHEL ACCAD Last month marked the 400th anniversary of the birth of John Graunt, commonly regarded as the father of epidemiology.  His major published work, Natural and Political Observations Made upon the Bills of Mortality, called attention to the death statistics published weekly in London beginning in the late 16th century.  Graunt was skeptical of how causes of death were ascribed, especially in times of plagues.  Evidently, 400 years of scientific advances have done little to lessen his doubts!  A few days ago, Fox News reported that Colorado governor Jared Polis ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: COVID-19 Medical Practice Physicians Diagnosis MICHEL ACCAD Source Type: blogs
We appreciate Chilvers and Clark's observation that the opioid epidemic is a unique phenomenon in the United States, and that the findings from our patient cohort might not reflect patients cared for in Europe.1 The significant difference in the disease burden of infective endocarditis related to intravenous drug use (IE-IVDU) implies that the case volume encountered in Europe may differ.2 This is an important consideration given the volume –outcome relationship, but the operative management itself might not differ significantly from that of non–IE-IVDU endocarditis, aside from the higher incidence of right-sided disease.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Letter to the Editor Source Type: research
We appreciate Chilvers and Clark's observation that the opioid epidemic is a unique phenomenon in the United States, and that the findings from our patient cohort might not reflect patients cared for in Europe.1 The significant difference in the disease burden of infective endocarditis related to intravenous drug use (IE-IVDU) implies that the case volume encountered in Europe may differ.2 This is an important consideration given the volume –outcome relationship, but the operative management itself might not differ significantly from that of non–IE-IVDU endocarditis, aside from the higher incidence of right-sided disease.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Adult: Endocarditis: Letters to the Editor Source Type: research
CONCLUSIONS: Operations for DU-IE have increased sharply in the United States during the last several years exhibiting substantial regional variability. DU-IE patients have unique clinical profiles, and worse risk-adjusted outcomes. This demonstrates the significant impact of the opioid epidemic on endocarditis surgeries and punctuates the urgent need for multidisciplinary regional and national efforts to reverse this trend. PMID: 32387035 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Morbidity and mortality from opioid use disorder (OUD) remain at epidemic levels in the United States. In the 12-month period ending July 2018, approximately 46,000 people died from opioid overdose in the United States, approximately five deaths every hour.[1] The harms of OUD extend beyond the well-publicized overdose deaths. Aside from the tragic toll on families, patients experience social and medical sequelae of drug use. Among the medical sequelae is drug use-associated infective endocarditis, whose incidence has risen dramatically where opioid use disorder (OUD) is endemic; at least one state experienced a tenfold in...
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Intravenous drug use has increased substantially over the past decade, with heroin abuse more than doubling. Injection drug use-related infective endocarditis hospitalizations have similarly increased over the same period. Right-sided infective endocarditis is strongly associated with intravenous drug use, and 90% of right-sided endocarditis involves the tricuspid valve. During the period of the opioid epidemic, tricuspid-related endocarditis rates have increased, while the incidence of surgery for tricuspid endocarditis has increased as much as five-fold.
Source: Operative Techniques in Cardiac and Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Adult Source Type: research
ConclusionsOur data reflect high rates of postvalve surgery morbidity and mortality in people with SUD-IE at a tertiary care center. The midterm postoperative period is a vulnerable period for people with SUD-IE worthy of further investigation.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: Our data reflect high rates of postvalve surgery morbidity and mortality in people with SUD-IE at a tertiary care center. The midterm postoperative period is a vulnerable period for people with SUD-IE worthy of further investigation. PMID: 31630767 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
There is a rising trend in incidence of infective endocarditis [1,2]. The injection drug use (IDU) epidemic and the aging population with associated use of intracardiac implantable electronic devices are contributing factors. The 2007 American Heart Association, 2008 National Institute for Health and Clinical Excellence (UK) and 2009 European Society of Cardiology restricted the antibiotic prophylaxis guidelines to high-risk patients and to certain invasive procedures. This may also have had an impact, although there is conflicting data to support this notion [1,3].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
This study identified prophages as mediators of bacterial virulence in a model of infectious endocarditis, probably through promotion of interaction with extracellular matrix components. Further studies are needed to identify mechanisms leading to promotion of intrinsic virulence. Introduction Challenges related to Staphylococcus aureus infections in the human and veterinary clinics mobilized important human and technical resources. S. aureus can colonize 20–30% of the general population asymptomatically but is also capable of causing a wide spectrum of diseases ranging from benign infections, to particularly...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
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