What is the best management option for non-significant residual shunt after device closure of perimembranous ventricular septal defect: A case report based on the lessons from post-procedure endocarditis

Rationale: Non-significant residual shunt is a relatively common complication after device closure of perimembranous ventricular septal defects (Pm-VSD). Lifelong antibiotic prophylaxis has been recommended in guidelines to avoid infectious endocarditis (IE) if residual shunt remains. Clinicians, however, rarely follow it in their practice and regular follow-up was the most common option since post-procedure IE after transcatheter closure of PmVSD is rarely reported. We firstly described a case of IE after transcatheter closure of PmVSD with modified symmetrical double-disk device with a residual shunt, highlighting the need for reassessing the prognostic implications of post-procedure non-significant residual shunt and the most appropriate treatment strategy. Patient concerns: A 3-year old female received transcatheter closure of PmVSD sized 5.0 mm on left ventricular angiography with an 8-mm modified symmetric double-disk occluder (SHAMA) owing to a history of recurrent lower respiratory tract infections. Post-procedure echocardiography documented a non-significant residual shunt, but no additional interventions were performed. Two months post procedure, the child was re-admitted into our department with a complaint of persistent fever up to 41°C for 11 days and nonresponse to 1-week course of amoxicillin. Diagnoses: The diagnosis of post procedure IE was established since a vegetation (13 × 9 mm) was found to be attached to the tricuspid valve and the...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

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Conclusion Consequently, characterization of epidural ASCs, will pave the way for new studies investigating their use in dural and also central nervous system healing and recovery after an injury. PMID: 32222128 [PubMed - as supplied by publisher]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
ConclusionsThe recommendations provided in this document are intended to assist the clinician in optimizing vancomycin for the treatment of invasive MRSA infections in adult and pediatric patients. An AUC/MIC by broth microdilution (BMD) ratio of 400 to 600 (assuming MICBMD of 1 mg/L) should be advocated as the target to achieve clinical efficacy while improving patient safety for patients with serious MRSA infections. In such cases, AUC ‐guided dosing and monitoring is the most accurate and optimal way to manage vancomycin therapy.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Special Article Source Type: research
ConclusionsThus, hMCs exhibit a highly individualized pattern of immune response possibly to meet tissue requirements and regulate bacteria coexistence vs defense.
Source: Immunity, Inflammation and Disease - Category: Allergy & Immunology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Biofilms usually occur on or within medical devices such as mechanical heart valves, prosthetic joints, peritoneal dialysis catheters, contact lenses, central venous catheters, pacemakers and urinary catheters. The presence of biofilms can be seen in different diseases like endocarditis, otitis, cystic fibrosis, periodontitis, osteomyelitis and chronic wounds. Toxin–antitoxin systems are reported to respond to stresses that are also found in the host. Some toxins of toxin–antitoxin systems modules have been proposed as potential weapons used by bacteria to act on host targets. In this review, we focus on the mo...
Source: Reviews in Medical Microbiology - Category: Microbiology Tags: BACTERIOLOGY Source Type: research
Interview with Brad Spellberg, MD, author of Evaluation of a Paradigm Shift From Intravenous Antibiotics to Oral Step-Down Therapy for the Treatment of Infective Endocarditis: A Narrative Review
Source: JAMA Specialty Journals Author Interviews - Category: General Medicine Authors: Source Type: podcasts
In this study we examined the consequences of such changes for the growth and photo‐physiology of two diatoms by mimicking the scenarios that correspond to present day and that predicted for the end of this century. Elevated light induced higher rates of damage to photosystem II (PSII) that significantly reduced photochemical yields of both diatoms. Treatments including UV radiation induced ~ 50% inhibition of PSII under present PAR levels. Generally, warming alleviated UVR inhibition, resulting in higher photochemical yields, and faster recovery during dim light exposure. Therefore, concurrent increase of irradiance and...
Source: Photochemistry and Photobiology - Category: Science Authors: Tags: RESEARCH ARTICLE Source Type: research
[Actividad antimicrobiana de hongos endófitos de las plantas medicinales Mammea americana (Calophyllaceae) y Moringa oleifera (Moringaceae)]. Biomedica. 2020 Mar 01;40(1):55-71 Authors: Mosquera WG, Criado LY, Guerra BE Abstract Introducción. Las enfermedades infecciosas son una causa importante de muertes en el mundo. La resistencia antimicrobiana es un problema global, por lo que es conveniente la investigación de nuevas fuentes de agentes antimicrobianos de origen natural potencialmente efectivos. Objetivo. Evaluar la actividad antimicrobiana de hongos endófitos de Mammea...
Source: Biomedica : Revista del Instituto Nacional de Salud - Category: International Medicine & Public Health Tags: Biomedica Source Type: research
For primary inguinal hernia repair, there is no apparent benefit to the robotic approach over the traditional laparoscopic approach, according to a randomized controlled trial.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: General Surgery News Source Type: news
Publication date: January 2020Source: Archives of Cardiovascular Diseases Supplements, Volume 12, Issue 1Author(s): I. Chamtouri, A. Farah, R. Khalifa, W. Jomaa, K. Ben Hamda, F. MaatoukIntroductionDespite the progress in diagnostic modalities and therapeutic strategies, Infective endocarditis remains a lethal disease especially in children.AimWe aimed to update current characteristics of infective endocarditis in children and to identify complications.Patients and methodsWe carried out in our department a retrospective study including 40 children diagnosed with infective endocarditis (IE) between 1983 and 2017.ResultsFort...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Authors: Varela Barca L, López-Menéndez J, Redondo Palacios A, Rodríguez-Roda Stuart J Abstract The case is reported of a 55 year-old woman, with a previously known congenital septal defect, who was admitted to the emergency department with a diagnosis of meningoencephalitis, septic shock, and rapid clinical deterioration. Echocardiography revealed a vegetation occupying the right-side heart. Endocarditis affectation of the septal defect, aortic and tricuspid valves was noted and blood cultures were positive for Staphylococcus aureus. Urgent surgical treatment was performed whereby the ventricu...
Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve Dis Source Type: research
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