Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It involves the heart valves. Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the surfaces of intracardiac devices. Endocarditis is characterized by lesions, known as vegetations, a mass of platelets, microcolonies of microorganisms, scant inflammatory cells. In the subacute form of infective endocarditis, the vegetation may include a center of granulomatous tissue, which may fibrose or calcify. There are several ways to classify endocarditis; the simplest classification is based on cause: either infective or non-infective, depending on whether a microorganism is the source of the inflammation or not. Regardless, the diagnosis of endocarditis is based on clinical features, investigations such as an echocardiogram, blood cultures demonstrating the presence of endocarditis-causing microorganisms. Signs and symptoms include fever, sweating, weakness, weight loss, flu-like feeling, cardiac murmur, heart failure, Osler's nodes, Janeway lesions, Roth's spots.
Infective endocarditis is an infection of the inner surface of the heart the valves. Symptoms may include fever, small areas of bleeding into the skin, heart murmur, feeling tired, low red blood cells. Complications may include valvular insufficiency, heart failure and kidney failure; the cause is a bacterial infection and less a fungal infection. Risk factors include valvular heart disease including rheumatic disease, congenital heart disease, artificial valves, intravenous drug use, electronic pacemakers; the bacterial most involved are streptococci or staphylococci. Diagnosis is supported by blood cultures or ultrasound; the usefulness of antibiotics following dental procedures for prevention is unclear. Some recommend them in those at high risk. Treatment is with intravenous antibiotics; the choice of antibiotics is based on the blood cultures. Heart surgery is required; the number of people affected is about 5 per 100,000 per year. Rates, vary between regions of the world. Males are affected more than females.
The risk of death among those infected is about 25%. Without treatment it is universally fatal. Nonbacterial thrombotic endocarditis is most found on undamaged valves; as opposed to infective endocarditis, the vegetations in NBTE are small and tend to aggregate along the edges of the valve or the cusps. Unlike infective endocarditis, NBTE does not cause an inflammation response from the body. NBTE occurs during a hypercoagulable state such as system-wide bacterial infection, or pregnancy, though it is sometimes seen in patients with venous catheters. NBTE may occur in patients with cancers mucinous adenocarcinoma where Trousseau syndrome can be encountered. NBTE does not cause many problems on its own, but parts of the vegetations may break off and embolize to the heart or brain, or they may serve as a focus where bacteria can lodge, thus causing infective endocarditis. Another form of sterile endocarditis is termed Libman–Sacks endocarditis. Like NBTE, Libman-Sacks endocarditis involves small vegetations, while infective endocarditis is composed of large vegetations.
These immune complexes precipitate an inflammation reaction, which helps to differentiate it from NBTE. Unlike NBTE, Libman-Sacks endocarditis does not seem to have a preferred location of deposition and may form on the undersurfaces of the valves or on the endocardium. Tissières P, Gervaix A, Beghetti M, Jaeggi ET. "Value and limitations of the von Reyn and modified Duke criteria for the diagnosis of infective endocarditis in children". Pediatrics. 112: e467–e471. Doi:10.1542/peds.112.6.e467. PMID 14654647. Meine TJ, Nettles RE, Anderson DJ, Cabell CH, Corey GR, Sexton DJ, Wang A. "Cardiac conduction abnormalities in endocarditis defined by the Duke criteria". American Heart Journal. 142: 280–5. Doi:10.1067/mhj.2001.116964. PMID 11479467. Endocarditis at Curlie
João Soares de Albergaria referred to as João Soares, was the second Portuguese Dontary-Captain of the islands of Santa Maria and São Miguel, succeeding his maternal uncle Gonçalo Velho Cabral in the title. After selling his rights to the Captaincy of the island of São Miguel, to Rui Gonçalves da Câmara, he continued as Donatary-Captain of Santa Maria, he was the son of Fernão Soares de Albergaria and Teresa Velho Cabral, one of the sisters of Gonçalo Velho Cabral. He had no heirs. In 1474, due to his wife's illness, Albergaria moved to the island of Madeira, in order to "find remedies and medics" to treat his wife's condition, as well as a milder climate for her to convalesce, they lodged with the family of the Captain of Funchal, João Gonçalves Zarco and his brother, Rui Gonçalves da Câmara. As Father Gaspar Frutuoso would relate, due to the unproductivity of the island, the many costs he developed during his move and treatments for his wife, Soares de Albergaria would decide to sell the Captaincy of São Miguel for 2,000 cruzados and 60,000 kilograms of sugar to Rui Gonçalves for his hospitality.
João Soares de Albergaria settled the island, restructured the population, founding the principal village, Vila do Porto, becoming the base for future Captains-Generals in the islands of the Azores. His maternal uncle was the "Commander of Santa Maria and Captain of the Azores", within a structural framework, not properly defined, his position as Captain of Santa Maria was confirmed in a similar edict from King Afonso V of Portugal, months later: We are to know that João Soares, knight of the House of the Duke of Viseu, my loved cousin, my esteemed nephew, that We were shown a title signed by Infanta Beatrice, my much-loved and esteemed sister, that mad me know that the above son...was given the charge to João Soares the island of Santa Maria, that he be Captain of it. During his Captaincy, Albergaria was responsible for promoting the settlement of the island, a charge that he was successful in initiating, attracting settlers from both Portugal, he was responsible for the defense of the island.
Albergaria did not escape the battle and was captured, taken prisoner to Castile, where he was ransomed. He paid his own ransom eight days before peace were declared by Afonso V of Portugal and Ferdinand of Castile. Albergaria was to marry Branca de Sousa Falcão by order of the King João II on 20 June 1492, with whom they had many descendants: João Soares de Sousa, who would inherit his father's title as 3rd Dontary-Captain of Santa Maria, he would return to island to Santa Maria late in life, died in 1499 at the age of 80 years. The captaincy of Santa Maria would be passed on to his descendants until its extinction in 1667. Notes SourcesBento, Carlos Melo, História dos Açores: Da descoberta a 1934, Ponta Delgada, Portugal: Câmara Municipal de Ponta Delgada Fructuoso, G.. Saudades da Terra, 1873. Instituto Cultural de Ponta Delgada, Ponta Delgada. ISBN 972-9216-70-3. Figueirdo, Jaime de. Ilha de Gonçalo Velho: da descoberta até ao Aeroporto. Vila do Porto, Santa Maria: Câmara Municipal de Vila do Porto.
John Schumacher was a German immigrant who became a wealthy landowner in Los Angeles and was a member of that city's governing council. Schumacher was born in Germany about 1816 and died in Los Angeles on March 2, 1885, at the age of sixty-nine, of apoplexy, reported Harris Newmark, in his book Sixty Years in California. Newmark called Schumacher " good-hearted, honest German of the old school, a first-class citizen", who had come from Wurtemberg to America. Newmark wrote that Schumacher arrived in California with Jonathan D. Stevenson's 1846 expedition to California, but a Los Angeles Times obituary of Schumacher's son, John, in 1885, stated instead that the elder John had been "one of Fremont's veterans, who followed him in his historic trek to California."Schumacher settled in Los Angeles in "1847 or 1848", Newmark wrote, in 1849 he went to Sutter's Creek, where he "found a nugget of gold worth eight hundred dollars". He returned to Los Angeles in 1853, where he purchased "100 feet of ground on the west side of Spring street, just off First street and extending through Broadway."
In 1882 he built a two-story residence between Franklin and First Streets. Schumacher was "proficient in languages, as an interpreter gave his time and services in serving his less-gifted neighbors the poor and unfortunate, to straighten out their affairs."He was married in 1855 to Mary Uhrie, they had six children, including three sons, Frank G. and F. F. and a daughter, Carrie. "The eldest daughter became Mrs. Edward A. Preuss." His wife died in 1880 when "at the railway station in Merced, she was jolted from the platform of a car and was killed."The Schumachers bought one of the first pianos to be seen in Los Angeles, which had to be shipped from the East around Cape Horn. The family owned a "spring wagon with a cover" made by local craftsman John Goller, which though "only a one-horse affair, but because of the springs and the top which afforded protection from both the sun and the rain, it was looked upon as a curiosity." Schumacher became a wealthy landowner in Los Angeles, but early on he had a grocery store, with a bar, "in a single room, as was common."
He had "bought nearly the whole block bounded by Spring and First streets and Franklin Alley for the value of his famous gold nugget, there he remained until the early seventies." For something else, Schumacher was known.... He put on sale the first lager beer introduced into Los Angeles, importing the same from San Francisco, of which enterprise the genial German was proud, it contained a good mixture with peach brandy, was a great favorite with politicians and frequenters of the neighboring Courthouse.... Whenever in fact anyone had a cold, or fancied that he was going to be so afflicted, he hastened to John for his reputedly-certain cure. For a time in the late 1870s, Schumacher had a vineyard "opposite the site of the city gardens", earlier he was in partnership with Jacob Bell in raising sheep. Schumacher was elected to the Los Angeles Common Council, the governing body of the city, on May 7, 1866, served two terms