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Objectives: Infective endocarditis is a life-threatening complication of congenital heart disease (CHD), but there are few studies concerning the contemporary risk profile, preceding invasive procedures and outcomes in this patient population. The aim of this study was to investigate the epidemiology of infective endocarditis (IE) in patients with CHD.Methods: Cases of IE in children and adults with CHD were prospectively recorded as part of the UK National Institute for Cardiovascular Outcomes Research (NICOR) National Congenital Heart Disease Audit. Patients were entered into the database between April 2008 and March 2016.Results: Eight hundred episodes of IE were recorded in 736 patients with CHD. Sixty-five patients (9%) were infants (aged <1 year), 235 (32%) were children (aged 1-15 years), and 436 (59%) were adults (aged >15 years). The most common diagnoses were Tetralogy of Fallot (n = 150, 22.8%), ventricular septal defect (n = 129, 19.6%) and bicuspid aortic valve (n = 70, 10.7%). Dental procedures preceded 67 of 635 episodes (11%) of IE, and non-dental invasive procedures preceded 177 of 644 episodes (27.4%). The most common causative organisms were streptococci, accounting for 40% of cases. Overall in-hospital mortality was 6.7%. On multivariable analysis, adverse factors associated with in-hospital mortality were staphylococcal infection and presence of an underlying atrioventricular septal defect.Conclusions: Infective endocarditis in patients with CHD is an ongoing clinical challenge. In contemporary practice in tertiary congenital centers, 1 of 15 patients do not survive to hospital discharge. Streptococci remain the most common causative organism, and antecedent dental or medical procedures were undertaken in a significant minority in the 3 months before diagnosis. The presence of an atrioventricular septal defect or staphylococcal infection is associated with significantly increased risk of early mortality. [ABSTRACT FROM AUTHOR]

This paper describes the types of, and circumstances surrounding, unintentional farm-related fatal injuries involving young and older adults in Australia. Information was obtained from an inspection of coronial files for the period 1989-1992. Around 14% of all farm-related fatalities in Australia during 1989-1992 were of young adults aged 15-24 years and approximately one-quarter were of older adults aged > or = 55 years. Young adults were commonly fatally injured in motor vehicle incidents and in incidents involving firearms. Tractors were the most common agent involved in fatal incidents involving older adults. Intervention measures to prevent fatalities of older adults in agriculture should focus on the safe use of tractors, while for young adults it appears prevention efforts should centre around safe use of firearms and operation of motor vehicles on the farm. Ways to overcome barriers to the use of injury prevention measures in rural Australia should be further explored. [ABSTRACT FROM AUTHOR]