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1.
Brigida E. Annicchiarico Concetta Santonocito Massimo Siciliano Margherita Scapaticci Donatella Guarino Carmine Di Stasi Maria E. Riccioni Enrico Di Stasio Ettore Capoluongo Antonio Gasbarrini 《Digestive and liver disease》2019,51(2):293-296
Background
In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed.Aim
The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure.Methods
Fifty-one consecutive cirrhotic patients were divided based on ACE genotype (DD, ID, and II). Kidney and liver function tests, upper endoscopy, and hepatic venous pressure gradient measurement (HVPG) were performed in all patients.Results
The presence of the ACE I allele was associated with a higher HVPG value (18.7 ± 6.4 vs 10.3 ± 6.3 mmHg; P < .001), higher frequency of large gastrooesophageal varices (59.3% vs 25.0%; P < .05), and higher frequency of variceal bleeding (63.0% vs 29.2%; P < .05). No significant differences were found between patients with and those without the ACE I allele regarding Child-Pugh score, MELD score, ascites, and hepatic encephalopathy.Conclusion
ACE I/D polymorphism seems to influence the severity of portal hypertension and the risk of variceal bleeding in liver cirrhosis, regardless of the severity of liver disease. 相似文献2.
Sumal Nandasena Chaminda Senavirathna Champa Munasinghe Chapa Wijesena Ridmi Sucharitharathna 《The Indian journal of tuberculosis》2019,66(1):76-80
Background
Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.Methods
Information of all newly diagnosed and registered patients in the District Chest Clinic, Kalutara in year 2013 were ascertained. Out of 687 newly reported TB patients, 669 records were included in final analysis.Results
Majority of patients were males (n = 451, 67.4%), in the age group of 36–60 years (n = 306, 45.7%) and underweight (n = 359, 61.7%). Substantial proportion of normal weight or overweight adult patients (92.1%) had sputum conversion at 2–3 months as compared to underweight adult patients (82.5%) (p = 0.034). Those who smoke tobacco is less likely to have sputum conversion at 2–3 months as compared to non-smokers (90.2% vs. 82.1%, p = 0.045).Conclusion
Provision of good nutrition, maintaining of appropriate body mass index (i.e., BMI), and abstinence from smoking and alcohol consumption are important for sputum conversion among smear-positive pulmonary TB patients. 相似文献3.
Aim
To investigate the demographic and clinico-radiological characteristic of patients of tuberculosis presented with pneumothorax in relation to the patients of active pulmonary tuberculosis.Material and Methods
The retrospective study was conducted between January 2013 to June 2014 and records of 78 patients of pulmonary tuberculosis with pneumothorax (TP) and 156 patients of pulmonary tuberculosis without pneumothorax (NPT) were analyzed. Demographic, etiologic, clinical, radiographic, and outcome data were collected.Results
The mean age of tuberculous pneumothorax patients was 38.0 ± 14.3 years and that of non-pneumothorax was 39.5 ± 12.3 years. Most common presenting clinical feature was cough (76.9%) followed by dyspnoea (74.4%), chest pain (64.0%) and fever (56.4%) in TP patients. Chest radiograph showed cavity in 38 (48.7%) TP patients followed by consolidation in 32 (41.0%) patients and infiltration in 33 (42.3%) patients. All the TP patients had undergone underwater seal intercostal tube drainage procedure for the management of pneumothorax. The mean duration between chest drain insertion and removal was 17.14 ± 6.37 days. Twenty-five (32.1%) of the cases developed chest tube drainage related complications.Conclusion
Patients of tuberculous pneumothorax required prolonged period of chest tube drainage and usually showed good response to the treatment. 相似文献4.
Ji-Won Hwang Jeong Hoon Yang Young Bin Song Taek Kyu Park Joo Myung Lee Ji-Hwan Kim Woo Jin Jang Seung-Hyuk Choi Joo-Yong Hahn Jin-Ho Choi Joonghyun Ahn Keumhee Carriere Sang Hoon Lee Hyeon-Cheol Gwon 《Revista espa?ola de cardiología》2019,72(2):120-129
Introduction and objectives
We sought to determine the association of reciprocal change in the ST-segment with myocardial injury assessed by cardiac magnetic resonance (CMR) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).Methods
We performed CMR imaging in 244 patients who underwent primary PCI for their first STEMI; CMR was performed a median 3 days after primary PCI. The first electrocardiogram was analyzed, and patients were stratified according to the presence of reciprocal change. The primary outcome was infarct size measured by CMR. Secondary outcomes were area at risk and myocardial salvage index.Results
Patients with reciprocal change (n = 133, 54.5%) had a lower incidence of anterior infarction (27.8% vs 71.2%, P < .001) and shorter symptom onset to balloon time (221.5 ± 169.8 vs 289.7 ± 337.3 min, P = .042). Using a multiple linear regression model, we found that patients with reciprocal change had a larger area at risk (P = .002) and a greater myocardial salvage index (P = .04) than patients without reciprocal change. Consequently, myocardial infarct size was not significantly different between the 2 groups (P = .14). The rate of major adverse cardiovascular events, including all-cause death, myocardial infarction, and repeat coronary revascularization, was similar between the 2 groups after 2 years of follow-up (P = .92).Conclusions
Reciprocal ST-segment change was associated with larger extent of ischemic myocardium at risk and more myocardial salvage but not with final infarct size or adverse clinical outcomes in STEMI patients undergoing primary PCI. 相似文献5.
6.
M. Inmaculada Poveda García M. Dolores del Pino y Pino Raquel Alarcón Rodriguez Cristian Rodelo-Haad Tesifón Parrón Carreño 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(1):67-72
Introduction
We aimed to assess the effectiveness of ambulatory blood pressure monitoring (ABPM) and subclinical target organ damage parameters for diagnosis of resistant hypertension (RH).Methods
We assessed demographic and anthropometric variables, the incidence of cardiovascular events and subclinical target organ damage (n = 112). We also studied the relationship between these variables and the ABPM results.Results
Of the 112 patients referred from primary care with a diagnosis of RH, 69 (61.6%) were confirmed by ABPM. We found statistically significant differences (P < .001) between patients with RH and pseudo-resistant hypertension in the appearance of subclinical target organ damage. A percentage of 84 of the patients had microalbuminuria: 66.25 ± 30.7 mg/dl); 44.9% had stage 3 chronic kidney disease: the average glomerular filtration was 59 ml/min/1.73 m2; and 56.5% had left ventricular hypertrophy on echocardiography. Fundoscopy revealed that 64% of the patients had hypertensive retinopathy. Three variables were associated with an increased HR risk: microalbuminuria, hypertensive retinopathy and left ventricular hypertrophy (OR 5.7, 6.2 and 11.2, respectively).Conclusions
This study shows that the systematic testing for target organ damage, particularly in terms of albuminuria, is a simple and inexpensive tool, with a high predictive value for RH (85%), which could be useful for prioritising patients who need ABPM. 相似文献7.
Guilherme Bricks Jorge Figueiredo Senise Henrique Pott-Jr Giuliano Grandi Dimas Carnaúba-Jr Hamilton Antonio Bonilha de Moraes Celso Franscisco Hernandes Granato Adauto Castelo 《The Brazilian journal of infectious diseases》2019,23(1):45-52
Background
Hepatitis E virus (HEV) infection in patients with pre-existing liver disease has shown high morbidity and lethality. The consequences of HEV superinfection in patients with chronic hepatitis C virus (HCV) infection are not fully understood. This study aimed to evaluate the association between the presence of anti-HEV antibodies, liver cirrhosis, and insulin resistance.Methods
A total of 618 patients chronically infected with HCV were included from three reference centers for viral hepatitis in São Paulo, Brazil. Presence of anti-HEV IgG was assessed by enzyme-linked immunosorbent assay (WANTAI HEV-IgG ELISA).Results
The seroprevalence of anti-HEV in patients with cirrhosis was significantly higher than in patients without cirrhosis (13.2% vs 8%, OR = 1.74, p = 0.04). Seropositivity for anti-HEV, adjusted for sex, age, and HCV genotype showed an association trend with hepatic cirrhosis (aOR = 1.75, p = 0.059). Presence of HEV antibodies, adjusted for age, body mass index and cirrhosis, was shown to be independently associated with insulin resistance (aOR: 4.39; p = 0.045).Conclusion
Patients with chronic hepatitis C are under risk of hepatitis E virus superinfection in Brazil. The trend toward association between cirrhosis and previous HEV infection suggests that it may accelerate liver fibrosis in patients with chronic hepatitis C. In addition, previous infection by HEV is independently associated with insulin resistance in the studied population, which may be an extra-hepatic manifestation of hepatitis E that persists after resolution of the active infection, and may contribute to fibrosis progression. 相似文献8.
S. Miceli Sopo G. Gurnari S. Monaco A. Romano L. Liotti B. Cuomo I. Dello Iacono L. Badina G. Longo M. Calvani A. Giannone C. Calabrò G. Scala M.C. Verga 《Allergologia et immunopathologia》2019,47(3):277-281
Introduction and objectives
The reproducibility of the adverse reaction increases the suggestiveness of a history of food allergy. However, the positive predictive value (PPV) of multiple adverse reaction episodes for the diagnosis of IgE-mediated food allergy is not known. This evaluation was the objective of our study.Patients and methods
We retrospectively studied 180 children with a history of non-anaphylactic adverse reactions after the ingestion of a food. All children had the prick test positive for the offending food and performed the oral food challenge (OFC) within 12 months after the last adverse reaction episode (ARE). We have evaluated whether increasing the number of ARE increased the probability that the OFC would be positive (failed).Results
93 patients (52%) presented one ARE, 49 (27%) presented two ARE, 24 (13%) presented three ARE, 14 (8%) patients presented ≥ four ARE. The OFC was positive in 94/180 (52%). The outcome of the OFC was found to be positively correlated with the number of ARE (OR = 1.56; 95% CI = 1.16–2.09; p = 0.003). A PPV = 100% was observed with a number of ARE ≥ five.Conclusions
The number of ARE is an important predictor of the diagnosis of food allergy, although less than we would have imagined. The number of ARE could be used to increase the predictability of the diagnostic tests currently in use, to define clinical prediction rules alternative to OFC and easy to use in clinical practice. 相似文献9.
Objective
To assess the impact of providing integrated psycho-socio-economic support to drug resistant tuberculosis (DRTB) patients on the treatment outcome under programmatic conditions.Study design
Retrospective cohort study.Setting
An urban district TB centre in India under the Revised National Tuberculosis Control Programme.Participants
A cohort of 123 patients who started DRTB treatment between June 2010 and May 2013.Methods
Patients started on treatment for DRTB between June 2010 and May 2013 who were provided with the integrated support package for at least 3 months formed the supported group while the other patients of the cohort formed the non-supported group. The treatment outcomes and sputum culture conversion rates were compared between the two groups.Results
The supported group consisted of 60 patients and the non-supported group of 63 patients. The treatment success rate was found to be significantly higher in the supported group (65% vs 46.03%; p = 0.0349). Support duration was significantly associated with lower incidence of death [HR 0.876, 95% CI 0.811–0.947; p = 0.0009] and loss to follow up [OR: 0.752, 95% CI 0.597–0.873; p = 0.0023]. The treatment failure rate was higher in the supported group (16.66% vs 4.76%) with 60% of the failures in the supported group occurring after 24 months of compliant treatment. There was no significant association found between support duration and treatment failure or sputum culture conversion.Conclusion
Integrated support seems to significantly increase the treatment success rate and improve survival and treatment adherence of DRTB patients. However, early diagnosis and effective pharmacotherapy are crucial for reducing treatment failures. 相似文献10.
Mariana R. Gazzotti Carolina M. Roco Cristiane O. Pradella Oliver A. Nascimento Elias F. Porto Mariana Adas Marise Lazaretti-Castro José R. Jardim 《Archivos de bronconeumología》2019,55(5):252-257
Background
Osteoporosis is a systemic skeletal disease characterized by low bone mass and/or microarchitectural deterioration of bone. Osteoporosis is a risk factor for fractures specially in patients with advanced COPD. The aim of this cross-sectional study was to determine the frequency of osteoporosis and vertebral fracture in COPD patients.Methods
We evaluated 91 COPD patients and compared to 82 healthy subjects (control group) matched for gender and age. We measured the bone mineral density by means of dual energy X-ray absorptiometry (DXA), evaluating the lumbar vertebra (L1–L4), proximal femur and total femur and evaluated vertebral fractures in thoracic and lumbar spine using X-ray. We questioned patients whether they had had any fall that resulted in any fracture in the past five years.Results
Males comprised 60.4% of COPD group and 57.3% of the control group. Mean age was 66.2 ± 9.2 years for COPD group and 64.2 ± 8.8 for the control group. The frequency of osteoporosis in the COPD group was 29.7% and 18.3% in control group (p = 0.007). The frequency of vertebral fractures was 18.6% in the COPD group and 9.0% in control group (p = 0.06). The frequency of reported falls at resulting in any fracture was 36.3% in the COPD group and 7.3% in control group (p = 0.001).Conclusions
Our data indicate that COPD patients present a high frequency of osteoporosis and falls seem to be an important factor for vertebral fracture. 相似文献11.
Introduction
Proton pump inhibitors (PPIs) have been associated with small intestinal bacterial overgrowth (SIBO), which increases with prolonged PPI use, and SIBO has been associated with irritable bowel syndrome (IBS).Objective
The aim of the present study was to study the prevalence of bowel symptoms in patients treated with PPIs in Mexico.Methods
Gastroenterologists in 36 cities surveyed patients treated with PPIs, utilizing an ad hoc questionnaire to determine the presence of bowel symptoms and IBS.Results
Two hundred and fifteen physicians interviewed 1,851 patients. PPI indications were gastritis (48.8%), gastroesophageal reflux (38.5%), peptic ulcer (6.2%), and others (6.5%). A total of 77.5% of the patients received treatment for ≤ 6 months and 11.9% for ≥ 1 year. Symptoms were reported in 92.3% of the patients: abnormal bowel habits (90%), bloating (82%), abdominal pain (63%), flatulence (58%), and abdominal discomfort (53%). A total of 67.5% of the patients fit the Rome III criteria for IBS. Symptoms presented in 55.9% of the patients before PPI intake and in 44.1% of the patients after PPI use (P < .005). Constipation (63.8%) predominated in the former, and diarrhea (56.5%) in the latter (P < .0001). The treatments prescribed for managing those symptoms were antispasmodics, antibiotics, prokinetics, and antiflatulents, but patients stated greater satisfaction with antibiotics (mainly rifaximin) (P < .0001).Conclusion
The association of PPIs with bowel symptoms and IBS is frequent in Mexico. Diarrhea and bloating predominate, and antibiotics produce the greatest treatment satisfaction, suggesting that SIBO or dysbiosis is the cause of the PPI-related bowel symptoms. However, that remains to be confirmed. 相似文献12.
Mauricio Restrepo-Escobar Paula Andrea Granda-Carvajal Fabián Jaimes 《Reumatología clinica》2019,15(1):27-33
Objective
To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies.Methods
Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve.Results
Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959).Conclusion
In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. 相似文献13.
María Victoria Rubio Rubio Luis Miguel Lou Arnal José Antonio Gimeno Orna Paula Munguía Navarro Alex Gutiérrez-Dalmau Elena Lambán Ibor Javier Paúl Ramos Raquel Pernaute Lavilla Belén Campos Gutiérrez Alberto San Juan Hernández-Franch 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(2):141-150
Introduction
Conservative Management (CM) has become a therapeutic option in Advanced Chronic Kidney Disease in the elderly. However, there is a lack of evidence about prognosis of these patients in terms of survival and health related quality of life (HRQoL).Objective
Establish predictive variables associated with mortality and analyse HRQoL in CM patients.Patients and methods
Prospective cohort study. An assessment of renal function parameters and a comprehensive geriatric assessment were made, including: analysis of comorbidity, functional, cognitive, fragility, nutritional, social and HRQoL status.Results
82 patients with a mean age of 84 years and significant pluripathology were studied: 56% had history of vascular event and Charlson > 8. The mortality rate was 23/1,000 patients per month, with a homogeneous mortality rate after 6 months.Survival differed significantly depending on whether they presented with a previous vascular event (36.7 vs. 14.8; p = 0.028), Charlson score ≥ 10 (42 vs. 17; p = 0.002), functional status (48.4 vs. 19; p = 0.002) and fragility (27 vs. 10; p = 0.05).Mortality predictors included eGFR and proteinuria, the presence of previous vascular events, Charlson comorbidity score, malnutrition-inflammation parameters (albumin and MNA score), degree of dependency, physical HRQoL and increase of PTH level. The presence of previous vascular event, comorbidity, decreased albumin and elevated PTH were independent predictors of mortality. HRQoL remained stable over time and no significant worsening occurred during treatment.Conclusions
Having knowledge of the factors associated with mortality and HRQoL assessment can be a useful tool to helping decision making during CM. Previous vascular events, comorbidity, decreased albumin and increased PTH were independent predictors of mortality. 相似文献14.
Siavosh Abedi Mahmood Moosazadeh Mahdi Afshari Jamshid Yazdani Charati Asghar Nezammahalleh 《The Indian journal of tuberculosis》2019,66(1):39-43
Background
Investigating the survival of tuberculosis (TB) patients is one of the main parts of the TB control program. It can be related to many factors. This study aimed to estimate the survival experience and its associated factors among these patients.Methodology
All TB patients detected during March 2005 to 31 September 2014 were entered into this prospective cohort. Each patient was investigated from the diagnosis date and followed until the last available information during treatment. Data analysis was performed using Kaplan Meier and multivariate Cox regression models.Results
The survival experience of 2493 TB patients was investigated 73.7% of which were pulmonary type. Mean and median survival time were 6.5 and 6.2 months respectively. The incidence rate of death among patients during the treatment courses was 0.99 (95% confidence interval: 0.84–1.1) per 100 person-months. Controlling the confounders, the incidence (95% confidence interval) of death was significantly higher among men (HR = 1.8; 1.2–2.6), diabetic patients (HR = 1.7; 1.2–2.6), cancerous patients (HR = 4.8; 2.6–8.8) and HIV positive patients (HR = 22.1; 7.3–66.4).Conclusion
This study showed that male gender, TB/HIV co-infection and concurrent development of TB and cancer were determinant factors of death during the treatment period of TB. 相似文献15.
Lucía Silva-Fernández Teresa Otón Anca Askanase Patricia Carreira Francisco Javier López-Longo Alejandro Olivé Íñigo Rúa-Figueroa Javier Narváez Esther Ruiz-Lucea Mariano Andrés Enrique Calvo Francisco Toyos Juan José Alegre-Sancho Eva Tomero Carlos Montilla Antonio Zea Esther Uriarte Jaime Calvo-Alén José Luis Andreu 《Reumatología clinica》2019,15(1):34-42
Objectives
The course and long-term outcome of pure membranous lupus nephritis (MLN) are little understood. The aims of this study are to evaluate the clinical features, course, outcome and prognostic indicators in pure MLN and to determine the impact of ethnicity and the type of health insurance on the course and prognosis of pure MLN.Methods
We conducted a retrospective review of medical records of 150 patients with pure MLN from Spain and the USA.Results
Mean age was 34.2 ± 12.5 and 80% were women. Sixty-eight percent of patients had nephrotic syndrome at diagnosis. The average serum creatinine was 0.98 ± 0.78 mg/dl. Six percent of patients died and 5.3% developed end-stage renal disease (ESRD). ESRD was predicted by male sex, hypertension, dyslipidemia, high basal 24 h-proteinuria, high basal serum creatinine and a low basal creatinine clearance. Age, cardiac insufficiency, peripheral artheriopathy, hemodialysis and not having received mycophenolate mofetil or antimalarials for MLN predicted death.Conclusions
Pure MLN frequently presents with nephrotic syndrome, high proteinuria and normal serum creatinine. Its prognosis is favourable in maintaining renal function although proteinuria usually persists over time. Baseline cardiovascular disease and not having a health insurance are related with poor prognosis. 相似文献16.
V. Spagnoli M. Diefenbronn B. Merat D. Logeart G. Sideris P. Henry S. Manzo-Silberman L. Drouet J.G. Dillinger 《Annales de cardiologie et d'angeiologie》2019,68(2):98-106
Background
Coronary lesions characteristics as well as patient thrombogenicity can explain coronary events manifestation. In young patient, local conditions are usually less important and thrombogenicity could play a significant role. Assessing thrombophilia could be justified in young patients and may induce an adapted therapeutic management.Purpose
We aimed to assess the prevalence of thrombophilia and therapeutic modification in young adults aged ≤ 55 years admitted in our department for ST elevation myocardial infarction (STEMI).Methods
From January 2013 to January 2017, data on all patients aged ≤ 55 years with STEMI admitted in emergency were retrospectively retrieved from our database. Thrombophilia investigation was made regarding clinical (with or without cardiovascular risk factors [CVRF]), biological and/or angiographic evaluation.Results
A total of 133 patients aged ≤ 55 years with STEMI were included. Cardiac arrest occurred in 15 patients (11%). One or less CVRF were found in 47 patients (35%). Smoking was reported in 93 patients (70%) and drug addiction (cannabis, cocaine) in 19 patients (14%). A subset of 51 patients (38%) were screened for thrombophilia. Patients with thrombophilia assessment were younger, less active smokers and presented less CVRF than patients without investigation (P < 0.001). Single vessel diseased was found in 88 patients (66%). No differences regarding coronary procedural characteristic were found between the two groups. The most frequently encountered aetiology, found in 122 patients (92%), was de novo intra-arterial thrombosis related to atherosclerosis. In patients with thrombophilia assessment (n = 51), one or more abnormal biological results was found in 22 patients (43%) and a therapeutic adjustment was made in 6 patients (12%).Conclusion
Thrombophilia screening in young STEMI adults showed an abnormality in 43% of cases. Antithrombotic treatment can be modified after its demonstration. 相似文献17.
N.F. Benatta D.D. Batouche S. Benouaz M.A. Djazouli 《Annales de cardiologie et d'angeiologie》2019,68(2):94-97
Introduction
Infectious endocarditis (IE) is a serious disease that has continued to evolve in diagnostic and therapeutic terms.Aim
To analyze the diagnostic and out come profile.Methods
We collected 57 (IE) cases with a definite diagnosis according to the modified Duke criteria. Patients were admitted consecutively to the Cardiology Department of the Oran university hospital from January 2011 to June 2017. Among the variables studied: clinical data, paraclinic data, therapeutic management and hospital outcome.Results
The mean age was 40.5 ± 15 years (extreme 16–67 years), with a male predominance (sex-ratio = 1.5). This was a native valve IE in 70% of cases, on valve prosthesis in 15.5% of patients, on congenital heart disease in 2% and on pacemaker probe in 4% of cases. The entrance door was dominated by oral origin. Blood cultures were positive only in 51% of cases. The most commonly implicated organism in staphylococci in 22.6%, streptococcus in 18.9% and brucellosis in 3.8%. Ultrasound data revealed vegetation (83%), cardiac abscess (19%), valvular perforation (15.1%) and prosthesis disintegration (7.5%). Complications were mainly neurological complications (27%) and hemodynamics (26%). Cardiac surgery occurred in 29% of patients. Hospital mortality was 26%, predictive factors were staphylococcal AI (P < 0.001), cardiac insufficiency (P < 0.001) and neurological complications (P = 0.04).Conclusion
Infectious endocarditis is a serious disease in the absence of surgery. The diagnosis is based on echocardiography in the first place and blood cultures. The population is often young revealing the EI by complications; its prevention is the best way to improve its prognosis. 相似文献18.
Gabriel Horta-Baas Adolfo Camargo-Coronel Dafhne Guadalupe Miranda-Hernández Leslie Gabriela Gónzalez-Parra María del Socorro Romero-Figueroa Mario Pérez-Cristóbal 《Reumatología clinica》2019,15(3):140-145
Introduction
End-stage renal disease (ESRD) due to lupus nephritis (LN) occurs in 10%-30% of patients. Initially systemic lupus erythematosus (SLE) was a contraindication for kidney transplantation (KT). Today, long-term graft survival remains controversial. Our objective was to compare the survival after KT in patients with SLE or other causes of ESRD.Methods
All SLE patients who had undergone KT in a retrospective cohort were included. Renal graft survival was compared with that of 50 controls, matched for age, sex, and year of transplantation. Survival was evaluated by the Kaplan-Meier test and the Cox proportional hazards model.Results
Twenty-five subjects with SLE were included. The estimated 1-year, 2- and 5-year survival rates for patients with SLE were 92%, 66% and 66%. Renal graft survival did not differ between patients with SLE and other causes of ESRD (P = .39). The multivariate analysis showed no significant difference in graft survival between the two groups (hazard ratio, HR = 1.95, 95% confidence interval [CI] 0.57-6.61, P = .28). The recurrence rate of LN was 8% and was not associated with graft loss. Acute rejection was the only variable associated with graft loss in patients with SLE (HR = 16.5, 95% CI 1.94-140.1, P = .01).Conclusions
Renal graft survival in SLE patients did not differ from that reported for other causes of ESRD. 相似文献19.
YoungBok Lee JiHyun Lee JinYoung Choi DongSoo Yu KyungDo Han Yong-Gyu Park 《Diabetes & metabolism》2019,45(1):32-38