Browsing by Subject "Endocarditis"

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    Behavior and attitudes among Spanish general dentists towards the anticoagulated patient: a pilot study
    (Wiley, 2010-01-21) López Jornet, Pia; Camacho Alonso, Fabio; González Escribano, Myriam; Martínez Beneyto, Yolanda; Dermatología, Estomatología, Radiología y Medicina Física
    Aim To determine the attitude of Spanish general dentists in relation to dental extraction in patients with heart valve prostheses subjected to acenocoumarol anticoagulation. Material and methods A telephone survey was made of Spanish general dentists, asking about the indicated approach in the case of performing dental extractions in patients with heart valve prostheses subjected to acenocoumarol (Sintrom®) anticoagulation. Results Of the 271 dentists answered, 175 were male (64.6%) and 96 were female (35.4%), with a mean professional experience of 20.17 ± 9.3 years. A total of 228 dentists (84.1%) indicated the need to refer the patient to a specialist for establishing the required approach, while 43 dentists (15.9%) did not consider such a measure to be necessary. Among this latter group of 43 dentists, 26 (60.5%) considered that acenocoumarol should be withdrawn or replaced by low-molecular weight heparin, while 17 (39.5%) were of the opinion that the anticoagulation regimen should not be modified. In relation to the international normalized ratio, 36 (83.7%) did not consider it necessary to request this parameter. As regards the prevention of endocarditis, 11 (25.6%) specified the need for prophylaxis, although only eight (72.7%) did so correctly. There were no statistically significant differences in behaviour in relation to either gender or years of professional experience. Conclusions This study identifies a lack of knowledge on the part of the dentists regarding the approach to dental extraction in patients with heart valve prostheses subjected to anticoagulation. Due educational measures therefore should be reinforced among these professionals.
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    EN-DALBACEN 2.0 Cohort: real-life study of dalbavancin as sequential/consolidation therapy in patients with infective endocarditis due to Gram-positive cocci
    (Elsevier, 2023-07-04) Hidalgo-Tenorio, Carmen; Sadyrbaeva-Dolgova, Svetlana; Enríquez-Gómez, Andrés; Muñoz, Patricia; Plata-Ciezar, Antonio; Miró, Jose Maria; Alarcón, Arístides; Martínez-Marcos, Francisco Javier; Loeches, Belén; Escrihuela-Vidal, Francesc; Vinuesa, David; Herrero, Carmen; Boix-Palop, Lucia; Arenas, María del Mar; García-Vázquez, Elisa; Arnaiz de las Revillas, Francisco; Pasquau, J.; EN-DALBACEN study group; Medicina
    Objectives: Infective endocarditis (IE) has high mortality and morbidity and requires long hospital staysto deliver the antibiotic treatment recommended in clinical practice guidelines. We aimed to analyse the health outcomes of the use of dalbavancin (DBV) in the consolidation treatment of IEs caused by Gram-positive cocci and to perform a pharmacoeconomic study. Materials and methods: This observational, retrospective, Spanish multicentre study in patients with IE who received DBV as part of antibiotic treatment in consolidation phase were followed for at least 12 months. The study was approved by the Provincial Committee of the coordinating centre. Results: The study included 124 subjects, 70.2% male, with a mean age of 67.4 years and median Charlson index of 4 (interquartile range: 2.5–6). Criteria for definite IE were met by 91.1%. Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (22.6%), Enterococcus faecalis (19.4%), and Streptococcus Spp. (9.7%) were isolated more frequently, all susceptible to vancomycin. Before DVB administration, 91.2% had undergone surgery; 60.5% had received a second regimen for 24.5 d (16.6–56); and 20.2% had received a third regimen for 14.5 d (12–19.5). DBV was administered to facilitate discharge in 95.2% of cases. At 12 months, the effectiveness was of 95.9%, and there was 0.8% loss to follow-up, 0.8% IE-related death, and 3.2% relapse. Adverse events were recorded in 3.2%. The hospital stay was reduced by 14 d, and there was a mean savings of 5548.57 €/patient vs. conventional treatments. Conclusion: DBV is highly effective, safe, and cost-effective as consolidation therapy in patients with IE by Gram-positive cocci, with few adverse events.
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    EN-DALBACEN 2.0 Cohort: real-life study of dalbavancin as sequential/consolidation therapy in patients with infective endocarditis due to Gram-positive cocci
    (Elsevier, 2023-07-04) Hidalgo-Tenorio, Carmen; Sadyrbaeva-Dolgova, Svetlana; Enríquez-Gómez, Andrés; Muñoz, Patricia; Plata-Ciezar, Antonio; Miró, Jose Maria; Alarcón, Arístides de; Martínez-Marcos, Francisco Javier; Loeches, Belén; Eschiruela- Vidal, Francesc; Vinuesa, David; Herrero, Carmen; Badia-Martí, Cristina; Arenas, María del Mar; García-Vázquez, Elisa; Arnaiz de las Revillas, Francisco; Pasquau, J.; EN-DALBACEN study group; Medicina
    Infective endocarditis (IE) has high mortality and morbidity and requires long hospital stays to deliver the antibiotic treatment recommended in clinical practice guidelines. The objectives were to analyze the health outcomes of the use of dalbavancin (DBV) in the consolidation treatment of IEs caused by Gram-positive cocci (GPC) and to perform a pharmacoeconomic study. Material and methods: This observational, retrospective, Spanish multicenter study in patients with IE who received DBV as part of antibiotic treatment in consolidation phase and were followed for at least 12 months. The study was approved by the Provincial Committee of the coordinating center. Results: The study included 124 subjects, 70.2% male, with a mean age of 67.4 years and median Charlson index of 4 (IQR:2.5-6). Criteria for definite IE were met by 91.1%. Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (22.6%), Enterococcus faecalis (19.4%), Streptococcus spp. (9.7%) were isolated more frequently, all susceptible to vancomycin. Before DVB administration, 91.2% had undergone surgery, 60.5% had received a second regimen for 24.5 days (16.6-56), and 20.2% a third regimen for 14.5 days (12-19.5). DBV was administered to facilitate discharge in 95.2% of cases. At 12 months, the effectiveness was of 95.9%, there was 0.8% loss to follow-up, 0.8% IE-related death and 3.2% relapse. Adverse events were recorded in 3.2%. The hospital stay was reduced by 14 days and there was a mean saving of 5,548.57€/patient versus conventional treatments. Conclusion: DBV is highly effective, safe, and cost-effective as consolidation therapy in patients with IE by GPC, with few adverse events.
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    Infective endocarditis in hypertrophic cardiomyopathy: A multicenter, prospective, cohort study
    (Lippincott, Williams & Wilkins, 2016-05-31) Dominguez, Fernando; Ramos, Antonio; Bouza, Emilio; Muñoz, Patricia; Valerio, Maricela C.; Fariñas, M. Carmen; Berrazueta, José Ramón de; Zarauza, Jesús; Pericás Pulido, Juan Manuel; Paré, Juan Carlos; Alarcón, Arístides de; Sousa, Dolores; Rodriguez Bailón, Isabel; Montejo-Baranda, Miguel; Noureddine, Mariam; García-Vázquez, Elisa; Garcia-Pavia, Pablo; Medicina
    Infective endocarditis (IE) complicating hypertrophic cardiomyopathy (HCM) is a poorly known entity. Although current guidelines do not recommend IE antibiotic prophylaxis (IEAP) in HCM, controversy remains. This study sought to describe the clinical course of a large series of IE HCM and to compare IE in HCM patients with IE patients with and without an indication for IEAP. Data from the GAMES IE registry involving 27 Spanish hospitals were analyzed. From January 2008 to December 2013, 2000 consecutive IE patients were prospectively included in the registry. Eleven IE HCM additional cases from before 2008 were also studied. Clinical, microbiological, and echocardiographic characteristics were analyzed in IE HCM patients (n = 34) and in IE HCM reported in literature (n = 84). Patients with nondevice IE (n = 1807) were classified into 3 groups: group 1, HCM with native-valve IE (n = 26); group 2, patients with IEAP indication (n = 696); group 3, patients with no IEAP indication (n = 1085). IE episode and 1-year follow-up data were gathered. One-year mortality in IE HCM was 42% in our study and 22% in the literature. IE was more frequent, although not exclusive, in obstructive HCM (59% and 74%, respectively). Group 1 exhibited more IE predisposing factors than groups 2 and 3 (62% vs 40% vs 50%, P < 0.01), and more previous dental procedures (23% vs 6% vs 8%, P < 0.01). Furthermore, Group 1 experienced a higher incidence of Streptococcus infections than Group 2 (39% vs 22%, P < 0.01) and similar to Group 3 (39% vs 30%, P = 0.34). Overall mortality was similar among groups (42% vs 36% vs 35%, P = 0.64). IE occurs in HCM patients with and without obstruction. Mortality of IE HCM is high but similar to patients with and without IEAP indication. Predisposing factors, previous dental procedures, and streptococcal infection are higher in IE HCM, suggesting that HCM patients could benefit from IEAP.
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    Mural Endocarditis: The GAMES Registry Series and Review of the Literature
    (Springer, 2021-07-26) Gutiérrez-Villanueva, Andrea; Muñoz, Patricia; Delgado-Montero, Antonia; Olmedo-Samperio, María; Alarcón, Arístides de; Gutiérrez-Carretero, Encarnación; Zarauza, Jesús; García i Pares, Delia; Goenaga, Miguel Ángel; Ojeda-Burgos, Guillermo; Goikoetxea-Agirre, Ane Josune; Reguera-Iglesias, José Mª; Ramos, Antonio; Fernández-Cruz, Ana; Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES)S); García-Vázquez, Elisa; Medicina
    Introduction: Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis. Methods: Patients with infectious endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series. Results: Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device associated IE (DIE), patients with MIE were younger (median age 59 years, p \ 0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE, p \ 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE, p = 0.006), catheter source (59.3% versus 9.7% VIE and 8.8% DIE, p \ 0.01) and Candida etiology (22.2% versus 2% DIE and 1.2% VIE, p \ 0.01) were more common in MIE, whereas the Charlson Index was lower (4 versus 5 in non- MIE, p = 0.006). Mortality was similar.MIE from the literature shared many characteristics with MIE from GAMES, although patients were younger (45 years vs. 56 years, p \ 0.001), the Charlson Index was lower (1.3 vs. 4.3, p = 0.0001), catheter source was less common (13.9% vs. 59.3%) and there were more IVDUs (25% vs. 3.7%). S. aureus was the most frequent microorganism (50%, p = 0.035). Systemic complications were more common but mortality was similar. Conclusion: MIE is a rare entity. It is often a complication of catheter use, particularly in immunocompromised and hemodialysis patients. Fungal etiology is common. Mortality is similar to other IEs.
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    Role of age and comorbidities in mortality of patients with infective endocarditis
    (Elsevier, 2019-03-21) Armiñanzas, Carlos; Fariñas-Álvarez, Concepción; Zarauza, Jesús; Muñoz, Patricia; González Ramallo, Víctor; Martínez Sellés, Manuel; Miró Meda, José Mª.; Pericás, Juan Manuel; Goenaga, Miguel Ángel; Ojeda Burgos, Guillermo; Rodríguez Álvarez, Regino; Fuster, David; García de la Mària, Cristina; Hernández-Meneses, Marta; Llopis Pérez, Jaume; Marco, Francesc; Miró, José M.; Moreno, Asunción; Nicolás, David; Ninot, Salvador; Quintana, Eduardo; Castelo Corral, Laura; Paré, Carlos; Pereda, Daniel; Pericás, Juan M.; Pomar, José L.; Ramírez, José; Rovira, Irene; Sandoval, Elena; Sitges, Marta; Soy, Dolors; Téllez, Adrián; Gálvez-Aceba, Juan; Tolosana, José M.; Vidal, Bárbara; Vila, Jordi; Adán, Iván; Bermejo, Javier; Bouza, Emilio; Celemín, Daniel; Cuerpo Caballero, Gregorio; Delgado Montero, Antonia; Fernández Cruz, Ana; Martínez Marcos, Francisco Javier; García Mansilla, Ana; García Leoni, Mª. Eugenia; González Ramallo, Víctor; Kestler Hernández, Martha; Mari Hualde, Amaia; Marín, Mercedes; Martínez-Sellés, Manuel; Menárguez, Mª. Cruz; Muñoz, Patricia; Rincón, Cristina; Fariñas, Maria Carmen; Rodríguez-Abella, Hugo; Rodríguez-Créixems, Marta; Pinilla, Blanca; Pinto, Ángel; Valerio, Maricela; Vázquez, Pilar; Verde Moreno, Eduardo; Antorrena, Isabel; Loeches, Belén; Martín Quirós, Alejandro; Fernández Sánchez, Fernando; Moreno, Mar; Ramírez, Ulises; Rial Bastón, Verónica; Romero, María; Saldaña, Araceli; Agüero Balbín, Jesús; Amado, Cristina; Armiñanzas Castillo, Carlos; Arnaiz García, Ana; Cobo Belaustegui, Manuel; Noureddine, Mariam; Fariñas, María Carmen; Fariñas-Álvarez, Concepción; Gómez Izquierdo, Rubén; García, Iván; González-Rico, Claudia; Gutiérrez-Cuadra, Manuel; Gutiérrez Díez, José; Pajarón, Marcos; Parra, José Antonio; Sarralde, Aurelio; Rosas, Gabriel; Teira, Ramón; Zarauza, Jesús; Domínguez, Fernando; García Pavía, Pablo; González, Jesús; Orden, Beatriz; Ramos, Antonio; Centella, Tomasa; Hermida, José Manuel; Moya, José Luis; Torre Lima, Javier de la; Martín-Dávila, Pilar; Navas, Enrique; Oliva, Enrique; Río, Alejandro del; Ruiz, Soledad; Hidalgo Tenorio, Carmen; Almendro Delia, Manuel; Araji, Omar; Barquero, José Miguel; Calvo Jambrina, Román; Aramendi, José; Cueto, Marina de; Gálvez Acebal, Juan; Méndez, Irene; Morales, Isabel; López-Cortés, Luis Eduardo; Alarcón, Arístides de; García, Emilio; Haro, Juan Luis; Lepe, José Antonio; López, Francisco; Bereciartua, Elena; Luque, Rafael; Alonso, Luis Javier; Azcárate, Pedro; Azcona Gutiérrez, José Manuel; Blanco, José; García-Álvarez, Lara; Oteo, José Antonio; Sanz, Mercedes; Benito, Natividad de; Gurguí, Mercé; Blanco, María José; Pacho, Cristina; Pericas, Roser; Pons, Guillem; Álvarez, M.; Fernández, A.L.; Martínez, Amparo; Prieto, A.; Regueiro, Benito; Tijeira, E.; Vega, Marino; Blanco, Roberto; Canut Blasco, Andrés; Cordo Mollar, José; Gainzarain Arana, Juan Carlos; García Uriarte, Oscar; Martín López, Alejandro; Ortiz de Zárate, Zuriñe; Urturi Matos, José Antonio; García Domínguez, Gloria; Sánchez-Porto, Antonio; Arribas Leal, José Mª.; Boado, María Victoria; García-Vázquez, Elisa; Hernández Torres, Alicia; Blázquez, Ana; Morena Valenzuela, Gonzalo de la; Alonso, Ángel; Aramburu, Javier; Calvo, Felicitas Elena; Moreno Rodríguez, Anai; Tarabini-Castellani, Paola; Heredero Gálvez, Eva; Campaña Lázaro, Marta; Maicas Bellido, Carolina; Largo Pau, José; Sepúlveda, Mª. Antonia; Toledano Sierra, Pilar; Iqbal-Mirza, Sadaf Zafar; Cascales Alcolea, Eva; Egea Serrano, Pilar; Hernández Roca, José Joaquín; Keituqwa Yañez, Ivan; Peláez Ballesta, Ana; Crespo, Alejandro; Soriano, Víctor; Moreno Escobar, Eduardo; Peña Monje, Alejandro; Sánchez Cabrera, Valme; Vinuesa García, David; Arrizabalaga Asenjo, María; Cifuentes Luna, Carmen; Núñez Morcillo, Juana; Pérez Seco, Mª. Cruz; Villoslada Gelabert, Aroa; Goikoetxea, Josune; Aured Guallar, Carmen; Fernández Abad, Nuria; García Mangas, Pilar; Matamala Adell, Marta; Palacián Ruiz, Mª. Pilar; Carlos Porres, Juan; Alcaraz Vidal, Begoña; Cobos Trigueros, Nazaret; Del Amor Espín, María Jesús; Giner Caro, José Antonio; Iruretagoyena, José Ramón; Jiménez Sánchez, Roberto; Jimeno Almazán, Amaya; Ortín Freire, Alejandro; Viqueira González, Monserrat; Pericás Ramis, Pere; Ribas Blanco, Mª. Ángels; Ruiz de Gopegui Bordes, Enrique; Vidal Bonet, Laura; Bellón Munera, Mª. Carmen; Escribano Garaizabal, Elena; Irurzun Zuazaba, Josu; Tercero Martínez, Antonia; Segura Luque, Juan Carlos; López-Soria, Leire; Montejo, Miguel; Nieto, Javier; Rodrigo, David; Rodríguez, David; Rodríguez, Regino; Vitoria, Yolanda; Voces, Roberto; García López, Mª. Victoria; Ivanova Georgieva, Radka; Ojeda, Guillermo; Rodríguez Bailón, Isabel; Ruiz Morales, Josefa; Cuende, Ana María; Echeverría, Tomás; Fuerte, Ana; Gaminde, Eduardo; Goenaga, Miguel Ángel; Idígoras, Pedro I; Iribarren, José Antonio; Izaguirre Yarza, Alberto; Kortajarena Urkola, Xabier; Reviejo, Carlos; Carrasco, Rafael; Climent, Vicente; Llamas, Patricio; Merino, Esperanza; Plazas, Joaquín; Reus, Sergio; Álvarez, Nemesio; Bravo-Ferrer, José María; Castelo, Laura; Cuenca, José; Llinares, Pedro; Miguez Rey, Enrique; Rodríguez Mayo, María; Sánchez, Efrén; Sousa Regueiro, Dolores; Martínez, Francisco Javier; Alonso, Mª. del Mar; Castro, Beatriz; García Rosado, Dácil; Durán, Mª. del Carmen; Miguel Gómez, Mª. Antonia; Lacalzada, Juan; Nassar, Ibrahim; Plata Cieza, Antonio; Reguera Iglesias, José Mª.; Asensi Álvarez, Víctor; Costas, Carlos; Hera, Jesús de la; Fernández Suárez, Jonnathan; Iglesias Fraile, Lisardo; León Arguero, Víctor; López Menéndez, José; Mencia Bajo, Pilar; Morales, Carlos; Moreno Torrico, Alfonso; Palomo, Carmen; Paya Martínez, Begoña; Rodríguez Esteban, Ángeles; Rodríguez García, Raquel; Telenti Asensio, Mauricio; Almela, Manuel; Ambrosioni, Juan; Azqueta, Manuel; Brunet, Mercè; Bodro, Marta; Cartañá, Ramón; Falces, Carlos; Fita, Guillermina; Medicina
    Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: < 65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the < 65-year group (20.3%, < 65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, < 65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged < 65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the < 65-year group.
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    Varón marroquí con espondilodiscitis de larga evolución, orquitis y endocarditis
    (Asociación Colombiana de Medicina Interna, 2015-08-02) Marín, Antonio; Muñoz, María Ángeles; Rodriguez, Tomás; Muñoz-Dávila, María J.; Genética y Microbiología
    Osteoarticular involvement is the most common complication of brucellosis. Spondylodiscitis is a serious complication as it is often associated with abscess formation. The case of a 43 years old man born in Morocco with symptoms, signs and imaging findings of longstanding spondylodiscitis, orchitis and endocarditis is presented. Through the implementation of complementary laboratory tests, diagnosis infection by Brucella spp. was made.This case aims to raise awareness in the medical community about the importance of considering Brucella spp. as a differential diagnosis in patients with suspected infectious spondylodiscitis, especially in those patients with epidemiological background, allowing make a successful and timely diagnosis. This case is interesting because never before had been described the simultaneous presence of these three manifestations of brucellosis in an immunocompetent patient. (Acta Med Colomb 2015; 40: 166-168).