Intravenous thrombolysis is contraindicated in acute ischemic stroke secondary to infective endocarditis. We report our initial experience in 6 cases of proximal vessel occlusion treated with ...mechanical thrombectomy, which was safe (no bleeding) and effective (significant early neurological improvement) and might be useful in this clinical setting.
Las dos Constituciones Apostólicas donde aparece la Teología Fundamenal como disciplina son la Sapientia christiana del 1979 y, casi cuatro lustros después, la Veritatis gaudium del 2017. En este ...marco, la Encíclica Fides et ratio (1998) ofrece una nueva formulación de la dimensión apologético-contextual complementaria a la dimensión dogmático-gnoseológica privilegiada por la DV. La aportación de la Teología Fundamental en España partiendo de su raíz bíblica y conciliar, ha ido articulando progresivamente estas dos dimensiones básicas, con un notable crescendo reciente en la dimensión apologética y contextual que posibilite mejor hoy el poder «dar razón de la esperanza» (1Pe 3,15). Abstract: The two Apostolic Constitutions where fundamental theology appears as discipline are the Sapientia christiana (1979) and, nearly twenty years later, the Veritatis gaudium (2017). In this period, the Encyclical Fides et ratio (1998) provides a new formulation to the contextual-apologetic dimension which complements the favoured dogmatic-gnosiological dimension by the DV. The contribution of the Fundamental Theology in Spain from its biblical and Conciliar roots has been gradually assembling these two dimensions with a considerable, recent crescendo in the contextual and apologetic dimension which, nowadays, best enables to be able to "give a reason for their hoping". (1Pe 3,15).
Prosthetic vascular graft infection (PVGI) is a severe complication associated with high morbidity and mortality. Clinical diagnosis is complex, requiring image testing such as CT angiography or ...leukocyte scintigraphy, which has considerable limitations. The aim of this study was to know the diagnostic yield of PET/CT with 18F-Fluorodeoxyglucose (18F-FDG) in patients with suspected PVGI.
We performed a prospective cohort study including 49 patients with suspected PVGI, median age of 62 ± 14 years. Three uptake patterns were defined following published recommendations: (i) focal, (ii) patched (PVGI criteria), and (iii) diffuse (no PVGI criterion).
Sensitivity, specificity, and positive and negative predictive values for 18F-FDG-PET/CT were 88%, 79%, 67%, and 93%, respectively. 18F-FDG-PET/CT identified 14/16 cases of PVGI showing a focal (n = 10) or patched pattern (n = 4), being true negative in 26/33 cases with either a diffuse pattern (n = 16) or without uptake (n = 10). Five of the seven false-positive cases (71%) showed a patched pattern and all coincided with the application of adhesives for PVG placement.
18F-FDG-PET/CT is a useful technique for the diagnosis of PVGI. A patched pattern on PET/CT in patients in whom adhesives were applied for prosthetic vascular graft placement does not indicate infection.
This study describes coagulase-negative staphylococcal (CoNS) infective endocarditis (IE) epidemiology at our institution, the antibiotic susceptibility profile, and the influence of vancomycin ...minimum inhibitory concentration (MIC) on patient outcomes. One hundred and three adults with definite IE admitted to an 850-bed tertiary care hospital in Barcelona from 1995-2008 were prospectively included in the cohort. We observed that CoNS IE was an important cause of community-acquired and healthcare-associated IE; one-third of patients involved native valves. Staphylococcus epidermidis was the most frequent species, methicillin-resistant in 52% of patients. CoNS frozen isolates were available in 88 patients. Vancomycin MICs of 2.0 μg/mL were common; almost all cases were found among S. epidermidis isolates and did not increase over time. Eighty-five patients were treated either with cloxacillin or vancomycin: 38 patients (Group 1) were treated with cloxacillin, and 47 received vancomycin; of these 47, 27 had CoNS isolates with a vancomycin MIC <2.0 μg/mL (Group 2), 20 had isolates with a vancomycin MIC ≥ 2.0 μg/mL (Group 3). One-year mortality was 21%, 48%, and 65% in Groups 1, 2, and 3, respectively (P = 0.003). After adjusting for confounders and taking Group 2 as a reference, methicillin-susceptibility was associated with lower 1-year mortality (OR 0.12, 95% CI 0.02-0.55), and vancomycin MIC ≥ 2.0 μg/mL showed a trend to higher 1-year mortality (OR 3.7, 95% CI 0.9-15.2; P=0.069). Other independent variables associated with 1-year mortality were heart failure (OR 6.2, 95% CI 1.5-25.2) and pacemaker lead IE (OR 0.1, 95%CI 0.02-0.51). In conclusion, methicillin-resistant S.epidermidis was the leading cause of CoNS IE, and patients receiving vancomycin had higher mortality rates than those receiving cloxacillin; mortality was higher among patients having isolates with vancomycin MICs ≥ 2.0 μg/mL.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Data on the incidence, associated factors, and prognosis of pericardial effusion (PE) in patients with infective endocarditis (IE) are scarce. Patients with native valve IE were prospectively ...followed in our center from 1990 to 2007. A logistic regression analysis was performed to identify independent variables associated with PE and mortality. We included 479 episodes of IE from 459 patients (70% men, mean age 51 years). Small-to-moderate PE was observed in 109 episodes (23%) and large-to-very large PE was observed in 9 episodes (2%). Patients with small-to-moderate PE had a greater prevalence of intravenous drug use (38% vs 23%) and more frequent right-sided IE than patients without PE (33% vs 17%). Patients with large-to-very large PE had a higher rate of systemic emboli (22% vs 18%) and periannular abscess (22% vs 6%) than patients without PE. Renal failure was associated with a higher risk of PE (odds ratio OR 2.1, 95% confidence interval CI 1.3 to 3.3); age was associated with a lower risk of PE (OR 0.98, 95% CI 0.97 to 0.99). One-year mortality of patients with IE with large-to-very large PE was higher than that of patients with small-to-moderate and absence of PE (56%, 18%, and 24%, respectively, p = 0.033). Large-to-very large PE increases the 1-year mortality of IE (OR 3.0, 95% CI 1.2 to 7.9). In conclusion, renal failure and younger age are associated with a higher risk of PE. Large-to-very large PE was associated with an increase in 1-year mortality.
Three patients who presented with massive hemoptysis after the insertion of a Swan-Ganz catheter for cardiac surgery are reported. Pulmonary artery pseudoaneurysms were diagnosed and successfully ...treated by embolization with a vascular plug. Follow-up at 15 months showed no recurrence of hemoptysis, and computed tomography helped confirm complete occlusion of the pseudoaneurysms.
A partir de la Dei Verbum la Teologia Fundamental actual presenta los puntos centrales del conocimiento teologico (Revelación, Fe, Escritura, Tradición...), por esto no basta analizar sus origenes en ...la Apologética clásica, sino que conviene incorporar como su origen la disciplina surgida en el s. XIX conocida como Epistemología, Gnoseología Conocimiento teológico, esbozada en el De locis theologicis de M. Cano (s. XVI) y desplegada en M. J. Scheeben como Teoria del conocimiento teológico (año 1874). Sobre su método: la parte Gnoseológico-epistemológica se debe inspirar en el axioma: «la fe que busca comprender», siguiendo el clásico MÉTODO TEOLÓGICO-DOGMÁTICO. Por otro lado, la parte Apologético-contextual se inspirará en el axioma: «la inteligencia que busca la fe», articulando novedosamente el MÉTODO TEOLÓGICO-FUNDAMENTAL, cuya actualizada función será mostrar que la verdad profesada por la fe puede presentar razonadamente «signos» y «testimonios» historicos y antropológicos por los cuales puede ser ofrecida y atestiguada como «disponible para ser creída» (le croyable disponible: P. Ricoeur). Following Dei Verbum the Fundamental Theology presents the central points of theological Knowledge (Revelation, Faith, Scripture, Tradition...), for this reason is necessary not only to analyze the origin of Fundamental Theology in the classical Apologetics, but must incorporate as its origin the discipline arisen in the s. XIX known as Epistemology, Gnoseology or Theological Knowledge, sketched in the De locis theologicis by M. Cano (16th century) and displayed in M. J. Scheeben as Theory of theological Knowledge (year 1874). On the theological method: the Gnoseologic-epistemological part must be inspired by the axiom: «the faith that seeks to understand», following the classic Theological-Dogmatic Method. On the other hand, the Apologetic-contextual part will be inspired by the axiom: «the intelligence that seeks faith», articulating novelly the Theological-Fundamental Method, whose updated function will show that the truth professed by faith can reasonably present historical and anthropological «signs» and «testimonies» by which it can be offered and attested as «available to be believed» (le croyable disponible, P. Ricoeur).
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