To determine the incidence of endocarditis in bacteremic patients with prosthetic heart valves and the risk factors for and the effect of duration of antibiotic therapy on development of endocarditis ...in such patients.
Multicenter, prospective observational study.
Six university teaching hospitals with high-volume cardiothoracic surgery.
One hundred seventy-one consecutive patients with prosthetic heart valves who developed bacteremia during hospitalization.
Patients were evaluated when they were identified as having bacteremia and 1, 2, 6, and 12 months after its occurrence. Of 171 patients, 74 (43%) developed endocarditis: Fifty-six (33%) had prosthetic valve endocarditis at the time bacteremia was discovered ("endocarditis at outset"), whereas 18 (11%) developed endocarditis a mean of 45 days after bacteremia was discovered ("new endocarditis"). Mitral valve location and staphylococcal bacteremia (Staphylococcus aureus or S. epidermidis) were significantly associated with the development of "new" endocarditis. All 18 cases of new endocarditis were nosocomial, and in 6 of these cases (33%) bacteremia was acquired via intravascular devices. Twenty-one patients without evidence of endocarditis at the time of bacteremia received short-term antibiotic therapy (< 14 days); 1 patient (5%) developed endocarditis. Eleven of 70 patients (16%) who received long-term antibiotic therapy (> 14 days) developed endocarditis (P > 0.2).
Bacteremic patients with prosthetic heart valves were at notable risk for developing endocarditis, even when they received antibiotic therapy before endocarditis developed and regardless of the duration of such therapy. Intravascular devices were a common portal of entry.
Interventional Nephrology in Puerto Rico Leon, Francisco Torre; Bermudez, Carlos Rivera; Hernandez, Victor ...
Seminars in dialysis,
03/2006, Letnik:
19, Številka:
2
Journal Article
Recenzirano
ABSTRACT
Vascular access is emerging as a critical issue for hemodialysis patients in Puerto Rico. In more than 50% of the hemodialysis patients, tunneled hemodialysis catheters are the sole access ...for providing dialysis therapy. Most disturbing is the fact that a significant number of these catheters are nontunneled temporary catheters, sometimes placed in the subclavian vein. These facts have contributed significantly to the morbidity and mortality seen in chronic dialysis patients. In addition, many cases of early or late dysfunction of arteriovenous access are not detected and treated in a timely manner due to the lack of a comprehensive vascular access program for end‐stage renal disease (ESRD) patients. In fact, monitoring programs to identify and detect vascular access dysfunction are virtually nonexistent in many chronic dialysis units. Even when diagnosed, it is not treated in a timely fashion. Recently literature has shown that procedure‐related delays in the treatment of patients with renal disease can be minimized and nephrology care more efficiently delivered by a nephrologist trained in nephrology‐related procedures. In an effort to optimize the care of our ESRD patients, we took the initiative to develop an interventional nephrology program that effectively deals with vascular access‐related procedures in a timely manner. This approach has minimized delays, decreased hospitalizations and the use of temporary catheters, and improved the medical care of our chronic dialysis patients. So far we have performed more than 400 procedures in the 6 months since the initiation of the program. In this article we describe our initial experience with interventional nephrology in Puerto Rico.
Il s’agit d’une réédition, un quart de siècle après, du tout premier livre de Vinciane Despret sur les oiseaux, quasiment sans modifications, hormis l’ajout d’une postface signée de la philosophe ...elle-même et l’inversion du titre et du sous-titre. L’ouvrage nous replonge dans le récit du premier terrain de Vinciane Despret, lorsque celle-ci part en Israël rejoindre l’éthologue Amotz Zahavi (1928-2017) et son équipe dans le désert du Néguev. Zahavi y étudie en effet depuis de longues années le...
Mexique Rivera, Antonio
Signata. Annales des sémiotiques (Online),
09/2019
Journal Article
Recenzirano
Odprti dostop
En 2018, la sémiotique au Mexique a connu une période de floraison et d’expansion. Étant donné que la principale association du pays, l’Association Mexicaine de Sémiotique Visuelle et de l’Espace ...(AMESVE), est entrée en vacance depuis son dernier congrès en 2014, le relais est désormais entre les mains des séminaires et des groupes situés dans différentes villes du territoire national. Ces groupes et séminaires réalisent, avec leurs propres ressources, diverses activités de portée locale, et ...
Mexique Rivera, Marco Antonio
Signata. Annales des sémiotiques (Online),
10/2021
Journal Article
Recenzirano
Odprti dostop
IXe Congrès Latino-américain de Sémiotique L’événement le plus important de cette année a été, peut-être, la célébration du IXe Congrès Latino-américain de Sémiotique, intitulé Sémiotique Visuelle : ...Perspectives latino-américaines, qui s’est tenu du 6 au 9 février 2019 dans la ville de Zacatecas parrainé par la Fédération Latino-américaine de Sémiotique (FELS) et l’Université Autonome de Zacatecas. Le congrès était composé de six conférences principales, huit panels, sept ateliers et cinquant...
We investigated the Castilian Spanish versions of three scales (the Hamilton Rating Scale for Depression, the Carroll Rating Scale for Depression, and the Montgomery-Asberg Depression Rating Scale) ...as to their suitability for classifying major depression patients in four levels of severity prior to treatment with tricyclic antidepressants, and also as to their suitability for classifying these patients in four improvement levels when administered posttreatment. Although the scales behaved quite similarly, each was most efficient at the task for which it had been designed, i.e., severity rating for the Hamilton and Carroll scales, improvement rating for the Montgomery-Asberg scale.
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