46 research outputs found

    Role of age and comorbidities in mortality of patients with infective endocarditis

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    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

    Role of age and comorbidities in mortality of patients with infective endocarditis

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    [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

    Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

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    BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

    Distribución de leguminosas pratenses en relación con la altitud y el fitoclima en la cuenca del Narcea (Asturias)

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    Se estudia la influencia de la altitud y el fitoclima en la distribución de especies de leguminosas pratenses en la cuenca del Narcea (Asturias). Se aplican métodos de elaboración y ordenación de perfiles ecológicos siguiendo las técnicas propuestas por el C.E.P.E. de Montpellier (Francia). Gran parte de las especies muestran preferencias por distintas altitudes. El número de especies disminuye con la altitud y siguiendo este criterio se han establecido tres zonas altitudinales en la cuenca. Cabe destacar que algunas de las especies más frecuentes, Vicia hirsuta, Vicia sativa y Trifolium campestre, muestran una preferencia clara por altitudes inferiores a 1.000 m. El resto de las especies con mayor número de presencias, Trifolium pratense, Trifolium repens, Trifolium dubium, Lotus corniculatus y Lotus uliginosus, muestran un intervalo de variación total respecto a los dos factores, si bien todas ellas tienen menor frecuencia en altitudes grandes Siguiendo las técnicas de ALLUE se han definido dos subregiones fitoclimáticas mediterráneas IV (V) y IV (VI). Con respecto a este factor destaca Trifolium patens, que se encuentra en gran número de prados bajos y de clima atlántico V (VI) y de Hippocrepis comosa, que se encuentra preferentemente en prados mediterranófilos

    Investigaciones preliminares sobre tipos de Trifolium pratense L. en poblaciones naturales de Asturias

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    Se han efectuado una serie de muestreos en praderas naturales y pastizales con el objeto de describir tipos silvestres de Trifolium pratense L., pues el número de sus poblaciones naturales está disminuyendo progresivamente. Con los resultados del análisis del material recogido se ha realizado una clasificación tipológica basándose en los criterios de: plasticidad, patrones morfosociológicos y desarrollo del tallo principal. Además, se han medido, en seis poblaciones de características ambientales diferentes, los siguientes parámetros: 1) tipo de crecimiento; 2) número de tallos; 3) número de unidades estructurales; 4) grosor de los tallos; 5) grado de fistulosidad de los tallos. Se encontró que la mayoría de las plantas examinadas pertenecen al tipo de crecimiento erecto, y que existe una estrecha relación entre el número de unidades estructurales y el número de tallos

    Serie de Comunicación Social 2022-2023

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    En este volumen se recogen 58 artículos sobre lingüística, lenguas extranjeras, medios de comunicación masiva y educación y comunicación

    Re-evaluation of the very large Eomellivora fricki (Pia, 1939) (Carnivora, Mustelidae, Mellivorinae) from the late miocene of Austria

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    We re-evaluated the Austrian material for Hadrictis fricki Pia, 1939, from the localities Wien XII-Altmannsdorf and Gaiselberg (MN9, Vallesian, Late Miocene), concluding that Hadrictis can be considered as a synonymy of Eomellivora Zdansky, 1924; we therefore named it as Eomellivora fricki. This species is one of the earliest representatives of the genus, together with E. piveteaui Ozansoy, 1965. Our phylogenetic analyses indicate that Eomellivora forms a monophyletic group, establishing the sister clade of the large and derived Late Miocene Ekorus ekakeran. Eomellivora fricki shows a primitive dental morphology and is the largest species of the genus. This species shows the complexity of the genus Eomellivora, in which large and small species coexisted since the beginning of the Late Miocene

    Megalictis, the bone-crushing giant mustelid (Carnivora, Mustelidae, Oligobuninae) from the Early Miocene of North America

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    We describe cranial and mandibular remains of three undescribed individuals of the giant mustelid Megalictis ferox Matthew, 1907 from the latest Arikareean (Ar4), Early Miocene mammal fauna of Nebraska, and Wyoming (USA) housed at the American Museum of Natural History (New York, USA). Our phylogenetic hypothesis indicates that Ar4 specimens assigned to M. ferox constitute a monophyletic group. We assign three additional species previously referred to Paroligobunis to Megalictis: M. simplicidens, M. frazieri, and "M." petersoni. The node containing these four species of Megalictis and Oligobunis forms the Oligobuninae. We test the hypothesis that Oligobuninae (Megalictis and Oligobunis) is a stem mustelid taxon. Our results indicate that the Oligobuninae form the sister clade to the crown extant mustelids. Based on the cranium, M. ferox is a jaguar-size mustelid and the largest terrestrial mustelid known to have existed. This new material also sheds light on a new ecomorphological interpretation of M. ferox as a bone-crushing durophage (similar to hyenas), rather than a cat-like hypercarnivore, as had been previously described. The relative large size of M. ferox, together with a stout rostrum and mandible made it one of the more powerful predators of the Early Miocene of the Great Plains of North America
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