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

[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

Nutritional condition in pediatric patients with cystic fibrosis

A pesar de los avances en el tratamiento, un porcentaje no desdeñable de pacientes con fibrosis quística presentan desnutrición. Por otra parte, las pautas de estilo de vida actuales y el soporte nutricional agresivo, podrían suponer en un pequeño porcentaje de casos la aparición de problemas nutricionales por exceso

Nutritional condition in pediatric patients with cystic fibrosis

A pesar de los avances en el tratamiento, un porcentaje no desdeñable de pacientes con fibrosis quística presentan desnutrición. Por otra parte, las pautas de estilo de vida actuales y el soporte nutricional agresivo, podrían suponer en un pequeño porcentaje de casos la aparición de problemas nutricionales por exceso

Hábitos de alimentación y consumo saludable

Esta obra está enmarcada dentro del programa 'Asturias, espacio educativo' y se realiza en colaboración con la Fundación Alimerka Asturias. Resumen basado en la publicaciónSe presenta una guía para el profesorado que desee integrar en su quehacer diario la Educación para la Salud y Consumo. Lo que se pretende, es fomentar hábitos de vida saludables en Alimentación y Nutrición a partir del apoyo en la planificación y desarrollo de proyectos. Asímismo, pretende animar a los centros educativos a participar y difundir entre la comunidad educativa sus experiencias, de modo que sean ejemplos a imitar, seguir y, siempre que sea posible, mejorar, en aras de favorecer la calidad de la enseñanza para todo el alumnado. Esta publicación se organiza en torno a los siguientes capítulos: 1)Justificación de la necesidad de educar en la mejora de los hábitos alimenticios y nutricionales del alumnado; 2) Salud y consumo: hábitos de alimentación y consumo saludable; 3) Proyectos de educación para la salud y consumo: cómo abordar el establecimiento de hábitos de vida saludables desde la escuela; 4) Experiencias didácticas de centros de la Comunidad Autónoma Asturiana; y 5) Glosario.AsturiasUniversidad de Oviedo. Facultad de Ciencias de la Educación; Calle Aniceto Sela s. n.; 33005 Oviedo; +34985103215; 985103214;ES

Buenas prácticas : Apertura de Centros a la Comunidad

Recopilación de 'Buenas Prácticas' presentadas en el Seminario Regional de Apertura de Centros celebrado en el Instituto de Educación Secundaria Carreño Miranda de Avilés en septiembre de 2006. A través de las propuestas de quince centros educativos asturianos, la publicación permite aproximarnos a diversas concepciones en el diseño y desarrollo del programa de Apertura de Centros a la Comunidad. La presentación de estos proyectos se realiza en torno a cuatro áreas: Participación, Promoción de la salud, Compensación de desigualdades, y Familia-Escuela.AsturiasUniversidad de Oviedo. Facultad de Ciencias de la Educación; Calle Aniceto Sela s. n.; 33005 Oviedo; +34985103215; +34985103214;ES

MAX mutations cause hereditary and sporadic pheochromocytoma and paraganglioma

Item does not contain fulltextPURPOSE: Pheochromocytomas (PCC) and paragangliomas (PGL) are genetically heterogeneous neural crest-derived neoplasms. Recently we identified germline mutations in a new tumor suppressor susceptibility gene, MAX (MYC-associated factor X), which predisposes carriers to PCC. How MAX mutations contribute to PCC/PGL and associated phenotypes remain unclear. This study aimed to examine the prevalence and associated phenotypic features of germline and somatic MAX mutations in PCC/PGL. Design: We sequenced MAX in 1,694 patients with PCC or PGL (without mutations in other major susceptibility genes) from 17 independent referral centers. We screened for large deletions/duplications in 1,535 patients using a multiplex PCR-based method. Somatic mutations were searched for in tumors from an additional 245 patients. The frequency and type of MAX mutation was assessed overall and by clinical characteristics. RESULTS: Sixteen MAX pathogenic mutations were identified in 23 index patients. All had adrenal tumors, including 13 bilateral or multiple PCCs within the same gland (P < 0.001), 15.8% developed additional tumors at thoracoabdominal sites, and 37% had familial antecedents. Age at diagnosis was lower (P = 0.001) in MAX mutation carriers compared with nonmutated cases. Two patients (10.5%) developed metastatic disease. A mutation affecting MAX was found in five tumors, four of them confirmed as somatic (1.65%). MAX tumors were characterized by substantial increases in normetanephrine, associated with normal or minor increases in metanephrine. CONCLUSIONS: Germline mutations in MAX are responsible for 1.12% of PCC/PGL in patients without evidence of other known mutations and should be considered in the genetic work-up of these patients