Ahorro energético en el consumo de gas residencial mediante aislamiento térmico en la construcción

Se determinaron los coeficientes volumétricos de pérdidas de calor, tanto en una vivienda “tipo casa” como en otra “tipo edificio”, considerando tres sistemas constructivos diferentes utilizados frecuentemente en el país. Se verificaron luego éstos mismos, pero aislando el techo y los muros con 3” y 2” respectivamente, de un aislante térmico convencional de conductividad media. Además, se cambiaron las carpinterías de vidrio simple por doble vidriado hermético. La tipología utilizada es una vivienda de 3 ambientes de aproximadamente 60 m² de superficie; obtenida como promedio de datos del Censo 2001, como así también de las cantidades de viviendas tipo “Hogares Casas” y tipo “Hogares Departamentos” relevados en cada Provincia. La demanda de gas en millones de m³ por día, destinada a calefacción para uso residencial y la cantidad de usuarios registrados, correspondientes al año 2006, fueron recabadas de ENARGAS. Como resultado, se estimó un ahorro de aproximadamente 40% aislando muros y techos; valor que puede superar el 50% si también se emplea doble vidriado hermético en las carpinterías.Volumetric heat loss coefficient was determined not only for a detached house but also for a unit in an apartment building. Three different construction systems usually used in our country were considered. Then, the same construction systems with added conventional 3” roof insulation and 2” wall insulation of medium thermal conductivity were analyzed. In addition, single glazing windows were changed for insulated double glazing ones. The pattern is a housing consisting of three rooms about 60 m² obtained as average from Census 2001 data, as well as the amount of single-unit and multi-unit dwellings taken form data of each Province. Daily gas demand for residential use, in millions of m³, and amount of registered users, were obtained from ENARGAS during 2006. As a result, savings of about 40% were obtained by roof and wall insulation; this value may exceed 50% if insulated double glazing windows are used.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Ahorro energético en el consumo de gas residencial mediante aislamiento térmico en la construcción

Se determinaron los coeficientes volumétricos de pérdidas de calor, tanto en una vivienda “tipo casa” como en otra “tipo edificio”, considerando tres sistemas constructivos diferentes utilizados frecuentemente en el país. Se verificaron luego éstos mismos, pero aislando el techo y los muros con 3” y 2” respectivamente, de un aislante térmico convencional de conductividad media. Además, se cambiaron las carpinterías de vidrio simple por doble vidriado hermético. La tipología utilizada es una vivienda de 3 ambientes de aproximadamente 60 m² de superficie; obtenida como promedio de datos del Censo 2001, como así también de las cantidades de viviendas tipo “Hogares Casas” y tipo “Hogares Departamentos” relevados en cada Provincia. La demanda de gas en millones de m³ por día, destinada a calefacción para uso residencial y la cantidad de usuarios registrados, correspondientes al año 2006, fueron recabadas de ENARGAS. Como resultado, se estimó un ahorro de aproximadamente 40% aislando muros y techos; valor que puede superar el 50% si también se emplea doble vidriado hermético en las carpinterías.Volumetric heat loss coefficient was determined not only for a detached house but also for a unit in an apartment building. Three different construction systems usually used in our country were considered. Then, the same construction systems with added conventional 3” roof insulation and 2” wall insulation of medium thermal conductivity were analyzed. In addition, single glazing windows were changed for insulated double glazing ones. The pattern is a housing consisting of three rooms about 60 m² obtained as average from Census 2001 data, as well as the amount of single-unit and multi-unit dwellings taken form data of each Province. Daily gas demand for residential use, in millions of m³, and amount of registered users, were obtained from ENARGAS during 2006. As a result, savings of about 40% were obtained by roof and wall insulation; this value may exceed 50% if insulated double glazing windows are used.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

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

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients

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

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. 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: A total of 3120 patients with IE (1327  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 th

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Infective Endocarditis After Transcatheter Versus Surgical Aortic Valve Replacement

Abstract Background Scarce data are available comparing infective endocarditis (IE) following surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). This study aimed to compare the clinical presentation, microbiological profile, management, and outcomes of IE after SAVR versus TAVR. Methods Data were collected from the “Infectious Endocarditis after TAVR International” (enrollment from 2005 to 2020) and the “International Collaboration on Endocarditis” (enrollment from 2000 to 2012) registries. Only patients with an IE affecting the aortic valve prosthesis were included. A 1:1 paired matching approach was used to compare patients with TAVR and SAVR. Results A total of 1688 patients were included. Of them, 602 (35.7%) had a surgical bioprosthesis (SB), 666 (39.5%) a mechanical prosthesis, 70 (4.2%) a homograft, and 350 (20.7%) a transcatheter heart valve. In the SAVR versus TAVR matched population, the rate of new moderate or severe aortic regurgitation was higher in the SB group (43.4% vs 13.5%; P &lt; .001), and fewer vegetations were diagnosed in the SB group (62.5% vs 82%; P &lt; .001). Patients with an SB had a higher rate of perivalvular extension (47.9% vs 27%; P &lt; .001) and Staphylococcus aureus was less common in this group (13.4% vs 22%; P = .033). Despite a higher rate of surgery in patients with SB (44.4% vs 27.3%; P &lt; .001), 1-year mortality was similar (SB: 46.5%; TAVR: 44.8%; log-rank P = .697). Conclusions Clinical presentation, type of causative microorganism, and treatment differed between patients with an IE located on SB compared with TAVR. Despite these differences, both groups exhibited high and similar mortality at 1-year follow-up