26 research outputs found
Effect of moderate potassium-elevating treatment in long QT syndrome:the TriQarr Potassium Study
Q Fever in Greenland
We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection
Temporal Changes, Patient Characteristics, and Mortality, According to Microbiological Cause of Infective Endocarditis:AÂ Nationwide Study
BACKGROUND: Monitoring of microbiological cause of infective endocarditis (IE) remains key in the understanding of IE; however, data from large, unselected cohorts are sparse. We aimed to examine temporal changes, patient characteristics, and inâhospital and longâterm mortality, according to microbiological cause in patients with IE from 2010 to 2017. METHODS AND RESULTS: Linking Danish nationwide registries, we identified all patients with firstâtime IE. Inâhospital and longâterm mortality rates were assessed according to microbiological cause and compared using multivariable adjusted logistic regression analysis and Cox proportional hazard analysis, respectively. A total of 4123 patients were included. Staphylococcus aureus was the most frequent cause (28.1%), followed by Streptococcus species (26.0%), Enterococcus species (15.5%), coagulaseânegative staphylococci (6.2%), and âother microbiological causesâ (5.3%). Blood cultureânegative IE was registered in 18.9%. The proportion of blood cultureânegative IE declined during the study period, whereas no significant changes were seen for any microbiological cause. Patients with Enterococcus species were older and more often had a prosthetic heart valve compared with other causes. For Streptococcus species IE, inâhospital and longâterm mortality (median followâup, 2.3âyears) were 11.1% and 58.5%, respectively. Compared with Streptococcus species IE, the following causes were associated with a higher inâhospital mortality: S aureus IE (odds ratio [OR], 3.48 [95% CI, 2.74â4.42]), Enterococcus species IE (OR, 1.48 [95% CI, 1.11â1.97]), coagulaseânegative staphylococci IE (OR, 1.79 [95% CI, 1.21â2.65]), âother microbiological causeâ (OR, 1.47 [95% CI, 0.95â2.27]), and blood cultureânegative IE (OR, 1.99 [95% CI, 1.52â2.61]); and the following causes were associated with higher mortality following discharge (median followâup, 2.9âyears): S aureus IE (hazard ratio [HR], 1.39 [95% CI, 1.19â1.62]), Enterococcus species IE (HR, 1.31 [95% CI, 1.11â1.54]), coagulaseânegative staphylococci IE (HR, 1.07 [95% CI, 0.85â1.36]), âother microbiological causeâ (HR, 1.45 [95% CI, 1.13â1.85]), and blood cultureânegative IE (HR, 1.05 [95% CI, 0.89â1.25]). CONCLUSIONS: This nationwide study showed that S aureus was the most frequent microbiological cause of IE, followed by Streptococcus species and Enterococcus species. Patients with S aureus IE had the highest inâhospital mortality
Prevalence and Mortality of Infective Endocarditis in Community-Acquired and Healthcare-Associated Staphylococcus aureus Bacteremia::A Danish Nationwide Registry-Based Cohort Study.
BACKGROUND: Staphylococcus aureus bacteremia (SAB) can be community-acquired or healthcare-associated, and prior small studies have suggested that this mode of acquisition impacts the subsequent prevalence of infective endocarditis (IE) and patient outcomes. METHODS: First-time SAB was identified from 2010 to 2018 using Danish nationwide registries and categorized into community-acquired (no healthcare contact within 30â
days) or healthcare-associated (SAB >48â
hours of hospital admission, hospitalization within 30â
days, or outpatient hemodialysis). Prevalence of IE (defined from hospital codes) was compared between groups using multivariable adjusted logistic regression analysis. One-year mortality of S aureus IE (SAIE) was compared between groups using multivariable adjusted Cox proportional hazard analysis. RESULTS: We identified 5549 patients with community-acquired SAB and 7491 with healthcare-associated SAB. The prevalence of IE was 12.1% for community-acquired and 6.6% for healthcare-associated SAB. Community-acquired SAB was associated with a higher odds of IE as compared with healthcare-associated SAB (odds ratio, 2.12 [95% confidence interval {CI}, 1.86â2.41]). No difference in mortality was observed with 0â40â
days of follow-up for community-acquired SAIE as compared with healthcare-associated SAIE (HR, 1.07 [95% CI, .83â1.37]), while with 41â365â
days of follow-up, community-acquired SAIE was associated with a lower mortality (HR, 0.71 [95% CI, .53â.95]). CONCLUSIONS: Community-acquired SAB was associated with twice the odds for IE, as compared with healthcare-associated SAB. We identified no significant difference in short-term mortality between community-acquired and healthcare-associated SAIE. Beyond 40â
days of survival, community-acquired SAIE was associated with a lower mortality
Myocardial Work in Patients Hospitalized With COVIDâ19:Relation to Biomarkers, COVIDâ19 Severity, and AllâCause Mortality
BACKGROUND: COVIDâ19 infection has been hypothesized to affect left ventricular function; however, the underlying mechanisms and the association to clinical outcome are not understood. The global work index (GWI) is a novel echocardiographic measure of systolic function that may offer insights on cardiac dysfunction in COVIDâ19. We hypothesized that GWI was associated with disease severity and allâcause death in patients with COVIDâ19. METHODS AND RESULTS: In a multicenter study of patients admitted with COVIDâ19 (n=305), 249 underwent pressureâstrain loop analyses to quantify GWI at a median time of 4âdays after admission. We examined the association of GWI to cardiac biomarkers (troponin and NTâproBNP [Nâterminal proâBâtype natriuretic peptide]), disease severity (oxygen requirement and CRP [Câreactive protein]), and allâcause death. Patients with elevated troponin (n=71) exhibited significantly reduced GWI (1508 versus 1707âmmâHg%; P=0.018). A curvilinear association to NTâproBNP was observed, with increasing NTâproBNP once GWI decreased below 1446âmmâHg%. Moreover, GWI was significantly associated with a higher oxygen requirement (relative increase of 6% per 100âmmâHg% decrease). No association was observed with CRP. Of the 249 patients, 37 died during followâup (median, 58âdays). In multivariable Cox regression, GWI was associated with allâcause death (hazard ratio, 1.08 [95% CI, 1.01â1.15], per 100âmmâHg% decrease), but did not increase Câstatistics when added to clinical parameters. CONCLUSIONS: In patients admitted with COVIDâ19, our findings indicate that NTâproBNP and troponin may be associated with lower GWI, whereas CRP is not. GWI was independently associated with allâcause death, but did not provide prognostic information beyond readily available clinical parameters. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04377035
Long QT Syndrome Type 1 and 2 Patients Respond Differently to Arrhythmic Triggers â The TriQarr In Vivo Study
Rare non-coding <i>Desmoglein</i>-2 variant contributes to Arrhythmogenic right ventricular cardiomyopathy
Asc-1 transporter regulation of synaptic activity via the tonic release of D-serine in the forebrain
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