The Ross procedure offers excellent survival compared with mechanical aortic valve replacement in a real-world setting

OBJECTIVES: The ideal prosthesis for young patients requiring aortic valve replacement has not been defined to date. Although the Ross procedure provides excellent survival, its application is still limited. We compared the long-term survival after the Ross procedure with mechanical aortic valve replacement. METHODS: All consecutive Ross procedures and mechanical aortic valve replacements performed between 1991 and 2008 at a single centre were analysed. Only adult patients between 18 and 50 years of age were included in the study. Survival and valve-related complications were evaluated. Furthermore, survival was compared with the age- and sex-matched Austrian population. RESULTS: A total of 159 Ross patients and 173 mechanical valve patients were included. The cumulative survival for the Ross procedure was significantly better, with survival rates of 96, 94 and 93% at 5, 10 and 15 years, respectively, in comparison to 90, 84 and 75% (P < 0.01) for patients with mechanical valves. A Cox regression analysis including patients' age, gender and valve type revealed age and the type of aortic valve replacement as independent significant factors influencing survival (for age, hazard ratio = 1.1, 95% confidence interval = 1.0-1.1, P = 0.03; and for valve type, hazard ratio = 2.6, 95% confidence interval = 1.2-5.8, P = 0.02). The observed survival was comparable to the expected standard survival for the Ross group but was significantly reduced in the mechanical valve group. CONCLUSIONS: In a real-world setting, the Ross procedure is associated with a long-term survival benefit in young adults in comparison to mechanical aortic valve replacement

Candidose der Haut

Seebacher C, Abeck D, Brasch J, et al. Candidose der Haut. Journal der Deutschen Dermatologischen Gesellschaft (JDDG). 2006;4(7):591-596

Tinea of glabrous skin

Seebacher C, Korting HC, Abeck D, et al. Tinea of glabrous skin. Journal der Deutschen Dermatologischen Gesellschaft. 2010;8(7):549-554

Onychomykose

Seebacher C, Brasch J, Abeck D, et al. Onychomycosis. Journal der Deutschen Dermatologischen Gesellschaft (JDDG). 2007;5(1):61-66.Dt. Version erschienen u.d.T.: Onychomykose ([https://doi.org/10.1111/j.1610-0387.2007.06134_supp.x]( https://doi.org/10.1111/j.1610-0387.2007.06134_supp.x)

Orale candidiasis

Reinel D, Plettenberg A, Seebacher C, et al. Orale Candidose. Journal der Deutschen Dermatologischen Gesellschaft. 2008;6(7):593-597

Tinea Capitis

Seebacher C, Abeck D, Brasch J, et al. Tinea Capitis. Journal der Deutschen Dermatologischen Gesellschaft (JDDG). 2006;4(12):1085-1091

Updates on the epidemiology of dermatophyte infections.

The spectrum of dermatophytes isolated from skin lesions had changed in last 70 years. Before the Second World War in Germany, Microsporum audouinii and Epidermophyton floccosum ranked the first, whereas Trichophyton rubrum is the most common dermatophyte since the fifties of last century, accounting for 80-90% of the strains, followed by T. mentagrophytes. This evolution is typical for Central and North Europe and it needs to be connected with the increase in the incidence of tinea pedis. In contrast, in Southern Europe and in Arabic countries, zoophilic dermatophytes, such as Microsporum canis or Trichophyton verrucosum, are the most frequently isolated. In Europe, especially in Mediterranean countries, the incidence of M. canis infection has strongly increased during the recent years and this dermatophyte is now the most prevalent in tinea capitis in children. An analysis of the frequency and distribution of tinea pedis in different occupations and leisure-time activities as well as the routes of infection are reported. The spreading of this disease in most developed countries of the world represents a considerable economic problem, since it was accompanied by a parallel increase in the frequency of onychomycosis which implies, as tinea pedis, large financial charges. In poor developing countries, mycoses appear endemically, primarily with children, and their treatment often fails because of the lack of efficient antifungals. The particular epidemiological situations of dermatophytoses and the pathogenic spectrum of dermatophytes are examined at the example of numerous countries