Caracterización del vértigo en nuestro medio

An evolutive, transversal and descriptive study was carried out in 106 patients affected by vertigo in the University Hospital “Arnaldo Milian Castro” of Santa Clara, Villa Clara province, from January 2001 to December 2004. The purpose of this research was making a topographical and ethiological characterization of vertigo, which was possible via questioning, physical exam and otoneurological studies such as: tonal audiometrics, impedanciometrics, auditive evoked potentials of brain stem, caloric tests, simple imagenelogical exam, the helicoidal computarized tomography and also a fallow-up of patients. The periferical vertigo proved to be the most frecuent (78.3%). The benign paroxiysmal positional vertigo turned to be the cause more prevalent (39.8%) and was diagnosed by a postural Dix-Hillpike test and the rest of studies. The cervical cause had the biggest incidente (58.3%) in regard with central vertigo and it behaved like a periferical one concerning its clinical chart.Se realizó un estudio descriptivo, transversal y evolutivo a 106 pacientes afectados de vértigo en el Hospital Universitario “Arnaldo Milián Castro” de Santa Clara, Villa Clara, en el período de enero de 2001 a diciembre de 2004. El propósito fue la caracterización topográfica y etiológica del vértigo, lo cual fue posible mediante el interrogatorio, el examen físico y los estudios otoneurológicos tales como la audiometría tonal, la impedanciometría, el potencial evocado auditivo del tallo cerebral, las pruebas calóricas, los exámenes imagenológicos simples y la tomografía axial computadorizada helicoidal, además del seguimiento del paciente. Se encontró que el vértigo periférico fue el más frecuente (78.3%). La causa que prevaleció fue el vértigo posicional paroxístico benigno (39.8%), diagnosticado por la prueba postural de Dix-Hallpike y el resto de los estudios. Dentro del vértigo central la causa cervical fue la de mayor incidencia (58.3%), que se comportó en relación a su cuadro clínico como un vértigo periférico

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

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