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

Alimentación y diabetes Food and diabetes

Una dieta con bajo índice glicémico puede mejorar el control metabólico en la diabetes tipo 2, pero el debate aún continúa. Las frutas a pesar de la fructosa que contienen, también puede bajar el índice glicérico, además su consumo se ha asociado con una reducción de los niveles de A1c y pueden influir positivamente en el colesterol HDL, presión arterial y riesgo de enfermedad coronaria en general. Con respecto a la ingesta de grasa no se observa una relación entre ella y la A1c. Con respecto al consumo de alcohol se ha reportado que el consumo moderado de alcohol se asocia con una menor prevalencia de síndrome metabólico, aunque no hay información que lo relacione con el A1c. En este artículo se revisa la evidencia publicada sobre el efecto del consumo de frutas, grasas y alcohol sobre el control metabólico en diabéticos.A low glycemic diet may improve metabolic control in type 2 diabetes, but the debate continues. Fruits, despite the fructose they contain, may also lower the glycemic index, as well as its consumption has been associated with a reduction in A1c levels and can positively influence HDL cholesterol, blood pressure and risk of coronary heart disease in general. There is no relationship between fat intake and A1c. On the consumption of alcohol has been reported that moderate alcohol consumption is associated with a lower prevalence of metabolic syndrome, although there is information that relates to the A1c. This article reviews the published evidence on the effect of consumption of fruits, fats and alcohol on metabolic control in diabetics

Comparación en calidad de vida y estado nutricional entre alumnos de nutrición y dietética y de otras carreras universitarias de la Universidad Santo Tomás de Chile Comparison between the quality of life and nutritional status of nutrition students and those of other university careers at the Santo Thomas University in Chile

Objetivo: Determinar y comparar la calidad de vida, estado nutricional y auto percepción de imagen corporal entre estudiantes de Nutrición y Dietética (ND) con otras carreras (OC) de la Universidad Santo Tomas (UST), Sede Viña del Mar. Métodos: Se evaluaron 200 estudiantes voluntarios (100 ND y 100 OC) aplicándoles: una encuesta de calidad de vida, evaluación nutricional y encuesta de autopercepción de imagen corporal. Resultados: El grupo ND presentó menor percepción de su calidad de vida, consumo de tabaco y sedentarismo. Mujeres ND presentaron menor IMC y circunferencia de cintura (CC) y hombres ND presentaron menor CC (p Objective: To determine and compare the quality of life, nutritional status, and self-perceived body image between nutrition students and students from other careers from the University Santo Tomás-Viña del Mar. Methods: We evaluated 200 student volunteers (100 nutrition students and 100 students from other careers) with a quality of life survey, a nutritional evaluation, and a survey of body image perception. Results: The group of nutritional students perceived a lower quality of life, consumed less tobacco, and was less sedentary. Women of the nutritional group had a lower BMI and showed a lower hip circumference. Men of the nutritional group also showed a lower hip circumference. The nutritional group consumed more milk, chicken, and fish in their diet. Both groups presented an elevated consumption of alcohol. The concordance between BMI and body image was low, 34% in the nutritional group and 38% in the other careers group (Kappa 0.04 and 0.02). Conclusion: With respect to perception of quality of life, students from other careers perceived a better quality of life, however students from the nutritional group presented better nutritional status and selection of food

Delaying surgery for patients with a previous SARS-CoV-2 infection

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