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

Metodología e investigación humanística aplicada al Parque Natural Agrario "Los Carrizales" (Elche, Alicante, España)

La metodología para la calidad de la investigación humanística implica que el hombre o mujer conozca el territorio que habita a fin de aprovecharlo de manera sustentable. Tal es, el caso del Parque Natural Agrario “Los Carrizales”, en los que la viabilidad económica de la agricultura y la ganadería no sólo no está reñida con la integridad ambiental, la preservación de los ecosistemas y la conservación de la biodiversidad, sino que el aprovechamiento agropecuario y la protección ecológica forman un binomio equilibrado, armonioso y mutuamente dependiente.The methodology is very important in the humanistics studies for the sustainable management of territory. Here are several cases, such as that of the Los Carrizales Agricultural Natural Park, where the economic viability of agriculture and stockbreeding is not at odds with environmental integrity, the protection of ecosystems and the conservation of biodiversity; here, agricultural and livestock exploitation and ecological protection actually make a balanced, harmonious and mutually dependent couple

Percepción de la calidad ambiental en los Parques Naturales Agrarios alicantinos como estrategia para la competitividad global

Comunicación presentada en el VII Congreso Anual de la Red Internacional de Investigadores en Competitividad, Puerto Vallarta (Jalisco, México), noviembre 2013.La calidad de la investigación en competitividad ambiental implica que el hombre o mujer conozca el territorio que habita a fin de aprovecharlo de manera sustentable. El objetivo es presentar los atributos de todo Espacio Natural Protegido (ENP). La metodología desarrollada es geográfica (Niño, Melo y Castillo 2008), enriquecida con técnicas cualitativas (observación participante y entrevistas), cuantitativas (análisis de bases de datos estadísticos), fueron empleados materiales impresos y digitales en trabajo de gabinete y tres recorridos exploratorios en campo cuyos resultados son en el caso del Parque Natural Agrario “Los Carrizales” destaca que, la viabilidad económica de la agricultura y la ganadería no sólo no está reñida con la integridad ambiental, la preservación de los ecosistemas y la conservación de la biodiversidad, sino que el aprovechamiento agropecuario y la protección ecológica forman un binomio equilibrado, armonioso y mutuamente dependiente.The methodology is very important in the environmental competitiveness studies for the sustainable management of territory. The objective of the document is to present the attributes of all Protected Natural Areas (ANP). The methodology applied here focuses on the geography (Niño, Melo y Castillo 2008), enriched with qualitative (participant observation and interviews), quantitative (analysis of statistical databases), involved the use of printed and digital materials in the work of cabinet and exploratory tours to fieldwork the results are the Los Carrizales Agricultural Natural Park, where the economic viability of agriculture and stockbreeding is not at odds with environmental integrity, the protection of ecosystems and the conservation of biodiversity; here, agricultural and livestock exploitation and ecological protection actually make a balanced, harmonious and mutually dependent couple

La Universidad Autónoma de Guerrero (UAGro): Política educativa y sociedad (2010-2016)

El objetivo, es sintetizar la calidad educativa lograda a la fecha en la UAGro con inclusión social. En tanto que, la metodología comprendió la revisión de materiales impresos y digitales de tópicos como la Teoría General de Sistemas, enfoque socioformativo, políticas públicas educativas, Gobierno, Posgrado, problemas complejos, sociedad y territorio así como trabajo de campo en diversas Unidades Académicas (UA) de la UAGro, donde se tuvo la oportunidad de preguntar a un grupo focal de 20 universitarios a través de la entrevista a profundidad con expertos sobre el salto cualitativo de la institución, estrategias y acciones implementadas enriquecida con tomas fotográficas y observación participante. Los resultados incluyeron: a) el salto cualitativo en la educación ofertada por la UAGro, b) mayor inclusión de la población objetivo que atiende, c) solidez en la formación por competencias, d) planta académica consolidada y e) infraestructura suficiente y actualizada. Las conclusiones fueron: i) actualmente la UAGro es la Máxima Casa de Estudios en Guerrero donde se produce el 75% de la investigación estatal, ii) evidencia de educación de calidad con inclusión social y iii) estrecha vinculación con el Estado y Sociedad civil.The objective is to synthesize the quality of education attained up to date in UAGro with social inclusion. While the metodology included the review of printed and digital materials like the General Theory of Systems, Social Training Approach, Educational Public Policies, Government, Graduate, complex problems, society and territory as well as field work in different Academic Units (UA) of UAGro where they had the opportunity to ask a focus group of 20 University students through depth interview with experts about the qualitative leap of the institutional strategies and actions, implemented, enriched with photographs and participants’ observation. The results included: a) the qualitative leap in the education offered by the UAGro, b) greater inclusion of the objective population serving, c) strength in the competency-based training, d) consolidated academic staff and e) adequate and up-to-date infrastructure. The conclusions were: the UAGro is i) currently the maximum House of Studies in Guerrero, which produces 75 percent of the State investigation, ii) evidence of quality education with social inclusion and iii) close ties with the State and civil society

Ex Vivo Cardiotoxicity of Antineoplastic Casiopeinas Is Mediated through Energetic Dysfunction and Triggered Mitochondrial-Dependent Apoptosis

Casiopeinas are a group of copper-based antineoplastic molecules designed as a less toxic and more therapeutic alternative to cisplatin or Doxorubicin; however, there is scarce evidence about their toxic effects on the whole heart and cardiomyocytes. Given this, rat hearts were perfused with Casiopeinas or Doxorubicin and the effects on mechanical performance, energetics, and mitochondrial function were measured. As well, the effects of Casiopeinas-triggered cell death were explored in isolated cardiomyocytes. Casiopeinas III-Ea, II-gly, and III-ia induced a progressive and sustained inhibition of heart contractile function that was dose- and time-dependent with an IC50 of 1.3 ± 0.2, 5.5 ± 0.5, and 10 ± 0.7 μM, correspondingly. Myocardial oxygen consumption was not modified at their respective IC50, although ATP levels were significantly reduced, indicating energy impairment. Isolated mitochondria from Casiopeinas-treated hearts showed a significant loss of membrane potential and reduction of mitochondrial Ca2+ retention capacity. Interestingly, Cyclosporine A inhibited Casiopeinas-induced mitochondrial Ca2+ release, which suggests the involvement of the mitochondrial permeability transition pore opening. In addition, Casiopeinas reduced the viability of cardiomyocytes and stimulated the activation of caspases 3, 7, and 9, demonstrating a cell death mitochondrial-dependent mechanism. Finally, the early perfusion of Cyclosporine A in isolated hearts decreased Casiopeinas-induced dysfunction with reduction of their toxic effect. Our results suggest that heart cardiotoxicity of Casiopeinas is similar to that of Doxorubicin, involving heart mitochondrial dysfunction, loss of membrane potential, changes in energetic metabolites, and apoptosis triggered by mitochondrial permeability

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