Reseñas

Obra ressenyada: Jean-Louis BOSCH, Montpellier et la médecine andalouse au Moyen Âge: transfert des textes et des savoirs. Montpellier: Presses Universitaires de la Méditterranée, 2016

Precisiones sobre nuestra traducción castellana del Kitab al-KulIiyat de Ibn Rusd.

Sin resume

Juan Vernet Ginés (1923-2011)

El año 2011 ha visto, en el corto espacio de tres meses, la desaparición de tres destacados miembros del arabismo español: los profesores Juan Vernet Ginés, Joaquín Vallvé Bermejo y Juan Souto Lasala, por orden cronológico

Alternative therapies in medieval Arab medicine

El presente trabajo se basa en el estudio de fuentes manuscritas y cotejo de textos sobre ḫawāṣṣ, propiedades o virtutes peculiares de ciertos medicamentos que, en ocasiones, constituyen auténticos remedios mágico-simpáticos. Tales remedios fueron comúnmente utilizados en la medicina árabe medieval como terapia alternativa para tratar diversas enfermedades, especialmente la epilepsia, así como para determinadas cuestiones ginecológicas. Los escritos vaciados son el Kitāb al-Ḫawāṣṣ y Kitāb al-Ḥāwī de Rāzī, el Kitāb fī ‘Ilm alḫawāṣṣ de al-Madā’inī, el Kitāb al-Taṣrīf (Maqālah ii) de Abū l-Qāsim Ḫalaf al-Zahrāwī, y el Kitāb ‘Amal man ṭabba li-man ḥabba de Ibn al-Ḫaṭīb.This work is based on the study of manuscript sources and the collation of texts dealing with khawāṣṣ; the properties or «virtutes peculiares» of certain medicaments sometimes considered authentic magical-sympathetic remedies. Such remedies were often used in medieval Arab medicine as an alternative therapy to treat different ailments and especially epilepsy, as well as certain gynecological issues. The consulted writings are: Kitāb al-Ḫawāṣṣ and Kitāb al-Ḥāwī of Rāzī, Kitāb fī ‘Ilm al-ḫawāṣṣ of al-Madā’inī, Kitāb al-Taṣrīf (Maqālah ii) of Abū l-Qāsim Ḫalaf al-Zahrāwī, and Kitāb ‘Amal man ṭabba li-man ḥabba of Ibn al-Ḫaṭīb

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

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