Risk factors for Gram-negative bacterial infection of cardiovascular implantable electronic devices: multicenter observational study (CarDINe Study).

Infections of cardiovascular implantable electronic devices (CIED) are mainly due to gram-positive bacteria (GPB). Data about gram negative bacteria CIED (GNB-CIED) infections are limited. Aims of our work are to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Multicenter, international, retrospective, case-control-control study on patients undergoing CIED implantation from 2015 to 2019 in 17 centers across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No differences regarding clinical presentation, diagnostic and therapeutic managements were found between the groups. A trend toward higher rate of FDG PET/CT positivity was observed among patients with GN than in those with GPB-CIED infection (85.7% vs. 66.7%, p=0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (RRR=1.211, P= 0.011), obesity (RRR: 5.122, P=0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker (PM-VVI) implantation (RRR: 3,027, P=0.006) and the right subclavian vein site of implantation (RRR: 5.014, P=0.004). At 180-day survival analysis GNB-CIED infection was associated with increased mortality risk (HR=1.842, P=0.067). Obesity, high number of comorbidities, and right subclavian vein implantation site are associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided by the use of FDG PET/CT is suggested in patients with GNB-CIED infection considering the poorer outcome observed in this group

The impacts of some sedative drugs on α -glycosidase, acetylcholinesterase and butyrylcholinesterase enzymes-potential drugs for some metabolic diseases

Background: The present paper focuses on the in vitro inhibition of some sedative drugs such as Midazolam, Propofol, Hipnodex, Ketamine, and Pental sodium on acetylcholinesterase (AChE), Butyrylcholinesterase (BChE), and α-glycosidase (α-Gly) enzymes. Methods: These drugs were tested in diverse concentrations, which showed positive effects in vitro AChE, BChE, and α-Gly activities. Ki values were 20.14, 94.93, 636.78, 416.42, and 953.75 μM for AChE, 17.52, 32.03, 88.02, 93.48, and 91.84 μM for BChE, and 10.87, 156.68, 48.21, 37.88, 151.01 μM for α-glycosidase, respectively. Results: An enhancing number of experiential observations show potentially harmful effects of sedative drugs on the extension of brain Conclusion: Midazolam exhibited effective inhibitory activity compared with the other drugs for these enzymes. © 2019 Bentham Science Publishers

A snapshot of geriatric infections in Turkey: ratio of geriatric inpatients in hospitals and evaluation of their infectious diseases: A multicenter point prevalence study

Introduction: The human population is aging at an astonishing rate. The aim of this study is to capture a situation snapshot revealing the proportion of individuals aged 65 years and over among inpatients in healthcare institutions in Turkey and the prevalence and type of infections in this patient group in order to draw a road map. Materials and Methods: Hospitalized patients over 65 years at any of the 62 hospitals in 29 cities across Turkey on February 9, 2017 were included in the study. Web-based SurveyMonkey was used for data recording and evaluation system. Results: Of 17,351 patients 5871 (33.8%) were ≥65 years old. The mean age was 75.1 ± 7.2 years; 3075 (52.4%) patients were male. Infection was reason for admission for 1556 (26.5%) patients. Pneumonia was the most common infection. The median length of hospital stay was 5 days (IQR: 2–11 days). The Antibiotic therapy was initiated for 2917 (49.7%) patients at the time of admission, and 23% of the antibiotics prescribed were inappropriate. Healthcare-associated infections developed in 1059 (18%) patients. Urinary catheters were placed in 2388 (40.7%) patients with 7.5% invalid indication. Conclusion: This study used real data to reveal the proportion of elderly patients in hospital admissions. The interventions done, infections developed during hospitalization, length of hospital stay, and excessive drug load emphasize the significant impact on health costs and illustrate the importance of preventive medicine in this group of patients. © 2020 The Author