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  1. Article ; Online: Trends in epidemiology, surgical management, and prognosis of infective endocarditis during the XXI century in Spain: A population-based nationwide study.

    Calderón-Parra, Jorge / Gutiérrez-Villanueva, Andrea / Yagüe-Diego, Itziar / Cobo, Marta / Domínguez, Fernando / Forteza, Alberto / Ana, Fernández-Cruz / Muñez-Rubio, Elena / Moreno-Torres, Victor / Ramos-Martínez, Antonio

    Journal of infection and public health

    2024  Volume 17, Issue 5, Page(s) 881–888

    Abstract: Background: Few population-based studies have evaluated the epidemiology of infective endocarditis (IE). Changes in population demographics and guidelines on IE may have affected both the incidence and outcomes of IE. Therefore, the aim of our study is ... ...

    Abstract Background: Few population-based studies have evaluated the epidemiology of infective endocarditis (IE). Changes in population demographics and guidelines on IE may have affected both the incidence and outcomes of IE. Therefore, the aim of our study is to provide contemporary population-based epidemiological data of IE in Spain.
    Methods: Retrospective nationwide observational study using data from the Spanish National Health System Discharge Database. We included all patients hospitalized with IE from January 2000 to December 2019.
    Results: A total of 64,550 IE episodes were included. The incidence of IE rose from 5.25 cases/100,000 person-year in 2000 to 7.21 in 2019, with a 2% annual percentage change (95% CI 1.3-2.6). IE incidence was higher among those aged 85 or older (43.5 cases/100.000 person-years). Trends across the study period varied with sex and age. Patients with IE were progressively older (63.9 years in 2000-2004 to 70.0 in 2015-2019, p < 0.001) and had more frequent comorbidities and predispositions, including, previous valvular prosthesis (12.1% vs 20.9%, p < 0.001). After adjustment, a progressive reduction in mortality was noted including in 2015-2019 compared to 2010-2014 (adjusted odds ratio 0.93, 95% confident interval 0.88-0.99, p = 0.023)., which was associated with more frequent cardiac surgery in recent years (15.1% in 2010-2014 vs 19.9% in 2015-2019).
    Conclusions: In Spain, the incidence of IE has increased during the XXI century, with a more pronounced increase in elderly individuals. Adjusted-mortality decreased over the years, which could be related to a higher percentage of surgery. Our results highlight the changing epidemiology of IE.
    MeSH term(s) Aged ; Humans ; Spain/epidemiology ; Retrospective Studies ; Endocarditis, Bacterial/epidemiology ; Endocarditis, Bacterial/surgery ; Endocarditis/epidemiology ; Endocarditis/surgery ; Prognosis ; Incidence
    Language English
    Publishing date 2024-03-13
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2467587-8
    ISSN 1876-035X ; 1876-0341
    ISSN (online) 1876-035X
    ISSN 1876-0341
    DOI 10.1016/j.jiph.2024.03.011
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  2. Article ; Online: Actualización sobre infección por Clostridium difficile en el paciente mayor.

    Bermejo Boixareu, Cristina / Tutor-Ureta, Pablo / Ramos Martínez, Antonio

    Revista espanola de geriatria y gerontologia

    2020  Volume 55, Issue 4, Page(s) 225–235

    Abstract: Clostridium difficile infection is the most common cause of health care-associated diarrhoea, and its incidence increases with age. Clinical challenges, risk of resistance to treatment, risk of recurrence, and treatment responses are different in elderly. ...

    Title translation Updated review of Clostridium difficile infection in elderly.
    Abstract Clostridium difficile infection is the most common cause of health care-associated diarrhoea, and its incidence increases with age. Clinical challenges, risk of resistance to treatment, risk of recurrence, and treatment responses are different in elderly. The aim of this review is to discuss the updated epidemiology, pathophysiology, diagnosis, and therapeutic management of C. difficile infection in elderly with the available data.
    MeSH term(s) Aged ; Clostridium Infections/diagnosis ; Clostridium Infections/epidemiology ; Clostridium Infections/physiopathology ; Clostridium Infections/therapy ; Humans ; Risk Factors
    Language Spanish
    Publishing date 2020-05-16
    Publishing country Spain
    Document type Journal Article ; Review
    ZDB-ID 605609-x
    ISSN 1578-1747 ; 0211-139X
    ISSN (online) 1578-1747
    ISSN 0211-139X
    DOI 10.1016/j.regg.2019.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Re: 'the unique COVID-19 presentation of patients with B cell depletion' by Belkin et al.

    Múñez-Rubio, Elena / Calderón-Parra, Jorge / Fernández-Cruz, Ana / Moreno-Torres, Víctor / Blanco-Alonso, Silvia / Ramos-Martínez, Antonio

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2022  Volume 29, Issue 2, Page(s) 272–273

    MeSH term(s) Humans ; COVID-19/diagnosis ; SARS-CoV-2
    Language English
    Publishing date 2022-10-27
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2022.10.025
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  4. Article ; Online: Ninety-eight years old female successfully successfully treated with fecal microbiota transplantation after recurrent Clostridium difficile infection.

    Bermejo Boixareu, Cristina / Ramos Martínez, Antonio / Tutor-Ureta, Pablo

    Medicina clinica

    2019  Volume 153, Issue 6, Page(s) e27

    Title translation Mujer de 98 años con infección recidivante por Clostridium difficile tratada con trasplante de flora intestinal.
    MeSH term(s) Aged, 80 and over ; Clostridium Infections/therapy ; Fecal Microbiota Transplantation ; Female ; Humans ; Recurrence ; Remission Induction
    Language Spanish
    Publishing date 2019-01-02
    Publishing country Spain
    Document type Case Reports ; Letter
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2018.11.024
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  5. Article ; Online: Efficacy and safety of antiviral plus anti-spike monoclonal antibody combination therapy vs. monotherapy for high-risk immunocompromised patients with mild-to-moderate SARS-CoV2 infection during the Omicron era: A prospective cohort study.

    Calderón-Parra, Jorge / Gutiérrez-Villanueva, Andrea / Ronda-Roca, Gerard / Jimenez, Maria Luisa Martín / de la Torre, Helena / Ródenas-Baquero, María / Paniura-Pinedo, María / Lozano-Llano, Carla / Pintos-Pascual, Ilduara / Fernández-Cruz, Ana / Ramos-Martínez, Antonio / Muñez-Rubio, Elena

    International journal of antimicrobial agents

    2024  Volume 63, Issue 3, Page(s) 107095

    Abstract: Introduction: Antivirals and monoclonal antibodies lower the risk of progression in immunocompromised patients. However, combination therapy with both types of agents has not been studied.: Patients and methods: This was a single-centre, prospective, ...

    Abstract Introduction: Antivirals and monoclonal antibodies lower the risk of progression in immunocompromised patients. However, combination therapy with both types of agents has not been studied.
    Patients and methods: This was a single-centre, prospective, cohort study. All immunocompromised patients who received treatment for mild-to-moderate COVID-19 from 1 January 2022 to 30 October 2022 were enrolled. The primary endpoint was COVID-19 progression at 90 days, defined as hospital admission or death due to COVID-19 and/or seronegative persistent COVID-19.
    Results: A total of 304 patients were included: 43 patients (14.1%) received sotrovimab plus a direct-acting antiviral, and 261 (85.9%) received monotherapy. Primary outcome occurred more frequently after monotherapy (4.6% vs. 0%, P=0.154). Among patients with anti-spike immunoglobulin G (anti-S IgG) titre <750 BAU/mL, COVID-19 progression was more common after monotherapy (23.9% vs. 0%, P=0.001), including more frequent COVID-related admission (15.2% vs. 0%, P=0.014) and seronegative persistent COVID-19 (10.9% vs. 0%, P=0.044). Combination therapy was associated with lower risk of progression (odds ratio [OR] 0.08, 95% confidence interval [95% CI] 0.01-0.64). Anti-S IgG titre <750 BAU/mL and previous anti-CD20 were associated with higher risk of progression (OR 13.70, 95% CI 2.77-67.68; and OR 3.05, 95% CI 1.20-10.94, respectively).
    Conclusions: In immunocompromised patients, combination therapy with sotrovimab plus an antiviral may be more effective than monotherapy for SARS-CoV2.
    MeSH term(s) Humans ; Prospective Studies ; RNA, Viral ; Antiviral Agents/therapeutic use ; Cohort Studies ; COVID-19 ; Hepatitis C, Chronic ; SARS-CoV-2 ; Antibodies, Monoclonal/adverse effects ; Immunocompromised Host ; Immunoglobulin G
    Chemical Substances RNA, Viral ; Antiviral Agents ; Antibodies, Monoclonal ; Immunoglobulin G
    Language English
    Publishing date 2024-01-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1093977-5
    ISSN 1872-7913 ; 0924-8579
    ISSN (online) 1872-7913
    ISSN 0924-8579
    DOI 10.1016/j.ijantimicag.2024.107095
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  6. Article ; Online: Bezlotoxumab during the first episode of Clostridioides difficile infection in patients at high risk of recurrence.

    Escudero-Sanchez, Rosa / Ramos-Martínez, Antonio / Caballero-Bermejo, Antonio F / Díaz-Pollán, Beatriz / Ruiz-Carrascoso, Guillermo / Samperio, María Olmedo / García, Patricia Muñoz / Amador, Paloma Merino / Romo, Fernando González / Segarra, Oriol Martín / Jiménez, Gema Navarro / Del Campo Albendea, Laura / García, Alfonso Muriel / Cobo, Javier

    European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology

    2024  Volume 43, Issue 3, Page(s) 533–540

    Abstract: Purpose: To describe a cohort with a high risk of recurrence who received bezlotoxumab during the first episode of Clostridioides difficile infection (CDI) and to compare this cohort with patients with similar characteristics who did not receive the ... ...

    Abstract Purpose: To describe a cohort with a high risk of recurrence who received bezlotoxumab during the first episode of Clostridioides difficile infection (CDI) and to compare this cohort with patients with similar characteristics who did not receive the monoclonal antibody.
    Methods: A prospective and multicentre study of patients with a high risk of recurrence (expected recurrence rate>35%) who were treated with bezlotoxumab during their first episode of CDI was conducted. A propensity score-matched model 1:2 was used to compare both cohorts that were weighed according to basal characteristics (hospital-acquisition, creatinine value, and fidaxomicin as a CDI treatment).
    Results: Sixty patients (mean age:72 years) were prospectively treated with bezlotoxumab plus anti-Clostridioides antibiotic therapy. Vancomycin (48 patients) and fidaxomicin (12 patients) were prescribed for CDI treatment, and bezlotoxumab was administered at a mean of 4.2 (SD:2.1) days from the beginning of therapy. Recurrence occurred in nine out of 54 (16.7%) evaluable patients at 8 weeks. Forty bezlotoxumab-treated patients were matched with 69 non-bezlotoxumab-treated patients. Recurrence rates at 12 weeks were 15.0% (6/40) in bezlotoxumab-treated patients vs. 23.2% (16/69) in non-bezlotoxumab-treated patients (OR:0.58 [0.20-1.65]). No adverse effects were observed related to bezlotoxumab infusion. Only one of 9 patients with previous heart failure developed heart failure.
    Conclusion: We observed that patients treated with bezlotoxumab in a real-world setting during a first episode of CDI having high risk of recurrence, presented low rate of recurrence. However, a significant difference in recurrence could not be proved in comparison to the controls. We did not detect any other safety concerns.
    MeSH term(s) Humans ; Aged ; Fidaxomicin/therapeutic use ; Prospective Studies ; Recurrence ; Anti-Bacterial Agents/adverse effects ; Antibodies, Monoclonal/adverse effects ; Clostridium Infections/microbiology ; Heart Failure/chemically induced ; Heart Failure/drug therapy ; Broadly Neutralizing Antibodies
    Chemical Substances bezlotoxumab (4H5YMK1H2E) ; Fidaxomicin (Z5N076G8YQ) ; Anti-Bacterial Agents ; Antibodies, Monoclonal ; Broadly Neutralizing Antibodies
    Language English
    Publishing date 2024-01-18
    Publishing country Germany
    Document type Multicenter Study ; Journal Article
    ZDB-ID 603155-9
    ISSN 1435-4373 ; 0934-9723 ; 0722-2211
    ISSN (online) 1435-4373
    ISSN 0934-9723 ; 0722-2211
    DOI 10.1007/s10096-024-04762-6
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  7. Article ; Online: Reply: The Need for Quality and Unbiased Data in Infective Endocarditis.

    Pericàs, Juan M / Llopis, Jaume / Ramos-Martínez, Antonio / Muñoz, Patricia / Miró, José M

    Journal of the American College of Cardiology

    2020  Volume 75, Issue 23, Page(s) 2994–2995

    MeSH term(s) Endocarditis/diagnosis ; Endocarditis, Bacterial ; Heart Diseases ; Humans
    Language English
    Publishing date 2020-06-11
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2020.04.034
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  8. Article: Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis.

    Calderón-Parra, Jorge / de Villarreal-Soto, Juan E / Oteo-Domínguez, Juan Francisco / Mateos-Seirul, María / Ríos-Rosado, Elsa / Dorado, Laura / Vera-Puente, Beatriz / Arellano-Serrano, Carlos / Ramos-Martínez, Antonio / Forteza-Gil, Alberto

    Journal of clinical medicine

    2023  Volume 12, Issue 2

    Abstract: Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE ... ...

    Abstract Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an observational study of a prospective cohort, including patients with TAVI/SAVR, from March 2015 to December 2020. IE was defined according to the modified Duke’s criteria. IE occurring during the first 12 months of the procedure was considered early IE, and an episode occurring after 12 months was considered late IE. The propensity score was designed to include variables previously associated with TAVI/SAVR and IE. An inverse probability of treatment weight was generated. Results: In total, 355 SAVR and 278 TAVI were included. Median follow-up, 38 vs. 41 months, p = 0.550. IE occurred in 5 SAVR (1.41%, 95% CI 0.2−2.6) vs. 13 TAVI (4.65%, 95% CI 2.2−7.2), p = 0.016. TAVI patients had more frequent early IE (3.2% vs. 0.3%, p = 0.006). In the PS analyses, IE risk did not differ: OR 0.65, 95% CI 0.32−1.32. Factors associated with TAVI IE included younger age (74y vs. 83y, p = 0.030), complicated diabetes mellitus (38.5% vs. 6.8%, p = 0.002), COPD (46.2% vs. 16.3%, p = 0.015), advanced heart failure (100% vs. 52.9%, p < 0.001), and peripheral arteriopathy (61.5% vs. 26.7%, p = 0.011). Conclusions: Early IE was higher with TAVI, but in the PS analyses, the risk attributable to each procedure was similar. Studies are needed to identify and optimize the risk factors of IE prior to TAVI.
    Language English
    Publishing date 2023-01-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12020586
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  9. Article ; Online: Determining the usefulness of systematic

    Gutiérrez, Andrea / Rodriguez, Begoña / Velasquez, Karina / Gutiérrez, Isabel / García, Sonia / Múñez, Elena / Calderón-Parra, Jorge / Callejas-Diaz, Alejandro / Ramos-Martinez, Antonio / Fernandez-Cruz, Ana

    BMJ open

    2023  Volume 13, Issue 6, Page(s) e074240

    Abstract: Introduction: The evaluation of staging and activity of invasive fungal infection (IFI) is used to adjust the type and duration of antifungal therapy (AT). Typically anatomy-based imaging is used. Positron emission tomography/CT with : Methods and ... ...

    Abstract Introduction: The evaluation of staging and activity of invasive fungal infection (IFI) is used to adjust the type and duration of antifungal therapy (AT). Typically anatomy-based imaging is used. Positron emission tomography/CT with
    Methods and analysis: Multicentre prospective cohort study of IFI with performance of systematic
    Ethics and dissemination: The Clinical Research Ethics Committee of Puerta de Hierro-Majadahonda University Hospital approved the protocol of the study at the primary site. We plan to publish the results in high-impact journals.
    Trial registration number: NCT05688592.
    MeSH term(s) Humans ; Fluorodeoxyglucose F18 ; Invasive Fungal Infections/diagnostic imaging ; Invasive Fungal Infections/drug therapy ; Multicenter Studies as Topic ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography ; Positron-Emission Tomography ; Prospective Studies ; Radiopharmaceuticals
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Radiopharmaceuticals
    Language English
    Publishing date 2023-06-23
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-074240
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  10. Article ; Online: Better prognostic ability of NEWS2, SOFA and SAPS-II in septic patients.

    Moreno-Torres, Víctor / Royuela, Ana / Múñez, Elena / Ortega, Alfonso / Gutierrez, Ángela / Mills, Patricia / Ramos-Martínez, Antonio

    Medicina clinica

    2021  Volume 159, Issue 5, Page(s) 224–229

    Abstract: Background and objectives: To compare the ability of qSOFA, NEWS2, SOFA, LODS, SIRS, APACHE-II and SAPS-II scores.: Material and methods: Analysis of in-hospital mortality of 203 patients admitted to the ICU because of sepsis. The scores were ... ...

    Title translation Mejor capacidad pronóstica de NEWS2, SOFA y SAPS-II en pacientes con sepsis.
    Abstract Background and objectives: To compare the ability of qSOFA, NEWS2, SOFA, LODS, SIRS, APACHE-II and SAPS-II scores.
    Material and methods: Analysis of in-hospital mortality of 203 patients admitted to the ICU because of sepsis. The scores were compared according to their application. Discrimination was evaluated with AUC-ROC curve and performance with the Akaike's (AIC) and Bayesian information criterion (BIC).
    Results: In-hospital mortality was 31.53%. NEWS2 showed better mortality discrimination ability and better performance considering the AIC/BIC criterion for mortality tan qSOFA (AUC-ROC=.615 and .536; P=.039). SOFA presented higher performance and AUC-ROC tan LODS (.776 vs .693; P=.01) and both showed higher discrimination ability than SIRS (AUC-ROC=.521; P<.003). Finally, SAPS-II was able to predict mortality with better performance than APACHE-II and presented higher discrimination capacity but without statistical significance compared (AUROC=.738 for SAPS-II and AUROC=.673 for APACHE-II; P=.08).
    Conclusion: NEWS2 is a better predictor of mortality than qSOFA and its implementation for the early recognition of the septic patient or the patient with higher risk in the emergency and hospitalization wards should be addressed. In addition, given that SOFA and SAPS-II showed better performance and are simpler than LODS and APACHE-II, respectively, both should be considered the scores of choice in this setting.
    MeSH term(s) Bayes Theorem ; Hospital Mortality ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Prognosis ; ROC Curve ; Retrospective Studies ; Sepsis/diagnosis ; Triacetoneamine-N-Oxyl
    Chemical Substances Triacetoneamine-N-Oxyl (2896-70-0)
    Language Spanish
    Publishing date 2021-12-20
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2021.10.021
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