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1. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Author

Laura Herrera-Hidalgo, Patricia Muñoz, Ana Álvarez-Uría, David Alonso-Menchén, Rafael Luque-Marquez, Encarnación Gutiérrez-Carretero, María Del Carmen Fariñas, Jose Maria Miró, Miguel Angel Goenaga, Luis Eduardo López-Cortés, Basilio Angulo-Lara, Lucia Boix-Palop, Arístides de Alarcón, Fernando Fernández Sánchez, José Mª García de Lomas, Gabriel Rosas, Javier de la Torre Lima, Elena Bereciartua, María José Blanco Vidal, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Laura Guio Carrión, Mikel Del Álamo Martínez de Lagos, Gorane Euba Ugarte, Ane Josune Goikoetxea, Marta Ibarrola Hierro, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Mª Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ignacio Álvarez Rodríguez, Harkaitz Azkune Galparsoro, Elisa Berritu Boronat, Mª Jesús Bustinduy Odriozola, Cristina del Bosque Martín, Tomás Echeverría, Alberto Eizaguirre Yarza, Ana Fuentes, Miguel Ángel Goenaga, Muskilda Goyeneche del Río, Ángela Granda Bauza, José Antonio Iribarren, Xabier Kortajarena Urkola, José Ignacio Pérez-Moreiras López, Ainhoa Rengel Jiménez, Karlos Reviejo, Alberto Sáez Berbejillo, Elou Sánchez Haza, Rosa Sebastián Alda, Itziar Solla Ruiz, Irati Unamuno Ugartemendia, Diego Vicente Anza, Iñaki Villanueva Benito, Mar Zabalo Arrieta, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Alberto Bouzas, Brais Castelo, José Cuenca, Laura Gutiérrez, Lucía Ramos, María Rodríguez Mayo, Joaquín Manuel Serrano, Dolores Sousa Regueiro, Francisco Javier Martínez, Mª del Mar Alonso, Beatriz Castro, Teresa Delgado Melian, Javier Fernández Sarabia, Dácil García Rosado, Julia González González, Juan Lacalzada, Lissete Lorenzo de la Peña, Alina Pérez Ramírez, Pablo Prada Arrondo, Fermín Rodríguez Moreno, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Guillermo Cuervo, Carlos Falces, Mariana J Fernández-Pittol, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Mercè Roque, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, David Alonso, Juan Carlos Alonso, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Agustín Estévez, Ramón Fortuny Ribas, Esther Gargallo, Mª Eugenia García Leoni, Ana González Mansilla, Francisco Javier González Moraga, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Marina Machado, Mercedes Marín, Manuel Martínez-Sellés, Rosa Melero, Diego Monzón, María Olmedo, Álvaro Pedraz, Blanca Pinilla, Ángel Pinto, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Eduardo Sánchez-Pérez, Antonio Segado, Neera Toledo, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Sofía de la Villa, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Sandra Rosillo, Jesús Agüero Balbín, Cristina Amado Fernández, Carlos Armiñanzas Castillo, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Marta Fernández Sampedro, Iván García, Claudia González Rico, Laura Gutiérrez-Fernández, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Pablo García Pavía, Ana Fernández Cruz, Antonio Ramos-Martínez, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Sergio Sequera, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, José Antonio Lepe, José López-Haldón, Rafael Luque-Márquez, Guillermo Marín, Antonio Ortiz-Carrellán, Eladio Sánchez-Domínguez, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Estíbaliz Corral Armas, Lara García-Álvarez, José Antonio Oteo, Antonio Barros Membrilla, Antonino Ginel Iglesias, Sara Grillo, Rubén Leta Petracca, Joaquín López-Contreras, María Alba Rivera Martínez, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Amaia Aguirre Quiñonero, Ángela Alonso Miñambres, Juan Carlos Gainzarain Arana, Sara González de Alaiza Ortega, Miguel Ángel Morán Rodríguez, Anai Moreno Rodríguez, Zuriñe Ortiz de Zárate, José Joaquín Portu Zapirain, Ester Sáez de Adana Arroniz, Daisy Carolina Sorto Sánchez, Sánchez-Porto Antonio, Úbeda Iglesias Alejandro, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Mª Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, María Jesús Del Amor Espín, Francisco Buendía, Roberto Jiménez Sánchez, Rosario Mármol, Francisco Martínez, Antonio Meseguer, Beatriz Pérez, Leticia Risco, Zoser Saura, Vanina Silva, Mª Belén Villmarín, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Miquel Vives Borràs, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Xerach Bosch, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Imanol Pulido, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Daniel San Román Sánchez, Jorge Boan Pérez, Eva Mª Aguilar Blanco, Mercedes Catalán González, María Angélica Corres Peiretti, Andrea Eixerés Esteve, Laura Domínguez Pérez, Santiago de Cossío Tejido, Francisco Galván Román, José Antonio García Robles, Francisco López Medrano, Mª Jesús López Gude, Mª Ángeles Orellana Miguel, Patrick Pilkington, Yolanda Revilla Ostalaza, Juan Ruiz Morales, Sebastián Ruiz Solís, Ana Sabín Collado, Marcos Sánchez Fernández, Javier Solera Rallo, Jorge Solís Martín, Francesc Escrihuela-Vidal, Jordi Carratalà, Inmaculada Grau, Carmen Ardanuy, Dámaris Berbel, José Carlos Sánchez Salado, Oriol Alegre, Alejandro Ruiz Majoral, Fabrizio Sbraga, Arnau Blasco, Laura Gracia Sánchez, Iván Sánchez-Rodríguez, Gonzalo Aldamiz, Beatriz Álvarez, Marina Bernal Palacios, Alfonso Cabello Úbeda, Ricardo Fernández Roblas, Rafael Hernández, Victoria Andrea Hortigüela Martín, Andrea Kallmeyer, Cristina Landaeta Kancev, Marta Martín, Miguel Morante Ruiz, Miguel Ángel Navas Lobato, Ana María Pello, Laura Prieto, Marta Tomás Mallebrera, Laura Varela, Mireia de la Peña Triguero, Ruth Esther Figueroa Cerón, Lara Ruiz Gómez, Mireia Ble, Juan Pablo Horcajada Gallego, Antonio José Ginel, Inmaculada López, Alexandra Mas, Antoni Mestres, Lluís Molina, Ramón Serrat, Núria Ribas, Francisca Sánchez, Ana Silverio, Marina Suárez, Luisa Sorlí, Lluís Recasens, Manuel Taurón, María Fernández Regueras, María Ángeles Mantecón Vallejo, José Ángel Pérez Rivera, Nuria Sánchez Mata, Antonia Calvo Cano, Miguel Fajardo Olivares, María Victoria Millán Núñez, and Agustín Muñoz Sanz

Subjects
Infective endocarditis, Methicillin-susceptible Staphylococcus aureus, Cefazolin, Antistaphylococcal penicillin, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

Published
2023
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2. Characterisation and Outcomes of Patients with Solid Organ Malignancies Admitted to the Intensive Care Unit: Mortality and Impact on Functional Status and Oncological Treatment

Author

Marta García de Herreros, Juan Carlos Laguna, Joan Padrosa, Tanny Daniela Barreto, Manoli Chicote, Carme Font, Ignacio Grafiá, Lucía Llavata, Elia Seguí, Albert Tuca, Margarita Viladot, Carles Zamora-Martínez, Sara Fernández-Méndez, Adrián Téllez, Josep Maria Nicolás, Aleix Prat, Pedro Castro-Rebollo, and Javier Marco-Hernández

Subjects
neoplasms, critical care, prognosis, intensive care unit, hospital mortality, hypoalbuminemia, Medicine (General), R5-920
Abstract

Background: Despite the increasing number of ICU admissions among patients with solid tumours, there is a lack of tools with which to identify patients who may benefit from critical support. We aim to characterize the clinical profile and outcomes of patients with solid malignancies admitted to the ICU. Methods: Retrospective observational study of patients with cancer non-electively admitted to the ICU of the Hospital Clinic of Barcelona (Spain) between January 2019 and December 2019. Data regarding patient and neoplasm characteristics, ICU admission features and outcomes were collected from medical records. Results: 97 ICU admissions of 84 patients were analysed. Lung cancer (22.6%) was the most frequent neoplasm. Most of the patients had metastatic disease (79.5%) and were receiving oncological treatment (75%). The main reason for ICU admission was respiratory failure (38%). Intra-ICU and in-hospital mortality rates were 9.4% and 24%, respectively. Mortality rates at 1, 3 and 6 months were 19.6%, 36.1% and 53.6%. Liver metastasis, gastrointestinal cancer, hypoalbuminemia, elevated basal C-reactive protein, ECOG-PS greater than 2 at ICU admission, admission from ward and an APACHE II score over 14 were related to higher mortality. Functional status was severely affected at discharge, and oncological treatment was definitively discontinued in 40% of the patients. Conclusion: Medium-term mortality and functional deterioration of patients with solid cancers non-electively admitted to the ICU are high. Surrogate markers of cachexia, liver metastasis and poor ECOG-PS at ICU admission are risk factors for mortality.

Published
2024
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3. Characterization of the endotheliopathy, innate-immune activation and hemostatic imbalance underlying CAR-T cell toxicities: laboratory tools for an early and differential diagnosis

Author

Alvaro Urbano-Ispizua, Sara Fernández, Pedro Castro, Francesc Fernández-Avilés, Enric Carreras, Adrián Téllez, Valentín Ortiz-Maldonado, Carlos Fernández de Larrea, Julio Delgado, Olaf Penack, Ana Belen Moreno-Castaño, Helena Ventosa, Marta Palomo, Julia Martinez-Sanchez, Alex Ramos, J M Nicolás, Gines Escolar, and Maribel Diaz-Ricart

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Background Chimeric antigen receptor (CAR)-T cell-based immunotherapy constitutes a revolutionary advance for treatment of relapsed/refractory hematological malignancies. Nevertheless, cytokine release and immune effector cell-associated neurotoxicity syndromes are life-threatening toxicities in which the endothelium could be a pathophysiological substrate. Furthermore, differential diagnosis from sepsis, highly incident in these patients, is challenging. Suitable laboratory tools could be determinant for their appropriate management.Methods Sixty-two patients treated with CAR-T cell immunotherapy for hematological malignancies (n=46 with CD19-positive diseases, n=16 with multiple myeloma) were included. Plasma samples were obtained: before CAR-T cell infusion (baseline); after 24–48 hours; at suspicion of any toxicity onset and 24–48 hours after immunomodulatory treatment. Biomarkers of endothelial dysfunction (soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble TNF receptor 1 (sTNFRI), thrombomodulin (TM), soluble suppression of tumorigenesis-2 factor (ST2), angiopoietin-2 (Ang-2)), innate immunity activation (neutrophil extracellular traps (NETs), soluble C5b-9 (sC5b-9)) and hemostasis/fibrinolysis (von Willebrand Factor antigen (VWF:Ag), ADAMTS-13 (A13), α2-antiplasmin (α2-AP), plasminogen activator inhibitor-1 antigen (PAI-1 Ag)) were measured and compared with those in cohorts of patients with sepsis and healthy donors.Results Patients who developed CAR-T cell toxicities presented increased levels of sVCAM-1, sTNFRI and ST2 at the clinical onset versus postinfusion values. Twenty-four hours after infusion, ST2 levels were good predictors of any CAR-T cell toxicity, and combination of ST2, Ang-2 and NETs differentiated patients requiring intensive care unit admission from those with milder clinical presentations. Association of Ang-2, NETs, sC5b-9, VWF:Ag and PAI-1 Ag showed excellent discrimination between severe CAR-T cell toxicities and sepsis.Conclusions This study provides relevant contributions to the current knowledge of the CAR-T cell toxicities pathophysiology. Markers of endotheliopathy, innate immunity activation and hemostatic imbalance appear as potential laboratory tools for their prediction, severity and differential diagnosis.

Published
2023
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6. Distinctive Biomarker Features in the Endotheliopathy of COVID-19 and Septic Syndromes

Author

Ferran Segui, Helena Ventosa, Paul G. Richardson, Enric Carreras, Carmelo Carlo-Stella, Gines Escolar, Sara Fernández, Pedro Castro, Ana Belen Moreno-Castaño, Sergi Torramade-Moix, Edward Richardson, Maribel Diaz-Ricart, Marta Palomo, José M. Moraleda, Julia Martinez-Sanchez, Josep M. Nicolás, Adrián Téllez, and David García-Bernal

Subjects
Male, medicine.medical_specialty, endothelium, Thrombomodulin, medicine.medical_treatment, ADAMTS13 Protein, Vascular Cell Adhesion Molecule-1, Complement Membrane Attack Complex, Critical Care and Intensive Care Medicine, Clinical Science Aspects, Gastroenterology, sepsis, Endothelial activation, Sepsis, Von Willebrand factor, Coagulopathy, Internal medicine, Plasminogen Activator Inhibitor 1, von Willebrand Factor, Fibrinolysis, Humans, Medicine, Prospective Studies, Aged, alpha-2-Antiplasmin, biology, SARS-CoV-2, business.industry, Septic shock, Patient Acuity, COVID-19, DNA, Middle Aged, medicine.disease, Systemic inflammatory response syndrome, Receptors, Tumor Necrosis Factor, Type I, Emergency Medicine, biology.protein, septic shock, Biomarker (medicine), Female, Heparitin Sulfate, business, Biomarkers
Abstract

Background: Endotheliopathy is a key element in COVID-19 pathophysiology, contributing to both morbidity and mortality. Biomarkers distinguishing different COVID-19 phenotypes from sepsis syndrome remain poorly understood. Objective: To characterize circulating biomarkers of endothelial damage in different COVID-19 clinical disease stages compared with sepsis syndrome and normal volunteers. Methods: Patients with COVID-19 pneumonia (n = 49) were classified into moderate, severe, or critical (life-threatening) disease. Plasma samples were collected within 48 to 72 h of hospitalization to analyze endothelial activation markers, including soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1), von Willebrand Factor (VWF), A disintegrin-like and metalloprotease with thrombospondin type 1 motif no. 13 (ADAMTS-13) activity, thrombomodulin (TM), and soluble TNF receptor I (sTNFRI); heparan sulfate (HS) for endothelial glycocalyx degradation; C5b9 deposits on endothelial cells in culture and soluble C5b9 for complement activation; circulating dsDNA for neutrophil extracellular traps (NETs) presence, and alpha 2-antiplasmin and PAI-1 as parameters of fibrinolysis. We compared the level of each biomarker in all three COVID-19 groups and healthy donors as controls (n = 45). Results in critically ill COVID-19 patients were compared with other intensive care unit (ICU) patients with septic shock (SS, n = 14), sepsis (S, n = 7), and noninfectious systemic inflammatory response syndrome (NI-SIRS, n = 7). Results: All analyzed biomarkers were increased in COVID-19 patients versus controls (P < 0.001), except for ADAMTS-13 activity that was normal in both groups. The increased expression of sVCAM-1, VWF, sTNFRI, and HS was related to COVID-19 disease severity (P < 0.05). Several differences in these parameters were found between ICU groups: SS patients showed significantly higher levels of VWF, TM, sTNFRI, and NETS compared with critical COVID-19 patients and ADAMTS-13 activity was significantly lover in SS, S, and NI-SIRS versus critical COVID-19 (P < 0.001). Furthermore, alpha 2-antiplasmin activity was higher in critical COVID-19 versus NI-SIRS (P < 0.01) and SS (P < 0.001), whereas PAI-1 levels were significantly lower in COVID-19 patients compared with NI-SIRS, S, and SS patients (P < 0.01). Conclusions: COVID-19 patients present with increased circulating endothelial stress products, complement activation, and fibrinolytic dysregulation, associated with disease severity. COVID-19 endotheliopathy differs from SS, in which endothelial damage is also a critical feature of pathobiology. These biomarkers could help to stratify the severity of COVID-19 disease and may also provide information to guide specific therapeutic strategies to mitigate endotheliopathy progression.

Published
2021

7. Is the Endothelium the Missing Link in the Pathophysiology and Treatment of COVID-19 Complications?

Author

Georgina Pascual, Enric Carreras, Paul G. Richardson, Ana Belen Moreno-Castaño, Marta Palomo, Julia Martinez-Sanchez, Edward Richardson, Josep M. Nicolás, Juan J. Badimon, Sara Fernández, Adrián Téllez, Maribel Diaz-Ricart, Gines Escolar, Sergi Torramade-Moix, and Pedro Castro

Subjects
0301 basic medicine, Complement system, Endothelium, Review Article, Disease, 030204 cardiovascular system & hematology, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Coagulopathy, Humans, Medicine, Pharmacology (medical), Vascular Diseases, Endothelial dysfunction, Pharmacology, SARS-CoV-2, business.industry, Microangiopathy, Endothelial Cells, COVID-19, General Medicine, medicine.disease, Endotheliopathy, Cytokine release syndrome, 030104 developmental biology, medicine.anatomical_structure, Immunology, Endothelial protection, COVID-19 therapies, Endothelium, Vascular, medicine.symptom, Cytokine Release Syndrome, Cardiology and Cardiovascular Medicine, business, Cytokine storm
Abstract

Patients with COVID-19 present a wide spectrum of disease severity, from asymptomatic cases in the majority to serious disease leading to critical care and even death. Clinically, four different scenarios occur within the typical disease timeline: first, an incubation and asymptomatic period; second, a stage with mild symptoms due mainly to the virus itself; third, in up to 20% of the patients, a stage with severe symptoms where a hyperinflammatory response with a cytokine storm driven by host immunity induces acute respiratory distress syndrome; and finally, a post-acute sequelae (PASC) phase, which present symptoms that can range from mild or annoying to actually quite incapacitating. Although the most common manifestation is acute respiratory failure of the lungs, other organs are also frequently involved. The clinical manifestations of the COVID-19 infection support a key role for endothelial dysfunction in the pathobiology of this condition. The virus enters into the organism via its interaction with angiotensin-converting enzyme 2-receptor that is present prominently in the alveoli, but also in endothelial cells, which can be directly infected by the virus. Cytokine release syndrome can also drive endothelial damage independently. Consequently, a distinctive feature of SARS-CoV-2 infection is vascular harm, with severe endothelial injury, widespread thrombosis, microangiopathy, and neo-angiogenesis in response to endothelial damage. Therefore, endothelial dysfunction seems to be the pathophysiological substrate for severe COVID-19 complications. Biomarkers of endothelial injury could constitute strong indicators of disease progression and severity. In addition, the endothelium could represent a very attractive target to both prevent and treat these complications. To establish an adequate therapy, the underlying pathophysiology and corresponding clinical stage should be clearly identified. In this review, the clinical features of COVID-19, the central role of the endothelium in COVID-19 and in other pathologies, and the potential of specific therapies aimed at protecting the endothelium in COVID-19 patients are addressed.

Published
2021

8. Development of High-Level Daptomycin Resistance in Abiotrophia and Granulicatella Species Isolates from Patients with Infective Endocarditis

Author

Javier García-González, Cristina Garcia de la Maria, José M. Miró, Anders Dahl, Marta Hernández-Meneses, Adrián Téllez, Asunción Moreno, Juan Ambrosioni, Eduard Quintana, Elena Sandoval, Carlos Falces, Andrés Perissinotti, Barbara Vidal, María Alexandra Cañas, José María Tolosana, Manel Almela, and Juan M. Pericàs

Subjects
Pharmacology, Abiotrophia defectiva, biology, business.industry, Abiotrophia, biology.organism_classification, medicine.disease, Microbiology, Penicillin, Infectious Diseases, Infective endocarditis, Ampicillin, medicine, Vancomycin, Pharmacology (medical), Daptomycin, Granulicatella, business, medicine.drug
Abstract

Abiotrophia and Granulicatella species are fastidious organisms, representing the causative agents of ∼1% to 3% of cases of infective endocarditis (IE). Little is known about the optimal antibiotic treatment for these species, and daptomycin has been suggested as a therapeutic option. We describe the antimicrobial profiles of Abiotrophia and Granulicatella IE isolates, investigate high-level daptomycin resistance (HLDR) development, and evaluate daptomycin activity in combination therapy. In vitro studies with 16 IE strains (6 Abiotrophia defectiva strains, 9 Granulicatella adiacens strains, and 1 G. elegans strain) were performed using microdilution to determine MICs and time-kill methodology to evaluate combination therapy. Daptomycin nonsusceptibility (DNS) (MIC ≥ 2 mg/liter) and HLDR (MIC ≥ 256 mg/liter) were based on existing Clinical and Laboratory Standards Institute (CLSI) breakpoints for viridans group streptococci. All isolates were susceptible to vancomycin: G. adiacens was more susceptible to penicillin and ampicillin than A. defectiva (22% versus 0% and 67% versus 33%) but less susceptible to ceftriaxone and daptomycin (56% versus 83% and 11% versus 50%). HLDR developed in both A. defectiva (33%) and G. adiacens (78%) after 24 h of exposure to daptomycin. Combination therapy did not prevent the development of daptomycin resistance with ampicillin (2/3 strains), gentamicin (2/3 strains), ceftriaxone (2/3 strains), or ceftaroline (2/3 strains). Once developed, HLDR was stable for a prolonged time (>3 weeks) in G. adiacens, whereas in A. defectiva, HLDR reversed to the baseline MIC at day 10. This study is the first to demonstrate rapid HLDR development in Abiotrophia and Granulicatella species in vitro. Resistance was stable, and most combination therapies did not prevent it.

Published
2021

9. Mitral valve repair in infective endocarditis is not inferior to valve replacement: results from a Spanish nationwide prospective registry

Author

Javier Bermejo, Víctor José González Ramallo, Marta Hernández-Meneses, Adrián Téllez, Víctor Asensi Álvarez, Claudia González-Rico, Vicente Climent, Luis Eduardo López-Cortés, José David Rodrigo Carbonero, Castelo-Corral Laura, Francesc Marco, Eduard Quintana, Leyre López-Soria, Pere Pericas, Pilar Martín-Dávila, Ana Fernández-Cruz, Alejandro Martin-Quiros, José Ignacio Aramendi, José A. Oteo, Roberto Blanco Mata, David Nicolás, Marina Cueto-López, Guillermo Ojeda Burgos, Marta Bodro, Esperanza Merino de Lucas, Natividad Benito, Fernando Dominguez, Jose A. Lepe, Patricia Carmen Muñoz García, Juan M Pericas, Daniel Pereda, Javier De La Torre-Lima, Omar A Araji-Tiliani, Antonia Delgado-Montero, and Asunción Moreno Camacho

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Heart Valve Diseases, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Recurrence, Mitral valve, medicine, Humans, Endocarditis, Prospective Studies, Registries, Aged, Heart Valve Prosthesis Implantation, Mitral valve repair, business.industry, Mitral valve replacement, EuroSCORE, General Medicine, Middle Aged, medicine.disease, Surgery, Survival Rate, medicine.anatomical_structure, 030228 respiratory system, Spain, Cardiothoracic surgery, Infective endocarditis, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

Introduction Infective endocarditis (IE) still carries high morbidity and mortality and frequently requires surgery. The benefit of mitral valve repair (MVr) in the setting of IE is yet to be proven. The goal of this study was to assess the results of MVr in patients with IE after a minimum follow-up of 1 year. Methods This study is based on a Spanish nationwide prospective registry that included patients operated on for native mitral valve IE. The collaborating Institutions pooled their pre-, peri-, and postoperative data into the database of the GAMES group [Grupo de Apoyo al Manejo de la EndocarditiS (Group for support and management of infective endocarditis)]. Results Data from 27 hospitals were recorded and 3524 cases of active IE identified between 2008 and 2016. There were 1513 cases of mitral IE, of which 898 involved native valves. Of these, 437 patients underwent surgical treatment, and 369 completed the 1-year follow-up. The valve was repaired in 68 cases (18.4%). Preoperative groups were comparable (EuroSCORE MVr 7.7 vs MVR 8.0; p = ns). Mortality in the repair group was inferior to that in the replacement group (16.2% vs 27.2%, p = 0.058). At 1 year, mortality remained higher in the replacement group: 3.7% vs 2.9%. Relapse of the infection was slightly more frequent in the repair group (7.1% vs 3.7%; p = ns), although this did not lead to higher rates of reintervention (MVr/MVR: 2.9% vs 4.9%). Conclusion MVr is an attractive option for specific patients with IE and does not seem to negatively impact on relapses.

Published
2019

10. Progressive endothelial cell damage in correlation with sepsis severity. Defibrotide as a contender

Author

Marta Palomo, Adrián Téllez, Montserrat Rovira, Pedro Castro, Maribel Diaz-Ricart, Sara Fernández, Enric Carreras, Ferran Segui, Gines Escolar, Sergi Torramade-Moix, Josep M. Nicolás, Patricia Molina, and Helena Ventosa

Subjects
Endothelium, endothelium, 030204 cardiovascular system & hematology, Defibrotide, defibrotide, Sepsis, sepsis, 03 medical and health sciences, Polydeoxyribonucleotides, 0302 clinical medicine, Von Willebrand factor, medicine, Humans, biology, Septic shock, business.industry, Organ dysfunction, Endothelial Cells, Hematology, medicine.disease, endothelial cells, Endothelial stem cell, Systemic inflammatory response syndrome, medicine.anatomical_structure, Immunology, biology.protein, septic shock, Endothelium, Vascular, medicine.symptom, business, medicine.drug
Abstract

Background The vascular endothelium plays a key role in sepsis pathophysiology and the associated organ dysfunction. Methods We evaluated endothelial function in an experimental in vitro model of sepsis, using endothelial cells grown in the presence of serum from patients with septic syndromes (sepsis, severe sepsis, and septic shock), noninfectious systemic inflammatory response syndrome (NI-SIRS) and healthy volunteers. Experiments were performed in the absence and presence of defibrotide (DF) (100 mu g/ml) to evaluate its potential protective effect. Results After exposure to patients' sera, there was a progressive endothelial cell activation in correlation with sepsis severity, with a proinflammatory and prothrombotic phenotype, exhibiting significantly increased expression of adhesion receptors at the surface (intercellular adhesion molecule-1, p < .05 and vascular cell adhesion molecule-1, p < .05); higher production and release to the extracellular matrix (ECM) of von Willebrand factor (p < .001); augmented thrombogenicity of the ECM toward platelets (p < .001); and increased phosphorylation of intracellular p38MAPK. DF prevented these changes in all groups. Conclusions Markers of endothelial damage increased progressively in association with the severity of septic syndromes. The endothelium is therefore an important therapeutic target to prevent complications of sepsis. DF shows promising potential to modulate the endothelial damage associated with sepsis and may constitute a pharmacological tool to decrease its sequelae including multiorgan failure.

Published
2021

12. A Contemporary Picture of Enterococcal Endocarditis

Author

Juan M. Pericàs, Jaume Llopis, Patricia Muñoz, Juan Gálvez-Acebal, Martha Kestler, Maricela Valerio, Marta Hernández-Meneses, Miguel Á. Goenaga, Manuel Cobo-Belaustegui, Miguel Montejo, Guillermo Ojeda-Burgos, M. Dolores Sousa-Regueiro, Arístides de Alarcón, Antonio Ramos-Martínez, José M. Miró, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Jaume Llopis Pérez, Francesc Marco, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Carmen Díaz Pedroche, Fernando Chaves, Santiago de Cossío, Francisco López Medrano, Ma Jesús López, Javier Solera, Jorge Solís, Carmen Ardanuy, Guillermo Cuervo Requena, Sara Grillo, and Alejandro Ruiz Majoral

Subjects
Aortic valve, Male, medicine.medical_specialty, relapses, Enterococci, Epidemiology, medicine.medical_treatment, heart failure, Heart failure, 030204 cardiovascular system & hematology, Logistic regression, Prosthesis, prosthetic valves, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, enterococci, Internal medicine, Post-hoc analysis, medicine, Enterococcus faecalis, Endocarditis, Humans, 030212 general & internal medicine, Gram-Positive Bacterial Infections, Aged, Bacteria, business.industry, infective endocarditis, ComputingMilieux_PERSONALCOMPUTING, Endocarditis, Bacterial, Middle Aged, Prosthetic valves, medicine.disease, medicine.anatomical_structure, Spain, Infective endocarditis, Cohort, epidemiology, Female, Cardiology and Cardiovascular Medicine, business, Relapses
Abstract

GAMES Investigators., [Background] Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking., [Objectives] The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort., [Methods] This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses., [Results] Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse., [Conclusions] Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE.

Published
2020

14. Gentamicin may have no effect on mortality of staphylococcal prosthetic valve endocarditis

Author

Antonio Ramos-Martínez, Alejandro Muñoz Serrano, Arístides de Alarcón González, Patricia Muñoz, Ana Fernández-Cruz, Maricela Valerio, María Carmen Fariñas, Manuel Gutiérrez-Cuadra, José Ma Miró, Josefa Ruiz-Morales, Dolores Sousa-Regueiro, José Miguel Montejo, Juan Gálvez-Acebal, Carmen HidalgoTenorio, Fernando Domínguez, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, Roberto Blanco, María Victoria Boado, Itxasne Cabezón Estébanez, Marta Campaña Lázaro, Josune Goikoetxea, Juan José Goiti, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodríguez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Ana Fernández Cruz, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez-Sellés, Ma Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavíaz, Jesús Gonzálezz, Beatriz Ordenz, Antonio Ramosz, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Arístides de Alarcón, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, and Juan Carlos Porres

Subjects
Male, 0301 basic medicine, Microbiology (medical), Staphylococcus aureus, medicine.medical_specialty, Prosthesis-Related Infections, 030106 microbiology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Cloxacillin, Vancomycin, Internal medicine, medicine, Humans, Endocarditis, Pharmacology (medical), Prospective Studies, Renal Insufficiency, 030212 general & internal medicine, Aged, Heart Failure, business.industry, Endocarditis, Bacterial, Middle Aged, Staphylococcal Infections, medicine.disease, Anti-Bacterial Agents, Regimen, Infectious Diseases, Heart Valve Prosthesis, Multivariate Analysis, Female, Gentamicin, Gentamicins, Rifampin, business, Complication, Rifampicin, medicine.drug
Abstract

Purpose: To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE). Methods: From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on β-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin. Results: Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR: 4.58; CI 95%: 1.84–11.42) and not performing surgery when indicated (OR: 2.68; CI 95%: 1.03–6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR: 1.001; CI 95%: 0.29–3.38) in the multivariable analysis. Conclusions: The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome.

Published
2018

15. Mechanical Thrombectomy for Acute Ischemic Stroke Secondary to Infective Endocarditis

Author

José María Tolosana, Asunción Moreno, Juan Ambrosioni, Adrián Téllez, Eduard Quintana, Barbara Vidal, Xabier Urra, Elena Sandoval, Ángel Chamorro, José M. Miró, Carlos Falces, Manel Almela, Marta Hernández-Meneses, and David Fuster

Subjects
Microbiology (medical), medicine.medical_specialty, business.industry, medicine.medical_treatment, Vessel occlusion, Thrombolysis, 030204 cardiovascular system & hematology, medicine.disease, Mechanical thrombectomy, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Mechanical Thrombolysis, Internal medicine, Infective endocarditis, Ischemic stroke, medicine, Cardiology, Endocarditis, business, Acute ischemic stroke, 030217 neurology & neurosurgery
Abstract

Intravenous thrombolysis is contraindicated in acute ischemic stroke secondary to infective endocarditis. We report our initial experience in 6 cases of proximal vessel occlusion treated with mechanical thrombectomy, which was safe (no bleeding) and effective (significant early neurological improvement) and might be useful in this clinical setting.

Published
2017

16. Epidemiology, Clinical Features, and Outcome of Infective Endocarditis due to Abiotrophia Species and Granulicatella Species: Report of 76 Cases, 2000–2015

Author

Juan M. Pericàs, Juan Ambrosioni, Jaume Llopis, Manel Almela, José María Tolosana, Francesc Marco, Barbara Vidal, Asunción Moreno, Eduard Quintana, Adrián Téllez, C. Falces, Elena Sandoval, Cristina Garcia de la Maria, José M. Miró, Marta Hernández-Meneses, and David Fuster

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Pediatrics, biology, Heart disease, business.industry, Aggregatibacter, 030106 microbiology, Retrospective cohort study, Abiotrophia, biology.organism_classification, medicine.disease, body regions, 03 medical and health sciences, Infectious Diseases, Internal medicine, Infective endocarditis, parasitic diseases, Epidemiology, medicine, Endocarditis, business, Complication, human activities
Abstract

BackgroundInfective endocarditis (IE) caused by Abiotrophia (ABI) and Granulicatella (GRA) species is poorly studied. This work aims to describe and compare the main features of ABI and GRA IE.MethodsWe performed a retrospective study of 12 IE institutional cases of GRA or ABI and of 64 cases published in the literature (overall, 38 ABI and 38 GRA IE cases).ResultsABI/GRA IE represented 1.51% of IE cases in our institution between 2000 and 2015, compared to 0.88% of HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella)–related IE and 16.62% of Viridans group streptococci (VGS) IE. Institutional ABI/GRA IE case characteristics were comparable to that of VGS, but periannular complications were more frequent (P = .008). Congenital heart disease was reported in 4 (10.5%) ABI and in 11 (28.9%) GRA cases (P = .04). Mitral valve was more frequently involved in ABI than in GRA (P < .001). Patient sex, prosthetic IE, aortic involvement, penicillin susceptibility, and surgical treatment were comparable between the genera. New-onset heart failure was the most frequent complication without genera differences (P = .21). Five (13.2%) ABI patients and 2 (5.3%) GRA patients died (P = .23). Factors associated with higher mortality were age (P = .02) and new-onset heart failure (P = .02). The genus (GRA vs ABI) was not associated with higher mortality (P = .23).ConclusionsGRA/ABI IE was more prevalent than HACEK IE and approximately one-tenth as prevalent as VGS; periannular complications were more frequent. GRA and ABI genera IE presented similar clinical features and outcomes. Overall mortality was low, and related to age and development of heart failure.

Published
2017

17. DAPTOMICINA COMBINADA CON AMPICILINA, CEFTRIAXONA, CEFTAROLINA PRESENTA SINERGIA IN VITRO Y PREVIENE EL DESARROLLO DE RESISTENCIA DE ALTO NIVEL A DAPTOMICINA EN A.DEFECTIVA Y G.ADIACENS

Author

Cristina Garcia de la Maria, Carlos Falces, Juan Ambrosioni, José M. Miró, Marta Hernández-Meneses, Adrián Téllez, Manel Almela, Asunción Moreno, María Alexandra Cañas, and Javier García-González

Subjects
business.industry, lcsh:R, lcsh:Surgery, Medicine, lcsh:Medicine, Surgery, lcsh:RD1-811, Cardiology and Cardiovascular Medicine, business, Humanities
Published
2020

18. Prevalence of Colorectal Neoplasms Among Patients With Enterococcus faecalis Endocarditis in the GAMES Cohort (2008-2017)

Author

Juan M. Pericàs, Juan Ambrosioni, Patricia Muñoz, Arístides de Alarcón, Martha Kestler, Amaia Mari-Hualde, Asunción Moreno, Miguel Á. Goenaga, M. Carmen Fariñas, Regino Rodríguez-Álvarez, Guillermo Ojeda-Burgos, Juan Gálvez-Acebal, Carmen Hidalgo-Tenorio, Mariam Noureddine, José M. Miró, Fernando Fernández Sánchez, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, Ma del Mar Alonso, Beatriz Castro, Dácil García Rosado, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Ma Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Ma Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García-Domínguez Gloria, Sánchez-Porto Antonio, José Ma Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Ma Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ma Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Ma Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars. Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego Héctor Marrero Santiago, Isabel de Miguel Martínez, and Elena Pisos Álamo

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Population, Colonoscopy, Enterococcus faecalis, Risk Factors, Internal medicine, medicine, Prevalence, Endocarditis, Humans, education, Gram-Positive Bacterial Infections, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, biology, business.industry, Retrospective cohort study, General Medicine, Endocarditis, Bacterial, Middle Aged, medicine.disease, biology.organism_classification, Infective endocarditis, Cohort, Female, business, Colorectal Neoplasms
Abstract

Objective: To investigate the rate of colorectal neoplasms (CRNs) in patients who have Enterococcus faecalis infective endocarditis (EFIE) with available colonoscopies and to assess whether this is associated with the identification of a focus the infection. Patients and Methods: Retrospective analysis of data from a prospective multicenter study involving 35 centers who are members of the Grupo de Apoyo para el Manejo de la Endocarditis en Espana [Support Group for the Management of Infective Endocarditis in Spain] cohort. A specific set of queries regarding information on colonoscopy and histopathology of colorectal diseases was sent to each participating center. Four-hundred sixty-seven patients with EFIE were included from January 1, 2008, to December 31, 2017, from whom data on colonoscopy performance and results were available in 411 patients. Results: One hundred forty-two (34.5%) patients had a colonoscopy close to the EFIE episode. The overall rate of colorectal diseases was 70.4% (100 of 142), whereas the prevalence of CRN (advanced adenomas and colorectal carcinoma) was 14.8% (21 of 142), with no significant differences between the group of EFIE of unknown focus and that with an identified focus. Conclusion: Our study adds to prior evidence suggesting a much higher rate of CRN among patients with EFIE than in the general population of the same age and sex. In addition, our findings suggest that this phenomenon might take place both in EFIE with an unknown and an identified source of infection.

Published
2019

19. Giant Glioblastoma in a Patient with Previous Prostate Adenocarcinoma

Author

Pedro Castro Rebollo, Ramón Estruch Riba, Anna Aldea Parés, and Adrián Téllez Santoyo

Subjects
Prostate adenocarcinoma, Pathology, medicine.medical_specialty, Temozolomide, business.industry, Brain tumor, General Medicine, medicine.disease, Nodular lesions, Detoxification, Glioma, medicine, business, Brain neoplasm, medicine.drug, Glioblastoma
Published
2018

20. Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Author

Isabel Zegri-Reiriz, Arístides de Alarcón, Patricia Muñoz, Manuel Martínez Sellés, Victor González-Ramallo, Jose M. Miro, Carles Falces, Claudia Gonzalez Rico, Xabier Kortajarena Urkola, José Antonio Lepe, Regino Rodriguez Alvarez, Jose Maria Reguera Iglesias, Enrique Navas, Fernando Dominguez, Pablo Garcia-Pavia, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, José Aramendi, Elena Bereciartua, María José Blanco, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, David Rodríguez, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, María Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, María del Mar Alonso, Beatriz Castro, Dácil García Rosado, Mª del Carmen Durán, Mª Antonia Miguel Gómez, Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José María Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan Manuel Pericás, José Luis Pomar, José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana Fernández Cruz, Ana García Mansilla, María Eugenia García Leoni, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, María Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Fernando Domínguez, Pablo García-Pavía, Jesús González Mirelis, Beatriz Orden, Antonio Ramos, Marta Cobo-Marcos, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Oliva, Alejandro del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad de Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Ángel Luis Fernández, Amparo Martínez, Arturo Prieto, Benito Regueiro, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Gloria García Domínguez, Antonio Sánchez-Porto, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, María Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca, Ivan Keituqwa Yañez, Ana Peláez Ballesta, Víctor Soriano, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, and Juan Carlos Segura Luque

Subjects
Adult, Male, medicine.medical_specialty, bicuspid aortic valve, Enfermedad cardiovascular, Heart Valve Diseases, 030204 cardiovascular system & hematology, Intracardiac injection, 03 medical and health sciences, Tratamiento médico, 0302 clinical medicine, Bicuspid aortic valve, Bicuspid Aortic Valve Disease, medicine, Mitral valve prolapse, Endocarditis, Humans, In patient, 030212 general & internal medicine, Registries, Antibiotic prophylaxis, Antibióticos, Aged, Endocarditis infecciosa, Mitral Valve Prolapse, antibiotic prophylaxis, business.industry, Incidence (epidemiology), Antibiotic Prophylaxis, Middle Aged, medicine.disease, Surgery, Infective endocarditis, Aortic Valve, Válvulas cardíacas, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background: There is little information concerning infective endocarditis (IE) in patients with bicuspid aortic valve (BAV) or mitral valve prolapse (MVP). Currently, IE antibiotic prophylaxis (IEAP) is not recommended for these conditions. Objectives: This study sought to describe the clinical and microbiological features of IE in patients with BAV and MVP and compare them with those of IE patients with and without IEAP indication, to determine the potential benefit of IEAP in these conditions. Methods: This analysis involved 3,208 consecutive IE patients prospectively included in the GAMES (Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España) registry at 31 Spanish hospitals. Patients were classified as high-risk IE with IEAP indication (high-risk group; n = 1,226), low- and moderate-risk IE without IEAP indication (low/moderate-risk group; n = 1,839), and IE with BAV (n = 54) or MVP (n = 89). Results: BAV and MVP patients had a higher incidence of viridans group streptococci IE than did high-risk group and low/moderate-risk group patients (35.2% and 39.3% vs. 12.1% and 15.0%, respectively; all p < 0.01). A similar pattern was seen for IE from suspected odontologic origin (14.8% and 18.0% vs. 5.8% and 6.0%; all p < 0.01). BAV and MVP patients had more intracardiac complications than did low/moderate-risk group (50% and 47.2% vs. 30.6%, both p < 0.01) patients and were similar to high-risk group patients. Conclusions: IE in patients with BAV and MVP have higher rates of viridans group streptococci IE and IE from suspected odontologic origin than in other IE patients, with a clinical profile similar to that of high-risk IE patients. Our findings suggest that BAV and MVP should be classified as high-risk IE conditions and the case for IEAP should be reconsidered. Sin financiación 18.639 JCR (2018) Q1, 3/136 Cardiac & Cardiovascular Systems 9.280 SJR (2018) Q1, 1/365 Cardiology and Cardiovascular Medicine No data IDR 2018 UEM

Published
2018

21. Risk factors for mortality in patients with acute leukemia and bloodstream infections in the era of multiresistance

Author

Jordi Esteve, Laura Morata, Carolina Garcia-Vidal, Olga Rodríguez-Núñez, Celia Cardozo-Espinola, Francisco Romero-Santana, Eva Giné, Francesc Marco, Josep Mensa, Pedro Puerta-Alcalde, Daiana Agüero, José Antonio Martínez, Adrián Téllez, Marina Díaz-Beyá, and Alex Soriano

Subjects
Male, 0301 basic medicine, Multivariate analysis, Epidemiology, Antibiotics, Cephalosporin, lcsh:Medicine, Bacteremia, Drug resistance, Pathology and Laboratory Medicine, White Blood Cells, 0302 clinical medicine, Animal Cells, Risk Factors, Drug Resistance, Multiple, Bacterial, Medicine and Health Sciences, Medicine, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, lcsh:Science, Acute leukemia, Multidisciplinary, Leukemia, Antimicrobials, Pharmaceutics, Gram Positive Bacteria, Drugs, Leucèmia, Middle Aged, Prognosis, Bacterial Pathogens, Medical Microbiology, Female, Cellular Types, Pathogens, Research Article, Cohort study, Adult, medicine.medical_specialty, Neutropenia, Death Rates, medicine.drug_class, Immune Cells, Immunology, 030106 microbiology, Microbiology, 03 medical and health sciences, Population Metrics, Drug Therapy, Diagnostic Medicine, Microbial Control, Internal medicine, Mortalitat, Chemotherapy, Humans, Mortality, Microbial Pathogens, Pharmacology, Blood Cells, Population Biology, Bacteria, business.industry, lcsh:R, Organisms, Biology and Life Sciences, Bacteriology, Cell Biology, lcsh:Q, business, Enterococcus
Abstract

Objectives: We assess the epidemiology and risk factors for mortality of bloodstream infection (BSI) in patients with acute leukemia (AL). Methods: Prospectively collected data of a cohort study from July 2004 to February 2016. Multivariate analyses were performed. Results: 589 episodes of BSI were documented in 357 AL patients, 55% caused by gram-positive bacteria (coagulase-negative staphylococci 35.7%, Enterococcus spp 10.8%) and 43.5% by gram-negative bacteria (E. coli 21%, PA 12%). We identified 110 (18.7%) multidrug-resistant (MDR) microorganisms, especially MDR-Pseudomonas aeruginosa (7%) and extended-spectrum beta-lactamase producing Enterobacteriaceae (7%). The 30-day mortality was 14.8%. Age (OR 3.1; 95% CI 1.7–5.7); chronic lung disease (4.8; 1.1–21.8); fatal prognosis according to McCabe index (13.9; 6.4–30.3); shock (3.8; 1.9–7.7); pulmonary infection (3.6; 1.3–9.9); and MDR-PA infections with inappropriate treatment (12.8; 4.1–40.5) were related to mortality. MDR-PA BSI was associated to prior antipseudomonal cephalosporin use (9.31; 4.38–19.79); current use of betalactams (2.01; 1.01–4.3); shock (2.63; 1.03–6.7) and pulmonary source of infection (9.6; 3.4–27.21). Conclusions: MDR organisms were commonly isolated in BSI in AL. Inappropriate empiric antibiotic treatment for MDR-PA is the primary factor related to mortality that can be changed. New treatment strategies to improve the coverage of MDR-PA BSI should be considered in those patients with risk factors for this infection.

Published
2018

22. Eficacia de daptomicina y cloxacilina en el tratamiento de la endocarditis experimental por staphylococcus aureus sensible a la meticilina

Author

Juan M. Pericàs, Javier García-González, A. Moreno, Marta Hernández-Meneses, Adrián Téllez, M. Villamonte, Juan Ambrosioni, Manuel Almela, C. Falces, Miró Jm, Jaume Llopis, Eduard Quintana, C. García de la Mària, and Barbara Vidal

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, Surgery, Cardiology and Cardiovascular Medicine, business
Published
2019

23. Infective endocarditis in patients with cancer: a consequence of invasive procedures or a harbinger of neoplasm?: A prospective, multicenter cohort

Author

Antonio Sánchez-Porto, Javier Bermejo, Víctor José González Ramallo, Marta Hernández-Meneses, Adrián Téllez, Víctor Asensi Álvarez, Claudia González-Rico, Vicente Climent, Luis Eduardo López-Cortés, Angel L. Fernández, Eduard Quintana, Jordi Vila, Pilar Martín-Dávila, Ana Fernández-Cruz, José A. Oteo, Jose Maria Arribas Leal, Marina Cueto-López, Natividad Benito, Fernando Dominguez, Jose A. Lepe, Patricia Carmen Muñoz García, Javier De La Torre-Lima, Omar A Araji-Tiliani, Universidad de Cantabria, and Universitat de Barcelona

Subjects
Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Duke criteria, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Risk Factors, Internal medicine, Neoplasms, medicine, Endocarditis, Neoplasm, Humans, In patient, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, Càncer, Aged, Cancer, Cross Infection, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Estudi de casos, Infective endocarditis, Cohort, Female, Case studies, business
Abstract

The aim of the study was to draw a comparison between the characteristics of infective endocarditis (IE) in patients with cancer and those of IE in noncancer patients.Patients with IE, according to the modified Duke criteria, were prospectively included in the GAMES registry between January 2008 and February 2014 in 30 hospitals. Patients with active cancer were compared with noncancer patients.During the study period, 161 episodes of IE fulfilled the inclusion criteria. We studied 2 populations: patients whose cancer was diagnosed before IE (73.9%) and those whose cancer and IE were diagnosed simultaneously (26.1%). The latter more frequently had community-acquired IE (67.5% vs 26.4%, P

Published
2017

24. The Changing Epidemiology of Infective Endocarditis in the Twenty-First Century

Author

Jaume Llopis, C. Falces, José M. Miró, Asunción Moreno, Juan M. Pericàs, Eduard Quintana, Marta Hernández-Meneses, Adrián Téllez, Manuel Almela, Juan Ambrosioni, Barbara Vidal, and José María Tolosana

Subjects
0301 basic medicine, Prosthetic valve, medicine.medical_specialty, business.industry, Mortality rate, 030106 microbiology, Twenty-First Century, Rheumatic disease, medicine.disease, 03 medical and health sciences, Infectious Diseases, Infectious disease (medical specialty), Infective endocarditis, Epidemiology, medicine, Intensive care medicine, business
Abstract

Infective endocarditis (IE) is a relatively infrequent infectious disease. It does, however, causes serious morbidity, and its mortality rate has remained unchanged at approximately 25%. Changes in IE risk factors have deeply impacted its epidemiology during recent decades but literature from low-income countries is very scarce. Moreover, prophylaxis guidelines have recently changed and the impact on IE incidence is still unknown. In high-income countries, the proportion of IE related to prior rheumatic disease has decreased significantly and has been replaced proportionally by cases related to degenerative valvulopathies, prosthetic valves, and cardiovascular implantable electronic devices. Nosocomial and non-nosocomial-acquired cases have risen, as has the proportion caused by staphylococci, and the median age of patients. In low-income countries, in contrast, rheumatic disease remains the main risk factor, and streptococci the most frequent causative agents. Studies performed to evaluate impact of guidelines changes’ have shown contradictory results. The increased complexity of cases in high-income countries has led to the creation of IE teams, involving several specialties. New imaging and microbiological techniques may increase sensitivity for diagnosis and detection of IE cases. In low-income countries, IE remained related to classic risk factors. The consequences of prophylaxis guidelines changes are still undetermined.

Published
2017

26. Eficacia y seguridad de la combinación de daptomicina y ceftarolina en la endocarditis por Staphylococcus aureus resistente a meticilina (SARM). Estudio in vitro de las combinaciones de daptomicina con fosfomicina o antibióticos β-lactámicos

Author

Antony Croxatto, Adrián Téllez, Marta Hernández-Meneses, José M. Miró, Francesc Marco, Oriol Manuel, Elena Sandoval, François-Regis Duss, Cristina Garcia-de-la-Maria, and Juan Ambrosioni

Subjects
business.industry, lcsh:R, lcsh:Surgery, lcsh:Medicine, Medicine, Surgery, lcsh:RD1-811, Cardiology and Cardiovascular Medicine, business, Molecular biology
Published
2018

28. Enteropathy associated with chronic use of olmesartan

Author

Martina Pellicé, Adrián Téllez, Arturo Llobell, and José C. Milisenda

Subjects
medicine.medical_specialty, business.industry, Prostatectomy, medicine.medical_treatment, MEDLINE, medicine.disease, Gastroenterology, Text mining, Chronic disease, Atrophy, Hypertension complications, Internal medicine, medicine, Enteropathy, business, Olmesartan, medicine.drug
Published
2015

29. Machine learning using the extreme gradient boosting (XGBoost) algorithm predicts 5-day delta of SOFA score at ICU admission in COVID-19 patients

Author

Jonathan Montomoli, Luca Romeo, Sara Moccia, Michele Bernardini, Lucia Migliorelli, Daniele Berardini, Abele Donati, Andrea Carsetti, Maria Grazia Bocci, Pedro David Wendel Garcia, Thierry Fumeaux, Philippe Guerci, Reto Andreas Schüpbach, Can Ince, Emanuele Frontoni, Matthias Peter Hilty, Mario Alfaro-Farias, MD, Gerardo Vizmanos-Lamotte, MD, PhD, Thomas Tschoellitsch, MD, Jens Meier, MD, Hernán Aguirre-Bermeo, MD, PhD, Janina Apolo, BSc, Alberto Martínez, MD, Geoffrey Jurkolow, MD, Gauthier Delahaye, MD, Emmanuel Novy, MD, Marie-Reine Losser, MD, PhD, Tobias Wengenmayer, MD, Jonathan Rilinger, MD, Dawid L. Staudacher, MD, Sascha David, MD, Tobias Welte, MD, Klaus Stahl, MD, “Agios Pavlos”, Theodoros Aslanidis, MD, PhD, Anita Korsos, MD, Barna Babik, MD, PhD, Reza Nikandish, MD, Emanuele Rezoagli, MD, PhD, Matteo Giacomini, MD, Alice Nova, MD, Alberto Fogagnolo, MD, Savino Spadaro, MD, PhD, Roberto Ceriani, MD, Martina Murrone, MD, Maddalena A. Wu, MD, Chiara Cogliati, MD, Riccardo Colombo, MD, Emanuele Catena, MD, Fabrizio Turrini, MD, MSc, Maria Sole Simonini, MD, Silvia Fabbri, MD, Antonella Potalivo, MD, Francesca Facondini, MD, Gianfilippo Gangitano, MD, Tiziana Perin, MD, Maria Grazia Bocci, MD, Massimo Antonelli, MD, Diederik Gommers, MD, PhD, Raquel Rodríguez-García, MD, Jorge Gámez-Zapata, MD, Xiana Taboada-Fraga, MD, Pedro Castro, MD, Adrian Tellez, MD, Arantxa Lander-Azcona, MD, Jesús Escós-Orta, MD, Maria C. Martín-Delgado, MD, Angela Algaba-Calderon, MD, Diego Franch-Llasat, MD, Ferran Roche-Campo, MD, PhD, Herminia Lozano-Gómez, MD, Begoña Zalba-Etayo, MD, PhD, Marc P. Michot, MD, Alexander Klarer, Rolf Ensner, MD, Peter Schott, MD, Severin Urech, MD, Nuria Zellweger, Lukas Merki, MD, Adriana Lambert, MD, Marcus Laube, MD, Marie M. Jeitziner, RN, PhD, Beatrice Jenni-Moser, RN, MSc, Jan Wiegand, MD, Bernd Yuen, MD, Barbara Lienhardt-Nobbe, Andrea Westphalen, MD, Petra Salomon, MD, Iris Drvaric, MD, Frank Hillgaertner, MD, Marianne Sieber, Alexander Dullenkopf, MD, Lina Petersen, MD, Ivan Chau, MD, Hatem Ksouri, MD, PhD, Govind Oliver Sridharan, MD, Sara Cereghetti, MD, Filippo Boroli, MD, Jerome Pugin, MD, PhD, Serge Grazioli, MD, Peter C. Rimensberger, MD, Christian Bürkle, MD, Julien Marrel, MD, Mirko Brenni, MD, Isabelle Fleisch, MD, Jerome Lavanchy, MD, Marie-Helene Perez, MD, Anne-Sylvie Ramelet, MD, Anja Baltussen Weber, MD, Peter Gerecke, MD, Andreas Christ, MD, Samuele Ceruti, MD, Andrea Glotta, MD, Katharina Marquardt, MD, Karim Shaikh, MD, Tobias Hübner, MD, Thomas Neff, MD, Hermann Redecker, MD, Mallory Moret-Bochatay, MD, FriederikeMeyer zu Bentrup, MD, MBA, Michael Studhalter, MD, Michael Stephan, MD, Jan Brem, MD, Nadine Gehring, MD, Daniela Selz, MD, Didier Naon, MD, Gian-Reto Kleger, MD, Urs Pietsch, MD, Miodrag Filipovic, MD, Anette Ristic, MD, Michael Sepulcri, MD, Antje Heise, MD, Marilene Franchitti Laurent, MD, Jean-Christophe Laurent, MD, Pedro D. Wendel Garcia, MSc, Reto Schuepbach, MD, Dorothea Heuberger, PhD, Philipp Bühler, MD, Silvio Brugger, MD, PhD, Patricia Fodor, MD, Pascal Locher, MD, Giovanni Camen, MD, Tomislav Gaspert, MD, Marija Jovic, MD, Christoph Haberthuer, MD, Roger F. Lussman, MD, and Elif Colak, MD

Subjects
Machine learning, Extreme gradient boosting (XGBoost), COVID-19, Multiple organ failure, Clinical decision support system (CDSS), Organ dysfunction score, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Background: Accurate risk stratification of critically ill patients with coronavirus disease 2019 (COVID-19) is essential for optimizing resource allocation, delivering targeted interventions, and maximizing patient survival probability. Machine learning (ML) techniques are attracting increased interest for the development of prediction models as they excel in the analysis of complex signals in data-rich environments such as critical care. Methods: We retrieved data on patients with COVID-19 admitted to an intensive care unit (ICU) between March and October 2020 from the RIsk Stratification in COVID-19 patients in the Intensive Care Unit (RISC-19-ICU) registry. We applied the Extreme Gradient Boosting (XGBoost) algorithm to the data to predict as a binary outcome the increase or decrease in patients’ Sequential Organ Failure Assessment (SOFA) score on day 5 after ICU admission. The model was iteratively cross-validated in different subsets of the study cohort. Results: The final study population consisted of 675 patients. The XGBoost model correctly predicted a decrease in SOFA score in 320/385 (83%) critically ill COVID-19 patients, and an increase in the score in 210/290 (72%) patients. The area under the mean receiver operating characteristic curve for XGBoost was significantly higher than that for the logistic regression model (0.86 vs. 0.69, P

Published
2021
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30. HACEK infective endocarditis: Epidemiology, clinical features, and outcome: A case–control study

Author

Juan Ambrosioni, Clara Martinez-Garcia, Jaume Llopis, Cristina Garcia-de-la-Maria, Marta Hernández-Meneses, Adrián Tellez, Carles Falces, Manel Almela, Bàrbara Vidal, Elena Sandoval, David Fuster, Eduard Quintana, José M. Tolosana, Francesc Marco, Asunción Moreno, and José M. Miró

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Objectives: The study aimed to describe the epidemiological, microbiological, and clinical features of a population sample of 17 patients with HACEK infective endocarditis (HACEK-IE) and to compare them with matched control patients with IE caused by viridans group streptococci (VGS-IE). Methods: Cases of definite (n = 14, 82.2%) and possible (n = 3, 17.6%) HACEK-IE included in the Infective Endocarditis Hospital Clinic of Barcelona (IE-HCB) database between 1979 and 2016 were identified and described. Furthermore, a retrospective case–control analysis was performed, matching each case to three control subjects with VGS-IE registered in the same database during the same time period. Results: Seventeen out of 1209 IE cases (1.3%, 95% confidence interval 0.69–1.91%) were due to HACEK group organisms. The most frequently isolated HACEK species were Aggregatibacter spp (n = 11, 64.7%). Intracardiac vegetations were present in 70.6% of cases. Left heart failure (LHF) was present in 29.4% of cases. Ten patients (58.8%) required in-hospital surgery and none died during hospitalization. In the case–control analysis, there was a trend towards larger vegetations in the HACEK-IE group (median (interquartile range) size 11.5 (10.0–20.0) mm vs. 9.0 (7.0–13.0) mm; p = 0.068). Clinical manifestations, echocardiographic findings, LHF rate, systemic emboli, and other complications were all comparable (p > 0.05). In-hospital surgery and mortality were similar in the two groups. One-year mortality was lower for HACEK-IE (1/17 vs. to 6/48; p = 0.006). Conclusions: HACEK-IE represented 1.3% of all IE cases. Clinical features and outcomes were comparable to those of the VGS-IE control group. Despite the trend towards a larger vegetation size, the embolic event rate was not higher and the 1-year mortality was significantly lower for HACEK-IE. Keywords: Endocarditis, HACEK, Viridans group streptococci, epidemiology, clinical characteristics, outcome, case-control

Published
2018
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32. Risk factors for mortality in patients with acute leukemia and bloodstream infections in the era of multiresistance.

Author

Carolina Garcia-Vidal, Celia Cardozo-Espinola, Pedro Puerta-Alcalde, Francesc Marco, Adrian Tellez, Daiana Agüero, Francisco Romero-Santana, Marina Díaz-Beyá, Eva Giné, Laura Morata, Olga Rodríguez-Núñez, Jose Antonio Martinez, Josep Mensa, Jordi Esteve, and Alex Soriano

Subjects
Medicine, Science
Abstract

OBJECTIVES:We assess the epidemiology and risk factors for mortality of bloodstream infection (BSI) in patients with acute leukemia (AL). METHODS:Prospectively collected data of a cohort study from July 2004 to February 2016. Multivariate analyses were performed. RESULTS:589 episodes of BSI were documented in 357 AL patients, 55% caused by gram-positive bacteria (coagulase-negative staphylococci 35.7%, Enterococcus spp 10.8%) and 43.5% by gram-negative bacteria (E. coli 21%, PA 12%). We identified 110 (18.7%) multidrug-resistant (MDR) microorganisms, especially MDR-Pseudomonas aeruginosa (7%) and extended-spectrum beta-lactamase producing Enterobacteriaceae (7%). The 30-day mortality was 14.8%. Age (OR 3.1; 95% CI 1.7-5.7); chronic lung disease (4.8; 1.1-21.8); fatal prognosis according to McCabe index (13.9; 6.4-30.3); shock (3.8; 1.9-7.7); pulmonary infection (3.6; 1.3-9.9); and MDR-PA infections with inappropriate treatment (12.8; 4.1-40.5) were related to mortality. MDR-PA BSI was associated to prior antipseudomonal cephalosporin use (9.31; 4.38-19.79); current use of betalactams (2.01; 1.01-4.3); shock (2.63; 1.03-6.7) and pulmonary source of infection (9.6; 3.4-27.21). CONCLUSIONS:MDR organisms were commonly isolated in BSI in AL. Inappropriate empiric antibiotic treatment for MDR-PA is the primary factor related to mortality that can be changed. New treatment strategies to improve the coverage of MDR-PA BSI should be considered in those patients with risk factors for this infection.

Published
2018
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33. Eficacia y seguridad de la combinación de daptomicina y ceftarolina en la endocarditis por Staphylococcus aureus resistente a meticilina (SARM). Estudio in vitro de las combinaciones de daptomicina con fosfomicina o antibióticos β-lactámicos

Author

Cristina García-de-la-Maria, François-Regis Duss, Antony Croxatto, Juan Ambrosioni, Marta Hernández-Meneses, Francesc Marco, Elena Sandoval, Adrián Tellez, Oriol Manuel, and José Maria Miró

Subjects
Medicine, Surgery, RD1-811
Published
2018
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34. Una imagen contemporánea de la endocarditis enterocócica

Author

Pericàs, Juan M., Jaume Llopis, Patricia Muñoz, Juan Gálvez Acebal, Martha Kestler, Maricela Valerio, Marta Hernández-Meneses, Miguel Goenaga, Manuel Cobo Belaustegui, Miguel Montejo, Guillermo Ojeda-Burgos, Dolores Sousa Regueiro, Arístides de Alarcón, Antonio Ramos-Martínez, Miró, José M., Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre Lima, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Josune Goikoetxea, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Victoria García López, M., Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Francisco Javier Martínez, Del Mar Alonso, M., Beatriz Castro, Dácil García Rosado, Del Carmen Durán, M., Antonia Miguel Gómez, M., Juan Lacalzada, Ibrahim Nassar, Antonio Plata Ciezar, Reguera Iglesias, José M., Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Jaume Llopis Pérez, Francesc Marco, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Pericás, Juan M., Pomar, José L., José Ramírez, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, Tolosana, José M., Bárbara Vidal, Jordi Vila, Iván Adán, Javier Bermejo, Emilio Bouza, Daniel Celemín, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Ana García Mansilla, Eugenia García Leoni, M., Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Mercedes Marín, Manuel Martínez-Sellés, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Pilar Vázquez, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Alejandro Martín Quirós, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Jesús Agüero Balbín, Carlos Armiñanzas Castillo, Ana Arnaiz, Francisco Arnaiz de las Revillas, María Carmen Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Iván García, Claudia González Rico, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Alberto Fortaleza, Pablo García Pavía, Jesús González, Ana Fernández Cruz, Elena Múñez, Antonio Ramos, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Irene Méndez, Isabel Morales, Luis Eduardo López-Cortés, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Antonio Cabrera Villegas, Lara García-Álvarez, José Antonio Oteo, Mercedes Sanz, Natividad Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, Álvarez, M., Fernández, A. L., Amparo Martínez, Prieto, A., Benito Regueiro, Tijeira, E., Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, García Domínguez Gloria, Sánchez Porto Antonio, Arribas Leal, José M., Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Antonia Sepúlveda, M., Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Cruz Pérez Seco, M., Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Pilar Palacián Ruiz, M., Juan Carlos Porres, Begoña Alcaraz Vidal, Nazaret Cobos Trigueros, María Jesús Del Amor Espín, José Antonio Giner Caro, Roberto Jiménez Sánchez, Amaya Jimeno Almazán, Alejandro Ortín Freire, Monserrat Viqueira González, Pere Pericás Ramis, Ángels Ribas Blanco, M., Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Carmen Bellón Munera, M., Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Carmen Díaz Pedroche, Fernando Chaves, Santiago de Cossío, Francisco López Medrano, Jesús López, M., Javier Solera, Jorge Solís, Carmen Ardanuy, Guillermo Cuervo Requena, Sara Grillo, and Alejandro Ruiz Majoral

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