Characteristics, management, and outcome of infective endocarditis in the Czech Republic: prospective data from the ESC EORP EURO-ENDO registry.

INTRODUCTION: Data describing contemporary profile of infective endocarditis (IE) in the Czech Republic are lacking. The aim of this study was to describe the current profile and outcomes of IE patients. METHODS: Prospectively collected data on consecutive patients admitted for IE diagnosis between April 2016 and March 2018 to 11 main tertiary care cardiac centers in the Czech Republic were used for this analysis. RESULTS: Among 208 patients, 88 patients (42.3 %) had native valve IE (NVIE), 56 patients (26.9 %) had prosthetic valve IE (PVIE), and 57 patients (27.4 %) had intracardiac device-related IE (CDRIE). The mean age was 61.66±15.54 years. Staphylococcus aureus was the most common etiological agent of IE (27.4 %), whereas Culture negative IE was present in 26.4 % patients. Surgery was performed during hospitalization in 112 (53.8 %) patients. In-hospital death occurred in 21.2 % patients, while 1-year mortality was 40.3 %. In patients, who had an indication for surgery, but the procedure was not performed, mortality was significantly higher (p=0.002). CONCLUSION: High proportion of culture negative IE and IE related to artificial intra-cardiac materials calls for action. Furthermore, we show that cardiac surgery should be more often contemplated, especially in the presence of risk factors as septic shock and congestive heart failure (Tab. 6, Fig. 1, Ref. 32).

[Radiofrequency ablation (RFA) of pancreatic tumors]. / Radiofrekvencní ablace tumoru pankreatu.

UNLABELLED: The authors refer about their first experience with radiofrequency ablation of locally advanced pancreatic tumors. They put forward the prospective study of five patients (four with ductal adenocarcinoma of the head and one with malignant neuroendocrine tumor of pancreatic body), who either because of local advanced disease or performance status, were not able to undergo radical curative surgery. All patients underwent peroperative radiofrequency ablation of pancreatic tumors. In the case of pancreatic head localization, posterior retrocolic gastro-enterostomy and hepatico-jejunostomy to Y Roux jejunal loop were performed. There was no perioperative mortality. In one case duodenal leak apeared in the fourth postoperative day. This was healed conservatively by drainage. At one patient the subfascial absces developed. This was solved by drainage reoperation at the fourteenth postoperative day. After consolidation, all patients were released to home care. CONCLUSION: According to our early experience, radiofrequency ablation of inoperable pancreatic tumors is relatively save cytoreductive procedure.