RESUMEN
Among patients with pathologically proven infective endocarditis, the association of pathogen with occurrence of infection-related glomerulonephritis (IRGN) was examined in 48 case patients with IRGN and 192 propensity score-matched controls. Bartonella was very strongly associated with IRGN (odds ratio, 38.2 [95% confidence interval, 6.7-718.8]; P < .001); other microorganisms were not.
Asunto(s)
Endocarditis , Glomerulonefritis , Humanos , Glomerulonefritis/microbiología , Masculino , Femenino , Persona de Mediana Edad , Anciano , Endocarditis/microbiología , Endocarditis/complicaciones , Adulto , Estudios de Casos y Controles , Bartonella/aislamiento & purificación , Endocarditis Bacteriana/microbiologíaRESUMEN
BACKGROUND: Primary fit tracheoesophageal puncture (TEP) is widely preferred for individuals who have not undergone prior radiation. However, there is no consensus on the relative utility of primary-fit TEP in the setting of salvage laryngectomy. METHODS: A retrospective, single-center review was conducted of individuals undergoing laryngectomy with primary fit TEP between 2012 and 2018. Multivariable analysis was conducted to compare short-term and long-term complications, as well as speech and swallowing outcomes, of those who underwent primary versus salvage laryngectomy. RESULTS: In this study, 134 patients underwent total laryngectomy with primary fit TEP. Aside from a higher rate of peristomal dehiscence (13.1% vs. 1.4%) found in the salvage group, there was no difference in incidence of all other complications, including pharyngocutaneous fistula formation. The groups had comparable speech and swallow outcomes. CONCLUSION: Primary fit TEP is a safe and effective surgical choice for individuals undergoing salvage laryngectomy who desire a voice prosthesis.
Asunto(s)
Esófago , Neoplasias Laríngeas , Laringectomía , Complicaciones Posoperatorias , Punciones , Terapia Recuperativa , Humanos , Laringectomía/efectos adversos , Laringectomía/métodos , Masculino , Terapia Recuperativa/métodos , Estudios Retrospectivos , Femenino , Persona de Mediana Edad , Anciano , Neoplasias Laríngeas/cirugía , Complicaciones Posoperatorias/epidemiología , Esófago/cirugía , Tráquea/cirugía , Laringe Artificial , Resultado del TratamientoRESUMEN
The purpose of this study was to compare survival, relapse, and stroke for patients with methicillin-resistant Staphylococcus aureus (MRSA) vs methicillin-susceptible S. aureus (MSSA) infective endocarditis (IE). In this retrospective study, the primary outcome of death and secondary outcomes of stroke and relapse were compared using multivariable Cox proportional hazards regression. Surgical treatment was adjusted for as a time-dependent variable. In total, 355 patients with at least one episode of IE caused by S. aureus were included. Patients with MRSA IE had higher mortality than those with MSSA IE (HR 1.34, 95% CI 1.01-1.77), but did not have a higher risk of stroke (HR 0.75, 95% CI 0.43-1.32) or relapse (HR 0.89, 95% CI 0.26-3.05). The cumulative incidence of relapse was very small. Among patients with IE caused by S. aureus MRSA infection is associated with higher mortality than MSSA infection.