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1.
Int J Dev Disabil ; 69(5): 697-709, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37547558

RESUMEN

Participation in physical activity (PA) occurs differently in each individual. Investigating how it comes about in adolescents with autism spectrum disorder (ASD) is seen as an area that does not receive enough attention. In this paper, which was designed to get more information and contribute to the field, the participation of adolescents with ASD in PA was examined in line with the socio-ecological model through the opinions of 17 Turkish parents. Semi-structured interviews well-used to understand the perspective of parents', and as a main themes constraints and facilitating factors affecting participation of adolescents with ASD in PA were determined. When investigated in terms of intrapersonal factors, which are the first stage of the model, are examined, it is seen that ASD related problems as a constraint and experiences as a facilitator were the foremost themes. Interpersonal constraints were prejudice and family attitude while facilitators were family attitude and attitude of close surroundings. In environmental factors, the main constraints were adapted physical activity (APA) opportunities, while facilitators were neighborhood and facilities. While negative PA approaches of organizations was an institutional constraint, positive PA approach of organizations was a facilitator. In the final stages of the model, in terms of public policy, the constraint was not meeting expectations of current policies and the facilitator was improvements in policies. Consequently, it was understood that adolescents with ASD still participate in PA in some way even though they encounter many constraints when participating in physical activities, the constraints outweigh the facilitating factors.

2.
Cir Cir ; 90(6): 726-733, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36472841

RESUMEN

BACKGROUND: Concerns about surgical site infection (SSI) give rise to practices and procedures not evidence-based. OBJECTIVES: This study investigates whether the type of patient transfer to operating rooms plays a role in developing surgical site infection. METHODS: Three thousand four hundred and seventy-one patients were divided into two groups: transfer group with stretcher (ST) (n = 1699) and patient bed transfer group (PBT) (n = 1772). The data of the two groups and the SSI rates were comparatively analyzed. RESULTS: The SSI rate was 2.5% (n = 43) in the ST group and 2.8% (n = 49) in the PBT group, and there was no statistically significant difference. Both types of patient transfer had similar effects on the probability of SSI development. The odds ratio was 1.095 for stretcher transfer while 0.913 for patient bed transfer. CONCLUSION: Patients transfer to operating rooms on their beds are comfortable and safe. Furthermore, it has a similar effect to stretcher transfer on the probability of surgical site infection. Therefore, it is safer and cheaper to act based on evidence instead of trusting our concerns.


ANTECEDENTES: las preocupaciones sobre la infección del sitio quirúrgico (ISQ) dan lugar a prácticas y procedimientos que no se basan en pruebas. OBJETIVOS: Este estudio investiga si el tipo de traslado del paciente a los quirófanos influye en el desarrollo de la infección del sitio quirúrgico. MÉTODOS: Se dividieron 3471 pacientes en dos grupos: Grupo de transferencia con camilla (ST) (n = 1699) y Grupo de transferencia de cama de paciente (PBT) (n = 1772). Los datos de los dos grupos y las tasas de ISQ se analizaron comparativamente. RESULTADOS: La tasa de ISQ fue de 2.5% (n = 43) en el grupo ST y 2.8% (n = 49) en el grupo PBT, y no hubo diferencia estadísticamente significativa. Ambos tipos de transferencia de pacientes tuvieron efectos similares sobre la probabilidad de desarrollo de ISQ. La razón de posibilidades fue de 1.095 para el traslado en camilla y de 0,913 para el traslado de la cama del paciente. CONCLUSIÓN: El traslado de los pacientes a los quirófanos en sus camas es cómodo y seguro. Además, tiene un efecto similar al traslado en camilla sobre la probabilidad de infección del sitio quirúrgico. Por lo tanto, es más seguro y económico actuar en base a evidencias en lugar de confiar en nuestras preocupaciones.


Asunto(s)
Transferencia de Pacientes , Infección de la Herida Quirúrgica , Humanos , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/prevención & control
3.
Turk J Gastroenterol ; 29(2): 177-182, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29749324

RESUMEN

BACKGROUND/AIMS: The present study aimed to determine the changes in the epidemiology of hepatitis in recent years in an adult Turkish population. MATERIALS AND METHODS: Overall, 852 patients with acute viral hepatitis from 17 centers were included in this study. Their sociodemographic characteristics, clinical courses, treatments, and laboratory findings were retrospectively analyzed. RESULTS: The most commonly found microorganisms were the hepatitis B virus (55.2%) and hepatitis A virus (37.6%), and the types of acute viral hepatitis differed significantly according to the age group (p≤0.001). The most frequently reported symptom was fatigue (73.7%), and the most common complications were cholecystitis (0.4%) and fulminant hepatitis (0.4%). The median hospital stay was 9 days (range 1-373). In total, 40.8% patients with acute hepatitis B virus developed immunity. CONCLUSION: In Turkey, there are significantly large adolescent and adult populations susceptible to acute viral hepatitis. Therefore, larger vaccination programs covering these age groups should be implemented.


Asunto(s)
Hepatitis Viral Humana/epidemiología , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hepatitis A/epidemiología , Hepatitis B/epidemiología , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Turquía/epidemiología , Adulto Joven
4.
Int J Infect Dis ; 58: 111-114, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28419820

RESUMEN

OBJECTIVES: Data on the impact of refugees on Intensive Care Units (ICUs) are lacking in the literature, in particular for community-acquired (CA) infectious diseases, for which they are known to be at higher risk. We did a descriptive, multicenter study to analyze CA infections among refugee patients requiring ICU admission. METHODS: Inclusion criteria were adult refugee patients admitted to an ICU due to CA infections. Anonymized data were collected between January 1, 2010 and December 30, 2015 across 10 referral centers. RESULTS: 29.885 patients were admitted to the ICUs in the study period. 37 patients were included the study, the majority were from Syria (n=31, 83.8%). Mean (SD) age of the patients was 45.92±20.16years. The 5-year prevalence rate was 123.8 per 100.000 patients in the ICUs. All patients had at least one comorbid condition. Forty-nine CA infections were diagnosed. The most common CA infection was pneumonia (49%) followed by urinary-tract infections (16.3%). 21 patients (56.7%) hospitalized in the ICU had trauma history. Mortality rate was high at 22 patients (59.5%) with 5 (22.7%) deaths directly attributed to CA infections. CONCLUSIONS: Refugees presented to ICUs with CA infections similar to the host populations (pneumonia and urinary-tract infections) but had high mortality rates (59.5%). It seems that Turkish ICUs were not congested with the refugee patients' influx for CA infections. More research needs to be done to better understand how to deliver preventative and timely health care services to this group of patients.


Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Unidades de Cuidados Intensivos , Refugiados , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Comunitarias Adquiridas/mortalidad , Infecciones Comunitarias Adquiridas/terapia , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Neumonía/epidemiología , Prevalencia , Estudios Retrospectivos , Siria/etnología , Turquía/epidemiología , Infecciones Urinarias/epidemiología , Adulto Joven
5.
J Chemother ; 29(1): 19-24, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27238248

RESUMEN

This multi-centre study aimed to determine the antibiotic consumption in Turkish hospitals by point prevalence. Antibiotic consumption of 14 centres was determined using the DDD method. Among hospitalized patients, 44.8% were using antibiotics and the total antibiotic consumption was 674.5 DDD/1000 patient-days (DPD). 189.6 (28%) DPD of the antibiotic consumption was restricted while 484.9 (72%) DPD was unrestricted. Carbapenems (24%) and beta lactam/beta lactamase inhibitors (ampicillin-sulbactam or amoxicillin-clavulanate; 22%) were the most commonly used restricted and unrestricted antibiotics. Antibiotics were most commonly used in intensive care units (1307.7 DPD). Almost half of the hospitalized patients in our hospitals were using at least one antibiotic. Moreover, among these antibiotics, the most commonly used ones were carbapenems, quinolones and cephalosporins, which are known to cause collateral damage. We think that antibiotic resistance, which is seen at considerably high rates in our hospitals, is associated with this level of consumption.


Asunto(s)
Antibacterianos/uso terapéutico , Utilización de Medicamentos/estadística & datos numéricos , Estudios Transversales , Hospitales/estadística & datos numéricos , Humanos , Prevalencia , Turquía
6.
Int J Infect Dis ; 30: 106-14, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25461657

RESUMEN

OBJECTIVE: In order to define the current characteristics of infective endocarditis (IE) in Turkey, we evaluated IE cases over a 14-year period in a tertiary referral hospital. METHODS: All adult patients who were hospitalized in our hospital with a diagnosis of IE between 2000 and 2013 were included in the study. Modified Duke criteria were used for diagnosis. The Chi-square test, Student's t-test, Mann-Whitney U-test, Cox and logistic regression analysis were used for the statistical analysis. RESULTS: There were 325 IE cases during the study period. The mean age of the patients was 47 years. Causative microorganisms were identified in 253 patients (77.8%) and included staphylococci (36%), streptococci (19%), enterococci (7%), and Brucella spp (5%). A streptococcal aetiology was associated with younger age (<40 years) (p=0.001), underlying chronic rheumatic heart disease (CRHD) (odds ratio (OR) 3.89) or a congenital heart defect (OR 4.04), community acquisition (OR 17.93), and native valve (OR 3.68). A staphylococcal aetiology was associated with healthcare acquisition (OR 2.26) or pacemaker lead-associated endocarditis (OR 6.63) and an admission creatinine level of >1.2mg/dl (OR 2.15). Older age (>50 year) (OR 3.93), patients with perivalvular abscess (OR 9.18), being on dialysis (OR 6.22), and late prosthetic valve endocarditis (OR 3.15) were independent risk factors for enterococcal IE. Independent risk factors for mortality in IE cases were the following: being on dialysis (hazard ratio (HR) 4.13), presence of coronary artery heart disease (HR 2.09), central nervous system emboli (HR 2.33), and congestive heart failure (HR 2.15). Higher haemoglobin (HR 0.87) and platelet (HR 0.996) levels and surgical interventions for IE (HR 0. 33) were found to be protective factors against mortality. CONCLUSIONS: In Turkey, IE occurs in relatively young patients and Brucella spp should always be taken into consideration as a cause of this infection. We should first consider streptococci as the causative agents of IE in young patients, those with CRHD or congenital heart valve disease, and cases of community-acquired IE. Staphylococci should be considered first in the case of pacemaker lead IE, when there are high levels of creatinine, and in cases of healthcare-associated IE. Enterococci could be the most probable causative agent of IE particularly in patients aged >50 years, those on dialysis, those with late prosthetic valve IE, and those with a perivalvular abscess. The early diagnosis and treatment of IE before complications develop is crucial because the mortality rate is high among cases with serious complications. The prevention of bacteraemia with the measures available among chronic haemodialysis patients should be a priority because of the higher mortality rate of subsequent IE among this group of patients.


Asunto(s)
Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/mortalidad , Adulto , Anciano , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/etiología , Enterococcus/aislamiento & purificación , Femenino , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/microbiología , Infecciones por Bacterias Grampositivas/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/mortalidad , Staphylococcus/aislamiento & purificación , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/mortalidad , Streptococcus/aislamiento & purificación , Turquía/epidemiología
7.
Int J Infect Dis ; 28: 153-9, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25286184

RESUMEN

OBJECTIVE: To compare responses to tenofovir (TDF) and entecavir (ETV) therapy. METHODS: This was a multicenter retrospective study including treatment-naïve patients with chronic hepatitis B (CHB) who received TDF or ETV. The primary end-points were undetectable HBV-DNA at 48 weeks and serological and biochemical responses. RESULTS: Out of 195 CHB patients, 90 (46%) received TDF and 105 (54%) received ETV; 72% were male, their mean age was 43±12 years, and the mean duration of treatment was 30.2±15.7 months. Hepatitis B e antigen (HBeAg) seropositivity was 32% in the TDF group and 34% in the ETV group. HBeAg seroconversion rates in HBeAg-positive patients were 24% in the TDF group and 39% in the ETV group; the difference was not significant (p=0.2). The mean time to alanine aminotransferase (ALT) normalization and rates of ALT normalization at 3, 6, 12, 18, and 24 months were similar in the two groups (p > 0.05). The mean time to undetectable HBV-DNA levels in the TDF and ETV groups was 11.5±8.9 and 12.9±10.8 months, respectively (p=0.32). A significantly greater decline in HBV-DNA levels at 12 and 18 months was observed in the TDF group (p=0.02 and p=0.03, respectively). Seven (7%) patients on ETV therapy had virological breakthrough (p=0.01). Only one patient in each group had hepatitis B surface antigen (HBsAg) clearance. None of the patients developed decompensation or hepatocellular carcinoma during treatment. CONCLUSIONS: The two drugs appear to have similar efficacy in CHB patients. However, 7% of patients on ETV therapy had virological breakthrough, while none of the patients on TDF therapy did.


Asunto(s)
Antivirales/uso terapéutico , Guanina/análogos & derivados , Hepatitis B Crónica/tratamiento farmacológico , Tenofovir/uso terapéutico , Adulto , Alanina Transaminasa/análisis , ADN Viral/sangre , Femenino , Guanina/uso terapéutico , Antígenos e de la Hepatitis B/inmunología , Virus de la Hepatitis B/genética , Virus de la Hepatitis B/aislamiento & purificación , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
8.
Int J Ophthalmol ; 7(4): 686-8, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25161944

RESUMEN

AIM: To assess the incidence of anterior chamber bacterial contamination during phacoemulsification surgery using an automated microbial detection system (BacT/Alert). METHODS: Sixty-nine eyes of 60 patients who had uneventful phacoemulsification surgery, enrolled in this prospective study. No prophylactic topical or systemic antibiotics were used before surgery. After antisepsis with povidone-iodine, two intraoperative anterior chamber aqueous samples were obtained, the first whilst entering anterior chamber, and the second at the end of surgery. BacT/Alert culture system was used to detect bacterial contamination in the aqueous samples. RESULTS: Neither aqueous samples obtained at the beginning nor conclusion of the surgery was positive for microorganisms on BacT/Alert culture system. The rate of bacterial contamination during surgery was 0%. None of the eyes developed acute-onset endophthalmitis after surgery. CONCLUSION: In this study, no bacterial contamination of anterior chamber was observed during cataract surgery. This result shows that meticulous surgical preparation and technique can prevent anterior chamber contamination during phacoemulsification cataract surgery.

9.
Eur J Gastroenterol Hepatol ; 26(7): 774-80, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24901822

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infection is a health problem worldwide. Current treatment options for chronic hepatitis B (CHB) are nucleoside or nucleotide analogues and pegylated interferons. Tenofovir and entecavir are much more commonly used as they have better efficacy, tolerability, and high genetic barriers to resistance. AIM: The aim of this study was to assess the efficacies of tenofovir and entecavir in previously untreated CHB patients in a treatment cohort. PATIENTS AND METHODS: We included CHB patients in a cohort including previously untreated HBeAg-positive and HBeAg-negative patients from 10 centers in Istanbul, Turkey. The patients were compared in terms of baseline characteristics, decrease in alanine transaminase (ALT), decrease in HBV-DNA to undetectable levels, HBeAg loss and anti-HBe development (among baseline HBeAg-positive patients), interventions to therapy because of lack of efficacy, side effects, severe side effects, and side effects that required change in treatment. RESULTS: The study included 121 patients who were administered tenofovir and 130 patients who were administered entecavir. The majority of patients were men, with mild to moderate histology in both treatment groups. The mean duration of follow-up was 18 and 20 months for tenofovir and entecavir, respectively. Patients receiving both drugs showed comparable rates of HBeAg loss, rates of undetectable HBV-DNA levels, rates of ALT normalization, ALT decrease, and decrease in HBV-DNA. Both drugs were well tolerated. CONCLUSION: This study shows that although the baseline characteristics did not match, tenofovir and entecavir sustained comparable virological efficacies. More patients discontinued entecavir during follow-up. Both drugs provided effective viral control, with few side effects.


Asunto(s)
Adenina/análogos & derivados , Guanina/análogos & derivados , Virus de la Hepatitis B/efectos de los fármacos , Hepatitis B Crónica/tratamiento farmacológico , Organofosfonatos/administración & dosificación , Adenina/administración & dosificación , Adenina/efectos adversos , Adolescente , Adulto , Antivirales/administración & dosificación , Antivirales/efectos adversos , Estudios de Cohortes , Farmacorresistencia Viral/genética , Femenino , Estudios de Seguimiento , Guanina/administración & dosificación , Guanina/efectos adversos , Virus de la Hepatitis B/genética , Hepatitis B Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Organofosfonatos/efectos adversos , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Inhibidores de la Transcriptasa Inversa/efectos adversos , Tenofovir , Resultado del Tratamiento , Adulto Joven
11.
Scand J Infect Dis ; 39(3): 278-80, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17366068

RESUMEN

A baby case of haematogenous rib osteomyelitis that was caused by Leuconostoc lactis was presented. The patient had high fever and an abscess formation on the right scapula. Diagnosis was made with the results of blood, bone and abscess cultures, pathological findings of the involved rib and direct bone graphies. The patient was treated succesfully with cefotaxime for 6 weeks.


Asunto(s)
Infecciones por Bacterias Grampositivas/microbiología , Leuconostoc/aislamiento & purificación , Osteomielitis/microbiología , Infecciones por Bacterias Grampositivas/patología , Humanos , Lactante , Masculino , Osteomielitis/patología
12.
Heart Vessels ; 21(5): 331-3, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17151824

RESUMEN

Brucella endocarditis is a zoonosis transmitted by contaminated dairy products. Endocarditis is a rare complication of brucellosis and mainly the aortic valve is infected. We present the case of a female patient with prosthetic mitral valve endocarditis associated with QT prolongation and torsades de pointes. Transesophageal echocardiography revealed vegetation on both anterior and posterior mitral annulus. She was seropositive with Brucella agglutination titers of up to 1/320. The QT interval was markedly prolonged upon admission (QTc 530 ms). She experienced torsades de pointes several times. She underwent reoperation under an appropriate antibiotic regimen. She continued on triple antibiotic therapy for 12 months. She is now well and free of symptoms.


Asunto(s)
Brucelosis , Endocarditis Bacteriana/etiología , Prótesis Valvulares Cardíacas/efectos adversos , Válvula Mitral , Infecciones Relacionadas con Prótesis/microbiología , Torsades de Pointes/etiología , Brucella/aislamiento & purificación , Brucelosis/terapia , Ecocardiografía Transesofágica , Endocarditis Bacteriana/fisiopatología , Endocarditis Bacteriana/terapia , Femenino , Humanos , Persona de Mediana Edad , Reoperación , Torsades de Pointes/fisiopatología , Torsades de Pointes/terapia
13.
Infect Control Hosp Epidemiol ; 27(9): 958-63, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16941323

RESUMEN

OBJECTIVE: To determine the incidence of and identify risk factors for sternal surgical site infection (SSI). DESIGN: Prospective cohort study. Data on potential risk factors, including the type of operating theater and infection data, were collected prospectively and analyzed by multivariate analysis. SETTING: Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, a 700-bed teaching hospital and the largest center for cardiac surgery in Turkey. The cardiothoracic unit performs approximately 3,000 cardiac operations per year. PATIENTS: All adult patients who underwent cardiac surgery with sternotomy between January 14, 2002, and July 1, 2002, and who survived at least 4 days after surgery were included in the study. RESULTS: Potential risk factor data were complete for 991 patients. There was sternal SSI in 41 patients (4.1%). Female sex, diabetes mellitus, operation performed in the older operating theaters, and duration of procedure exceeding 5 hours were identified as independent risk factors for sternal SSI. CONCLUSIONS: Female and diabetic patients are at higher risk for sternal SSI and should be followed up carefully after cardiac surgery to prevent the development of sternal SSI. Reducing the duration of surgery could reduce the rate of postoperative sternal SSI. The operating theater environment may have an important role in the pathogenesis of sternal SSI, and appropriate ventilation of the operating theaters would be critical in the prevention of sternal SSI.


Asunto(s)
Quirófanos/normas , Infección de la Herida Quirúrgica/etiología , Ventilación/normas , Procedimientos Quirúrgicos Cardíacos/estadística & datos numéricos , Puente de Arteria Coronaria , Complicaciones de la Diabetes , Femenino , Mortalidad Hospitalaria , Humanos , Modelos Logísticos , Masculino , Cuidados Posoperatorios , Factores de Riesgo , Infección de la Herida Quirúrgica/prevención & control , Turquía/epidemiología
14.
Diagn Microbiol Infect Dis ; 44(2): 133-5, 2002 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12458118

RESUMEN

The diagnosis of brucellosis is generally made when a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies in the presence of compatible clinical signs and symptoms. However isolation of the organism from blood or bone marrow is the proof of the disease. In this study we aimed to describe the rate and duration of isolation of Brucella spp. from blood and bone marrow by use of automated blood culture system (BACTEC 9240). Between 1997 to 2001, 23 adults were diagnosed as brucellosis. Blood culture was obtained in all and simultaneous bone marrow culture in 18 and both specimens were cultured by BACTEC 9240. Brucella was isolated from blood and bone marrow cultures in 19 (82.6%) and 13 (81.2%) respectively. All positive blood cultures yielded within 7 days and bone marrow cultures in 4 days. We concluded that automated BACTEC culture systems can isolate Brucella spp. in a fast and efficient way.


Asunto(s)
Técnicas Bacteriológicas/métodos , Brucella/aislamiento & purificación , Brucelosis/diagnóstico , Adulto , Automatización , Sangre/microbiología , Médula Ósea/microbiología , Brucelosis/sangre , Femenino , Humanos , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad
15.
Ann Thorac Cardiovasc Surg ; 8(6): 381-5, 2002 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12517300

RESUMEN

Endocarditis is a rare complication of brucellosis but it is the main cause of the mortality in this disease. The accepted treatment for Brucella endocarditis (BE) is a combination of valve replacement and antibiotics. Conservative antibiotic treatment alone is not recommended by most of the authors as it is considered ineffective and increase the risk of fatality. In our literature search, we found 14 adult patients with BE treated only with antibiotics with a favorable outcome. In this report, we described a patient treated with antibiotics alone and reviewed the literature. Depending on the data from the growing literature and our patient we suggest that in selected patients with BE who do not have congestive heart failure, valvular destruction, abscess formation, or a prosthetic valve, conservative antibiotic treatment may be a valid alternative to surgery.


Asunto(s)
Antibacterianos , Brucelosis/tratamiento farmacológico , Quimioterapia Combinada/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad
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