Safety of benzodiazepines in patients with acute heart failure: A propensity score-matching study.

AIM: Benzodiazepines (BZDs) are one of the most used drugs to control symptoms in patients with acute heart failure (HF). However, the evidence on its safety is inconclusive. The objective was to describe the characteristics of patients admitted for HF and treated with BZDs and to assess the relationship of this treatment and mortality. PATIENTS AND METHODS: We performed a cross-sectional, multicentre (74 Spanish hospitals), cohort study. Patients admitted for HF were divided depending on whether they were treated with BZDs or not. Propensity score analysis matched patients in both groups in a 1:1 manner according to different factors. The primary outcome was mortality at day 7. Secondary outcomes were mortality at days 30 and 180, as well as readmissions and emergency room visits at 180 days. RESULTS: We included 1855 patients: 639 (34.4%) had prescribed BZDs treatment versus 1216 (65.6%) who had not been treated. Patients receiving BZDs had advanced heart disease, severe symptoms, need more HF intensive treatment and higher mortality. After propensity matching 381 balanced paired cases were included in each group. Treatment with BZDs was not associated with greater risk of mortality at day 7 of index hospitalization (7.6% vs 5.2%, adjusted OR 1.49, 95% CI 0.83-2.68, p = 0.186). There were also no differences between groups in terms of mortality at day 30 and 180, readmissions or visits to the emergency room. CONCLUSIONS: Our data support that benzodiazepines could be safely used for improving symptoms. in patients admitted for acute HF in terms of short-medium term mortality.

Sífilis e infección por el virus de la inmunodeficiencia humana: una endemia en hombres que tienen sexo con hombres / Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men

OBJETIVO: Describir las características epidemiológicas, clínicas y analíticas de los hombres que tienen sexo con hombres (HSH) con infección por el VIH diagnosticados de sífilis en la Unidad de Gestión Clínica de Enfermedades Infecciosas del Hospital Virgen de la Victoria de Málaga durante el período 2004-2013. Pacientes y método: Estudio descriptivo de 196 episodios de sífilis en 167 HSH infectados por el VIH (2004-2013). Se recogieron datos epidemiológicos, clínicos y analíticos de todos los pacientes. La incidencia anual de sífilis en HSH con infección por el VIH corresponde al cociente entre el número de episodios de sífilis en HSH en un año dividido por el número de HSH en seguimiento en ese año. RESULTADOS: La incidencia anual osciló entre el 1,2% (2007) y el 7,8% (2012). Presentación asintomática en el 42,8% y diagnóstico coincidente de sífilis e infección por el VIH en el 28,5%. CONCLUSIONES: La incidencia anual de sífilis ha aumentado en los HSH con infección por el VIH. Un tercio de los diagnósticos de infección por el VIH coincidió con el de sífilis y casi la mitad eran cuadros asintomáticos

OBJECTIVE: to analyse epidemiological, clinical, and analytical features of HIV-infected men who have sex with men (MSM) diagnosed with syphilis in the Infectious Diseases Unit (Hospital Virgen de la Victoria, Málaga, Spain) during 2004-2013. PATIENTS AND METHODS: An observational study was conducted on 196 syphilis episodes in 167 MSM infected with HIV (2004-2013). Epidemiological, clinical, and analytical data were collected. Annual syphilis incidence among HIV-MSM is calculated as the number of syphilis episodes among MSM in one year divided by the number of MSM followed up in that year. RESULTS: Incidence ranged from 1.2% (2007) to 7.8% (2012). There were asymptomatic episodes in 42.8% cases, and an HIV-syphilis coincident diagnosis in 28.5%. CONCLUSIONS: The annual incidence of syphilis has increased within HIV infected MSM. One third of the syphilis episodes were simultaneous to HIV diagnosis and near half of them were asymptomatic

[Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men]. / Sífilis e infección por el virus de la inmunodeficiencia humana: una endemia en hombres que tienen sexo con hombres.

OBJECTIVE: to analyse epidemiological, clinical, and analytical features of HIV-infected men who have sex with men (MSM) diagnosed with syphilis in the Infectious Diseases Unit (Hospital Virgen de la Victoria, Málaga, Spain) during 2004-2013. PATIENTS AND METHODS: An observational study was conducted on 196 syphilis episodes in 167 MSM infected with HIV (2004-2013). Epidemiological, clinical, and analytical data were collected. Annual syphilis incidence among HIV-MSM is calculated as the number of syphilis episodes among MSM in one year divided by the number of MSM followed up in that year. RESULTS: Incidence ranged from 1.2% (2007) to 7.8% (2012). There were asymptomatic episodes in 42.8% cases, and an HIV-syphilis coincident diagnosis in 28.5%. CONCLUSIONS: The annual incidence of syphilis has increased within HIV infected MSM. One third of the syphilis episodes were simultaneous to HIV diagnosis and near half of them were asymptomatic.