[Positive blood cultured isolated bacteria in children under 90 days old admitted for fever in Hospital Exequiel González Cortés between 2014 and 2016]. / Bacterias aisladas en hemocultivos positivos en lactantes bajo 90 días de edad ingresados por fiebre al Hospital Exequiel González Cortés entre 2014 y 2016.

BACKGROUND: Fever in infants younger than 90 days may reflect a serious bacterial infection, so blood cultures (BC) are taken routinely and the patient is hospitalized. The observation time to detect occult bacteremia is not well established. AIM: To describe type and positivity time of isolated bacteria in blood cultures in infants under 90 days admitted for fever. METHODS: Retrospective, descriptive study. Positive blood cultures taken between 2014-2016 in young infants admitted for fever were included. Identification and time of positivity of each bacteria, clinical, laboratory and demographic data were recorded. Demographic variables and the clinical outcome was obtained. RESULTS: There were 172 positive blood cultures, only 51 met inclusion criteria. Of these, 21 microorganisms were pathogenic (Escherichia coli: 10, Streptococcus agalactiae: 3, Streptococcus pyogenes: 3, others: 5) and 30 were considered contamination, mainly coagulase negative Staphylococcus. In relation to the total sample, the median time of positivity was 10 hrs. At 24 hours of culture, bacterial growth was detected in 94% of the sample. CONCLUSION: The pathogenic bacteria isolated in the blood cultures of patients younger than 90 days who were admitted with fever correspond mainly to Gram negative bacilli and streptococci. All isolated pathogens were detected before 24 h of incubation.

Bacterias aisladas en hemocultivos positivos en lactantes bajo 90 días de edad ingresados por fiebre al Hospital Exequiel González Cortés entre 2014 y 2016 / Positive blood cultured isolated bacteria in children under 90 days old admitted for fever in Hospital Exequiel González Cortés between 2014 and 2016

INTRODUCCIÓN: En neonatos y lactantes bajo 90 días de vida la fiebre constituye un signo clínico relevante ya que puede corresponder a una infección bacteriana grave, por lo que se toman hemocultivos de forma rutinaria y el paciente es hospitalizado. Aún no existe una recomendación respecto al tiempo de observación necesario una vez internado el paciente. OBJETIVO: Describir las bacterias aisladas en hemocultivos de lactantes bajo 90 días de vida hospitalizados por fiebre y el tiempo de detección de crecimiento microbiano en los mismos. ¨MÉTODO: Estudio descriptivo, retrospectivo. Se revisaron hemocultivos positivos tomados entre 2014 y 2016 en neonatos y lactantes < 90 días de edad. Se obtuvieron las identificaciones, tiempo de positividad de las bacterias, así como datos clínicos, de laboratorio y demográficos. RESULTADOS: Se identificaron 172 hemocultivos positivos, 51 cumplían los criterios de inclusión. De éstos, 21 microorganismos fueron patógenos (Escherichia coli: 10, Streptococcus agalactiae: 3, Streptococcus pyogenes: 3, otros: 5) y 30 se consideraron contaminación, principalmente Staphylococcus coagulasa negativa. En relación al total de la muestra, la mediana del tiempo de positividad fue de 10 h. A las 24 h de cultivo se detectó crecimiento bacteriano en 94% de la muestra. CONCLUSIÓN: Las bacterias patógenas aisladas en los hemocultivos de pacientes < 90 días de edad, que ingresaron con fiebre, corresponden principalmente a bacilos gramnegativos y estreptococos. Todos los patógenos aislados fueron detectados antes de 24 h de incubación.

BACKGROUND: Fever in infants younger than 90 days may reflect a serious bacterial infection, so blood cultures (BC) are taken routinely and the patient is hospitalized. The observation time to detect occult bacteremia is not well established. AIM: To describe type and positivity time of isolated bacteria in blood cultures in infants under 90 days admitted for fever. METHODS: Retrospective, descriptive study. Positive blood cultures taken between 2014-2016 in young infants admitted for fever were included. Identification and time of positivity of each bacteria, clinical, laboratory and demographic data were recorded. Demographic variables and the clinical outcome was obtained. RESULTS: There were 172 positive blood cultures, only 51 met inclusion criteria. Of these, 21 microorganisms were pathogenic (Escherichia coli: 10, Streptococcus agalactiae: 3, Streptococcus pyogenes: 3, others: 5) and 30 were considered contamination, mainly coagulase negative Staphylococcus. In relation to the total sample, the median time of positivity was 10 hrs. At 24 hours of culture, bacterial growth was detected in 94% of the sample. CONCLUSION: The pathogenic bacteria isolated in the blood cultures of patients younger than 90 days who were admitted with fever correspond mainly to Gram negative bacilli and streptococci. All isolated pathogens were detected before 24 h of incubation.

[Risk stratification in patients with a first myocardial infarct based on simple clinico-instrumental variables]. / Stratificazione del rischio in pazienti con primo infarto miocardico in base ad alcune semplici variabili clinico-strumentali.

UNLABELLED: It is an acknowledged fact that the prognosis for patients with a first myocardial infarction depends mainly on the degree of residual left ventricle function. We wanted to evaluate the importance that certain simple clinical and instrumental variables can have in stratifying post-infarction cardiovascular risk with particular emphasis on chronic obstructive lung disease (COLD). We selected 97 out of the 512 patients treated in the coronary intensive care unit (CICU) from February 1, 1988 to October 31, 1990 according to the following criteria: First myocardial infarction; no cardiogenic shock; no serious concomitant diseases with considered negative prognosis within 6 months. The following variables were considered for all the patients: age; sex; positive family history for ischemic heart disease; history of diabetes mellitus; arterial hypertension; previous cerebrovascular incident; history of obstructive arteriopathy of the lower limbs, of angor and COLD. The following tests were performed on all the patients: echocardiogram prior to discharge form the CICU; angiocardioscintigraphy with Tc-99 between the 20th and 30th day following the acute event; bicycle ergometer stress test on the 30th day. END POINTS: general mortality; cardiac mortality; non-fatal reinfarction; residual angina at 3 months. All the patients were treated with aspirin (325 mg/die) and/or heparin (12,500 units subcutaneously). All 97 patients were monitored for a mean follow-up time of 19.8 months. General mortality was 2.08% (for reinfarction) 24 (24.7%) non-fatal cardiac events.(ABSTRACT TRUNCATED AT 250 WORDS)

[An epidemiological study of congenital heart disease. I. Incidence of cardiovascular malformations in 11,584 live-born babies in the District of Florence (Italy) (author's transl)]. / Epidemiologia delle cardiopatie congenite. I. Incidenza della malformazioni cardiovascolari in 11.584 nati vivi nella Provincia di Firenze.

11,584 consecutive live-born babies in the Ostetric Clinic of Florence in the years 1975 and 1976 were examined for the presence of congenital heart disease. Diagnosis was made by necropsy, cardiac catheterization and operation in 20% of cases and by clinical observations in 80%. The 74% of babies who were diagnosed as affected by congenital heart disease at birth were eventually controlled. The incidence of congenital heart disease was 7.1% in 10,789 live-born of weight over 2500 g while it was 37% in 795 under such weight. Global incidence was 9.2%. The first essentials in epidemiological study of congenital heart malformations is to define the method which is used for diagnosis since this is the primary factor responsible for wide variations in incidence. It is suggested that the institution of a Regional Register of malformations would allow more accurate estimate of overall incidence of congenital cardiopathies.