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1. Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Author

Laura Herrera-Hidalgo, Patricia Muñoz, Ana Álvarez-Uría, David Alonso-Menchén, Rafael Luque-Marquez, Encarnación Gutiérrez-Carretero, María Del Carmen Fariñas, Jose Maria Miró, Miguel Angel Goenaga, Luis Eduardo López-Cortés, Basilio Angulo-Lara, Lucia Boix-Palop, Arístides de Alarcón, Fernando Fernández Sánchez, José Mª García de Lomas, Gabriel Rosas, Javier de la Torre Lima, Elena Bereciartua, María José Blanco Vidal, Roberto Blanco, María Victoria Boado, Marta Campaña Lázaro, Alejandro Crespo, Laura Guio Carrión, Mikel Del Álamo Martínez de Lagos, Gorane Euba Ugarte, Ane Josune Goikoetxea, Marta Ibarrola Hierro, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Javier Nieto, David Rodrigo, Regino Rodríguez, Yolanda Vitoria, Roberto Voces, Mª Victoria García López, Radka Ivanova Georgieva, Guillermo Ojeda, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ignacio Álvarez Rodríguez, Harkaitz Azkune Galparsoro, Elisa Berritu Boronat, Mª Jesús Bustinduy Odriozola, Cristina del Bosque Martín, Tomás Echeverría, Alberto Eizaguirre Yarza, Ana Fuentes, Miguel Ángel Goenaga, Muskilda Goyeneche del Río, Ángela Granda Bauza, José Antonio Iribarren, Xabier Kortajarena Urkola, José Ignacio Pérez-Moreiras López, Ainhoa Rengel Jiménez, Karlos Reviejo, Alberto Sáez Berbejillo, Elou Sánchez Haza, Rosa Sebastián Alda, Itziar Solla Ruiz, Irati Unamuno Ugartemendia, Diego Vicente Anza, Iñaki Villanueva Benito, Mar Zabalo Arrieta, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Alberto Bouzas, Brais Castelo, José Cuenca, Laura Gutiérrez, Lucía Ramos, María Rodríguez Mayo, Joaquín Manuel Serrano, Dolores Sousa Regueiro, Francisco Javier Martínez, Mª del Mar Alonso, Beatriz Castro, Teresa Delgado Melian, Javier Fernández Sarabia, Dácil García Rosado, Julia González González, Juan Lacalzada, Lissete Lorenzo de la Peña, Alina Pérez Ramírez, Pablo Prada Arrondo, Fermín Rodríguez Moreno, Antonio Plata Ciezar, José Mª Reguera Iglesias, Víctor Asensi Álvarez, Carlos Costas, Jesús de la Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Mencia Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Manuel Azqueta, Mercè Brunet, Marta Bodro, Ramón Cartañá, Guillermo Cuervo, Carlos Falces, Mariana J Fernández-Pittol, Guillermina Fita, David Fuster, Cristina García de la Mària, Delia García-Pares, Marta Hernández-Meneses, Jaume Llopis Pérez, Francesc Marco, José M. Miró, Asunción Moreno, David Nicolás, Salvador Ninot, Eduardo Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericás, José L. Pomar, José Ramírez, Mercè Roque, Irene Rovira, Elena Sandoval, Marta Sitges, Dolors Soy, Adrián Téllez, José M. Tolosana, Bárbara Vidal, Jordi Vila, Iván Adán, David Alonso, Juan Carlos Alonso, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo Caballero, Antonia Delgado Montero, Agustín Estévez, Ramón Fortuny Ribas, Esther Gargallo, Mª Eugenia García Leoni, Ana González Mansilla, Francisco Javier González Moraga, Víctor González Ramallo, Martha Kestler Hernández, Amaia Mari Hualde, Marina Machado, Mercedes Marín, Manuel Martínez-Sellés, Rosa Melero, Diego Monzón, María Olmedo, Álvaro Pedraz, Blanca Pinilla, Ángel Pinto, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Eduardo Sánchez-Pérez, Antonio Segado, Neera Toledo, Maricela Valerio, Pilar Vázquez, Eduardo Verde Moreno, Sofía de la Villa, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Sandra Rosillo, Jesús Agüero Balbín, Cristina Amado Fernández, Carlos Armiñanzas Castillo, Francisco Arnaiz de las Revillas, Manuel Cobo Belaustegui, María Carmen Fariñas, Concepción Fariñas-Álvarez, Marta Fernández Sampedro, Iván García, Claudia González Rico, Laura Gutiérrez-Fernández, Manuel Gutiérrez-Cuadra, José Gutiérrez Díez, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Jorge Calderón Parra, Marta Cobo, Fernando Domínguez, Pablo García Pavía, Ana Fernández Cruz, Antonio Ramos-Martínez, Isabel Sánchez Romero, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Jorge Rodríguez-Roda Stuart, Soledad Ruiz, Carmen Hidalgo Tenorio, Sergio Sequera, Manuel Almendro Delia, Omar Araji, José Miguel Barquero, Román Calvo Jambrina, Marina de Cueto, Juan Gálvez Acebal, Irene Méndez, Isabel Morales, José Antonio Lepe, José López-Haldón, Rafael Luque-Márquez, Guillermo Marín, Antonio Ortiz-Carrellán, Eladio Sánchez-Domínguez, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona Gutiérrez, José Ramón Blanco, Estíbaliz Corral Armas, Lara García-Álvarez, José Antonio Oteo, Antonio Barros Membrilla, Antonino Ginel Iglesias, Sara Grillo, Rubén Leta Petracca, Joaquín López-Contreras, María Alba Rivera Martínez, M. Álvarez, A.L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Amaia Aguirre Quiñonero, Ángela Alonso Miñambres, Juan Carlos Gainzarain Arana, Sara González de Alaiza Ortega, Miguel Ángel Morán Rodríguez, Anai Moreno Rodríguez, Zuriñe Ortiz de Zárate, José Joaquín Portu Zapirain, Ester Sáez de Adana Arroniz, Daisy Carolina Sorto Sánchez, Sánchez-Porto Antonio, Úbeda Iglesias Alejandro, José Mª Arribas Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo de la Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Mª Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Ivan Keituqwa Yañez, Julián Navarro Martínez, Ana Peláez Ballesta, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, María Arrizabalaga Asenjo, Carmen Cifuentes Luna, Juana Núñez Morcillo, Mª Cruz Pérez Seco, Aroa Villoslada Gelabert, Carmen Aured Guallar, Nuria Fernández Abad, Pilar García Mangas, Marta Matamala Adell, Mª Pilar Palacián Ruiz, Juan Carlos Porres, Begoña Alcaraz Vidal, María Jesús Del Amor Espín, Francisco Buendía, Roberto Jiménez Sánchez, Rosario Mármol, Francisco Martínez, Antonio Meseguer, Beatriz Pérez, Leticia Risco, Zoser Saura, Vanina Silva, Mª Belén Villmarín, Mª Ángels Ribas Blanco, Enrique Ruiz de Gopegui Bordes, Laura Vidal Bonet, Miquel Vives Borràs, Mª Carmen Bellón Munera, Elena Escribano Garaizabal, Antonia Tercero Martínez, Juan Carlos Segura Luque, Cristina Badía, Lucía Boix Palop, Mariona Xercavins, Sónia Ibars, Xerach Bosch, Eloy Gómez Nebreda, Ibalia Horcajada Herrera, Irene Menduiña Gallego, Imanol Pulido, Héctor Marrero Santiago, Isabel de Miguel Martínez, Elena Pisos Álamo, Daniel San Román Sánchez, Jorge Boan Pérez, Eva Mª Aguilar Blanco, Mercedes Catalán González, María Angélica Corres Peiretti, Andrea Eixerés Esteve, Laura Domínguez Pérez, Santiago de Cossío Tejido, Francisco Galván Román, José Antonio García Robles, Francisco López Medrano, Mª Jesús López Gude, Mª Ángeles Orellana Miguel, Patrick Pilkington, Yolanda Revilla Ostalaza, Juan Ruiz Morales, Sebastián Ruiz Solís, Ana Sabín Collado, Marcos Sánchez Fernández, Javier Solera Rallo, Jorge Solís Martín, Francesc Escrihuela-Vidal, Jordi Carratalà, Inmaculada Grau, Carmen Ardanuy, Dámaris Berbel, José Carlos Sánchez Salado, Oriol Alegre, Alejandro Ruiz Majoral, Fabrizio Sbraga, Arnau Blasco, Laura Gracia Sánchez, Iván Sánchez-Rodríguez, Gonzalo Aldamiz, Beatriz Álvarez, Marina Bernal Palacios, Alfonso Cabello Úbeda, Ricardo Fernández Roblas, Rafael Hernández, Victoria Andrea Hortigüela Martín, Andrea Kallmeyer, Cristina Landaeta Kancev, Marta Martín, Miguel Morante Ruiz, Miguel Ángel Navas Lobato, Ana María Pello, Laura Prieto, Marta Tomás Mallebrera, Laura Varela, Mireia de la Peña Triguero, Ruth Esther Figueroa Cerón, Lara Ruiz Gómez, Mireia Ble, Juan Pablo Horcajada Gallego, Antonio José Ginel, Inmaculada López, Alexandra Mas, Antoni Mestres, Lluís Molina, Ramón Serrat, Núria Ribas, Francisca Sánchez, Ana Silverio, Marina Suárez, Luisa Sorlí, Lluís Recasens, Manuel Taurón, María Fernández Regueras, María Ángeles Mantecón Vallejo, José Ángel Pérez Rivera, Nuria Sánchez Mata, Antonia Calvo Cano, Miguel Fajardo Olivares, María Victoria Millán Núñez, and Agustín Muñoz Sanz

Subjects
Infective endocarditis, Methicillin-susceptible Staphylococcus aureus, Cefazolin, Antistaphylococcal penicillin, Infectious and parasitic diseases, RC109-216
Abstract

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

Published
2023
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2. Prevención de la oclusión coronaria en el implante de prótesis aórtica transcatéter valve-in-valve mediante técnica BASILICA

Author

Agustín Albarrán González-Trevilla, Julio García Tejada, Fernando Sarnago Cebada, José Antonio García Robles, Maite Velázquez Martín, and Danny Dvir

Subjects
Internal medicine, RC31-1245
Abstract

Sr. Editor: La obstrucción coronaria es una complicación más frecuente tras los implantes de prótesis aórtica transcatéter valve-in-valve que tras el implante percutáneo de válvula aórtica sobre válvula nativa. Se origina por el desplazamiento del velo de la válvula quirúrgica previa por el implante percutáneo de válvula aórtica hasta tapar el ostium coronario1. El riesgo es mayor con prótesis quirúrgicas sin stent y con aquellas en las que los velos están montados por fuera del stent. También depende de la altura de la salida de las coronarias y de la anchura de los senos2. Se pueden proteger las coronarias avanzando una guía o incluso un stent a la coronaria en riesgo, lo que crea una especie de chimenea para mantener abierto el ostium3, con resultados poco predecibles, sobre todo a largo plazo. Recientemente se ha descrito la técnica BASILICA (Bioprosthetic or native aortic scallop intentional ...

Published
2021
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3. Prevention of coronary occlusions during transcatheter aortic valve-in-valve implantation using the BASILICA technique

Author

Agustín Albarrán González-Trevilla, Julio García Tejada, Fernando Sarnago Cebada, José Antonio García Robles, Maite Velázquez Martín, and Danny Dvir

Subjects
Medicine
Abstract

To the Editor, Coronary occlusion is a more common complication after transcatheter aortic valve-in-valve implantation than after transcatheter aortic valve implantation over the native valve. It is due to the displacement of the veil of the surgical valve prior to transcatheter aortic valve implantation until occluding the coronary ostium.1 The risk is higher with surgical prostheses without stent and with those with veils mounted outside the stent. It also depends on the height of coronary ostia and width of sinuses.2 Coronary arteries can be protected by advancing a guidewire or even a stent inside the coronary artery at risk, which creates some sort of chimney to keep the ostium open3 with unpredictable results especially in the long-term. Recently, the BASILICA technique (Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) has been described to avoid coronary occlusions. It consists of lacerating the veil of the surgical prosthesis facing the ostium at risk with an electrified guidewire so that it opens when implanting the new prosthesis while leaving the ostium uncovered.4 This is the case of an 89-year-old woman—carrier of a 19 mm Mitroflow bioprosthesis (Sorin Group Inc., Mitroflow Division; Vancouver, Canada) due to severe aortic stenosis since 2010—who was admitted...

Published
2021
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4. Miocarditis aguda como manifestación de granulomatosis eosinofílica

Author

Miguel Calderón-Flores, Laura Morán-Fernández, José Antonio García-Robles, Ana Belén Enguita-Valls, and Juan Francisco Delgado-Jiménez

Abstract

Se presenta el caso de un varón joven, viajero por el sudeste asiático, que consulta por dolor torácico y es tratado inicialmente como síndrome coronario agudo. Se descarta enfermedad coronaria y se objetiva hipereosinofilia, por lo que comienza un amplio diagnóstico diferencial de sus posibles causas. Las pruebas complementarias confirman una miocarditis eosinofílica con disfunción ventricular. Profundizando en la historia clínica y ampliando las pruebas, se alcanza el diagnóstico de granulomatosis eosinofílica con poliangeítis. Tras la instauración de fármacos para insuficiencia cardíaca, así como corticoides y mepolizumab, el paciente mejora clínicamente y la fracción de eyección se restablece completamente.

Published
2022

5. Prevention of coronary occlusions during transcatheter aortic valve-in-valve implantation using the BASILICA technique

Author

and Maite Velázquez Martín, José Antonio García Robles, Fernando Sarnago Cebada, Julio García Tejada, Danny Dvir, and Agustín Albarrán González-Trevilla

Subjects
medicine.medical_specialty, Transcatheter aortic, business.industry, Internal medicine, cardiovascular system, medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Valve in valve
Abstract

To the Editor, Coronary occlusion is a more common complication after transcatheter aortic valve-in-valve implantation than after transcatheter aortic valve implantation over the native valve. It is due to the displacement of the veil of the surgical valve prior to transcatheter aortic valve implantation until occluding the coronary ostium.1 The risk is higher with surgical prostheses without stent and with those with veils mounted outside the stent. It also depends on the height of coronary ostia and width of sinuses.2 Coronary arteries can be protected by advancing a guidewire or even a stent inside the coronary artery at risk, which creates some sort of chimney to keep the ostium open3 with unpredictable results especially in the long-term. Recently, the BASILICA technique (Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) has been described to avoid coronary occlusions. It consists of lacerating the veil of the surgical prosthesis facing the ostium at risk with an electrified guidewire so that it opens when implanting the new prosthesis while leaving the ostium uncovered.4 This is the case of an 89-year-old woman—carrier of a 19 mm Mitroflow bioprosthesis (Sorin Group Inc., Mitroflow Division; Vancouver, Canada) due to severe aortic stenosis since 2010—who was admitted...

Published
2021

6. Aprendiendo a diferenciar las hipertrofias del miocardio en la práctica diaria

Author

José Antonio García-Robles and Esther Pérez-David

Subjects
Pharmaceutical Science
Abstract

La hipertrofia ventricular es una condición frecuente en los laboratorios de imagen cardíaca. Dado que es común a múltiples patologías es de gran importancia encontrar claves que permitan reconocer la causa. Aunque no hay datos patognomónicos para cada enfermedad, sí que es posible encontrar alteraciones que, combinadas, harán sospechar una determinada etiología. Para ello, se utilizará la información de la ecocardiografía y de la resonancia magnética cardíaca (cardio-RM). El presente artículo analiza la información disponible en grandes grupos de patología (miocardiopatía hipertrófica, cardiopatía hipertensiva, enfermedades infiltrativas [amiloidosis] y de depósito, con la enfermedad de Fabry como más característica) y el corazón de atleta, dada su importancia en el diagnóstico diferencial con situaciones patológicas.

Published
2016

7. The alpha-galactosidase A p.Arg118Cys variant does not cause a Fabry disease phenotype: data from individual patients and family studies

Author

Jesús Egido, Miguel Viana-Baptista, João Paulo Oliveira, Eduardo Gutiérrez-Rivas, Dominique P. Germain, Helena Alves, Diego Garcia, Scott C. Garman, Maria Fenollar-Cortés, Raluca Oancea, Angel Gallegos-Villalobos, Luis Manuel Salazar-Martín, Sebastian Mas, Jesús Solera-Garcia, Paloma Péres, Alberto Ortiz, José Antonio García-Robles, António Caldeira-Gomes, Marta Camprecios, José Antonio Herrero, and Susana Ferreira

Subjects
Proband, Adult, Male, variant p.(Arg118Cys), α-galactosidase A, Variant p.(Arg118Cys), Genotype, 2409.91 Genética del desarrollo, Endocrinology, Diabetes and Metabolism, Biology, medicine.disease_cause, Kidney, Biochemistry, Article, Endocrinology, Gene Frequency, α-Galactosidase A, Genetics, medicine, Humans, Allele, R118C, Codon, Molecular Biology, Allele frequency, GLA gene, Alleles, Family Health, Mutation, Fabry disease, Alpha-galactosidase, Molecular Structure, 2302.08 Coenzimas, Middle Aged, medicine.disease, Phenotype, Ciencias Biomédicas, Amino Acid Substitution, alpha-Galactosidase, biology.protein, Fabry Disease, Female
Abstract

Lysosomal α-galactosidase A (α-Gal) is the enzyme deficient in Fabry disease (FD), an X-linked glycosphingolipidosis caused by pathogenic mutations affecting the GLA gene. The early-onset, multi-systemic FD classical phenotype is associated with absent or severe enzyme deficiency, as measured by in vitro assays, but patients with higher levels of residual α-Gal activity may have later-onset, more organ-restricted clinical presentations. A change in the codon 118 of the wild-type α-Gal sequence, replacing basic arginine by a potentially sulfhydryl-binding cysteine residue – GLA p.(Arg118Cys) –, has been recurrently described in large FD screening studies of high-risk patients. Although the Cys118 allele is associated with high residual α-Gal activity in vitro, it has been classified as a pathogenic mutation, mainly on the basis of theoretical arguments about the chemistry of the cysteine residue. However its pathogenicity has never been convincingly demonstrated by pathology criteria. We reviewed the clinical, biochemical and histopathology data obtained from 22 individuals of Portuguese and Spanish ancestry carrying the Cys118 allele, including 3 homozygous females. Cases were identified either on the differential diagnosis of possible FD manifestations and on case-finding studies (n=11; 4 males), or on unbiased cascade screening of probands’ close relatives (n=11; 3 males). Overall, those data strongly suggest that the GLA p.(Arg118Cys) variant does not segregate with FD clinical phenotypes in a Mendelian fashion, but might be a modulator of the multifactorial risk of cerebrovascular disease, since the allelic frequency in stroke patients was 0.0087 (p=0.0185 vs the general population). The Cys118 allelic frequency in healthy Portuguese adults (n=696) has been estimated as 0.001, therefore not qualifying for “rare” condition

Published
2015

9. Transesophageal Echocardiography

Author

Miguel Ángel García Fernández, José Juan Gómez de Diego, Esther Pérez David, José Antonio García Robles, and Eulogio García Fernández

Published
2011

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