BackgroundHost factors and complications have been associated with higher mortality in infective endocarditis (IE). We sought to develop and validate a model of clinical characteristics to predict 6‐month mortality in IE.Methods and ResultsUsing a large multinational prospective registry of definite IE (International Collaboration on Endocarditis [ICE]–Prospective Cohort Study [PCS], 2000–2006, n=4049), a model to predict 6‐month survival was developed by Cox proportional hazards modeling with inverse probability weighting for surgery treatment and was internally validated by the bootstrapping method. This model was externally validated in an independent prospective registry (ICE‐PLUS, 2008–2012, n=1197). The 6‐month mortality was 971 of 4049 (24.0%) in the ICE‐PCS cohort and 342 of 1197 (28.6%) in the ICE‐PLUS cohort. Surgery during the index hospitalization was performed in 48.1% and 54.0% of the cohorts, respectively. In the derivation model, variables related to host factors (age, dialysis), IE characteristics (prosthetic or nosocomial IE, causative organism, left‐sided valve vegetation), and IE complications (severe heart failure, stroke, paravalvular complication, and persistent bacteremia) were independently associated with 6‐month mortality, and surgery was associated with a lower risk of mortality (Harrell's C statistic 0.715). In the validation model, these variables had similar hazard ratios (Harrell's C statistic 0.682), with a similar, independent benefit of surgery (hazard ratio 0.74, 95% CI 0.62–0.89). A simplified risk model was developed by weight adjustment of these variables.ConclusionsSix‐month mortality after IE is ≈25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.

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a b s t r a c tIntroduction: Recurrent wheezing is one of the leading causes of chronic illness in childhood. We aimed to evaluate the prevalence of Human Rhinovirus (HRV) infection in the acute attack of wheezy chest which began after a respiratory illness. Methodology: The study was conducted on 200 children aged 2 months to 5 years presenting to the emergency department with an acute wheezy episode either for the first time or recurrent wheeze defined as >2 reports of wheezing in the first 3 years of life. All subjects were subjected to a complete history and clinical examination. Chest X-ray was done to all subjects. Nasopharyngeal and oropharyngeal swabs were obtained from all subjects and the presence of HRV was determined by PCR examination. Results: By PCR method, 163 patients (81.5%) were positive for viral infection. Due to viral co-infection, 49.5% (99 cases) were +ve for Respiratory Syncytial virus followed by HRV 43.5% (87 cases). Conclusion: HRV was the second common viral infection in children with wheezes. Its prevalence was more in winter with higher incidence of recurrence. Compared to the other respiratory viruses, it had the higher mortality 43.7%.

Introduction Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide. Methods The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century. Results IE cases from 13 European countries were included. Two periods were considered: 2000–2006 and 2008–2012. Two European regions were considered, according to the United Nations geoscheme for Europe: Southern (SE) and Northern–Central Europe (NCE). Comparisons were performed between regions and periods. A total of 4195 episodes of IE were included, 2113 from SE and 2082 from NCE; 2787 cases were included between 2000 and 2006 and 1408 between 2008 and 2012. Median (IQR) age was 63.7 (49–74) years and 69.4% were males. Native valve IE (NVE), prosthetic valve IE (PVE), and device-related IE were diagnosed in 68.3%, 23.9%, and 7.8% of cases, respectively; 52% underwent surgery and 19.3% died during hospitalization. NVE was more prevalent in NCE, whereas device-related IE was more frequent in SE. Higher age, acute presentation, hemodialysis, cancer, and diabetes mellitus all were more prevalent in the second period. NVE decreased and PVE and device-related IE both increased in the second period. Surgical treatment also increased from 48.7% to 58.4% ( p < 0.01). In-hospital and 6-month mortality rates were comparable between regions and significantly decreased in the second period. Conclusions Despite an increased complexity of IE cases, prognosis improved in recent years with a significant decrease in 6-month mortality. Outcome did not differ according to the European region (SE versus NCE). Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s40121-023-00763-8.

Background: The rate of admissions to hospital with bronchiolitis has increased over the past years. The reasons for this are likely to be multifactorial including improved survival of preterm infants. Aim: To assess the severity of viral bronchiolitis in preterm compared with term infants admitted at a tertiary hospital in Cairo, Egypt, based on the outcome. Materials and Methods: This prospective study was conducted throughout a 3-year period from September 2011 to October 2014. It included 153 infants, 74 healthy preterm and 79 healthy term infants, admitted with clinical diagnosis of bronchiolitis at a tertiary hospital in Cairo, Egypt. Bronchiolitis severity score (BSS) was recorded, and nasopharyngeal swabs were obtained from each patient at the time of presentation. Viruses were identified using reverse transcription PCR. The clinical course and patient's outcome were recorded. Results: This study recorded a significantly more severe BSS for preterm compared with term infants. The preterm group had an increased mean length of hospital stay and oxygen therapy and were more likely to need ICU admission and mechanical ventilation compared with the term group. The mean ±SD BSS for infections with human metapneumovirus, respiratory syncytial virus, parainfluenza 3 was more significantly severe in preterm compared with term infants. Bacterial co-infection was significantly correlated with severity scoring in both groups.. Conclusion: Prematurity significantly affects the severity of bronchiolitis, and this underscores the importance of early categorization of these infants as a high-risk group on their first visit. Physician should be aware that their illness runs a more severe course, even if they have no underlying disorders.