Aims The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). Methods and results Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.

Background: The interplay between cancer and IE has become of increasing interest. This study sought to assess the prevalence, baseline characteristics, management, and outcomes of IE cancer patients in the ESC EORP EURO-ENDO registry.Methods: Three thousand and eighty-five patients with IE were identified based on the ESC 2015 criteria. Three hundred and fifty-nine (11.6%) IE cancer patients were compared to 2,726 (88.4%) cancer-free IE patients.Results: In cancer patients, IE was mostly community-acquired (74.8%). The most frequently identified microorganisms were S. aureus (25.4%) and Enterococci (23.8%). The most frequent complications were acute renal failure (25.9%), embolic events (21.7%) and congestive heart failure (18.1%). Theoretical indication for cardiac surgery was not significantly different between groups (65.5 vs. 69.8%, P = 0.091), but was effectively less performed when indicated in IE patients with cancer (65.5 vs. 75.0%, P = 0.002). Compared to cancer-free IE patients, in-hospital and 1-year mortality occurred in 23.4 vs. 16.1%, P = 0.006, and 18.0 vs. 10.2%; P < 0.001, respectively. In IE cancer patients, predictors of mortality by multivariate analysis were creatinine > 2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated).Conclusions: Cancer in IE patients is common and associated with a worse outcome. This large, observational cohort provides new insights concerning the contemporary profile, management, and clinical outcomes of IE cancer patients across a wide range of countries.

ResumenEl presente artículo evidencia que el tráfi co de drogas en la población Santa Adriana está asociado a los procesos de exclusión social que han debido enfrentar los vecinos desde la etapa fundacional del barrio. Si bien este tipo de delincuencia es la que causa un mayor nivel de deterioro en la calidad de vida de sus habitantes, el análisis realizado releva que no es una actividad aislada. En el vecindario se observan otras actividades ilegales y fi guras delictivas cuyo origen se remonta al origen del vecindario. En este sentido, la trayectoria barrial nos habla de la presencia de mapas normativos diferenciados a la sociedad que tienen larga

Se puede decir que la gramát ica y la estilística convergen y se bifurcan dentro de cualquier ftnÓ · meno linguistico concreto : si 5f! analila tan sólo dentro del sistema de la lengua, se trata de un fenómeno gramatical. pero si se analiza dentro de la totalidad de un enunciado individual o de un genero discursivo, es un fenómeno de estilo. La misma e(tcción de determinada forma gramatical por d hablante es un acto de estilística.M. Bajtin, Est¡:tica dt fa c",.ario" ver bal. L El. TMPERFECTO: TIEMPO, ASPECTO Y MODOEn el presente trabajo propongo un análisis del imperfecto de indicativo español hecho a la luz de estudios recientes sobre los significados de las {or-mas verbales y sus funciones en el discurso. Me voy a detener en los usos del imperfecto que distinguen a esta forma de las restantes formas de pasado de la conjugación española y especialmente del pretérito indefinido, haciendo hincapié en los valores estilísticos que presenta el uso de CANTABA frente al pretérito CANTf o a las formas que -alternan con CANTÉ en los textos na· rrativos. Por valores estilísticos debe entenderse aquí significados expresivos (relacionados con el hablante) o pragmáticos (relacionados con el discurso mismo y con la situación), que se originan en determinadas intenciones ca· Illunicativas del hablante. Los valores estilísticos están ligados a convenciones genéricas, que, pese a sus imposiciones, dejan siempre un margen para la creatividad discursiva.La forma de la conjugación española que conocemos con el nombre de imperfecto tiene significados temporales, aspectuales y modales. Temporal. mente. el imperfecto CANTABA significa lo mismo que el pretérito simple Revista de Filología Española, vol. LXX, n.º 1/2 (1990) (c) Consejo Superior de Investigaciones Científicas Licencia Creative Commons 3.0 España (by-nc)

Purpose High mortality and a limited performance of valvular surgery are typical features of infective endocarditis (IE) in octogenarians, even though surgical treatment is a major determinant of a successful outcome in IE. Methods Data from the prospective multicentre ESC EORP EURO-ENDO registry were used to assess the prognostic role of valvular surgery depending on age. Results As compared to < 80 yo patients, ≥ 80 yo had lower rates of theoretical indication for valvular surgery (49.1% vs. 60.3%, p < 0.001), of surgery performed (37.0% vs. 75.5%, p < 0.001), and a higher in-hospital (25.9% vs. 15.8%, p < 0.001) and 1-year mortality (41.3% vs. 22.2%, p < 0.001). By multivariable analysis, age per se was not predictive of 1-year mortality, but lack of surgical procedures when indicated was strongly predictive ). By propensity analysis, 304 ≥ 80 yo were matched to 608 < 80 yo patients. Propensity analysis confirmed the lower rate of indication for valvular surgery (51.3% vs. 57.2%, p = 0.031) and of surgery performed (35.3% vs. 68.4%, p < 0.0001) in ≥ 80 yo. Overall mortality remained higher in ≥ 80 yo (in-hospital: HR 1.50[1.06-2.13], p = 0.0210; 1-yr: HR 1.58[1.21-2.05], p = 0.0006), but was not different from that of < 80 yo among those who had surgery (in-hospital: 19.7% vs. 20.0%, p = 0.4236; 1-year: 27.3% vs. 25.5%, p = 0.7176). Conclusion Although mortality rates are consistently higher in ≥ 80 yo patients than in < 80 yo patients in the general population, mortality of surgery in ≥ 80 yo is similar to < 80 yo after matching patients. These results confirm the importance of a better recognition of surgical indication and of an increased performance of surgery in ≥ 80 yo patients.