Introduction: Acinetobacter baumannii causes severe infections that primarily affect intensive care unit (ICU) patients. It has a high prevalence of multidrug resistance, including carbapenems, and a high potential for intra-hospital and inter-hospital transmission. The aim of this study was to determine the origin of extensively drug-resistant (XDR) A. baumannii isolates in our hospital during 2009. Methodology: This was an observational retrospective study. Isolates of A. baumannii were obtained from patients hospitalized during 2009. XDR isolates were defined using criteria published by Magiorakos et al.. The isolates were classified as community acquired, hospital acquired, and inter-hospital transmission. Results: A total of 48 isolates of A. baumannii were isolated during 2009, corresponding to 34 patients. Of these, 18 (53%) were susceptible, 6 (18%) were multidrug resistant (MDR), and 10 (29%) were XDR. Of the 10 XDR isolates, 9 were isolated from patients transferred from other hospitals. The median time of hospitalization in origin hospitals was 17 days, while the median time of hospitalization in the study hospital, previous to isolation of A. baumannii, was 1 day. A total of 6 out of 10 patients had a positive culture taken on the day of admission. None of the patients shared a clinical ward or time during hospitalization. Genotypic characterization demonstrated the existence of two clones (A and B) which were geographically associated with patients transferred from two different regions of the country. Conclusions: During 2009, all XDR A. baumannii isolates were recovered from patients coming from other hospitals, indicative of interhospital transmission.

Inflammation is a key feature of atherosclerosis. The inflammatory process is involved in all stages of disease progression, from the early formation of plaque to its instability and disruption, leading to clinical events. This strongly suggests that the use of anti-inflammatory agents might improve both atherosclerosis progression and cardiovascular outcomes. Colchicine, an alkaloid derived from the flower Colchicum autumnale, has been used for years in the treatment of inflammatory pathologies, including Gout, Mediterranean Fever, and Pericarditis. Colchicine is known to act over microtubules, inducing depolymerization, and over the NLRP3 inflammasome, which might explain its known anti-inflammatory properties. Recent evidence has shown the therapeutic potential of colchicine in the management of atherosclerosis and its complications, with limited adverse effects. In this review, we summarize the current knowledge regarding colchicine mechanisms of action and pharmacokinetics, as well as the available evidence on the use of colchicine for the treatment of coronary artery disease, covering basic, translational, and clinical studies.

Background: Angiotensin II is a potent activator of the Rho-kinase (ROCK) pathway, through which it exerts some of its adverse vasoconstrictor effects. Clinical evidence on the effects of blocking the angiotensin II receptor 1 on ROCK activity in hypertensive patients is scarce. Objective: To demonstrate that ROCK activity in peripheral blood mononuclear cells (PMBCs) in patients with essential hypertension is reduced earlier than previously observed, along with blood pressure (BP) lowering on treatment with olmesartan. Methods: Prospective pilot open study; 17 hypertensive patients were treated with progressive olmesartan doses starting with 20 mg qd. BP was measured at 3, 6 and 9 weeks after treatment initiation. If treatment failed to normalize BP after 3 weeks, olmesartan dose was increased to 40 mg qd, and if still hypertensive after 6 weeks, 12.5 mg of hydrochlorothiazide qd was added. ROCK activity was measured at baseline and 9 weeks after treatment as myosin phosphatase target subunit 1 phosphorylation (MYPT1-p/T ratio) in PBMC. Results: Mean baseline BP was 162 ± 4.9/101 ± 2.4 mmHg. After 9 weeks of treatment, both systolic and diastolic BP were reduced by 41 and 22 mmHg, respectively (p<0.05). Mean pretreatment MYPT1- p/T ratio in PMBCs was significantly reduced by 80% after 9 weeks with olmesartan (p<0.01). Conclusion: Normotension achieved after 9 weeks in 82% of the patients treated with olmesartan was associated with a significant reduction of ROCK activity in PBMC.

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Transcatheter aortic-valve implantation.A ten years clinical experienceBackground: Transcatheter aortic-valve implantation (TAVI) was introduced in 2002 and the first implants in our country were performed in 2010. Aim: To review the TAVI experience in our hospital, considering the technology improvements and gained experience throughout this period. Material and Methods: All patients undergoing TAVI in our center were included. Results and complications were adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria. Patients were divided in 3 groups, according to procedural year: