Aims: To investigate the annual hospitalization rate and seasonal variation in confirmed heart failure (HF) admissions. Methods and Results: Records from all admissions to one hospital during 1 year with a HF diagnostic code were reviewed. From 1953 admissions, 595 were excluded because they did not fulfill the diagnostic criteria. A total of 1069 patients had 1358 admissions with confirmed HF. Mean age was 74.8"11.5 years, 42% were males. The admission data were matched with data from the municipal census with 537 666 people aged G15 years. There were 2.5 admissions per 1000 for the adult population and 26.5y 1000 in those aged G80 years. There were 444 males and 625 females, giving a higher rate of admission for female patients 2.2y1000 vs. 1.7y1000 (P-0.0001), although age adjusted rates in females were higher only for G80 years. Echocardiogram was performed in 706 patients (66%), 325 (46%) had a normal ejection fraction. This proportion increased in females-64% vs. 29% males-and in older patients-55% in G75 vs. 39% in -75 years. Mortality during the first admission of 1996 was 8.3%. There was a seasonal variation in HF hospitalizations (P-0.0001) peaking at 25% above average in January and dipping to 33% below average in August. Conclusion: The rate of HF admissions was 2.5y1000 with an elderly preponderance and a higher rate of admission in males -80 years and in females G80 years. A seasonal variation ranging from 25% above average in January to 33% below average in August was observed.
Enterococcal IE may be more frequent than generally thought. Depending on local prevalence of endocarditis, application of the NOVA score may safely obviate echocardiography in 14%-27% of patients with E-BSI.
Aims: To evaluate in patients with heart failure (HF) due to systolic dysfunction the occurrence of polypharmacy, alternative medicine, immunization against influenza, and patients' knowledge about their medication. Methods and results: Sixty-five patients, 49 men, mean age 60.5"12.0 years answered a confidential questionnaire during 2002. Polypharmacy was frequent, 48 (74%) were taking six or more pills per day and 18 (28%) 11 or more. Fifteen patients (23%) used over-the-counter analgesics. Eight patients (12%) used alternative medicine wfive women (31%) vs. three men (6%), Ps0.02x. Forty-four patients (68%) received immunization against influenza (18 patients -65 years (54%) vs. 25 patients G65 years (79%), Ps0.03). Half the patients knew that beta-blockers and vasodilators decreased blood pressure, 31 patients receiving diuretics (88%) knew that this drugs help to eliminate liquids, 12 patients (38%) recognized this effect with low dose spironolactone and 23% or less with other drugs. Only 12 patients (42%) treated with acenocoumarol and 13 of those treated with aspirin (32%) recognized the action of these drugs. Conclusion: Patients with HF and systolic dysfunction have a poor knowledge about the medication they receive. Polypharmacy, over-the-counter, homeopathic and alternative medicine use is frequent whereas the rate of immunization against influenza is low.
Daptomycin-treated patients more frequently required a therapeutic change due to worse microbiological and clinical response, although mortality was not increased. Our findings do not support the use of daptomycin as single therapy in the treatment of EIE. Its role in combined strategies should be further investigated.
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