Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis

Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality.

Social networks applied to training

In this article, we address the importance and relevance that social networks exhibit in their use as an educational resource.  This relevance relies in the possibility of implementing new learning resources or increasing the level of the participant's connectivity, as well as developing learning communities.  Also, the risk entailed from their use is discussed, especially for the students that have a low technological education or those having excessive confidence on the media.  It is important to highlight that the educational use of social networks is not a simple extension or translation of the student's habitual, recreational use, but that it implies an important change in the roles given to teachers as well as learners; from accommodative learning environments that only encourage memorization to other environments that demand an active, reflective, collaborative and proactive attitude, that require the development/acquisition of technological as well as social abilities, aptitudes and values.  It is also important to highlight that a correct implementation and adequate use will not only foment formal learning, but also informal and non-formal learning.

Inspección radiográfica de soldaduras [por] Heriberto Ruiz Caballero

Tesis (Maestría en Ciencias de la Ingeniería Mecánica, con especialidad en Metalurgia) U.A.N.L.

Proyecto para un programa de capacitación para maestros de sistemas operativos I de la Facultad de Ingeniería Mecánica y Eléctrica por Ariadne Beatriz Sánchez Ruiz

Tesis (Maestría en Ciencias de la Administración con Especialidad en Relaciones Industriales) U.A.N.L.

Filosofía I [2do. semestre] [por] Fernando Ruiz Arredondo [y] Gerardo García Ibarra.

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Problemas filosóficos, 1 [por] Marcos Ruiz R., Rodolfo Martínez C. [y] Aurelio Isaak C.

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Análisis argumental de la Ilíada y la Odisea comp. : Héctor M. Hernández Ruiz.

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Biología [Othón R. Núñez Ambriz, G. Baldomero Salinas G. [y] Javier Ruiz Steele

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Biología [Othón R. Núñez Ambriz, G. Baldomero Salinas G. [y] Javier Ruiz Steele

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Biología [Othón R. Núñez Ambriz, G. Baldomero Salinas G. [y] Javier Ruiz Steele

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Informe que dieron los señores D. José Ruiz de la Bárcena, comisario de guerra honorario, D. José María de Echabe y Teniente Coronel D. Gregorio Sáenz de Sicilia, prior y cónsules del Real Tribunal del Consulado de México al Exmo. Sr. D. Juan Ruiz de Apodaca, virey Gobernador y Capitán General de esta Nueva España... Escrito por el Lic. D. Basilio De

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Discursos leídos ante la Real Academia Española en la recepción pública del excmo señor D. Pedro Antonio de Alarcón el 25 de Febrero de 1877.

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Estudios crítico-biográficos : Semblanzas y biografías del Excmo. e Illmo. Sr. Dn. Eloy Noriega y Ruiz, ingeniero industrial e ingeniero electricista

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Carta pastoral colectiva de los ilmos. y rmos. sres. doctores D. Próspero M. Alarcón, arzobispo de México, D. Perfecto Amezquita, obispo de Puebla... sobre los ayunos y abstinencia

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Carta pastoral colectiva de los Ilmos. y Rmos. Sres. Doctores D. Próspero M. Alarcón, Arzobispo de México, D. Perfecto Amézquita, Obispo de Puebla, D. Ramón Ybarra, Obispo de Chilapa... ...sobre los ayunos y abstinencia

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