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Introduction: Early intravenous thrombolysis in elevated ST-segment myocardial infarcted patients reduces morbidity/mortality, however in non-responsive patients, it can delay the endovascular revascularization process. Increased epicardial adipose tissue thickness (EATT) is associated with adverse cardiovascular events and artery patency. Our aim was to evaluate if EATT influences the response to thrombolytic therapy in patients with acute myocardial infarction. Material and Method: This prospective cohort study included fifty patients (40 males and 10 females) with a mean age of 60 ± 9 years old and a presumptive acute myocardial infarct diagnosis. All the patients were hospitalized in the intensive care coronary unit. According to ESC and ACC guidelines, the diagnosis of acute myocardial infarct was corroborated. Patients were treated with 0.5 mg/kg IV bolus of the specific recombinant plasminogen activator Tenecteplase. The transthoracic 2-dimensional echocardiography was performed to recognize EAT from the parasternal long-axis view. Results: The time lapse between initial symptoms and thrombolysis was 227±43 mm. Sixteen patients showed positive reperfusion less than 90 minutes after thrombolysis, and the remaining 34 required a percutaneous coronary intervention. The mean EATT value of thrombolysis-responding patients was 2.4 ± 0.4 mm vs 6.5 ± 0.6 mm of the non)responders (p= 0.001). In responders, the percentage of body mass index (BMI) was 26.1 ± 0.02% vs 29.1± 0.02% (kg/m2) in non-responders (p= 0.001). Interestingly, an EATT value > 2.5 mm and a BMI > 26 showed a highly significant inverse correlation response to thrombolysis and positive myocardial reperfusion (r = -0.71 y 0.55, p = 0.001 respectively). These values had a prognostic sensitivity of 93% and specificity of 84%. Conclusion: EATT and BMI could be usefull serve as early decision indicators to determine the possible response to thrombolysis and positive myocardial reperfusion in acute myocardial infarcted patients, although there is a need for studies with larger sample sizes. [ABSTRACT FROM AUTHOR]

Copyright of Revista Electrónica de Psicología Iztacala is the property of Facultad de Estudios Superiores Iztacala and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Aortic valve replacement with either mechanical or bioprosthetic valves is the gold standard treatment for severe aortic stenosis. Unfortunately, enhanced bleeding and hemodynamic decompensation thrombocytopenia is a frequent postoperative complication. The latter could be secondary to the shearing effect of mechanical prosthesis upon the blood flow that favors platelet aggregation or the presence of thrombogenic materials such as glutaraldehyde used to preserve bioprosthetic valves. Our aim was to discern which type of valve is associated with a more severe post-surgery thrombocytopenia so we compared postoperative platelet counts in patients treated with mechanical vs bioprosthetic valves. Material and Method: Two hundred and fifty patients with severe aortic stenosis underwent valve replacement surgery were included in the analysis. 126 patients received a mechanical (group A) and 124 patients received a biological (group B) prosthesis. A conventional surgical procedure with Extracorporeal Life Supports (ECLS) was performed in all. Patients' age, gender, cardiovascular risk factors, type and time length of antiaggregant treatment, size of the implanted valve, and perioperative events were recorded. Pre-surgery platelet count and daily post-surgery registers of platelets count for a 10-day period was documented. Results: Platelet count before surgery was within normal values in both groups. There was a significant decrease the first postsurgical day in both groups (127±48 vs 224±56 in group A, and 132±45 vs 229±54 in group B, p <0.001). Normal platelet count, was reached the fourth post-surgery day in group A patients compared to the eighth day of group B. The differences in platelet count between both groups, independently of the postsurgical day, were highly significant. Thrombocytopenia remained significantly lower and did not reach normal values (141) in the 10 days follow-up in patients that received the 19 mm prosthesis, whereas those receiving the 21 mm valves reached normal values (150) the eighth day. Conclusion : Thrombocytopenia in patients undergoing aortic valve replacement is secondary to the synergic effect of ECLS, aldehydes present on the preservation solution of prosthesis, and the shear flow induced by the prosthesis diameter. The implant of small diameter prosthesis prolongs thrombocytopenia. [ABSTRACT FROM AUTHOR]

Uterine neoplasm metastases to heart is infrequent, especially from uterine cancer, although it is possible because leiomyosarcoma is very invasive. We present a case of a 33 years old woman with 9 months evolution of this neoplasm. By cardiac and brain symptomatology, this patient was diagnosed with cardiac and brain tumors in imaging studies. The patient underwent tumors resection by cardiac surgery and stereotaxic procedure and subsequent chemo and radiotherapy, without neurological and cardiac symptoms in her evolution. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic and inflammatory disorders are widely described in COVID-19 disease by SARS-CoV-2, especially in advanced gravity stages, nevertheless, the increase in inflammatory and tissue damage biomarkers could identify patients with higher mortality risk since early disease stages. Material and Method: A retrospective Cohort study was performed to evaluate the progression pattern and mortality risk of proinflammatory (Ferritin and IL- 6) and damage tissue biomarkers seric levels (LDH, CPK, CPK-MB and TnIc) since the beginning of the disease to end outcome considered, in this study, as death or recovery. Results: We evaluated 120 patients with mean age 51±10 years. The CAT study showed in all patients bilateral polished glass lung lesions. The inflammatory and seric tissue injured biomarkers were significantly higher since the beginning of the hospitalization in patients who died compared with patients that survived (p = 0.01). The myocardial injury biomarkers (CPK-MB and TnIc) were significantly higher in severe gravity stages of deceased patients compared to patients who survived (p = 0.001 and 0.003 respectively) with a global mortality of 38.3% (n = 48). The mortality risk was extremely elevated (RR> 10) when inflammatory and tissue injury biomarkers showed seric levels 2 folds above normal values, showing survival of < 60% after tenth day since the beginning disease. Conclusion: Since the beginning of COVID-19 disease by SARS CoV2 virus, patients show serum elevation in ferritin, LDH and CPK. This seric values were associated with higher mortality risk, when elevated 2 folds above normal values. [ABSTRACT FROM AUTHOR]

Clinical presentation of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) usually is nonspecific in young, representing a challenge diagnostic. We present an 11-year-old male patient, with a syncope event and normal ECG in the first medical assessment. Eight months later, presented a new syncope event, but now with 1st degree block that evolved to complete AV block in 24 hrs in ECG. In Tertiary Medical Care Hospital showed sinus arrhythmia with nodal rescues. The echocardiographic assessment showed dilatation and global hypokinesia in the Right Ventricle. The MR showed in apex and lateral wall late Gadolinium enhancement indicating fibrosis greater than 20%. The electrophysiologic assessment showed a low-voltage zone in the RVOT, normal stimulation between sinus and AV nodes. Was implanted ICD which identified events of ventricular tachycardia (185 bpm), giving discharges between 21 to 41 Jules, which were not perceived for the patient. Currently continues under cardiology surveillance to eventually receive a heart transplant as definitive treatment. [ABSTRACT FROM AUTHOR]

Introduction The digital subtraction angiography is considered the gold standard in detecting cerebral aneurysms. Other less invasive techniques that require a lesser dose of contrast medium are currently employed such as rotational angiography (RA) and computed tomography angiography with three-dimensional reconstruction (3D-CTA). The aim of this study is to recommend 3D-CTA as a screening test for cerebral aneurysms in patients with suspected cerebrovascular pathology, having compared it to other tests requiring the use of less contrast medium, in this case, RA and 3D-CTA. Materials and Methods The study was performed between 2010 and 2014 among all patients referred to the Centro Médico Nacional "20 de Noviembre" ISSSTE, in Mexico City, presenting a total of 332 patients with suspected cerebral aneurysm; 182 patients who had undergone angiography or digital subtraction angiography in a different hospital were not included, and 50 patients who tested negative for cerebral aneurysm were also excluded. Experts in neurological imaging examined the results, comparing those diagnosed with cerebral aneurysms, using RA and 3D-CTA against the gold standard. Results Both RA and 3D-CTA registered the same aneurysm dimensions. Differences were observed in aneurysm's dome only. Conclusion The RA should be reserved for those cases where a DSA is deemed necessary, but cannot be performed due to the high amount of contrast medium required and risk of adverse reactions in allergic population; in this case, the 3D-CTA is a better test. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Acute myocardial infarction is the first cause of morbidity and mortality in the world, resulting in the combination of genetic and environmental factors. It has been postulated that the R353Q polymorphism of the coagulation FVII gene represents a protective factor for acute myocardial infarction, whereas the N700S polymorphism in the thrombospondin-1 gene is associated with an increased risk for acute myocardial infarction; however, the results are still contradicted. The objective of the study was to examine the possible association of the FVII R353Q and N700S polymorphism and acute myocardial infarction in Mexican patients with acute myocardial infarction younger than 45 years old., Methods: Case-control study that included 252 patients who were diagnosed with acute myocardial infarction and 252 apparently healthy, age- and gender-matched individuals without a history of coronary artery disease. R353Q and N700S polymorphisms were determined in all participants by PCR-RFLP., Results: There was no statistical significant difference in genotype distribution (p = 0.06) between the acute myocardial infarction and control groups. Also, there was a similar genotype distribution of N700S polymorphism between stroke and control groups (p = 0.50). Hypertension, diabetes mellitus, family history of coronary disease and dyslipidemia represented independent risk factors for acute myocardial infarction., Conclusions: Polymorphisms R353Q and N700S do not represent a protective or risk factor for acute myocardial infarction in young Mexican individuals.