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Objective: To identify the relationship between red blood cell distribution width (RDW, %), interleukin-6 (IL-6) (pg/ml), high sensitivity-c-reactive protein (hs-CRP) (mg/l), in-hospital mortality and disease severity among patients with heart failure (HF). Methods: Prospective cohort. We included adults diagnosed with acute non-ischemic HF in 2015. The dependent variables were in-hospital mortality (yes or no) and disease severity. The latter was assessed with the Get With The Guidelines-HF score. We used hierarchical regression models to describe the pattern of association between biomarkers, mortality, and severity. We used the Youden index to identify the best cut-off for mortality prediction. Results: We included 167 patients; the mean age was 72.61 (SD: 11.06). The majority of patients presented with New York Heart Association classification II (40.12%) or III (43.11%). After adjusting for age and gender, all biomarkers were associated with mortality. After adding comorbidities, only IL-6 was associated. The final model with all clinical variables showed no effect from any biomarker. The best cut-off for RDW, hs-CRP and IL-6 for mortality were 14.8, 68.7 and 52.9, respectively. IL-6 presented the highest sensitivity (100%), specificity (75.35%) and area under the curve (0.91). Conclusions: No biomarker is independent from the most important clinical variables; therefore it should not be used for management modifications. Resumo: Objetivo: Identificar a relação entre a amplitude de distribuição dos eritrócitos (ADE, %), IL-6 (pg/nl), hs-PCR (mg/l), mortalidade intra-hospitalar e gravidade da doença em doentes com insuficiência cardíaca (IC). Métodos: Coorte prospetiva. Incluímos adultos com IC aguda de etiologia não isquémica durante o ano de 2015. As variáveis dependentes foram a mortalidade intra-hospitalar (sim ou não) e a gravidade da doença. A última foi avaliada com o score de Get With Guidelines-HF (GWTG-HF). Utilizámos modelos de regressão hierarquizados para descrever o padrão de associação entre os biomarcadores, mortalidade e gravidade. Utilizámos o índice Youden para identificar o melhor cut-off na previsão da mortalidade. Resultados: Foram incluidos 167 doentes. A idade média foi de 72,61 (MS: 11,6). A maioria dos doentes estava em Classe II (40,12%) ou III NYHA (43,11%). Após ajuste para idade e género, todos os biomarcadores se associaram à mortalidade. Após adicionar as comorbilidades, só a IL-6 se associou com mortalidade. O modelo final com todas as variáveis clínicas incluidas não mostrou qualquer efeito de qualquer dos biomarcadores estudados. Os melhor cut-off de ADE, hs-PCR e IL-6 para mortalidade foi de 14,8, 68,7 e 52,9 respetivamente. A IL-6 apresentou a sensibilidade mais elevada (100%), especificidade (75,35%) e área sob a curva (0,91). Conclusões: Nenhum dos biomarcadores analisados se revelou independente das variáveis clínicas mais importantes, pelo que os biomarcadores estudados não devem ser utilizados como orientação clínica.

Esta producción, forma parte de la investigación “La autopercepción de la salud mental positiva: el caso de los adultos mayores que concurren a los Centros Jubilados de Río Gallegos”. Una propuesta de tipo cuali-cuantitativa, descriptiva que está buscando conocer las fortalezas de las personas mayores que asisten a los Centros de Jubilados de Río Gallegos. Se realizan aportes y reflexiones sobre la salud mental positiva y su vínculo con el envejecimiento activo. Se pone de manifiesto la relevancia y el fundamento que tiene la salud mental positiva para la vida de los seres humanos y en particular para la etapa de la vejez. Se posiciona en reconocer las virtudes y capacidades de las personas mayores, que les permiten ser miembros activos y productivos en la sociedad. Mientras que el envejecimiento activo es una teoría basada en la actividad que apunta a la ideología de la acción y la participación de las personas en la vida personal y vincular. Ambos paradigmas jerarquizan y valoran la capacidad que tiene esta población para poder vivir libre y disfrutar del momento presente, devenida de la acumulación de experiencias y el disfrute de la vida.

El Canal Natural Calle Don Pedro (CNCDP) ha generado erosión lateral e inundaciones. Por lo anterior, ha sido necesario proteger el fondo y las paredes del mismo y transportar más eficientemente sus aguas. Este trabajo resume las obras de mitigación realizadas, lo que incluye la identificación y descripción de las mismas. Estos valiosos aportes a la gestión local de riesgos rara vez son divulgados y valorados por lo que se considera de suma importancia difundirlos. La publicación pretende no solo dar a conocer contribuciones a la gestión de riesgos sino generar datos que alimenten una futura plataforma local de información para gestión de riesgos. La investigación requirió revisión bibliográfica, trabajo de campo y cartografía de las estructuras realizadas. Lo implementado incluye canales de concreto y muros de gaviones.

Objetivos: Determinar las características clínicas, de imágenes y laboratoriales así como la sobrevida al año del diagnóstico de pacientes con amiloidosis cardíaca en un hospital de referencia nacional. Materiales y métodos: Estudio de serie de casos. Evaluamos las características clínicas, exámenes complementarios y supervivencia de pacientes con amiloidosis cardíaca diagnosticados, tratados y seguidos en el servicio de Cardiología Clínica del Instituto Nacional Cardiovascular - INCOR EsSalud. Resultados: Se encontraron 8 pacientes con diagnóstico de amiloidosis cardíaca. La mediana de la edad fue 64.5 años y el 75% de sexo masculino. La etiología fue amiloidosis cardíaca no especificada (25%), amiloidosis cardíaca transtiretina (37.5%) y amiloidosis cardíaca de cadenas ligeras (37.5%). La insuficiencia cardíaca sintomática (NYHA II-III) fue la presentación inicial más común (87.5%). Las manifestaciones extracardíacas más frecuentes fueron: neuropatía sensitivo-motora (62.5%), muscu- loesqueléticas (37.5%), nefropatía (25%), síndrome de túnel carpiano bilateral (25%), gammapatías monoclonales (25%) y efusión pleural refractaria (25%). La sobrevida al año fue del 75% y la causa de muerte en los 2 fallecidos fue muerte súbita. Conclusiones: En este estudio sobre amiloidosis cardíaca en un centro especializado las manifestaciones clínicas más frecuentes fueron la insuficiencia cardíaca y la neuropatía sensitivo-motora. La mortalidad fue del 25% al año, y en todos los casos como muerte súbita.

Me propongo analizar el significado del libro Los heraldos negros en el contexto de la poesía en lengua castellana de su tiempo a nuestros días. Se trata de un libro con un asombroso legado poético existencial y cuya trascendencia, a cien años de su aparición, se confirma en estudios como el que nos convoca. Se sigue explorando el alcance vital y humano de la trascendente y singular aventura poética de César Vallejo a través de su primer texto poético, en el cual el imaginario colectivo de la cosmovisión andina inicia su incorporación, y para siempre, a la literatura universal.

Primary effusion lymphoma (PEL) is an aggressive B-cell lymphoma confined to body cavities and universally associated with human herpesvirus type 8 infection. The prognosis of this entity remains poor, with a median survival time of 6 to 9 months. To better understand the clinicopathologic features of the disease and identify possible prognostic factors, we performed a systematic review of the literature for cases of PEL, including 2 previously unreported cases from our institution. PEL was more prevalent in men (92%), with a median age at diagnosis of 55 years. The median overall survival for the entire series was 6 months. Peritoneal involvement (HR:1.62; 95% CI:1.06-2.48) and elevated serum lactate dehydrogenase (LDH) levels (HR:2.50; 95% CI:1.21-5.19) were associated with higher risk of death, while pericardial involvement (HR:0.43; 95% CI:0.20-0.94) was associated with lower risk of death. Therefore, effusion site and serum LDH levels are potential prognostic factors in patients with PEL.

Background and objective Chuquiraga spinosa Lessing (ChS) has shown protective effect on N-Nitroso-N-methylurea (NMU)-induced prostate cancer in rats. Currently, statins are being studied for their pro-apoptotic and antimetastatic effects. The main objective of this research was to determine the protective effect associated with the oral administration of simvastatin and ethanolic extract of the aerial parts of ChS in the prevention of prostate cancer. Methods Fifty-six albino male rats were randomized into seven groups: I) negative control: physiological serum: 2 mL/kg; II) TCN: testosterone 100 mg/kg + cyproterone 50 mg/kg + NMU 50 mg/kg; III) TCN + S40 (simvastatin 40 mg/kg); IV) TCN + ChS250 (ChS 250 mg/kg); V) TCN + ChS50 (ChS 50 mg/kg) + S40; VI) TCN + ChS250 (ChS 250 mg/kg) + S40; and VII) TCN + ChS500 (ChS 500 mg/kg) + S40. The antioxidant activity was tested by using (2,2-diphenyl-1-picrylhydrazyl) (DPPH) assay. Hematology, toxicological biochemical parameters, prostate-specific antigen (PSA), histology and prostate size were evaluated as main indicators of protective effect. Results Triglyceride values were decreased in the groups receiving ChS, being significant (P=0.02) in IV and VII group compared to cancer-inducing group (TCN). In groups that received ChS, PSA levels (P=0.71) were significant compared with TCN group. The VII group had the lowest prostate volume by sonography. The TCN group showed multiple foci of high-grade prostatic intraepithelial neoplasia (HG-PIN) with the presence of cells in mitosis; whilst, groups V and VI had few areas of HG-PIN. Conclusion In experimental conditions, the ethanolic extract of C. spinosa in association with simvastatin showed a protective effect on prostate cancer through hypolipidemic and antioxidant activity.

espanolEl objetivo de la investigacion presentada en este articulo es analizar el impacto de planes de mejoramiento institucional (PMI) en resultados de acreditacion para institutos tecnicos de nivel superior en Chile, entendiendo que asegurar la calidad es crucial para ofrecer servicios educacionales de excelencia, siendo la acreditacion su indicador de logro. Mediante metodologia cualitativa, se revisaron resultados de acreditacion institucional, analizando fortalezas y debilidades para las areas evaluadas. Los resultados muestran que, si bien existe una relacion relativa entre implementacion de PMI y anos de acreditacion obtenidos, los datos recogidos son insuficientes para demostrar su impacto; esto se debe a que no se encontraron relaciones entre las areas evaluadas y las mejoras propuestas por PMI. En conclusion, se recomienda una revision exhaustiva de asignacion de recursos, asi como de las condiciones en las que se implementan debiendo identificarse su impacto en la mejora de la calidad en Chile. EnglishThe objective of this research is to analyze the impact of Institutional Improvement Plans (PMI) on accreditation results for the Higher-level Technical Institutes, in Chile, understanding that ensuring quality is crucial to providing educational services of excellence, being accreditation its achievements indicator. Through a qualitative methodology, the results of institutional accreditation were reviewed, by analyzing strengths and weaknesses for the areas assessed. The results show that while is there a relative relationship between the implementation of PMI and the accreditation-years obtained, the data collected are insufficient to demonstrate its impact, since the relationships between the areas evaluated and the improvements proposed by the PMI were not found. In conclusion, it is recommended to perform a comprehensive review of the allocation of resources and conditions under which it is applied, as well as the identification of its true impact on quality improvement, in Chile.

Systemic embolization has been reported in up to 40% of patients with left atrial myxoma, half of them with cerebral involvement. However, development of intracerebral embolization associated with parenchymal seeding of the myxoma emboli is an extremely rare complication, with only 36 histologically diagnosed cases reported in the published literature. We describe a 69-year-old woman who arrived at the emergency service with hemiparesis associated with drug-resistant epilepsy and a medical history of resection of a left atrial myxoma 10 months previously. Cranial computed tomography revealed multiple large lesions of heterogeneous density and cystic components in the occipital lobes and posterior fossa parenchyma. Histopathological analyses after stereotactic biopsy of the occipital lesion revealed infiltrative myxoma cells with benign histological findings and uniform expression of calretinin similar to that of the primary cardiac myxoma. Additional immunohistochemical studies confirmed brain parenchymal seeding of the myxoma cells with strong expression of interleukin-6 (IL-6) and focal expression of matrix metalloproteinases-2 (MMP-2). Here, we discuss the clinicopathological features of intracerebral embolization of left atrial myxomas associated with progressive parenchymal seeding of the tumor emboli and the potential pathogenic role of IL-6 and MMPs.

Fabry disease (FD), like COVID-19, can affect multiple organs, including the lungs. Patients with FD would be expected to develop severe forms of COVID-19, not only because of lung involvement but also because of renal involvement and other comorbidities. We present two cases of patients with Fabry disease who had an infection by COVID-19. In the two cases presented, they presented mild forms of COVID-19. Although the role of the X chromosome mutation in FD on the development of severe forms of COVID-19 is unknown; in the cases presented, it is suggested that it may play a protective role in the development of COVID-19. Two cases are presented; it is suggested that FD would not be a risk factor for severe COVID-19.

The present study describes the behavior of mood states in high performance athletes belonging to a University team in the national championship. For this purpose, twenty-five athletes were surveyed using the “Profile of Mood States” (POMS) instrument, in their adapted version, before (pretest) and immediately after (post-test) competing in the national final of the University Sports Leagues of Chile. The test consisted of 51 adjectives, grouped into five big factors: tension, depression, anger, vigor and fatigue. In the pretest, the factors that presented a higher score on the scale of 0-4 were: vigor (2.59), tension (1.57), followed by fatigue (.99), anger (.43) and depression (.34). In the posttest: vigor (1.66) and fatigue (1.39), followed by anger (.66), tension (.64) and depression (.33). Significant differences were found (on the basis of the value p≤.05) in the pretest vs. post-test for tension and vigor, with higher values in both cases than in the pretest. In conclusion, the tension and vigor factors are higher before to the competition, decreasing after the competition. These results could help coaches and professionals in the athletes’ preparation for important competitions.

Potato tocosh is a naturally processed potato for nutritional and curative purposes from traditional Peruvian medicine. The aim of this study was to investigate the acute and sub-acute toxicity of tocosh flour (TF). For sub-acute toxicity, TF was administered orally to rats daily once a day for 28 days at doses of 1000 mg/kg body weight (BW). Animals were observed for general behaviors, mortality, body weight variations, and histological analysis. At the end of treatment, relative organ weights, histopathology, hematological and biochemical parameters were analyzed. For acute toxicity, TF was administered orally to mice at doses of 2000 and 5000 mg/kg BW at a single dose in both sexes. Body weight, mortality, and clinical signs were observed for 14 days after treatment. The results of acute toxicity showed that the median lethal dose (LD50) value of TF is higher than 2000 g/kg BW but less than 5000 mg/Kg BW in mice. Death and toxicological symptoms were not found during the treatment. For sub-acute toxicity, we found that no-observed-adverse-effect levels (NOAEL) of TF in rats up to 1000 g/kg BW. There were statistically significant differences in body weight, and relative organ weight in the stomach and brain. No differences in hematological and biochemical parameters were observed when compared with the control group. For sub-acute toxicity, histopathological studies revealed minor abnormalities in liver and kidney tissues at doses of 5000 mg/Kg. Based on these results, TF is a traditional Peruvian medicine with high safety at up to 1000 mg/kg BW for 28 days in rats.

Con base en el estudio de especies realizado en las áreas protegidas dentro del estado de Hidalgo, identificamos un espécimen de martucha cazado en la porción sur del municipio de Zacualtipan. El espécimen fue cazado durante la primera semana de mayo de 2016. Confirmamos la presencia reciente de la especie en el estado de Hidalgo y en la Reserva de la Biosfera Barranca de Metztitlán. Por lo tanto, esperamos realizar más estudios en esta área que brinden una mejor comprensión de este taxón en México y su asociación con la pérdida de vegetación.

Intravascular leiomyomatosis is a rare condition characterized by histologically benign smooth muscle cell growth within the uterine veins and inferior vena cava and, rarely, into the right chambers of the heart. A 39-year-old female with a history of hysterectomy for uterine leiomyoma was admitted for lower limb oedema and progressive dyspnea of 5 months' duration. Transthoracic echocardiography and contrast-enhanced computed tomography showed a large mass extending through the inferior vena cava into the right chambers of the heart. As there was a suspicion of an intravenous thrombus, the patient underwent surgical resection. The histopathology of the resected mass led to a diagnosis of Intravascular leiomyomatosis with intracardiac extension.

Potato tocosh is a naturally processed potato for nutritional and curative purposes from traditional Peruvian medicine. The aim of this study was to investigate the acute and sub-acute toxicity of tocosh flour (TF). For sub-acute toxicity, TF was administered orally to rats daily once a day for 28 days at doses of 1000 mg/kg body weight (BW). Animals were observed for general behaviors, mortality, body weight variations, and histological analysis. At the end of treatment, relative organ weights, histopathology, hematological and biochemical parameters were analyzed. For acute toxicity, TF was administered orally to mice at doses of 2000 and 5000 mg/kg BW at a single dose in both sexes. Body weight, mortality, and clinical signs were observed for 14 days after treatment. The results of acute toxicity showed that the median lethal dose (LD50) value of TF is higher than 2000 g/kg BW but less than 5000 mg/Kg BW in mice. Death and toxicological symptoms were not found during the treatment. For sub-acute toxicity, we found that no-observed-adverse-effect levels (NOAEL) of TF in rats up to 1000 g/kg BW. There were statistically significant differences in body weight, and relative organ weight in the stomach and brain. No differences in hematological and biochemical parameters were observed when compared with the control group. For sub-acute toxicity, histopathological studies revealed minor abnormalities in liver and kidney tissues at doses of 5000 mg/Kg. Based on these results, TF is a traditional Peruvian medicine with high safety at up to 1000 mg/kg BW for 28 days in rats.

Cardiac myxomas are the most common primary tumors of the heart. Although these tumors have been reported in all cardiac chambers, myxomas arising from heart valves are extremely rare. Here, the details are described of a patient with mitral valve myxoma, and a review is provided of 99 cases reported in the literature. Mitral valve myxomas most often occur in middle-aged patients, with a slight female predominance. Most of the tumors arise in an isolated fashion on the atrial side of the anterior mitral valve leaflet. Embolic events were the most frequent manifestation, followed by obstructive symptoms. Unlike atrial wall myxomas, these tumors have a lower incidence of constitutional manifestations. Tumor resection with valve preservation is the usual method of surgical treatment in isolated tumors, while most patients with multiple valve myxomas underwent valve replacement. Mitral valve myxomas should be considered in the differential diagnosis of mitral valve tumors, with an awareness of a relatively high risk of embolic events. This location should not raise suspicion for a heritable myxoma syndrome. Prompt surgical resection is warranted to reduce complications.

Objetivos. Describir las características histopatológicas de los explantes cardiacos y las biopsias endomiocárdicas postrasplante realizadas en un centro de referencia nacional del Perú. Materiales y métodos. Estudio de una serie de casos de pacientes sometidos a trasplante cardiaco entre marzo de 2010 y febrero de 2018. Resultados. Los 61 pacientes trasplantados, tuvieron un promedio de edad de 40,1 (rango: 9-66 años). Cinco casos (8,2%) diagnosticados inicialmente como miocardiopatía dilatada fueron reclasificados después del estudio histopatológico. Las tres primeras causas de enfermedad primaria previa al trasplante fueron: miocardiopatía dilatada idiopática (50,8%), cardiopatía isquémica (16,4%), y cardiopatía valvular (6,6%). El seguimiento promedio fue de 2,8 años. La tasa de supervivencia después del trasplante fue del 85,1% al año y del 82,8% a los cinco años. El rechazo celular agudo moderado/severo ocurrió en 12 pacientes (21,1%) y el rechazo mediado por anticuerpos ocurrió en tres pacientes (5,3%). Conclusiones. La evaluación histopatológica rutinaria del explante cardiaco es esencial para confirmar la etiología de la insuficiencia cardíaca, especialmente en los casos diagnosticados clínicamente como miocardiopatía dilatada. Asimismo, el seguimiento rutinario mediante biopsias endomiocárdicas muestra que el rechazo celular agudo continúa siendo una complicación frecuente durante el primer año de trasplante, y que el rechazo mediado por anticuerpos tiene una baja frecuencia en nuestra población. Objetive. To describe the histopathological characteristics of explanted hearts and post-transplant biopsy specimens at a national reference center in Peru. Materials and Methods. A case series study of patients who underwent heart transplantation between March 2010 and February 2018. Results. Sixty-one (61) transplanted patients with a mean age of 40.1 years (range: 9-66 years). Five cases (8.2%) initially diagnosed as dilated cardiomyopathy were reclassified after the histopathological study. The three leading causes of primary disease after transplantation were: idiopathic dilated cardiomyopathy (50.8%), ischemic cardiomyopathy (16.4%), and valvular cardiomyopathy (6.6%). The mean follow-up was 2.8 years. The post-transplant survival rate was 85.1% at 1 year and 82.8% at 5 years. Moderate/severe acute cellular rejection occurred in 12 patients (21.1%) and antibody-mediated rejection occurred in 3 patients (5.3%). Conclusions. Routine histopathological evaluation of the explanted heart is essential to confirm the etiology of heart failure, especially in cases clinically diagnosed as dilated cardiomyopathy. In addition, routine follow-up through endomyocardial biopsies shows that acute cellular rejection is still a frequent complication after a heart transplant, especially within the first year, and that antibody-mediated rejection has a low incidence in our population.

Peripheral T-cell lymphoma (PTCL) encompasses a group of rare and aggressive lymphomas. PTCL, unspecified (PTCLU) is the most common subtype of PTCL, and carries a poor prognosis. The International Prognostic Index (IPI) and the Prognostic Index for PTCLU (PIT) scoring systems are powerful risk-stratification tools in patients with PTCL. The aim of this study was to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor in PTCLU. We retrospectively studied 83 patients with diagnosis of PTCLU. In the univariate analysis, NLR ≥ 4 was associated with worse overall survival (HR 3.96, 95% CI 1.92–8.17; p < 0.001). In the multivariate analysis, NLR ≥ 4 was independently associated with worse overall survival after adjustment for the PIT score (HR 4.30, 95% CI 1.90–9.69; p < 0.001), and for the IPI score (HR 2.60, 95% CI 1. 12–6.04; p = 0.03). Our study suggests the NLR could be helpful in refining the survival prognostication in patients with PTCLU.

Primary cardiac neoplasms are rare. However, among them, cardiac myxoma is the most common tumor. In contrast, primary cardiac lymphoma within a cardiac myxoma is extremely rare and might be difficult to diagnose because of non-specific clinical manifestations. We report the case of a previously healthy 52-year-old man who presented with acute onset of transient dysarthria and left hemiplegia. A transthoracic echocardiography showed a 6×2.5-cm solid mass in the left atrium, which was subsequently resected. Histological, immunohistochemical, and molecular analyses revealed an EBV-associated CD30-positive large B-cell lymphoma with anaplastic morphology within a cardiac myxoma and fibrinous material. Staging studies showed no evidence of lymphoma elsewhere. The patient achieved complete remission and is alive 42 months after diagnosis, and did not receive chemotherapy. We discuss the clinical and pathologic features of lymphoma arising in cardiac myxoma or in intra-atrial fibrinoid mass and the potential role of IL-6 in its pathogenesis.

To describe the histopathological characteristics of explanted hearts and post-transplant biopsy specimens at a national reference center in Peru.A case series study of patients who underwent heart transplantation between March 2010 and February 2018.Sixty-one (61) transplanted patients with a mean age of 40.1 years (range: 9-66 years). Five cases (8.2%) initially diagnosed as dilated cardiomyopathy were reclassified after the histopathological study. The three leading causes of primary disease after transplantation were: idiopathic dilated cardiomyopathy (50.8%), ischemic cardiomyopathy (16.4%), and valvular cardiomyopathy (6.6%). The mean follow-up was 2.8 years. The post-transplant survival rate was 85.1% at 1 year and 82.8% at 5 years. Moderate/severe acute cellular rejection occurred in 12 patients (21.1%) and antibody-mediated rejection occurred in 3 patients (5.3%).Routine histopathological evaluation of the explanted heart is essential to confirm the etiology of heart failure, especially in cases clinically diagnosed as dilated cardiomyopathy. In addition, routine follow-up through endomyocardial biopsies shows that acute cellular rejection is still a frequent complication after a heart transplant, especially within the first year, and that antibody-mediated rejection has a low incidence in our population.Describir las características histopatológicas de los explantes cardiacos y las biopsias endomiocárdicas postrasplante realizadas en un centro de referencia nacional del Perú.Estudio de una serie de casos de pacientes sometidos a trasplante cardiaco entre marzo de 2010 y febrero de 2018.Los 61 pacientes trasplantados, tuvieron un promedio de edad de 40,1 (rango: 9-66 años). Cinco casos (8,2%) diagnosticados inicialmente como miocardiopatía dilatada fueron reclasificados después del estudio histopatológico. Las tres primeras causas de enfermedad primaria previa al trasplante fueron: miocardiopatía dilatada idiopática (50,8%), cardiopatía isquémica (16,4%), y cardiopatía valvular (6,6%). El seguimiento promedio fue de 2,8 años. La tasa de supervivencia después del trasplante fue del 85,1% al año y del 82,8% a los cinco años. El rechazo celular agudo moderado/severo ocurrió en 12 pacientes (21,1%) y el rechazo mediado por anticuerpos ocurrió en tres pacientes (5,3%).La evaluación histopatológica rutinaria del explante cardiaco es esencial para confirmar la etiología de la insuficiencia cardíaca, especialmente en los casos diagnosticados clínicamente como miocardiopatía dilatada. Asimismo, el seguimiento rutinario mediante biopsias endomiocárdicas muestra que el rechazo celular agudo continúa siendo una complicación frecuente durante el primer año de trasplante, y que el rechazo mediado por anticuerpos tiene una baja frecuencia en nuestra población.

Leiomyosarcomas arising from the wall of blood vessels are rare and aggressive neoplasm. We report a case of a previously healthy 66-year-old woman who presented with intermittent abdominal pain, progressive constipation, and weight loss. Abdominal computed tomography showed a 12 cm solid heterogeneous tumor in the tail of the pancreas. The patient subsequently underwent surgical resection of the pancreatic mass. Surprisingly, histological and immunohistochemical analyses revealed leiomyosarcoma arising from the smooth muscle of the splenic vein. After surgery, she received adjuvant chemotherapy. One year later, there was no evidence of local recurrence. In this paper, we discuss the available information about leiomyosarcomas of splenic vein and its management.

Intravascular leiomyomatosis is a rare condition characterized by histologically benign smooth muscle cell growth within the uterine veins and inferior vena cava and, rarely, into the right chambers of the heart. A 39-year-old female with a history of hysterectomy for uterine leiomyoma was admitted for lower limb oedema and progressive dyspnea of 5 months' duration. Transthoracic echocardiography and contrast-enhanced computed tomography showed a large mass extending through the inferior vena cava into the right chambers of the heart. As there was a suspicion of an intravenous thrombus, the patient underwent surgical resection. The histopathology of the resected mass led to a diagnosis of Intravascular leiomyomatosis with intracardiac extension.

Primary cardiac osteosarcoma is a rare and aggressive neoplasm that can be difficult to diagnose. We report a case of a previously healthy 49-year-old woman who presented with dyspnea, atrial flutter, and heart failure. A mass was visualized in her left atrium by echocardiography and cardiac computed tomography, and the diagnosis of cardiac myxoma was raised. The patient subsequently underwent surgical resection of the mass and atrial reconstruction. Surprisingly, histological and immunohistological analyses revealed the mass to be an osteosarcoma. The patient received chemotherapy and radiotherapy. Eight months later, she has shown evidence of local recurrence. We briefly discuss primary osteosarcomas in the cardiac cavity and their management.