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Rheumatic heart disease is the leading cause of cardiovascular disease in children under 25 years of age worldwide, with the highest prevalence in low-income countries. The usual and distinctive finding of rheumatic aggression is mitral stenosis, which leads to serious cardiovascular consequences. International guidelines establish transthoracic echocardiography (TTE) as the diagnostic test for rheumatic heart disease; however, it has limitations in the measurement of planimetry and those inherent to Doppler. Transesophageal 3D echocardiography (TTE-3D) is a new modality that shows realistic images of the mitral valve and has the added value of accurately locating the plane of maximum stenosis and better determining commissural involvement.
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Objective: To analyze the clinical and angiographic characteristics of patients with coronary ectasia found on coronary angiography. Materials and methods: : Descriptive study of patients admitted to the cardiac catheterization laboratory of the Hospital Guillermo Almenara with coronary ectasia, during the years 2012 to 2020. The frequency of coronary ectasia, clinical, angiographic and coronary flow characteristics were determined. Results: 7504 catheterizations were reviewed, and 91 patients were found to have coronary ectasia (1.21%). Of these patients, 71 cases were male (78%), and the mean age was 67.74 ± 9.9 years. The 38.5% of cases were obese or overweight; 39.6% were hypertensive; 11% diabetic; 13.2% smoked; 3.3% had chronic kidney disease and 3.3% had polyglobulia. Sixty-one percent of cases had a diagnosis of acute coronary syndrome, and 24% of cases had high-risk stable angina. The artery most frequently involved by ectasia was the right coronary artery (70%). The average diameter of the ectatic artery was 5.7 mm. Occlusive thrombus was found in 19.8% of cases. There was a significant association between TIMI flow and diameter of the ectatic artery (p=0.000), and there was also an association between coronary ectasia and acute coronary syndrome among patients living at an altitude of more than 2500 m (p=0.000). Conclusions: coronary ectasia was an infrequent entity among patients who underwent coronary angiography, was predominantly male, mainly involved the right coronary artery, was associated with lower TIMI flow, and acute coronary syndrome among residents above 2500 m of altitude.
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BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown. AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries. METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms. RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms. CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.
Subject(s)
COVID-19 , Cardiovascular Diseases/epidemiology , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Diabetes Mellitus/epidemiology , Metabolic Syndrome/epidemiology , Adult , Aged , Cardiovascular Diseases/psychology , Coronary Artery Disease/epidemiology , Coronary Artery Disease/psychology , Depression/psychology , Depressive Disorder, Major/psychology , Diabetes Mellitus/psychology , Diet/statistics & numerical data , Dyslipidemias/epidemiology , Dyslipidemias/psychology , Eating , Exercise/psychology , Female , Fruit , Heart Failure/epidemiology , Heart Failure/psychology , Humans , Hypertension/epidemiology , Hypertension/psychology , Latin America/epidemiology , Male , Mental Health , Metabolic Syndrome/psychology , Middle Aged , SARS-CoV-2 , Sex Factors , Stroke/epidemiology , Stroke/psychology , Surveys and Questionnaires , Treatment Adherence and Compliance/psychology , Treatment Adherence and Compliance/statistics & numerical data , VegetablesABSTRACT
Objectives: During acute infection by the SARS-CoV-2 virus, myocardial involvement has been demonstrated; it is unknown if cardiovascular sequelae in patients recovered from this infection and if these are associated with global morbidity and mortality. The objective of this study was to compare myocardial deformation in patients recovered from mild SARS-CoV-2 virus infection with healthy controls. Materials and methods: This was a cross-sectional observational study that included 33 subjects recovered from mild SARS-CoV-2 infection, who were diagnosed in the previous three to six months, and 31 healthy volunteers, both groups free of cardiovascular risk factors. The study of myocardial deformation was performed using echocardiography with the speckle tracking modality. Clinical and anthropometric variables were compared. Results: The 2D global longitudinal strain of the left ventricle was lower in the subjects recovered from mild SARS-CoV-2 infection than the controls (-20.2% ± 2.6 v -21.6% ± 2.4; p: 0.036). Both groups presented differences in the three ventricular levels, significant at the apical level (-21.2 ± 4.0 vs -23.4% ± 4.2; p: 0.044). The effect by levels shows an inverse Takotsubo pattern. The left ventricular ejection fraction was preserved in both groups (p: 0.153). Conclusions: Left ventricular myocardial deformation is affected in subjects recovered from mild SARS-CoV-2 infection, while the ejection fraction was found in normal ranges. Our study shows a potential role of global longitudinal strain in the detection of subclinical myocardial alterations in patients who had SARS-CoV-2.
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OBJECTIVES: To determine the clinical epidemiological characteristics of young adult patients with colorectal cancer. MATERIALS AND METHODS: Information collected by the Direccion General de Epidemiologia by the surveillance strategy in non-communicable diseases for the period 2006-2014 was requested. The rate of age-adjusted incidence and a descriptive statistical analysis of the variables studied were calculated. RESULTS: 1261 CRC cases were reported in patients between 20-49 years of age. The annual percentage change (APC) for the incidence is declining -0.09% (p=0.004). The CPA for CRC cases was -3.9% in men (p=0.009) and -5.22% in women (p=0.014). 640 women and 621 men were reported. Most cases of CRC in the studied population is the group of 40-49 years with 60.3% of cases. Lima was the region with the highest number of reported cases (42.6%). 63.7% of CRC cases were represented by colon tumors. CONCLUSIONS: Based on case reports provided by the DGE, there is a trend of decrease in the incidence of CRC cases in young adults Peruvian in the last 10 years.
Subject(s)
Colorectal Neoplasms/epidemiology , Adult , Age Distribution , Colorectal Neoplasms/diagnosis , Female , Humans , Incidence , Male , Middle Aged , Peru/epidemiology , Young AdultABSTRACT
Objetivos: Determinar las características clínico epidemiológicas de pacientes adultos jóvenes con cáncer colorrectal. Materiales y métodos: Se solicitó la información recolectada por la Dirección General de Epidemiología mediante la estrategia de vigilancia en enfermedades no transmisibles durante el periodo 2006-2014. Se calculó la tasa de incidencia ajustada para la edad y un análisis estadístico descriptivo de las variables estudiadas. Resultados: Se reportaron 1261 casos de CCR en pacientes entre 20 a 49 años de edad. El cambio porcentual anual (CPA) en la muestra estudiada para la incidencia presentó un descenso para este periodo de -0,09% (p=0,004). El CPA para los casos de CCR fue de -3,9% en hombres (p=0,009) y -5,22% en mujeres ( p=0,014). Se reportaron 640 mujeres y 621 varones. La mayor cantidad de casos de CCR en la población estudiada corresponde al grupo de 40-49 años con el 60,3% de casos. Lima constituyó la región con mayor número de casos reportados (42,6%). El 63,7% de casos de CCR estuvo representado por tumores de colon. Conclusiones: En base al reporte de casos proporcionada por la DGE, existe una disminución en la tendencia de la incidencia de los casos de CCR en adultos jóvenes peruanos en los últimos 10 años.
Objectives: To determine the clinical epidemiological characteristics of young adult patients with colorectal cancer. Materials and methods: Information collected by the Direccion General de Epidemiologia by the surveillance strategy in non-communicable diseases for the period 2006-2014 was requested. The rate of age-adjusted incidence and a descriptive statistical analysis of the variables studied were calculated. Results: 1261 CRC cases were reported in patients between 20-49 years of age. The annual percentage change (APC) for the incidence is declining -0.09% (p=0.004). The CPA for CRC cases was -3.9% in men (p=0.009) and -5.22% in women (p=0.014). 640 women and 621 men were reported. Most cases of CRC in the studied population is the group of 40-49 years with 60.3% of cases. Lima was the region with the highest number of reported cases (42.6%). 63.7% of CRC cases were represented by colon tumors. Conclusions: Based on case reports provided by the DGE, there is a trend of decrease in the incidence of CRC cases in young adults Peruvian in the last 10 years.