[Update on functional mitral regurgitation: a comprehensive review]. / Actualización en insuficiencia mitral funcional: una revisión integral.

In recent decades, the advances in the management of functional mitral regurgitation (MR), makes knowledge of this disease extremely important to the clinical cardiologist, as it has an increasing prevalence in patients older than 50 years. The objective of this article is to review the pathophysiological bases of MR, in order to differentiate its mechanism, and to correlate them with the clinical, hemodynamic, and imaging findings that assess the severity of the disease. These data are relevant for the adequate selection of the patient and the opportune moment of the therapeutic interventions, which involves a multidisciplinary team in decision-making to achieve the greatest benefit within the treatment options of this pathology.

Attached right aortic valve leaflet causing ischemia and severe regurgitation: Successful repair with Ozaki technique.

INTRODUCTION: Coronary artery occlusion due to fusion of a leaflet to the sinotubular junction is a rare finding that we should consider in the differential diagnosis of young patients who have aortic regurgitation and angina. PATIENT AND METHOD: We present a young female with severe aortic regurgitation due to right coronary fusion who underwent mini-invasive aortic valve reconstruction. RESULTS: Postoperative evolution was satisfactory. The patient was discharged on the 5th postoperative day and after 3.5 years of follow-up he remains in functional class I, without anticoagulant treatment and with mild aortic regurgitation. COCNCLUSION: The Ozaki technique can be used in patients with aortic regurgitation due to single leaflet dysfunction.

[Invasive hemodynamic monitoring by Swan-Ganz pulmonary artery catheter: concepts and utility]. / Monitoreo hemodinámico invasivo por catéter de arteria pulmonar Swan-Ganz: conceptos y utilidad.

Since its beginnings in the last century, pulmonary artery catheterization (PAC) has evolved into an invasive hemodynamic evaluation technique that can be performed at the patient's bedside through a Swan-Ganz catheter; this procedure has maintained an intermittent course in terms of its use; however, it has currently demonstrated relevance in specific scenarios. The PAC allows access to the central venous circulation, the right heart and the pulmonary artery; it performs the calculation of hemodynamic variables directly or indirectly by means of established formulas and methods. This makes possible to perform an adequate hemodynamic evaluation and classification, perform specific tests (e.g. vasoreactivity test), which help to define the diagnosis, therapeutic , monitor the response to treatment, evaluation prior to advanced therapies (e.g. cardiac transplantation or mechanical circulatory assistance devices), and prognosis in our patients. In this article we discuss the concepts and usefulness of pulmonary artery catheterization.

[Should I treat a high-risk chronic coronary syndrome in an invasive way from the beginning? No, in most cases]. / Controversias en Cardiología. Parte 2. ¿Debo tratar un síndrome coronario crónico de alto riesgo invasivamente desde el inicio? No, en la mayoría de casos.

The definition of the high-risk chronic coronary syndrome varies depending on the noninvasive test used to trigger ischemia. The triggering occurs through increased myocardial work and oxygen demand, either through exercise or drugs. The initial approach to the chronic coronary syndrome leads us to discuss in which cases to prioritize an optimal initial medical therapy or to perform an initial invasive procedure of myocardial revascularization. In this article, we analyze both approaches based on previous studies carried out to date, where the initial invasive management has not been shown to be superior to initial optimal medical therapy in outcomes such as death or major adverse cardiovascular events.

Efecto sobre la motilidad intestinal del extracto de alcaloides de semilla de Jatropha curcas L. / Effect of the alkaloid extract from Jatropha curcas L. seeds on the intestinal motility

Introducción: estudios preclínicos del extracto total de la raíz de Jatropha curcas L. (piñón blanco) demostraron su efecto antidiarreico, en contraste, ensayos de toxicidad crónica del extracto total de la semilla muestran efecto diarreico. Objetivo: determinar el efecto sobre la motilidad intestinal del extracto de alcaloides de semilla de Jatropha curcas L. Métodos: se utilizaron 50 ratones albinos con pesos medios de 25 g, se empleó el método de Arbós y otros; se administró carbón activado al 5 % vía oral, dosis de 0,1 mL/10 g, como marcador intestinal. Los grupos experimentales fueron: agua destilada 0,1 mL/10 g, atropina 1 mg/kg, extracto de alcaloides de semilla de Jatropha curcas 500 y 1 000 mg/kg, respectivamente, y neostigmina 1 g/kg. Para la validación estadística se usó la prueba de Kruskal-Wallis, ANOVA, Tukey, y Newman-Keuls. Resultados: el porcentaje de recorrido del carbón activado fue de 69,21; 36,37; 58,96; 49,65 y 74,17, respectivamente. La prueba de ANOVA demostró diferencias estadísticas (p< 0,05; IC 95 %), y la prueba de Tukey y Newman-Keuls, demostraron diferencias significativas entre el grupo que recibió agua destilada y la planta a 1 000 mg/kg. Conclusiones: se comprobó efecto de disminución de la motilidad intestinal por acción del extracto de alcaloides de Jatropha curcas, en dosis de 1 000 mg/kg.

Introduction: preclinical research studies of Jatropha curcas L. (piñón blanco) root extract proved its antidiarrheal activity; however the chronic toxicity test of the total seed extract demonstrated diarrheal effect. Objectives: to determine the effect of the alkaloid extract from Jatropha curcas L. seeds on the gastrointestinal motility. Methods: fifty albino mice with average weight of 25 g were used. The Arbos et al.´s method was applied. The intestinal marker was 5 % activated charcoal administered at a dose of 0.1 mL/10 g. The experimental groups included 0.1 mL/10 g of distilled water, 1.5 mg/kg of atropine, alkaloid extract of Jatropha curcas L. seeds at doses of 500 and 1 000 mg/kg respectively, and 1 g/kg of neostigmine The statistical validation was based on Kruskal-Wallis test, ANOVA, and Tukey and Newman-Keuls test. Results: the percentages of the charcoal run were 69.21, 36.37, 58.96, 49.65, and 74.17 respectively. The ANOVA test demonstrated statistical significance (p< 0.05, IC 95 %). Comparative Tukey and Newman-Keuls test showed statistical significance between distilled water and Jatropha curcas at a dose of 1 000 mg/kg. Conclusions: the decrease on the gastrointestinal motility resulting from the effect of the alkaloid extract of Jatropha curcas seeds was proved at a dose of 1 000 mg/kg.

Estado Nutricional en niños de 6 a 10 años de edad de la comunidad infantil "Sagrada Familia". Lima, Marzo 2011 / Nutritional status in children 6 to 10 year old child

OBJETIVO: Describir el estado nutricional de niños de 6 a 10 años, de la Comunidad de Niños ôSagrada Familiaõ de Lima-Perú, durante marzo 2011. MATERIAL Y MÉTODO: Estudio descriptivo, transversal y prospectivo. Se estudió a 126 niños y niñas entre 6 y 10 años. Se consideró como variables: peso, talla e IMC. Para los diagnósticos de malnutrición se utilizaron: índices de Peso/edad, Talla/edad e IMC/edad, según el criterio actual de la OMS. Se determinó el valor ôzõ mediante programa OMS-AnthroPlus v1.0.4. El análisis de datos se realizó con el programa SPSS v15.0. RESULTADOS: 73% hombres y 27% mujeres, la mayoría tenían 10 años (29,4%). La media de peso, talla e IMC fueron 25,23 kg; 122,14 cm y 16,82 kg/m2. En cuanto al diagnóstico nutricional; 5,6% de niños presentaron desnutrición global, 23,8% desnutrición crónica, 21,4% sobrepeso y 2,4% obesidad, los hombres presentaron mayor porcentaje de desnutrición global (7,7%), desnutrición crónica (27,5%) y sobrepeso (23,1%), en cambio las mujeres presentaron mayor porcentaje de obesidad (2,9%). 71,4% de niños con desnutrición global eran desnutridos crónicos, 22,2% con sobrepeso poseían desnutrición crónica y 100% de obesos tenían crecimiento normal. CONCLUSIONES: El diagnóstico de malnutrición con mayor prevalencia es la desnutrición crónica. Además, se encontró solo casos de desnutridos crónicos con sobrepeso. Por tanto, a pesar que la desnutrición crónica está disminuyendo, no evita que sea la de mayor prevalencia a nivel escolar.

OBJETIVE: To describe the nutritional status of children from 6 to 10 years of age in the ôSagrada Familiaõ child community in Lima, Perú, in March 2011. MATERIALS AND METHOD: Type of study is descriptive, transversal and prospective. We studied 126 children between 6 and 10 years of the ôSagrada Familiaõchild community. The variables considered were weight, height and BMI as well as the diagnosis of malnutrition rates using weight / age, height / age and BMI / age current WHO criteria. We determined the value ôzõ using WHO-AnthroPlus v1.0.4. Data analysis was performed using SPSS v15.0. RESULTS: 73% were male and 27% female, most were 10 years of age (29.4%). Mean weight, height and BMI were 25.23 kg, 122.14 cm and 16.82 kg/m2 respectively. As for the nutritional diagnosis, 5.6% of children had global malnutrition, 23.8% had chronic malnutrition, 21.4% were overweight and 2.4% obese, males had a higher percentage of global malnutrition (7.7%), chronic malnutrition (27.5%) and overweight (23.1%), whereas women had a higher percentage of obesity (2.9%). 71.4% of children with global malnutrition had chronic malnutrition, 22.2% who were overweight had chronic malnutrition, and 100 % of obese have normal growth. CONCLUSIONS: The diagnosis of malnutrition is most prevalent as chronic malnutrition. It was also found only cases of chronically undernourished with overweight. Therefore, although chronic malnutrition is declining, it doesn´t stop being the most prevalent at school level.