[Fast pathway for heart surgery]. / Vía rápida para cirugía cardiaca.

The increasing demographic and life expectancy rates, together with the vertiginous technological development during the last two decades, have raised the number of cardiac patients requiring surgical treatment. Therefore, several institutions have been forced to give priority to advanced or more serious cases and to postpone those that do not demand an urgent surgery. This analysis was made from June 15, 1999 to June 15, 2000 and demonstrates the results obtained from maintaining a fast track at the National Institute of Cardiology "Ignacio Chávez". This has favored the practice of surgeries in cases with noncomplex pathologies, null mortality, and low morbidity rates. The analysis also compares results from patients who had been subjected to surgery for the same type of pathologies but following the usual course of admittance and surgery scheduling, proving to be cost-efficient. It also demonstrates the high incidence of inter-auricular communication and the Von Willebrand disease that exist in our environment. Based on the results, we propose to maintain and increase this type of surgeries, addressing their limitations.

[Uterine leiomyosarcoma which spread through the vena cava to the pulmonary artery]. / Leiomiosarcoma uterino propagado por vena cava hasta arteria pulmonar.

We describe a case of uterine leiomyosarcoma with four elongations that, through the vena cava, reached the pulmonary artery, left atrium, and right renal artery respectively. Clinical features suggested congenital pulmonary artery stenosis with pulmonary emboli. Clinical diagnosis was not made in spite of angiography and radionuclide scans. We review the literature on the subject. We also discuss the amenability of surgical correction as well as the mechanisms of the intravenous growth of this type of tumor.

[Socio-medical problems of senescence]. / Problemas socio médicos de la senectud.

Epidemiological studies by international groups have shown a demographic structure which in Latin America, by the year 2000, will cause especially complex problems demanding important social, political and economic changes. Between them, they emphasize the overall increase of population size (more than doubling, from 280 to 600 million people), the large urban concentration (64% of the total population), with rural depopulation, on 18% decrease in fertility, and an increased life expectancy. With regard to this point, 36 Latin American and Caribean countries will have an average life expectancy of 65 years, and 19 of 70 years. Increased longevity, causing a large elderly population, is an achievment of civilisation, but is also an overwhelming problem. Biophysiological and psychological considerations of the ageing process are raised, as are the inherent problems of forced retirement, which have influence in working, emotional and family sheres, in a poorly-understanding society, too disorganized to provide help. This, by feedback, creates a special emotional deterioration in the elderly individual (considered for this purpose as being an age of more than 60 years for men, and 55 years for women), which is made considerably worse by increased incidence of illness. The need for, and importance of, social care for this group, which concalves health as part of the greater concept of wellbeing and quality of life, is emphasized. It shows how the modern concept of social welfare as part of the state, with reference to securing the wellbeing of the elderly, should not be a charity which is offered but an obligation.(ABSTRACT TRUNCATED AT 250 WORDS)