Unexpected diagnosis: large hemangioma in the interatrial septum.

BACKGROUND: Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare. CASE PRESENTATION: We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma. CONCLUSIONS: Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis.

The Gap in Sustainable Food Services in Public Institutions: The Perceptions of Young Consumers from Public Universities in the Madrid Region (Spain).

The agri-food system needs to transition into a more balanced system that takes into account economic, social, and environmental factors. Young people are a key demographic group to consider as they are open to new trends of consumption, including sustainable buying practices. Public universities can play a significant role in promoting sustainable and healthy eating habits among students. In this paper, we focus on the perceptions of young people regarding sustainable food in the Madrid Region. We conducted a survey using a questionnaire-based approach among 1940 students in 2022. The results highlight that young consumers are highly concerned about food sustainability. They perceive sustainability as local and non-processed foods. However, this perception varies among young consumers, and we identified five different consumer profiles. Principal component analysis and cluster analysis provide insights into potential actions that universities can take to promote sustainable and healthy eating habits among students.

Mapping Adolescents' Sense of Place and Perceptions of Change in an Urban-Rural Transition Area.

Landscapes are changing, with rural areas becoming increasingly urbanized. Children and adolescents are underrepresented in the sense-of-place literature. Our study aimed to understand how adolescent residents of a rural-urban transition area perceive and value their urbanizing landscape by examining sense of place and perceptions of landscape change. A Public Participation GIS approach, accompanied by a questionnaire survey, was applied to elicit responses from a sample of 747 students aged 12-18 in Colmenar Viejo, Madrid (Spain). Respondents' sense of "self-in-place" or home range was small, around 1 km, although valued places were identified up to around 17 km away, and occasionally further afield. Most responses were associated with urban land, with clear difference between the urban core, strongly associated with emotions, and the suburbs, with activities. Functional locations (i.e. sports facilities) and places which were valued for their social meaning (i.e. shopping malls), could be differentiated. Students were perceptive about change processes in the urban area, but not about those on the peripheral semi-natural land. Younger children were less aware than older children of spaces outside of the town and carried out fewer activities there. Females carried out fewer outdoor activities than male adolescents. In contrast to the adult population, students were more strongly focused on urban areas than on their surrounding rural landscapes. Here, awareness-raising and incentives are needed, particularly those encouraging females into the use of areas beyond the urban land. Our results suggest a lack of meaningful integration between the core city and the periphery, with lessons for urban planners.

Mechanical efficiency of high versus moderate intensity aerobic exercise in coronary heart disease patients: A randomized clinical trial.

BACKGROUND: Mechanical efficiency (ME) refers to the ability of an individual to transfer energy consumed by external work. A decreased ME, could represent an increased energy cost during exercise and may, therefore, be limited in terms of physical activity. This study aimed to compare the influence of two different exercise protocols: moderate continuous training (MCT) versus high intensity interval training (HIIT), as part of a cardiac rehabilitation program on ME values among coronary patients. METHODS: One hundred and ten coronary patients were assigned to either HIIT or MCT groups for 8 weeks. Incremental exercise tests in a cycle ergometer were performed to obtain VO2peak. Net energy expenditure (EE) and ME were obtained at intensities corresponding to the first (VT1) and second (VT2) ventilatory thresholds, and at VO2peak. RESULTS: Both exercise programs significantly increase VO2peak with a higher increase in the HIIT group (2.96 ± 2.33 mL/kg/min vs. 3.88 ± 2.40 mL/kg/min, for patients of the MCT and HIIT groups, respectively, p < 0.001). The ME at VO2peak and VT2 only significantly increased in the HIIT group. At VT1, ME significantly increased in both groups, with a greater increase in the HIIT group (2.20 ± ± 6.25% vs. 5.52 ± 5.53%, for patients of the MCT and HIIT groups, respectively, p < 0.001). CONCLUSIONS: The application of HIIT to patients with chronic ischemic heart disease of low risk re- sulted in a greater improvement in VO2peak and in ME at VT1, than when MCT was applied. Moreover, only the application of HIIT brought about a significant increase in ME at VT2 and at VO2peak.

Structural and functional changes in the heart of adult patients with osteogenesis imperfecta: Case-control study. / Cambios estructurales y funcionales en el corazón de pacientes adultos con osteogénesis imperfecta: estudio de casos y controles.

INTRODUCTION AND OBJECTIVES: Osteogenesis imperfecta (OI) is a connective tissue disease characterised by an anomalous synthesis of type i collagen. Little is known about the cardiovascular affectation suffered by these patients. The most frequently described are valvular dysfunction and dilatation of the aorta. We wanted to analyse the structural and functional changes of the heart in adult patients with OI. METHODS: We prospectively studied 82 patients with OI and compared them with 60 healthy subjects matched for age and sex. All of them underwent an echocardiographic study. RESULTS: We found no differences in the incidence of valvulopathies compared to the control group. Our patients had a larger left atrium and larger left ventricle (LV) diameters adjusted for body surface area. Aortic root was significantly higher. LV ejection fraction in patients with OI was lower and they had higher pulmonary artery systolic pressure. CONCLUSIONS: Patients with OI suffer structural and functional changes in the heart. A follow-up is recommended to observe the evolution of these changes.

Infarto agudo miocárdico-embólico asociado a embolia Pulmonar / Embolic acute myocardial infarction associated with pulmonary embolism

Resumen El infarto agudo de miocardio de origen embólico es poco frecuente y suele ocurrir en pacientes con la fibrilación auricular o las valvulopatías. Suele afectar a la arteria descendente anterior. La presentación simultánea de un embolismo pulmonar y un infarto agudo de miocardio también es rara y difícil de diagnosticar porque ambas entidades producen síntomas parecidos y alteraciones electrocardiográficas a veces superponibles. Se presenta el caso de un paciente con embolia pulmonar y un infarto agudo de miocardio simultáneos, en probable relación con una embolia paradójica.

Abstract Acute myocardial infarction of embolic origin is rare and usually develops in patients with atrial fibrillation or valvular heart diseases. It affects the anterior descending artery. Simultaneous presentation of a pulmonary embolism and acute myocardial infarction is also rare and difficult to diagnose because both entities produce similar symptoms and sometimes overlapping electrocardiographic alterations. The case of a patient with simultaneous pulmonary embolism and acute myocardial infarction is presented, probably related to a paradoxical embolism.