[Non-compaction and restrictive cardiomyopathy in pediatrics: Two types of myocardial diseases that are important to recognize]. / Miocardiopatía no compactada y restrictiva en pediatría: Dos tipos de enfermedades del miocardio que son importantes saber reconocer.

Left ventricular non-compaction (LVNC) and restrictive cardiomyopathies (RCM) are rare diseases with high morbidity and mortality in the pediatric age group, particularly the restrictive. They can be diagnosed at any age even in fetal life, in isolation or association with other cardiomyopathies or congenital heart disease. The causes may be genetic, neuromuscular, metabolic, storage, or idiopathic disorders. The main morphological characteristic of LVNC is the presence of a non-compact myocar dium with numerous prominent trabeculations and deep recesses, which may results in myocardial dysfunction, malignant arrhythmias and thromboembolism. On the other hand, in RCM there is an abnormal myocardial stiffness, which generates a restrictive ventricular filling and atrial dilatation secondary. Clinically it manifested by severe diastolic dysfunction, pulmonary hypertension, arrhyth mias and sudden death. For both cardiomyopathies, the Doppler color echocardiography, electro cardiography and Holter monitoring of arrhythmias are the gold standard for diagnosis and follow up. Cardiac resonance adds information on functional assessment and quantification of myocardial fibrosis. The therapy is oriented to improve symptoms and quality of life. Patients with severe forms of LVNC and RCM may require extracorporeal ventricular support and cardiac transplantation, even in early stages of the disease. The pediatrician plays an important role in the early recognition of these pathologies for timing to referral as well as in the follow-up and screening for complications. The objective of this review is to update the clinical, genetic, diagnostic, therapeutic issues and prognostic of the LVNC and RCM.

Pacientes diabéticos hospitalizados en un servicio de medicina interna: características, causas de hospitalización y control metabólico / Diabetic patients hospitalized in a service of internal medicine: characteristics, reasons of hospitalization and metabolic control

Most of patients that present hyperglycemia during hospitalization still have the condition when they are discharged. A good level of metabolic control for hospitalized patients was set at a glycemic value between 70 and 180 mg/dl, taking into account that no statistics exist for the studied population. Aim: To describe reasons for hospitalization and glycemic control of patients with Diabetes Mellitus (DM) hospitalized in the Internal Medicine UNIT (SMI) of Hospital San Martin of Quillota (HSMQ). Patients and methods: Descriptive study of serial cases that included all patients of the SMI of HSMQ during July and August 2014. The information was obtained by daily census, analysis of nursing data, and interviews with patients. The information included general characteristics of the population and in patient management. Results: Of a total of 353 patients, 55 (15.6 percent) corresponded to diabetic patients, of them 92.7 percent had DM type 2. The average duration of hospitalization for not DM was 7 days where as for the DM it was 13.4 days. The principal reason for hospitalization for DM patients was infection: 23.6 percent (13/55). During hospitalization, most of patients’ care was controlled by means of "sliding scale" (28/55), but the schemes were quite variable, predominantly resulting in normal glycemia (63.8 percent) followed by hyperglycemia (33.7 percent). Conclusion: We found a significant percentage of patients with hyperglycemia and a great variability in the managing of DM in this sample, which indicates the importance of implementing a protocol for managing these cases...