Cierre percutáneo de foramen oval permeable con dispositivo de Amplatzer: Presentación de dos casos / Percutaneous closure of patent foramen ovale with Amplatzer device: Report of two cases

Propósito: Se presentan los 2 casos de foramen oval permeable tratados con dispositivo de Amplatzer por vía percutánea. Método: El primero del sexo femenino de 48 años y con antecedentes de enfermedad de Ebstein moderada a severa y de 3 accidentes vasculares cerebrales, siendo el último bajo efecto anticoagulante, manejada con antiarrítmicos a pesar de lo cual presentó bloqueo auriculoventricular (a-v) de primer grado, aumento del automatismo supraventricular y ventricular de diferente foco y bloqueo de rama derecha. El segundo paciente masculino de 22 años con antecedente de un evento embólico cerebral a los 21 años con secuelas de crisis convulsivas. Ambos fueron tratados por vía percutánea para implante de dispositivo de Amplatzer, el primero para foramen oval permeable (FOP) y el segundo con dispositivo para comunicación interatrial por el diámetro del foramen. Los dos pacientes se encuentran asintomáticos. Conclusiones: El cierre de FOP por vía percutánea está indicado en pacientes con antecedentes de eventos cerebrales transitorios o permanentes y se sospeche esta vía como fuente embolígena. La técnica es fácil de realizar pero se requiere de un mayor número de pacientes para concluir.

Objective: We present two cases of Patent Foramen Ovale (PFO) treated with percutaneous Amplatzer device. Method: The first case corresponds to 48 years old woman with Ebstein's disease with moderate to severe hemodynamic repercussion and three cerebrovascular accidents, the last one under coumarin treatment, she received antiarrhythmic medication and despite of it developed 1st degree AV block, supraventricular and ventricular ectopia, rigth branch block. The second case corresponds to a 22 years old man with antecedents of cerebrovascular accident at the age of 21 with sequelae of convulsive crisis. Both patients were percutaneously treated with Amplatzer devices. The first patient was treated with a foramen ovale device and second with septal occluder due to the diameter of the foramen. Both patients have remained asymptomatic during the follow-up period. Conclusions: The PFO devices are indicated for patients with a history of cerebrovascular accidents.

[Effect of reheating on iron availability and the protein nutritive value of cooked black bean (Phaseolus vulgaris)]. / Efecto del recalentamiento sobre la disponibilidad de hierro y el valor nutritivo de la proteína del frijol negro (Phaseolus vulgaris) cocido.

In Guatemala, at the rural level, beans are prepared for family consumption every two days. Beans are cooked again every 12 hours for 15 minutes prior to their consumption. Due to the adverse effect that the process causes on nutritive value, the present study evaluated the method and preparation practice of beans on protein value; tannin and soluble and ionizable iron content. As to the effect of re-cooking on protein level, findings revealed that there were no significant statistical effects on net protein ratio (NPR) or in protein efficiency ratio (PER) and number of bean cooking. Nevertheless, a constant effect in quality in the first and second cooking procedure was detected. The second cooking gave a similar value as the first. Also, the first and second heating reduced protein digestibility, but the third gave a value similar to the initial one. No changes were observed in the digestibility of dry matter. Relatively high amounts of protein were found in the cooking broth, which was not affected by the number of heating. It was also found that the bean broth contained high levels of tannins in the initial heating, decreasing later significantly. The same was observed in the cooked beans alone and in beans with their broth. With respect to iron, findings showed a relatively high transference of beans to broth, in total iron as well as in soluble, ionizable and insoluble iron. No changes were observed in whole beans without broth caused by number of heatings, on total, soluble or ionizable iron. In beans with their broth, a similar effect was observed, although a slight increase in insoluble iron was detected at the end of heating. A decrease in soluble and insoluble iron was observed in broth with number of heatings. Correlations were calculated among the parameters studied, which suggested an effect of tannins on the bioavailability of iron caused by tannins.