[Peripartum cardiomyopathy with biventricular failure plus pulmonary thromboembolism and atrial septal defect]. / Miocardiopatía periparto con fallo biventricular más tromboembolismo pulmonar y comunicación interauricular.

This case report examines peripartum cardiomyopathy (PPCM), a rare variant of heart failure with reduced ejection fraction, which manifests at the end of labor or puerperium. The frequency of this pathology varies globally, and its association with risk factors such as genetic disorders, autoimmune diseases, viral infections, suggests a multifactorial etiology. Diagnostic criteria include: Heart failure secondary to left ventricular systolic dysfunction, manifested in the puerperium or at the end of pregnancy and lack of other identifiable causes of heart failure. The case presents a patient with no significant personal pathological history, who, 17 days post cesarean section developed acute symptoms, including abdominal pain, dry cough and dyspnea. Clinical findings revealed hypoxemia, alterations in blood tests and an echocardiogram that confirmed an atrial septal defect. Multidisciplinary management resulted in successful treatment and the patient was discharged without complications. This case highlights the importance of MCPP, a disease with high maternal mortality. The connection between atrial septal defect and PPCM, as well as the involvement of pulmonary thromboembolism.

Algunas consideraciones clinicas del uso de lentes de contacto. / Some clinical considerations on the use of contact lens

El presente trabajo trata de demostrar algunas consideraciones clinicas con el uso de lentes de contacto. Se estudiaron 25 pacientes del Servicio de Oftalmologia del Hospital "Miguel Perez Carreno" del Seguro Social. Observamos que el tipo de lente que produjo mas dano fue el duro.Mas afectado el sexo masculino. La sintomatologia predominante por la cual consultaron los pacientes fue ojo, ardor y dolor. La lesion ocular encontrada en la mayoria de los casos fue la desepitelizacion corneal.El buen uso y adaptacion es importante para evitar las lesiones que aqui se presentan

Renal phosphate clearance in fetal lambs.

The purpose of this study was to investigate the possible role of diminished phosphate clearance by the fetal kidney in production of relative fetal hyperphosphatemia. Stimuli known to affect renal phosphate clearance in adults were investigated in young fetal lambs. Our studies confirm that the fetal lamb kidney responds to exogenous and endogenous parathyroid hormone (PTH) with inhibition of tubular phosphate reabsorption. Renal tubular phosphate reabsorption in the fetus is in part related to sodium reabsorption. These studies indicate that so-called "immaturity" of renal phosphate clearance in utero is not a significant factor in production of fetal hyperphosphatemia.

Corneal thickness in glaucoma.

The central corneal stromal thickness of patients with open angle glaucoma, secondary glaucoma (the majority aphakic), or a history of unilateral acute angle closure glaucoma were measured and compared with the stromal thickness of a group of normal patients. In open angle glaucoma, there was a small but significant increase in the average stromal thickness. This thickness increase was, in all likelihood, due to an abnormal function of the endothelium in this disease since the level of the intraocular pressure did not seem to be a factor. There was no correlation between stromal thickness and duration of the glaucoma or type of anti-glaucomatous medication. Most cases of secondary glaucome, controlled medically or not, had markedly increased corneal thickness, again, most likely, due to endothelial damage rather than to level of intraocular pressure. After an angle closure attack, permanent damage to the cornea was found to be rare.