[Cardiovascular abnormalities in Ehlers-Danlos syndrome. Report of a case]. / Anormalidades cardiovasculares en el síndrome de Ehlers-Danlos. Informe de un caso.

This is the case of a 34-year-old woman with Ehlers-Danlos syndrome whose cardiopulmonary manifestations are the following: Prolapse of mitral and tricuspid valves. Aneurysmal dilatation of main arteries without aortic or pulmonary insufficiency. Disturbances in pulmonary function tests and pulmonary arterial hypertension. The diagnosis was verified by skin biopsy and an electron microscopic study. Due to the clinical and histopathological characteristics, we have considered this case to be a non-specified type of the 10 varieties described up to now, and have decided to report it also because of the interesting findings in the hemodynamic and pulmonary function tests.

[Clinical impact of the Bezold-Jarisch reflex in coronary arteriography]. / Repercusiones clínicas del reflejo de Bezold-Jarisch en la arteriografía coronaria.

To evaluate the role that coronary arteriography has in the induction of the Bezold-Jarisch reflex we study 9 patients (group I) to whom 1 mg. of atropine was administered 45 min. before the coronary arteriography and 9 patients (group II) without pre-medication. The heart rate was measured before, during and after each intracoronary injection. In group I there was no change in heart rate in 6 patients, in 3 cases the heart rate dropped to 15 beats/min. In group II the heart rate decreased in 8 cases. We conclude that the injection of radiologic contrast material in the coronary arteries triggers the Bezold-Jarisch reflex and that this reflex is prevented by the administration of atropine.

[Origin of the left coronary artery from the trunk of the pulmonary artery. Report of a case]. / Origen de la arteria coronaria izquierda del tronco de la arteria pulmonar. Informe de un caso.

The congenital anomalies of the coronary arteries are varied. The left trunk arising from the pulmonary artery is a rare and serious one. With coronary angiography the diagnosis is possible. The surgical technics offer an effective treatment. We report the first case with these anomalies at the Instituto Nacional de Cardiología Ignacio Chávez. It was diagnosed with coronary angiography and it was treated by suturing the left main coronary artery in its origin, and with implantation of a safenous vein graft between the aorta and the left main coronary artery. The results were satisfactory.

Repercusiones clinicas del reflejo de Bezold-Jarisch en el arteriografia coronaria. / Clinical repercussions of Bezold-Jarish reflex in coronary arteriography

Para valorar el efecto de la arteriografia coronaria en la produccion del reflejo de Bezold-Jarisch estudiamos 9 enfermos (grupo I) a los que se les administro 1 mg de atropina por via subcutanea 45 min antes de ser sometidos a arteriografia coronaria y 9 enfermos (grupo II) sin premedicacion.En todos ellos se midio la frecuencia cardiaca antes, durante y despues de cada inyeccion intracoronaria.Dicha medicion no vario en 6 enfermos del grupo I aunque en los 3 restantes disminuyo 15 latidos/min en alguno de los disparos. En el grupo II la frecuencia cardiaca disminuyo en 8 enfermos. Se concluye que la inyeccion de medio de contraste radiologico en las arterias coronarias desencadena el refeljo de Bezold-jarisch que este se previene con la administracion de atropina

Origen de la arteria coronaria izquierda del tronco de la arteria pulmonar. Informe de un caso. / Origin of left coronary artery from pulmonary artery trunk. Report of a case

Las anomalias congenitas de las arterias coronarias son multiples y variadas. Entre ellas, el origen de la arteria coronaria izquierda naciendo en el tronco de la arteria pulmonar es de las mas raras y graves. Con las tecnicas angiograficas actuales se logra el diagnostico certero en vida y las tecnicas quirurgicas actuales permiten un tratamiento efectivo. Se informa el primer caso visto en este Instituto Nacional de Cardiologia Ignacio Chavez, donde se hizo el diagnostico por medio de angiografia y se practico el tratamiento quirurgico con buen resultado por medio de ligadura de la arteria coronaria izquierda en su origen y la implantacion de un conducto entre la aorta y el tronco de la coronaria izquierda con una porcion de vena safena

[Chorea and chloroquine. A new treatment for an ancient malady]. / Corea y cloroquina. Un nuevo tratamiento para un antiguo mal.

Chloroquine is a drug used mainly as an anti-malaria agent with many other pharmacological properties. It was given to a patient with chorea and disseminated lupus erytematosus seeking the anti-inflammatory effect of the drug. The unexpected result on chorea hastened its use in 7 other patients with the same success. Chloroquine seems to be an effective drug for the relief of chorea. The mechanism of action is unknown.

Measuring the relationship of public psychiatric admissions to rising unemployment.

The results of a correlational analysis of the relationship between monthly state unemployment statistics and admissions to eight Missouri Department of Mental Health facilities are presented. Over a period of 100 months, readmissions, rather than new admissions, showed the strongest positive relationship to unemployment. A second study-a retrospective analysis of admissions before and after a major increase in unemployment-supported the results of the correlational analysis. A third analysis of subset of the original sample, comprised of patients unemployed at the time of admission, suggests that public facilities are more accessible to the unemployed during times of economic adversity. The findings on the relationship of readmission rates to the state of the economy have important implications for policy on deinstitutionalization. The planning, development, and evaluation of community care programs should include consideration of employment data.

Corea y cloroquina. Un nuevo tratamiento para un antiguo mal. / Corea and chloroquine. A new treatment for an old illness

La cloroquina aunque medicamento anti-paludico, tiene muchas otras propiedades farmacologicas, por lo que se usa en diferentes enfermedades. Se le administro a una enferma portadora de corea y lupus eritematoso con el proposito de inactivar el lupus por medio del efecto anti-inflamatorio del medicamento. El sorpresivo alivio de su corea, nos alento a usar el tratamiento en otros 7 enfermos con tal enfermedad, obteniendose el mismo resultado. Por lo anterior pensamos que la cloroquina es un medicamento efectivo para el tratamiento de la corea. El mecanismo de accion es desconocido

[Coronary arteriovenous fistula]. / Fístula arterio-venosa coronaria.

We present the case of an 8 year old boy with A-V fistula from the right coronary artery to the right ventricle, successfully treated by surgery. The main clinical features with differential diagnosis are discussed and the advantages of early surgical treatment are commented.

[Lupus erythematosus and chorea (report of 3 cases)]. / Lupus eritematoso y corea (presentación de tres casos).

We present here three cases of systemic Lupus Erythematosus which fulfilled the diagnostic criteria of the American Rheumatism Association. These three cases also had Chorea. This kind of association is not frequent and the cases here described are the last three of 32 published until now. We discusse in this paper the significance of the Chorea Syndrome and the probable causes originating it.

[Myocardial reinfarction in male and female]. / Reinfarto del miocardio en el sexo masculino y femenino.

1). In 1001 patients with acute myocardial infarction 403 cases were found (40.2%) showing possible relapse. A study was made of 125 cases (12.5%) with positive diagnosis of acute myocardial infarction relapse, and among them, 12 were found to be occurring for the third time. Is possible for the real frequency of the iterative infarction to be even higher, because many cases were dismissed (27.7%) for lacking of conclusive electrocardiographic data pointing to myocardial transmural infarction. 2). Investigations were conducted about the evolutive condition of the danger factors in the coronary profile as well in the male as in the female group. Besides, a comparative study was made about symptoms, complications, morbidity and mortality. Clinical, enzimatic and electrocardiographic proofs were found, in every case, of a new myocardial transmural necrosis which was in evolution, with waves of injury and ischemia. Thirty eight deaths were registered in hospitals (30.4%) and in 25 of these, a necropsic study was conducted. 3). This illness is more frequent among men than among women, in a 3.5 to 1 proportion. The recurrent myocardial necrosis tends to be more frequently present during the first year following the first episode. In women, the first myocardial infarction as well as the iterative infarction occur at an older age than in men. 4). The influence of personality and stress is a very important factor of danger in the iterative infarction. Familiar antecedents of ischemic cardiopathy constitute a danger factor in patients presenting a single episode of myocardial infarction; nevertheless they don't seem to have a determining influence in this group of relapsing infarction. Although this study confirms with statistics that smoking has a decisive influence in the first myocardial infarction, neither frequency nor mortality of the relapsing infarction are in any way modified by the diminishing or suppression of the smoking habit.

[Cardiac neurosis. Study of 100 cases with a healthy heart]. / Neurósis cardíaca. Estudio de cien casos con corazón sano.

One-hundred records taken at chance from the archives of the Instituto Nacional de Cardiología de México, with the diagnosis of healthy heart, were studied. The following factors of these patients were analyzed: age, sex, civil status, socio-economic level, occupation, family antecedents, personal antecedents, smoking, alcoholism, presence of cardiac murmurs, arrhythmias, and electrocardiogram. In 80 of these patients there existed a clear neurotic alteration. The main symptoms which they suffered were: dyspnea, pain, palpitations, dizziness, and headaches. We found that the influence of the medical environment and living with cardiac patients in a neurotic individual were predisposing factors of a cardiac neurosis. In many cases the physician is responsable if he hesitates or does not advice properly. It can be concluded that it is necessary to establish a rehabilitation program for these patients since the illness is serious and invalidating and very frecuent, with repercussions at the familiar, social, and economic levels.

[Chagas myocardiopathy. Presentation of a case]. / Miocardiopatía chagásica. Presentación de un caso.

1. The first case of Chagasic Miocardiopathy with complete immunologic confirmation is described. 2. The clinical, radiological, and electrocardiographic basis of the case were analyzed. 3. The specificity and the sensibility to the different seroimmunologic reactions in the Chagasic Disease was discussed. 4. An emphasis is placed on the fact that Chagas illness is not a rare entity in the Mexican Republic. 5. We recommend that a campaign of serologic investigation is begin to discover the true frequency of this illness.