Diminished Anthropometric Measures and Other Associated Variables in a Sample of Violent Offenders: A Case-Control Study.

Background Predicting criminal behavior is a complex task due to its multidimensional nature. Nevertheless, health professionals and criminologists must consider individual criminogenic risk factors to provide reliable expert opinions. Physical traits have been a subject of scrutiny since the inception of biological positivism. Aim The main objective of this study is to analyze differences in individual characteristics between violent offenders and healthy volunteers to potentially identify predictors of criminal behavior. Methods We conducted a case-control study with a sample of inmates convicted of violent offenses and compared them to healthy volunteers. Anthropometrics, sociodemographic data, drug consumption, characteristics of the family nucleus, clinical background, and basic laboratory test results were collected. Quantitative data were tested for normality and homogeneity before applying the Mann-Whitney or T-Student tests, respectively. For categorical data, Pearson's chi-square test was used for associations, and the odds ratio was determined for the associated risk in drug abuse profiles. Results Among the male participants (N = 72), the inmate group (n = 41) showed significantly lower stature (mean height [m]: 1.7454 ± 0.0694 vs 1.6643 ± 0.0659, p < 0.001), a reduced left D2:D4 finger length ratio (mean ratio [cm]: 0.9638 ± 0.0572 vs 0.9380 ± 0.068cm, p < 0.05), and smaller anthropometric measurements, including armful (mean length [m]: 1.8080 ± 0.7690 vs 1.6582 ± 0.7250, p < 0.001), wrist (mean [cm]: 17.39 ± 1.10 vs 16.57 ± 1.84, p < 0.05), mid-upper arm (mean [cm]: 31.75 ± 3.79 vs 29.97 ± 3.79, p < 0.05), and head circumferences (mean [cm]: 58.43 ± 1.92 vs 55.39 ± 1.51, p < 0.001). Additionally, the inmate group exhibited shorter lower segments (mean [cm]: 102.67 ± 4.97 vs. 97.85 ± 5.04, p < 0.001) and plantar lengths (mean [cm]: 27.45 ± 1.25 vs. 26.78 ± 1.00, p < 0.05). Furthermore, this group displayed a higher risk of alcohol (OR = 4.4, p < 0.01), cocaine (OR = 3.36, p < 0.05), and benzodiazepine consumption (OR = 3.36, p < 0.05). Parental alcohol consumption (χ² = 12.66, p < 0.01) and the practice of Protestantism (χ² = 20.087, p < 0.001) were also associated with the inmate group. Conclusion Physical traits may be considered potential criminogenic risk factors, but larger studies are necessary to validate these findings. Future research should take into account physiological and psychological correlates to gain a comprehensive understanding of the complex relationship between physical traits and criminal behavior.

Functional and histological effects of Anthurium schlechtendalii Kunth extracts on adenine-induced kidney damage of adult Wistar rats.

Anthurium schlechtendalii Kunth is used by the Zoque group in southeastern Mexico for kidney and urinary diseases, but its safety and effectiveness are unproven, therefore a model of adenine-induced renal failure in rats was performed. The rats were fed with solid and aqueous plant extracts for 4 weeks to study its effects on kidney histological morphology. Kidneys were examined, and statistical analysis was performed. The adenine-containing diet caused renal failure, characterized by crystal deposits, cystic dilatation of tubules, and micro-abscesses. Both extracts caused tubular damage and collagen increase without inflammation. However, when combined with adenine, the extracts showed some protective effects, although cystic dilatation and granulomatous inflammation were observed. The extracts at the tested doses resulted in glomerular and tubular damage, aggravating cystic degeneration, therefore, its indiscriminate use in Humans is not safe. Additionally, the extracts can serve as a model for studying renal damage without crystal deposits.

Systemic exertion intolerance disease associated to neuroendocrine dysfunction and cortical atrophy: a case report.

BACKGROUND: Scarce evidence about the organic and functional abnormalities of systemic exertion intolerance disease (SEID) is found in literature and the pathophysiology is still unclear. METHODS: Following the CARE Guidelines, this case report describes a patient with a 5-year history of nonspecific symptoms, lately recognized as SEID. RESULTS: Low serum thyroid- and adrenocorticotropic stimulating hormone levels, and 24-h urinary cortisol excretion almost twice the upper limit were detected. Computed tomography scan found significant cortical atrophy. Low-dose modafinil improved the clinical outcome, added to nonpharmacologic approach. CONCLUSION: To ascertain an accurate SEID diagnosis and treatment are a challenge in daily clinical practice, that must be engaged based in clear methods and good practice recommendations. Thus, family practitioners should be aware of this diagnosis.

Milk production and quality patterns of double-purpose goats grazing in arid rangelands.

Lactation curves are a valuable tool for improving flock production efficiency, adjusting flock sizes, and improving farmers' income in grazing-based livestock production. Therefore, we used natural cubic splines to estimate (a) a general flock production pattern throughout a year, (b) an average lactation curve, and (c) patterns of milk chemical components in dual-purpose goats grazing in arid plant communities in the Sierra de San Francisco, Baja California Peninsula, during years of abundant precipitation. Also, milk chemical composition was compared between flocks. Annual flock milk production showed a wiggly pattern with two greater waves in summer and spring. The average individual lactation curve (kg/doe/day) and production curves of fat, protein, lactose, and ashes (g/doe/day) showed a decreasing and wiggly pattern across 35-week lactation; the greatest average daily production was in week 2. Milk, protein, lactose, and ash production curves had similar persistency values that were greater than those of the fat production curve. Milk production had a high-positive correlation with fat production and very high-positive correlations with protein, lactose, and ash production. Density (g/ml) and fat, protein, lactose, and ash contents (%) showed a ditch-shaped pattern across lactation, with greater values at the end. Goat flocks grazing across plant communities produced different quality milk. Thus, native plant communities are a valuable resource that favors a great fat content and moderate protein content in local goat milk. Also, breeding programs must pay attention that an increment in individual milk production could decrease fat and protein production, which are valuable for cheesemaking.

Frequency of non-alcoholic fatty liver disease in a series of forensic cases in Mexico / Frecuencia de hígado graso no alcohólico en una serie de casos forenses en México

Abstract Objective: To determine the frequency of non-alcoholic fatty liver in individuals with not known history of liver disease, who died instantly in a traffic accident. Materials and Methods: It was a prospective and cross-sectional study of a series of autopsy cases, with a convenience sample obtained from the forensic medical service in the municipality of Boca del Río, Mexico, during the period from January to December 2016. The variables studied included age, sex, weight, height, abdominal circumference, thickness of the adipose panicle, cause of death and findings of liver biopsy. Results: A 78.1% of the 32 cases studied were men. The average age was 48 years old (range 20-80 years old). The body mass index range was 17-33. 34% of the cases had fatty liver. 27.3% of cases with fatty liver had a normal body mass index. Conclusions: This postmortem study showed a higher frequency of asymptomatic hepatic steatosis than previously reported in the Mexican population. It is necessary to establish timely national measures to detect and to prevent complications of this disease.

Resumen Objetivo: Determinar la frecuencia de hígado graso no alcohólico en individuos sin antecedentes conocidos de enfermedad hepática, que murieron instantáneamente en un accidente de tráfico. Materiales y Métodos: Fue un estudio prospectivo y transversal, de una serie de casos de autopsia, con una muestra por conveniencia obtenida en el servicio médico forense en el municipio de Boca del Río, México, durante el período de enero a diciembre de 2016. Las variables estudiadas incluyeron edad, sexo, peso, altura, perímetro abdominal, grosor del panículo adiposo, causa de muerte y hallazgos de la biopsia hepática. Resultados: De los 32 casos estudiados, el 78,1% eran hombres. La edad promedio fue de 48 años (rango 20-80 años). El rango del índice de masa corporal fue de 17-33. Un 34% de los casos tenían hígado graso. El 27.3% de los casos con hígado graso tenían un índice de masa corporal normal. Conclusiones: Este estudio postmortem mostró una frecuencia más alta de esteatosis hepática asintomática que la reportada previamente en la población mexicana. Es necesario establecer medidas nacionales oportunas para detectar y prevenir complicaciones de esta enfermedad.

Persistent Pulmonary Hypertension in Corrected Valvular Heart Disease: Hemodynamic Insights and Long-Term Survival.

Background The determinants and consequences of pulmonary hypertension after successfully corrected valvular heart disease remain poorly understood. We aim to clarify the hemodynamic bases and risk factors for mortality in patients with this condition. Methods and Results We analyzed long-term follow-up data of 222 patients with pulmonary hypertension and valvular heart disease successfully corrected at least 1 year before enrollment who had undergone comprehensive hemodynamic and imaging characterization as per the SIOVAC (Sildenafil for Improving Outcomes After Valvular Correction) clinical trial. Median (interquartile range) mean pulmonary pressure was 37 mm Hg (32-44 mm Hg) and pulmonary artery wedge pressure was 23 mm Hg (18-26 mm Hg). Most patients were classified either as having combined precapillary and postcapillary or isolated postcapillary pulmonary hypertension. After a median follow-up of 4.5 years, 91 deaths accounted for 4.21 higher-than-expected mortality in the age-matched population. Risk factors for mortality were male sex, older age, diabetes mellitus, World Health Organization functional class III and higher pulmonary vascular resistance-either measured by catheterization or approximated from ultrasound data. Higher pulmonary vascular resistance was related to diabetes mellitus and smaller residual aortic and mitral valve areas. In turn, the latter correlated with prosthetic nominal size. Six-month changes in the composite clinical score and in the 6-minute walk test distance were related to survival. Conclusions Persistent valvular heart disease-pulmonary hypertension is an ominous disease that is almost universally associated with elevated pulmonary artery wedge pressure. Pulmonary vascular resistance is a major determinant of mortality in this condition and is related to diabetes mellitus and the residual effective area of the corrected valve. These findings have important implications for individualizing valve correction procedures. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00862043.

Efectos a la salud de dos bebidas carbonatadas en ratones experimentales / Health Effects of Two Carbonated Drinks in Experimental Mice

El consumo de bebidas carbonatadas es común a nivel mundial. En El Salvador es frecuente en la dieta de la población; sin embargo, algunos de sus componentes pueden ser responsables de afectar la salud. Objetivo. Evaluar los efectos a la salud de dos bebidas carbonatadas administradas continuamente durante 10 semanas a ratones experimentales. Metodología. Se utilizaron 12 ratones distribuidos en 3 grupos de 4 ratones cada uno; un control y dos experimentales, para administrar dos bebidas carbonatadas azucaradas de alto consumo dentro de la población salvadoreña por vía intragástrica. Resultados. Los chequeos clínicos presentaron alteraciones en algunos aspectos evaluados, como deshidratación, piloerección y diarrea. En peso corporal, hubo diferencias entre el grupo control y los experimentales. En la evaluación macroscópica de los órganos, los grupos tratados sufrieron irregularidades, tanto en la apariencia como en el color, aunque en su peso no existieron diferencias, a excepción del riñón derecho del grupo tratado con bebida carbonatada 1. La química sanguínea mostró únicamente diferencia en el colesterol total del grupo tratado con bebida carbonatada 2. Conclusión. La apariencia de los ratones tratados con bebidas carbonatadas mostró daños a la salud, principalmente el daño provocado en la apariencia de los órganos internos

Currently, the consumption of carbonated beverages is very common worldwide. In El Salvador it is frequent in the diet of the population; while some constituent components may be responsible for affecting health. Objective. To assess the health effects of two carbonated beverages administered continuously for 10 weeks to experimental mice. Methodology. Two carbonated beverages with high consumption sugar were chosen within the Salvadoran population. In this study 12 mice distributed in 3 groups of 4 mice each were used; one control and two experimental. The substances were administered intragastrically. Results. The clinical check-ups showed alterations in some aspects evaluated, such as dehydration, piloerection and diarrhea. In body weight, there were significant differences between the control and the experimental group. In the macroscopic evaluation of the organs, the treated groups suffered from certain irregularities, both in appearance and color, although there were no differences in weight, except for the right kidney of the group treated with carbonated beverage 1. Blood chemistry showed only

Sudden Death Report in Mexico (1998-2014).

Introduction: Sudden death (SD) is a health problem worldwide affecting all strata of the population. The main cause of SD is ischemic heart disease (IHD). The aims of the study were as follows: (i) to analyze the incidence of deaths from IHD in two successive periods (1998-2006 and 2007-2015) to visualize the magnitude of the problem and (ii) to review the official reports of SD in the same lapse of time. Materials and Methods: During that period, instantaneous death (ISD) and death that occurred in the first 24 h after the onset of symptoms were analyzed according to the official databases of National Institute of Statistics and Geography (INEGI) and National Health Information System (SINAIS). Results: There was an under-registration of SD cases in Mexico. Only 1394 cases of ISD were recorded officially in 17 years period of study, whereas it is estimated that 33,000 cases occur annually, exclusively due to sudden cardiac death. Conclusion: There is a serious gap in the official epidemiological information; placing the real problem in perspective would help to establish the adequate public policies for both, prevention and investigation of the causes of SD in Mexico.

Introducción: La muerte súbita (MS) es un problema mundial de salud que afecta a todos los estratos de la población. La principal causa de MS es la cardiopatía isquémica. Los objetivos del estudio fueron: i) Analizar la incidencia de muertes por cardiopatía isquémica en dos períodos sucesivos (1998-2006 y 2007-2015) para visualizar la magnitud del problema, y ii) revisar los informes oficiales de MS en los mismos lapsos. Metodología: Durante ese período, se analizaron la muerte instantánea (MSI) y la muerte ocurrida en las primeras 24 h después del inicio de los síntomas (MS24h) de acuerdo con las bases de datos oficiales del Instituto Nacional de Estadística y Geografía (INEGI) y el Sistema Nacional de Información de Salud (SINAIS). Resultados: Existe un subregistro de casos de MS en México. Solo 1,394 casos de MSI se registraron oficialmente en el período de estudio de 17 años, mientras que se estima que ocurren 33,000 casos al año, solo por muerte súbita cardíaca. Conclusión: Existe una subregistro de información epidemiológica oficial; poner el problema real en perspectiva ayudaría a establecer políticas públicas adecuadas tanto para la prevención como para la investigación de las causas de la MS en México.

Sudden Death Report in Mexico (1998-2014).

Introduction: Sudden death (SD) is a health problem worldwide affecting all strata of the population. The main cause of SD is ischemic heart disease (IHD). The aims of the study were as follows: (i) to analyze the incidence of deaths from IHD in two successive periods (1998-2006 and 2007-2015) to visualize the magnitude of the problem and (ii) to review the official reports of SD in the same lapse of time. Materials and Methods: During that period, instantaneous death (ISD) and death that occurred in the first 24 h after the onset of symptoms were analyzed according to the official databases of National Institute of Statistics and Geography (INEGI) and National Health Information System (SINAIS). Results: There was an under-registration of SD cases in Mexico. Only 1394 cases of ISD were recorded officially in 17 years period of study, whereas it is estimated that 33,000 cases occur annually, exclusively due to sudden cardiac death. Conclusion: There is a serious gap in the official epidemiological information; placing the real problem in perspective would help to establish the adequate public policies for both, prevention and investigation of the causes of SD in Mexico.

Introducción: La muerte súbita (MS) es un problema mundial de salud que afecta a todos los estratos de la población. La principal causa de MS es la cardiopatía isquémica. Los objetivos del estudio fueron: i) Analizar la incidencia de muertes por cardiopatía isquémica en dos períodos sucesivos (1998-2006 y 2007-2015) para visualizar la magnitud del problema, y ii) revisar los informes oficiales de MS en los mismos lapsos. Metodología: Durante ese período, se analizaron la muerte instantánea (MSI) y la muerte ocurrida en las primeras 24 h después del inicio de los síntomas (MS24h) de acuerdo con las bases de datos oficiales del Instituto Nacional de Estadística y Geografía (INEGI) y el Sistema Nacional de Información de Salud (SINAIS). Resultados: Existe un subregistro de casos de MS en México. Solo 1,394 casos de MSI se registraron oficialmente en el período de estudio de 17 años, mientras que se estima que ocurren 33,000 casos al año, solo por muerte súbita cardíaca. ­. Conclusión: Existe una subregistro de información epidemiológica oficial; poner el problema real en perspectiva ayudaría a establecer políticas públicas adecuadas tanto para la prevención como para la investigación de las causas de la MS en México.

Sudden Death Report in Mexico (1998-2014) / Reporte de muerte súbita en Mexico (1998-2014)

Abstract Introduction: Sudden death (SD) is a health problem worldwide affecting all strata of the population. The main cause of SD is ischemic heart disease (IHD). The aims of the study were as follows: (i) to analyze the incidence of deaths from IHD in two successive periods (1998-2006 and 2007-2015) to visualize the magnitude of the problem and (ii) to review the official reports of SD in the same lapse of time. Materials and Methods: During that period, instantaneous death (ISD) and death that occurred in the first 24 h after the onset of symptoms were analyzed according to the official databases of National Institute of Statistics and Geography (INEGI) and National Health Information System (SINAIS). Results: There was an under-registration of SD cases in Mexico. Only 1394 cases of ISD were recorded officially in 17 years period of study, whereas it is estimated that 33,000 cases occur annually, exclusively due to sudden cardiac death. Conclusion: There is a serious gap in the official epidemiological information; placing the real problem in perspective would help to establish the adequate public policies for both, prevention and investigation of the causes of SD in Mexico.

Resumen Introducción: La muerte súbita (MS) es un problema mundial de salud que afecta a todos los estratos de la población. La principal causa de MS es la cardiopatía isquémica. Los objetivos del estudio fueron: i) Analizar la incidencia de muertes por cardiopatía isquémica en dos períodos sucesivos (1998-2006 y 2007-2015) para visualizar la magnitud del problema, y ii) revisar los informes oficiales de MS en los mismos lapsos. Metodología: Durante ese período, se analizaron la muerte instantánea (MSI) y la muerte ocurrida en las primeras 24 h después del inicio de los síntomas (MS24h) de acuerdo con las bases de datos oficiales del Instituto Nacional de Estadística y Geografía (INEGI) y el Sistema Nacional de Información de Salud (SINAIS). Resultados: Existe un subregistro de casos de MS en México. Solo 1,394 casos de MSI se registraron oficialmente en el período de estudio de 17 años, mientras que se estima que ocurren 33,000 casos al año, solo por muerte súbita cardíaca. Conclusión: Existe una subregistro de información epidemiológica oficial; poner el problema real en perspectiva ayudaría a establecer políticas públicas adecuadas tanto para la prevención como para la investigación de las causas de la MS en México.

Sildenafil for improving outcomes in patients with corrected valvular heart disease and persistent pulmonary hypertension: a multicenter, double-blind, randomized clinical trial.

Aims: We aimed to determine whether treatment with sildenafil improves outcomes of patients with persistent pulmonary hypertension (PH) after correction of valvular heart disease (VHD). Methods and results: The sildenafil for improving outcomes after valvular correction (SIOVAC) study was a multricentric, randomized, parallel, and placebo-controlled trial that enrolled stable adults with mean pulmonary artery pressure ≥ 30 mmHg who had undergone a successful valve replacement or repair procedure at least 1 year before inclusion. We assigned 200 patients to receive sildenafil (40 mg three times daily, n = 104) or placebo (n = 96) for 6 months. The primary endpoint was the composite clinical score combining death, hospital admission for heart failure (HF), change in functional class, and patient global self-assessment. Only 27 patients receiving sildenafil improved their composite clinical score, as compared with 44 patients receiving placebo; in contrast 33 patients in the sildenafil group worsened their composite score, as compared with 14 in the placebo group [odds ratio 0.39; 95% confidence interval (CI) 0.22-0.67; P < 0.001]. The Kaplan-Meier estimates for survival without admission due to HF were 0.76 and 0.86 in the sildenafil and placebo groups, respectively (hazard ratio 2.0, 95% CI = 1.0-4.0; log-rank P = 0.044). Changes in 6-min walk test distance, natriuretic peptides, and Doppler-derived systolic pulmonary pressure were similar in both groups. Conclusion: Treatment with sildenafil in patients with persistent PH after successfully corrected VHD is associated to worse clinical outcomes than placebo. Off-label usage of sildenafil for treating this source of left heart disease PH should be avoided. The trial is registered with ClinicalTrials.gov, number NCT00862043.

Use of Cardiac Injury Markers in the Postmortem Diagnosis of Sudden Cardiac Death.

In the daily practice of forensic pathology, sudden cardiac death (SCD) is a diagnostic challenge. Our aim was to determine the usefulness of blood biomarkers [creatine kinase CK-MB, myoglobin, troponins I and T (cTn-I and T), and lactate dehydrogenase] measured by immunoassay technique, in the postmortem diagnosis of SCD. Two groups were compared, 20 corpses with SCD and 8 controls. Statistical significance was determined by variance analysis procedures, with a post hoc Tukey multiple range test for comparison of means (p < 0.05). SCD cases showed significantly higher levels (p < 0.05) of cTn-T and cTn-I compared to the control group. Although only cases within the first 8 h of postmortem interval were included, and the control group consisted mainly of violent death cases, our results suggest that blood troponin levels may be useful to support a diagnosis of SCD.

Impacto del remodelado del anillo mitral tras el procedimiento MitraClip en la reducción de la insuficiencia mitral funcional / Effects of mitral annulus remodeling following MitraClip procedure on reduction of functional mitral regurgitation

Introducción y objetivos: El procedimiento de reparación mitral percutánea (MitraClip) parece reducir los diámetros del anillo mitral de pacientes con etiología funcional, pero no se ha demostrado la relación con la intensidad de la regurgitación. El objetivo es evaluar si el remodelado del anillo mitral tiene algún impacto en la reducción de la regurgitación mitral en pacientes con insuficiencia mitral funcional. Métodos: Se incluyó a todos los pacientes con etiología funcional tratados con MitraClip en el centro hasta enero de 2015. Se les realizó ecocardiograma inmediatamente después de la colocación del dispositivo (equipo iE33, Philips). Los cambios en el anillo mitral se correlacionaron con la intensidad de la regurgitación mitral evaluada por el orificio regurgitante efectivo. Resultados: Se incluyó a 23 pacientes (edad, 65 ± 14 años; el 74% varones; fracción de eyección del ventrículo izquierdo, 31 ± 13%; presión sistólica de la arteria pulmonar, 47 ± 10 mmHg). Tras el procedimiento, el orificio regurgitante disminuyó en 0,30 ± 0,04 cm2 (p < 0,0005), desde un valor basal de 0,49 ± 0,9 cm2. Se observó una reducción del diámetro anteroposterior de 3,14 ± 1,01 mm (p < 0,0005) desde un valor basal de 28,27 ± 4,9 mm, sin cambios en el diámetro intercomisural (0,50 ± 0,91 frente a 40,68 ± 4,7 mm; p = 0,26). Se observó una relación significativa entre la reducción del diámetro anteroposterior y la reducción del orificio regurgitante (r = 0,49; p = 0,020). Conclusiones: El dispositivo MitraClip produce una inmediata reducción del diámetro anteroposterior en pacientes con insuficiencia mitral funcional. Este remodelado podría relacionarse con la reducción de la regurgitación mitral (AU)

Introduction and objectives: The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. Methods: The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. Results: The study included 23 patients (age, 65 ± 14 years; 74% men; left ventricular ejection fraction, 31% ± 13%; systolic pulmonary artery pressure, 47 ± 10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm2 ± 0.04 cm2 (P < .0005), from a baseline of 0.49 cm2 ± 0.09 cm2. Anteroposterior diameter decreased by 3.14 mm ± 1.01 mm (P < .0005) from a baseline of 28.27 mm ± 4.9 mm, with no changes in the intercommissural diameter (0.50 mm ± 0.91 mm vs 40.68 mm ± 4.7 mm; P = .26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r = .49; P = .020). Conclusions: In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation (AU)

Effects of Mitral Annulus Remodeling Following MitraClip Procedure on Reduction of Functional Mitral Regurgitation.

INTRODUCTION AND OBJECTIVES: The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. METHODS: The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. RESULTS: The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm2±0.04 cm2 (P<.0005), from a baseline of 0.49 cm2±0.09 cm2. Anteroposterior diameter decreased by 3.14 mm±1.01 mm (P<.0005) from a baseline of 28.27 mm±4.9 mm, with no changes in the intercommissural diameter (0.50 mm±0.91 mm vs 40.68 mm±4.7 mm; P=.26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r=.49; P=.020). CONCLUSIONS: In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation.

Mammographic breast density patterns in asymptomatic mexican women.

Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ(2)) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns.