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Anesthesiology, the medical specialty that deals with the management of vital functions in patients undergoing surgery, has played an important role in the successful development of cardiac interventions worldwide. Tracing the historical roots of cardiac anesthesia and critical care from its inception in the late 1950s, a paradigm shift in perioperative care has been driven by a better understanding of the mechanisms of organ dysfunction in stressful conditions and technological advances regarding surgical approach, patient monitoring, and organ protection. Although progress in cardiac anesthesia and critical care lagged a little behind in Caribbean territories, successful achievements have been accomplished over the last forty years. Compared with Western countries, the greater prevalence of obesity, diabetes mellitus, and hypertension as well as specific diseases such as cardiac amyloidosis, sickle cell anemia, rheumatic heart disease, and tropical infections may reduce a patient's physiologic reserve and increase the operative risk among the multi-ethnic population living in the French West Indies and Guiana. So far, cardiac anesthesiologists at the University Hospital of Martinique have demonstrated their abilities in implementing evidence-based clinical care processes and adaptating to efficiently working in a complex environment interacting with multiple partners. Attracting specialized physicians in dedicated cardiac surgical centers and the creation of a regional health network supported by governmental authorities, insurance companies, and charitable organizations are necessary to solve the unmet needs for invasive cardiac treatments in the Caribbean region.

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INTRODUCTION AND OBJECTIVE: Rapid and efficient interpretation of echocardiographic findings is critical in clinical decision-making. This study aimed to design and validate a new graphical method, called CARDIOBOX, to represent echocardiographic findings in dogs. METHODS: A prospective, observational, exploratory cohort study was conducted over three years. The design of CARDIOBOX was based on baseline values obtained from 802 healthy dogs and 2165 ill dogs. Using these data, a graph consisting of nine boxes was built to show the intervals of the different echocardiographic measurements. Validation of the method was performed by a survey of 55 veterinarians, who compared the use of CARDIOBOX with the use of numerical tables. RESULTS: CARDIOBOX demonstrated significantly faster interpretability (p < 0.05) without reducing its effectiveness. In addition, the staff surveyed considered it easy to use and interpret. CONCLUSIONS: The introduction of CARDIOBOX emerges as a resource that facilitates rapid and efficient interpretation of echocardiographic findings in dogs. This new graphical method is presented as a valuable tool for veterinary professionals in clinical decision-making in the field of veterinary cardiology.

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OBJECTIVE: To translate data relating childhood cardiovascular (CV) risk factors and adult CV disease and type 2 diabetes mellitus (T2DM) to clinically actionable values. STUDY DESIGN: This was a prospective observational study (n = 38 589) in the International Childhood Cardiovascular Cohort Consortium. Children at age 3 through 19 years were enrolled in the 1970s and 1980s and followed for more than 30 years. Five childhood CV risk factors (smoking, body mass index [BMI], systolic blood pressure, triglycerides, and total cholesterol) were related to adult CV events. Secondary analyses in a subset included low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose, and insulin level. Age- and sex-specific z scores were calculated for each risk factor, and a combined-risk z score was calculated by averaging z scores for the 5 key CV risk factors. Risk factor z scores were back-transformed to natural units for clinical interpretation, with hazard ratios for adult CV events presented in color-coded tables (green: no increased risk; orange: 1.4 to <2.0-fold increased risk; red: at least doubling of risk). Risk levels for development of adult T2DM on the basis of BMI, glucose, and insulin were similarly calculated and presented. RESULTS: Increased risk for CV events was observed at levels lower than currently defined abnormal clinical thresholds except for TC. Doubling of risk was observed at high normal levels just below the clinical cut point for abnormality. Risk for adult T2DM began at levels of BMI and glucose currently considered normal. CONCLUSIONS: On the basis of data showing significant relationships between childhood CV risk factors and adult CV events and T2DM, this study shows that risk in childhood begins below levels currently considered normal.

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In 1936, Ignacio Chávez submitted a proposal to the Mexican government for the creation of a cardiology institute. He had studied in Paris, Berlin, and other European cities in 1926. Upon his return to Mexico, he founded the Cardiology Service at the General Hospital in Mexico City, the first of its kind in the country. The National Institute of Cardiology of Mexico was inaugurated on April 18, 1944, becoming one of the first cardiology institutes in the world. Chávez explained the purpose of this new institute: "We were born with the purpose of studying, researching, and controlling heart diseases." According to him, the institute should be a place where cardiovascular diseases could be addressed comprehensively, combining clinical practice with research and teaching to provide effective knowledge for patient care and scientific advancement. "A health center is for the patient, of course; but something more than that is necessary: a great school for doctors, a great laboratory for researchers, and a social instrument of human help," he said. This vision was summarized in the words: love and science at the service of the heart. Chávez successfully institutionalized cardiology in Mexico. From its inception, the institute became an internationally recognized center, attracting students from various countries. Alfredo de Micheli noted that under Chávez's influence and example, new institutions emerged in the national medical field and expanded onto the international stage. The institute founded by Chávez became a model for similar institutions on other continents and a driving force in the international cardiology movement. Chávez's legacy was a work of love, intelligence, and culture, dedicated to the heart and the care of humanity.

En 1936 Ignacio Chávez presentó al gobierno mexicano un proyecto para la creación de un instituto de cardiología. Había estudiado en París, Berlín y otras ciudades europeas en 1926. Al regresar de Europa, fundó el servicio de Cardiología en el Hospital General de la Ciudad de México, el primero en el país. El 18 de abril de 1944 se inauguró el Instituto Nacional de Cardiología de México, uno de los primeros centros especializados en cardiología del mundo. Chávez explicó la razón de ser del nuevo instituto: «Nacimos para realizar la labor de estudio, investigación y control de las enfermedades del corazón¼. Para Chávez, un instituto debía ser el organismo donde se abordara la enfermedad de manera integral, en todos sus aspectos: la combinación de la práctica clínica con la investigación y la docencia proporcionaría los conocimientos para una atención eficaz del paciente y el avance de la ciencia. «Un centro de salud para el paciente, por supuesto; pero algo más que eso, una gran escuela de médicos, un gran laboratorio de investigadores y un instrumento social de ayuda humana¼, dijo Chávez. Su ideario se resumía en las siguientes palabras: amor y ciencia al servicio del corazón. Chávez logró la institucionalización de las ciencias del corazón en México. Desde su creación, el nuevo instituto se convirtió en un centro de estudios con proyección internacional, al que acudían estudiantes de diversos países. Alfredo de Micheli afirmó que, bajo la influencia y el ejemplo de Chávez, surgieron nuevas instituciones en el ámbito médico nacional, que también irrumpieron en el ámbito médico internacional. El instituto fundado por Chávez se convirtió en un modelo para la creación de instituciones similares en otros continentes y en el motor del movimiento cardiológico internacional. Realizó una obra de amor, inteligencia y cultura, dedicada al corazón y al cuidado del ser humano.

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Obstructive feline lower urinary tract disease (OFLUTD) is the most common complication of the urinary system, as metabolic and electrolyte changes can alter the functioning of the autonomic nervous system (ANS). The objective of this study was to describe the indices of heart rate variability (HRV) and their correlations with the observed alterations in Systolic Blood Pressure (SBP) and electrocardiographic, biochemical, and haemogasometric indices in cats diagnosed with OFLUTD. Sixty-five male cats up to 10 years of age were divided into two groups. The control group (CG) was composed of 25 healthy cats, and the obstructed group (OG) consisted of 40 cats with OFLUTD. The OG was evaluated by electrocardiography and blood pressure at four different time points. In the CG, electrocardiographic evaluation and SBP measurement were performed. A comparison of the HRV between the CG and OG (M0) revealed differences in the SDNN (standard deviation of all normal RR-NN) parameters (sympathetic and parasympathetic tone) and in the rMSSD (parasympathetic tone); there was a difference in the SBP, which was greater in the CG. There were higher rates in the CG. The HF and HR were greater in OG. The HRV serves as a preventive tool and predicts the severity of OFLUTD in patients due to an imbalance in the ANS.

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Long coronavirus disease (COVID), also known as the post-acute sequelae of coronavirus disease 2019 (COVID-19) (PASC), is a significant concern since the end of the COVID-19 pandemic, as it still manifests in individuals with persistent symptoms and complications beyond the acute phase of infection. Defining this disease is challenging, as it manifests as a spectrum of symptoms varying in severity among individuals who have previously tested positive for COVID-19. Long COVID is more prevalent in hospitalized COVID-19 patients and presents in various ways, ranging from pulmonary to extrapulmonary symptoms. This literature review examines the current body of research on long COVID with a focus on its effects on the cardiovascular, hematological, respiratory, renal, and neurological systems with systematically analyzed, peer-reviewed articles retrieved from the PubMed database. There have been several proposed pathophysiological mechanisms by which severe acute respiratory syndrome coronavirus 2 affects the aforementioned organ systems; however, research on the definite mechanisms is lacking, especially when considering the management of long COVID in the perioperative setting. The impact of post-COVID sequelae necessitates individualized management strategies tailored to each symptomatic profile, particularly in patients with comorbidities. The COVID-19 pandemic affected millions of people and had a profound impact on those who developed PASC, lowering their quality of life and increasing potential surgical risks. However, there is still uncertainty regarding the specific risk factors for long COVID and who is most susceptible to it. Further research is required to fill these gaps and explore potential avenues for preventing PASC.

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INTRODUCTION: The management of congenital heart disease (CHD) has evolved, improving patient outcomes; however, challenges persist for patients, emphasizing the importance of assessing health-related quality of life (HRQoL). The widely used Pediatric Quality of Life Inventory underscores the relevance of HRQoL assessment, especially in children subject to medical procedures. OBJECTIVE: To evaluate HRQoL in children with congenital heart disease undergoing cardiac catheterization, analysing its association with clinical and sociodemographic variables in a tertiary care hospital. MATERIALS AND METHODS: We conducted a cross-sectional study in paediatric patients aged 2-18 years undergoing haemodynamic procedures for congenital heart diseases. We used the Pediatric Quality of Life Inventory (PedsQL) to assess HRQoL. The statistical analysis included descriptive statistics, χ2 tests, Kruskal-Wallis tests and multivariate linear regression analysis with the aim of identifying factors associated with HRQoL. RESULTS: The sample included 164 patients, among whom pulmonary atresia and patent ductus arteriosus were frequent diagnoses. Physical functioning and school functioning were significantly impaired, with median scores of 32.14 (IQR, 17.14-62.87) and 56 (IQR, 28-88), respectively. The results were more favourable for emotional functioning and social functioning, with median scores of 62 (IQR, 32-74) and 68 (IQR, 44-100), respectively. Single ventricle defects and pulmonary atresia were associated with lower quality of life scores in emotional functioning (P = .035) and physical functioning (P = .048), respectively. CONCLUSION: This study highlights the current challenges in evaluating HRQoL for children with CHD. It identified significant associations between specific diagnoses and decreased HRQoL scores, emphasizing the need for comprehensive care strategies.

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The giant anteater (Myrmecophaga tridactyla) is a vulnerable species that is threatened mostly due to anthropogenic pressure. The anteater is a highly specialized insectivore, challenging the species' ex situ maintenance and conservation efforts. Several dietary-associated health issues have been reported in captive anteaters, including heart conditions such as dilated cardiomyopathy. On the other hand, cardiopathy is mainly diagnosed only on necropsy, and lack of clinical reference is one of the constraints. This work describes electrocardiographic parameters in twelve zoo-kept giant anteaters (Myrmecophaga tridactyla). The giant anteaters were evaluated after chemical immobilization. Surface electrocardiography using a digital electrocardiograph was performed to acquire data on the six frontal plane leads. Four animals were placed in both left and right recumbencies to assess changes in waveforms. Nine anteaters were considered healthy and included in the statistics. The mean heart rate and electrical axis were 37.8 bpm ± 3.45 and 75.6º ± 11.43, respectively. ECG parameters results were P wave duration (ms) 89.7 ± 9.2, P wave amplitude (mV) 0.14 ± 0.05, PR segment duration (ms) 148.6 ± 23, R wave amplitude (mV) 1.55 ± 0.56, QRS complex duration (ms) 88.6 ± 12.0, QT interval duration (ms) 529.6 ± 71.2, and T wave amplitude (mV) 0.76 ± 0.21. There was no difference between left or right recumbency. Heart parameters of giant anteaters are similar to other mammals and seem to be influenced both by size and metabolic rate when comparing with other species. This is the first description of ECG parameters in giant anteaters.

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Introduction: mHealth apps (MHA) are emerging as promising tools for cardiovascular risk assessment, but few meet the standards required for clinical use. We aim to evaluate the quality and functionality of mHealth apps for cardiovascular risk assessment by healthcare professionals. Methods: We conducted a systematic review of MHA for cardiovascular risk assessment in the Apple Store, Play Store, and Microsoft Store until August 2023. Our eligibility criteria were based on the 2021 European Society Cardiology Guidelines on Cardiovascular Disease Prevention in Clinical Practice, the Framingham Risk Score, and the Atherosclerotic Cardiovascular Disease score. Our protocol was drafted using the Preferred Reporting items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. To assess quality, we used the validated Mobile Apps Rating Scale (MARS) score, which includes 19 items across four objective scales (engagement, functionality, aesthetics, and information quality) and one additional subjective scale. For functionality evaluation, we used the IMS Institute for Healthcare Informatics functionality scale. We performed data synthesis by generating descriptive statistics. Results: A total of 18 MHA were included in the review. The most common scores used were the Framingham score, ASCVD score, and Score 2. Only six apps achieved an overall score of 4 or greater in the MARS evaluation. The MHA with the highest MARS score was ESC CVD Risk Calculation (5 points), followed by ASCVD Risk Estimator Plus (4.9 points). In the IMS scale, four MHA had a high functionality score: ASCVD Risk Estimator Plus (5 points), ESC CVD Risk Calculation (5 points), MDCalc Medical Calculator (4 points), and Calculate by QsMD (4 points). Discussion: A gap exists in the availability of high-quality MHA designed for healthcare professionals to facilitate shared decision-making in cardiovascular risk assessment. Systematic Review Registration: The International Prospective Register of Systematic Reviews, identifier CRD42023453807.

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Main: The pharmacological treatment of cancer can lead to undesirable hemodynamic adverse effects. Laser therapy may promote hemodynamic balance in these patients. This study aimed to analyze the values of the biomarkers ultrasensitive C-reactive protein (PCR_us) and Homocysteine (HCy) after the use of intravascular laser irradiation of blood (ILIB) in mastectomized patients using hormonal blockers Tamoxifen and Aromatase Inhibitors. Methods: This was an experimental, placebo-controlled, randomized clinical trial with experimental (G1) and control (G2) groups. In G1, patients were irradiated with ILIB using a red laser at 660 nm on the carotid artery, while G2 received a placebo treatment. Blood collection for HCy and us-CRP biomarker evaluation was conducted monthly for 4 months. Statistical analysis was performed using R Studio 4.4.2 and JAMOVI, with a significance level of 5%. Results: A total of 21 patients participated in the study, with 12 in G1 and 9 in G2. There were no differences in age, systolic, diastolic blood pressure, and heart rate between the groups. The initial and final mean PCR_us levels for G1 were 6.8 and 3.8 mg/dL, and for HCy were 14.2 and 12.1 µmol/L, respectively. While for G2 initial and final mean PCR_us levels were 9.40 and 7.60 mg/dL, and for HCy were 14.33 and 16.69 µmol/L. There was no statistical difference for PCR_us. However, a significant difference between the groups (p < 0.05) for HCy in the 3rd and 4th months. Conclusion: During ILIB Therapy, there was a reduction in HCy, which may favor the improvement of cardiovascular function in these patients undergoing anticancer therapies.

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El bloqueo auriculoventricular (BAV) corresponde a una alteración del sistema de conducción cardiaca, relacionada a diversos factores de riesgo y sin estudios epidemiológicos actualizados en Chile. Objetivo: Describir las tasas de egreso hospitalario (TEH) por BAV 1°, 2° y completo, durante 2019-2022 en Chile. Material y métodos: Estudio descriptivo, de tipo ecológico y transversal, sobre egresos hospitalarios por BAV entre los años 2019-2022 en Chile, según sexo, grupo etario y tipo de bloqueo, se calculó TEH (N=11.019). Los datos usados fueron obtenidos del Departamento de Estadística. No se requirió Comité de Ética. Resultados: Se evidenció una TEH del periodo de estudio de 15,68 por cada 100.000 habitantes. La mayor TEH se obtuvo durante 2022 con 18,41. Del total de datos, la TEH más alta se observó en el sexo masculino con 18,41. En cuanto a los grupos etarios, destaca el rango de 80 años y más con una TEH de 230,27. El BAV completo presentó la TEH más elevada con 12,04.18 Discusión y conclusión: Los datos obtenidos en el estudio muestran una disminución de egresos hospitalarios durante el 2020-2021 y un posterior aumento en el 2022, lo cual puede atribuirse al contexto de la pandemia de SARS-CoV-2. La edad, el sexo y el tipo de BAV con mayores tasas coinciden con los factores de riesgo asociados a esta patología y literatura internacional. El estudio constituye así un indicador epidemiológico relevante al no haber trabajos anteriores de esta índole.

Atrioventricular block (AVB) is an alteration of cardiac conduction system, related to many risk factors and without updated epidemiology studies in Chile. Objective: To describe the hospital discharge rate for first-degree, second-degree and third-degree atrioventricular block in Chile during 2019-2022. Material and methods: Descriptive, ecological and cross-sectional study about hospital discharge rate for AVB during 2019-2022 in Chile. It was considered information related to year, gender, age range and AVB degree and hospital discharge rate was calculated (N=11.019). The data was obtained from the Department of Statistics. No Ethics Committee was required. Results: A general rate of 15.68 per 100,000 inhabitants was observed during the study period. The highest hospital discharge rate occurred in 2022 with 18.41. Among the total data, the highest hospital discharge rate was observed in males with 18.41. The age range of 80 years and older presents the highest rate with 230,27 per 100.000 inhabitants. Additionally, the third-degree AVB shows the highest rate of hospital discharges with 12,04. Discussion and conclusion: The data obtained shows a decrease in hospital discharges during 2020-2021, followed by an increase in 2022. This could be explained by the SARS-CoV-2 pandemic context. Age, gender and AVB degree with higher hospital discharge rates match the risk factors of AVB. This study is a relevant epidemiology indicator because of the lack of information about this topic.

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Resumen Introducción: El síndrome de burnout es un fenómeno social y ocupacional reconocido por la OMS, frecuente en el área de la salud. Se caracteriza por baja realización personal, agotamiento emocional y despersonalización, afectando el desempeño profesional y estrategias de afrontamiento. A pesar de la relevancia del tema, es insuficiente la información disponible que permita visualizar la magnitud del problema con cifras reales en Colombia y, en especial, en el área de cardiología. Objetivo: Determinar la prevalencia del síndrome de burnout y las características sociodemográficas de médicos que realizan especialización en cardiología y cardiólogos en Colombia. Materiales y método: Estudio observacional, analítico, de corte transversal, realizado en Colombia mediante la aplicación de una encuesta virtual autodiligenciada dirigida a médicos que cursan especialización en cardiología y a cardiólogos. La primera parte de la encuesta obtuvo datos sociodemográficos-económicos y la segunda parte aplicó el cuestionario de Maslach Burnout Inventory (MBI), herramienta validada para evaluar síndrome de burnout. Resultados: En total se realizaron 207 encuestas; 145 médicos contestaron la primera parte, 67.59% eran hombres, la edad media fue 40.8 años, 64% de los cardiólogos y 79% de los estudiantes consideran que no tienen tiempo suficiente para realizar otras actividades diferentes a la medicina (p = 0.18). Al aplicar MBI, las dimensiones más afectadas son agotamiento emocional, baja realización personal y despersonalización. Al comparar cardiólogos y estudiantes, los segundos tienen mayor proporción de compromiso en las tres dimensiones. Teniendo en cuenta las dos dimensiones más afectadas, 61.72% de los cardiólogos y 81.57% de los estudiantes de cardiología tienen alta puntuación de síntomas sugestivos de síndrome de burnout. Conclusión: La prevalencia del síndrome de burnout en estudiantes de cardiología y cardiólogos incluidos en la encuesta descrita, es alta y amerita la realización pronta de estrategias que busquen retirar o mitigar factores que se asocien a mayor riesgo de presentar esta condición, que impacta directamente en el desempeño profesional y la calidad de vida de los médicos.

Abstract Introduction: Burnout syndrome is a social and occupational phenomenon recognized by the WHO, and common in healthcare. It is characterized by low personal accomplishment, emotional exhaustion, and depersonalization, affecting professional performance and coping strategies. Despite the relevance of the topic, there is insufficient available information to visualize the magnitude of the problem with real figures in Colombia, especially in the field of cardiology. Objective: To determine the prevalence of burnout syndrome and the sociodemographic characteristics of cardiology students and cardiologists in Colombia. Materials and method: Cross-sectional analytical observational study conducted in Colombia through the application of a self-completed virtual survey made to cardiology students and cardiologists in Colombia. The first part of the survey collected sociodemographic and economic data; in the second part was applied the Maslach Burnout Inventory (MBI) questionnaire. Results: A total of 207 surveys were conducted, 145 physicians answered the first part, 67.59% were men, the mean age was 40.8 years old, 64% of the cardiologists and 79% of the students consider that they do not have enough time to perform other activities not related to medicine (p = 0.18). When applying MBI, the most affected dimensions in the physicians surveyed are emotional exhaustion followed by low personal accomplishment and finally depersonalization. Comparing cardiologists and cardiology students, students have the highest proportion of compromise in all three dimensions. Taking into account the two most affected dimensions, 61.72% of the cardiologists and 81.57% of the cardiology students have a high score of symptoms suggestive of a diagnosis of burnout syndrome. Conclusion: The prevalence of burnout syndrome in cardiology students and cardiologists included in the described survey is high, this warrants the early implementation of strategies that seek to remove or mitigate factors that are associated with a higher risk of presenting this condition, which directly impacts the professional performance and quality of life of health professionals.

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Background.Anecdotal reports are appearing in the scientific literature about cases of brain tumors in interventional physicians who are exposed to ionizing radiation. In response to this alarm, several designs of leaded caps have been made commercially available. However, the results reported on their efficacy are discordant.Objective.To synthesize, by means of a systematic review of the literature, the capacity of decreasing radiation levels conferred by radiation attenuating devices (RADs) at the cerebral level of interventional physicians.Methodology.A systematic review was performed including the following databases: MEDLINE, SCOPUS, EBSCO, Science Direct, Cochrane Controlled Trials Register (CENTRAL), WOS, WHO International Clinical Trials Register, Scielo and Google Scholar, considering original studies that evaluated the efficacy of RAD in experimental or clinical contexts from January 1990 to May 2023. Data selection and extraction were performed in triplicate, with a fourth author resolving discrepancies.Results.Twenty articles were included in the review from a total of 373 studies initially selected from the databases. From these, twelve studies were performed under clinical conditions encompassing 3801 fluoroscopically guided procedures, ten studies were performed under experimental conditions with phantoms, with a total of 88 procedures, four studies were performed using numerical calculations with a total of 63 procedures. The attenuation and effectiveness of provided by the caps analyzed in the present review varying from 12.3% to 99.9%, and 4.9% to 91% respectively.Conclusion.RAD were found to potentially provide radiation protection, but a high heterogeneity in the shielding afforded was found. This indicates the need for local assessment of cap efficiency according to the practice.

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Mechanical circulatory support is an established therapy to support failing hearts as a bridge to transplantation. Although tolerated overall, arrhythmias may occur after ventricular assist device implantation and can complicate patient management. We report on an infant with dilated cardiomyopathy who developed ventricular tachycardia followed by recalcitrant ventricular fibrillation, refractory to comprehensive medical therapy post Berlin Heart EXCOR® (BHE) implant.

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Resumen Objetivo: El objetivo del presente estudio es evaluar en nuestro medio la prevalencia de anemia en el preoperatorio de la cirugía cardiovascular, su incidencia postoperatoria y su evolución durante el primer mes. Métodos: Se realizó un estudio de cohorte prospectivo en el que se incluyeron todos los pacientes sometidos a cirugía cardiovascular central intervenidos durante el periodo del 01/09/2021 al 01/09/2022 en un hospital universitario. Se realizó seguimiento clínico y de laboratorio previo a la cirugía, al quinto y al día treinta del postoperatorio. Se comparó a los grupos con y sin anemia preoperatoria. Resultados: La prevalencia de anemia en el preoperatorio fue del 32.1%. La incidencia de anemia en el postoperatorio fue del 96% en el grupo de pacientes sin anemia previa. Al mes de la cirugía un 73 y un 90% de los pacientes, con y sin anemia preoperatoria respectivamente, persistían anémicos. Los pacientes con anemia preoperatoria tuvieron una menor recuperación de sus valores de hemoglobina al mes. Se observó una tendencia a mayor mortalidad y una mayor necesidad de derivación a centros de rehabilitación postegreso hospitalario en aquellos con anemia preoperatoria. Conclusiones: En este trabajo se evidenció una alta prevalencia e incidencia de anemia en el perioperatorio de las cirugías cardiovasculares. Así como su subtratamiento y elevada persistencia durante el mes posterior a la cirugía.

Abstract Objective: The aim of this study is to evaluate the prevalence of anemia in the preoperative period of cardiovascular surgery, its postoperative incidence and its evolution during the first month in our setting. Methods: A prospective cohort study was carried out in which all patients undergoing central cardiovascular surgery operated during the period 09/01/2021-09/01/2022 in a university hospital were included. Clinical and laboratory follow-up was carried out prior to surgery, on the fifth and on the 30th postoperative day. Groups with and without preoperative anemia were compared. Results: The prevalence of anemia in the preoperative period was 32.1%. The incidence of anemia in the postoperative period was 96% in the group of patients without previous anemia. One month after surgery, 73 and 90% of the patients, with and without preoperative anemia, respectively, remained anemic. Patients with preoperative anemia had less recovery of their hemoglobin values at one month. A trend towards higher mortality and a greater need for referral to post-hospital discharge rehabilitation centers was observed in those with preoperative anemia. Conclusions: In this work, a high prevalence and incidence of anemia in the perioperative period of cardiovascular surgeries was evidenced. As well as its subtreatment and high persistence during the month after surgery.

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Objectives: Describe the characteristics of the different cardiology medical residencies in Latin America. Method: Cross-sectional study that aims to evaluate the characteristics of cardiology residencies in Spanish-speaking countries of Latin America, through self-administered electronic surveys. Results: Three hundred seven residents of 147 residences were surveyed. Mean age was 31 years and 63% were male. Ninety eight percent carry out their training in the capital city. The average total training time is 4.8 years. Forty four percent complete their residency in internal medicine prior to starting cardiology, and 10% have no prior training. In cardiology training is 3 years in most countries. Fifty four percent present academic activities every day and 16% only once or less, consisting of theoretical classes (93%), clinical cases (85%), bibliographic workshops (69%), and writing scientific papers (68%). Supervision is carried out by the chief resident (45%), resident coordinator (44%), resident instructor (27%) or the department head (54%), while 2.6% do not present supervision. The main rotations were echocardiography (99%), hemodynamics (96%), coronary unit (93%), and electrophysiology (92%). Residents highlighted the need to improve academic activities (23%) and scientific production (12%). Conclusions: There are important differences in the academic and practical training between the residences of the different countries of America.

Objetivos: Describir las características de las diferentes residencias médicas de cardiología de Latinoamérica. Método: Estudio de corte transversal que tiene como objetivo evaluar las características de las residencias de cardiología en países hispanohablantes de América Latina, mediante encuestas electrónicas autoadministradas. Resultados: Se encuestó a 307 residentes de 147 residencias. La mediana de edad fue 31 años y el 63% era de sexo masculino. El 98% realiza su formación en la ciudad capital. El tiempo de formación total promedio es de 4.8 años. El 44% realiza la residencia completa en medicina interna previo al inicio de cardiología, y el 10% no tiene formación previa. En cardiología la formación es de tres años en la mayoría de los países. El 54% presenta actividades académicas todos los días y el 16% solo una vez o menos, consistente en clases teóricas (93%), casos clínicos (85%), ateneos bibliográficos (69%) y redacción de trabajos científicos (68%). La supervisión es realizada por el jefe de residentes (45%), coordinador de residentes (44%), instructor de residentes (27%) o el jefe de servicio (54%), mientras que el 2.6% no presenta supervisión. Las rotaciones principales fueron ecocardiografía (99%), hemodinamia (96%), unidad coronaria (93%) y electrofisiología (92%). El 23% resaltó la necesidad de mejorar las actividades académicas y 12% la producción científica. Conclusiones: Existen importantes diferencias en la formación académica y práctica entre las residencias de los diferentes países de América.

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The purpose of this study is to evaluate the occupational doses (eye lens, extremities and whole body) in paediatric cardiac interventional and diagnostic catheterization procedures performed in a paediatric reference hospital located in Recife, Pernambuco. For eye lens dosimetry, the results show that the left eye receives a higher dose than the right eye, and there is a small difference between the doses received during diagnostic (D) and therapeutic (T) procedures. The extrapolated annual values for the most exposed eye are close to the annual limit. For doses to the hands, it was observed that in a significant number of procedures (37 out of 45 therapeutic procedures, or 82%) at least one hand of the physician was exposed to the primary beam. During diagnostic procedures, the physician's hand was in the radiation field in 11 of the 17 catheterization procedures (65%). This resulted in a 10-fold increase in dose to the hands. The results underscore the need for optimization of radiation safety and continued efforts to engage staff in a radiation safety culture.

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BACKGROUND: The Ignacio Chávez National Institute of Cardiology (NIC) has positioned itself as an international benchmark in cardiovascular medical education, standing out for its high academic standards and human quality. OBJECTIVE: This study aims to identify the employment and academic profile of cardiology fellowship graduates from the National Institute of Cardiology of Mexico (NIC). METHODS: A cross-sectional and retrospective study was conducted, involving 473 graduates from the period 2000-2015. Data was collected through an electronic survey. RESULTS: A total of 221 graduates agreed to participate, accounting for 46.7% of the total number of graduates. Among the participants, 85.2% were male. The majority of graduates (82.4%) held Mexican nationality, while the remaining individuals represented various Latin-American nationalities. Following the completion of the cardiology fellowship, 89% of graduates pursued further postgraduate degrees. Within this group, 95.4% completed at least one additional fellowship, while 4.6% pursued a master's or PhD program. The most popular fellowship program chosen was Interventional Cardiology. On average, NIC graduates dedicate 10.8 hours per day to their work, with 6.4 hours dedicated to cardiology and 4.3 hours to their other postgraduate degree. Those employed in both public and private health systems allocate 6.1 hours and 5.2 hours per day, respectively. Additionally, 75% of graduates are involved in teaching activities. Currently, 84% of graduates are employed in Mexico. CONCLUSION: The majority of NIC graduates are physicians who further their academic training by pursuing additional postgraduate programs. They work longer hours per day compared to the general Mexican population, with a significant focus on clinical cardiology. Graduates actively seek opportunities to share their expertise through various academic activities.

ANTECEDENTES: El Instituto Nacional de Cardiología Ignacio Chávez (INC) se ha posicionado como un referente internacional en la educación médica cardiológica, destacándose por su alto nivel académico y calidad humana. OBJETIVO: El objetivo de este estudio fue identificar el perfil laboral y académico actual de los egresados del Instituto Nacional de Cardiología Ignacio Chávez (INC). MÉTODOS: Se llevó a cabo un estudio transversal y retrospectivo que incluyó a 473 egresados del INC graduados entre 2000 y 2015. Se utilizó una encuesta electrónica para recopilar los datos. RESULTADOS: Un total de 221 egresados aceptaron participar en el estudio, lo que representa el 46.7% del total de egresados. El 85.2% de los participantes son hombres. La mayoría de los egresados son de nacionalidad mexicana (82.4%), mientras que el resto se distribuye en varios países de Latinoamérica. El 89% de los egresados completó otro posgrado después de cardiología. De este grupo, el 95.4% realizó al menos una alta especialidad, mientras que el 4.6% obtuvo una maestría o doctorado. La especialidad más comúnmente elegida fue Cardiología Intervencionista. Los egresados del INC trabajan en promedio 10.8 horas al día, de las cuales 6.4 horas se dedican a la cardiología clínica y 4.3 horas al otro posgrado. Aquellos que trabajan en el sector público y privado dedican 6.1 horas y 5.2 horas al día, respectivamente. Además, el 75% de los egresados desempeña actividades de enseñanza. El 84% de los egresados trabajan en México. CONCLUSIÓN: En su mayoría, los egresados del INC son médicos especialistas que continúan su formación académica a través de la realización de otros posgrados. Trabajan más horas al día en comparación con el resto de la población mexicana, y dedican la mayor parte de su tiempo al ejercicio de la cardiología clínica. También buscan transmitir sus conocimientos a través de actividades académicas y de enseñanza.

RESUMO

OBJECTIVE: This study aimed to assess the effects of telerehabilitation with multimodal exercise on cardiac remodeling and blood pressure in hypertensive older adults. METHODS: Thirty-two hypertensive older adults (66.7 ± 5.33 years; 29.5 ± 4.22 Kg/m2; 24 female) were randomized into either a telerehabilitation or a control group. Echocardiographic parameters and blood pressure were assessed before and after the 16-week intervention. The exercise program was supervised, individualized, and offered 3×/week via videoconference. RESULTS: Blood pressure significantly decreased after telerehabilitation when compared to the control group, presenting a large effect size. The moderate effect size in relative and posterior wall thickness (g = 0.63; g = 0.61), shortening fraction (g = 0.54), and ejection fraction (g = 0.68). CONCLUSION: As a preliminary study, telerehabilitation is favorable to promote a moderate clinical improvement of some cardiac morphofunctional parameters and reduce blood pressure in hypertensive older adults.