RESUMEN
The global environment is rapidly changing and the subsequent effects on human health are devastating. Planetary Health is a field focused on characterizing the human health impacts of human-caused disruptions of Earth's natural systems. It has been determined that Family Physicians (FPs) are the best suited to advocate and raise awareness of Planetary Health. The purpose of this research is to assess FPs in the Caribbean, their knowledge of planetary health, their ability to implement planetary health concepts in their practice, and the challenges that may impede implementation.
Asunto(s)
Humanos , Médicos de Familia , Trinidad y Tobago , Salud , AmbienteRESUMEN
Anomalous origin of the right coronary artery (RCA) from the pulmonary artery (PA) is a rare congenital anomaly, and only 28 cases have been reported in the pediatric age group. We describe the case of an infant who had progressive mitral regurgitation and papillary muscle dysfunction in association with anomalous origin of the RCA from the PA. The diagnosis was made by color flow Doppler, confirmed by angiography, and the case was successfully corrected by reimplantation of the anomalous RCA to the aorta. This is only the second case of anomalous origin of the RCA from the PA diagnosed in infancy without an associated congenital anomaly of the heart and great vessels.
Asunto(s)
Anomalías de los Vasos Coronarios/complicaciones , Insuficiencia de la Válvula Mitral/diagnóstico , Insuficiencia de la Válvula Mitral/etiología , Arteria Pulmonar/anomalías , Angiografía , Procedimientos Quirúrgicos Cardíacos/métodos , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Anomalías de los Vasos Coronarios/cirugía , Femenino , Humanos , Recién Nacido , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/cirugía , Ultrasonografía Doppler en ColorRESUMEN
OBJECTIVE: Heart transplantation has become available as a possible treatment for patients with malignancies. Primary cardiac malignant tumors are extremely rare but several patients have been treated with this modality. Whether survival is improved over the direct removal of tumor or heart transplantation is not known. We compiled data regarding malignant primary heart tumors that have been treated at various transplant centers in order to determine if early diagnosis and treatment with cardiac transplantation has resulted in an improved mortality. METHODS: A total of 173 questionnaires were sent to the heart transplant centers across the United States and Canada inquiring about those patients who were found to have a primary cardiac malignant tumor and who underwent heart transplantation. Cases reported in the literature, which had undergone transplantation, were also reviewed by a search in MEDLINE. RESULTS: Twenty-four cases were collected. The overall survival time was from 1 month to 66 months. The actuarial survival was 54% at 12 months, 45% at 24 months and 35% at 36, 48 and 60 months respectively. Metastases were present in 10 out of the 14 deceased patients, possibly being one of the major factors affecting survival. Only 1 living patient developed metastases. CONCLUSION: Survival rates of patients with primary cardiac malignancies treated with resection, radiation, chemotherapy, or a combination of them (conventional therapy) versus heart transplantation are similar. Early diagnosis and resection are the most important factors for a better outcome, however these factors will not guarantee success since the presence or development of metastasis is a major contributor to death in both groups of patients
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Neoplasias Cardíacas/cirugía , Trasplante de Corazón , Canadá/epidemiología , Estados Unidos/epidemiología , Encuestas de Atención de la Salud , Neoplasias Cardíacas/mortalidad , Neoplasias Cardíacas/terapia , Tasa de Supervivencia , Trasplante de Corazón/mortalidadRESUMEN
OBJECTIVE: Heart transplantation has become available as a possible treatment for patients with malignancies. Primary cardiac malignant tumors are extremely rare but several patients have been treated with this modality. Whether survival is improved over the direct removal of tumor or heart transplantation is not known. We compiled data regarding malignant primary heart tumors that have been treated at various transplant centers in order to determine if early diagnosis and treatment with cardiac transplantation has resulted in an improved mortality. METHODS: A total of 173 questionnaires were sent to the heart transplant centers across the United States and Canada inquiring about those patients who were found to have a primary cardiac malignant tumor and who underwent heart transplantation. Cases reported in the literature, which had undergone transplantation, were also reviewed by a search in MEDLINE. RESULTS: Twenty-four cases were collected. The overall survival time was from 1 month to 66 months. The actuarial survival was 54% at 12 months, 45% at 24 months and 35% at 36, 48 and 60 months respectively. Metastases were present in 10 out of the 14 deceased patients, possibly being one of the major factors affecting survival. Only 1 living patient developed metastases. CONCLUSION: Survival rates of patients with primary cardiac malignancies treated with resection, radiation, chemotherapy, or a combination of them (conventional therapy) versus heart transplantation are similar. Early diagnosis and resection are the most important factors for a better outcome, however these factors will not guarantee success since the presence or development of metastasis is a major contributor to death in both groups of patients.