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Heart masses, including tumors (primary and secondary) and pseudotumor (cysts and thrombus), are rare entities, but of increasing interest in cardiac imaging areas. The clinical manifestations are related to the intracardiac effect of mass, embolization, and systemic symptoms in the case of tumors; however, some of them are detected incidentally. Nowadays, imaging techniques and the advancement of their tools perform the morphological, functional, and tissue characterization of the masses, and additionally know the anatomical relationships, which are crucial factors for the treatment and surgical planning.

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Although uncommon, Libman-Sack endocarditis is the most characteristic cardiac manifestation of Systemic Lupus Erythematosus (SLE). It forms vegetations made of inflammatory tissue on the cardiac valves, leading them to malfunction. Here we present a case of a young woman who presented with severe mitral valve regurgitation in need for a valve replacement. Integral evaluation of the patient revealed the diagnosis of SLE, which was aggressively treated in an outpatient setting with immunosuppressive therapy. Only after achieving medical stabilization of the underlying disease, she was able to undergo surgical mitral valve replacement. After the surgery, the patient no longer suffered from mitral regurgitation, and with a mechanical prosthesis in place, the risk of Libman-Sacks endocarditis recurrence is thought to be minimal.

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We present the case of a patient with myocardial infarction and COVID-19 disease who developed hemorrhagic pericardial effusion and cardiac tamponade. The differential diagnosis included post-infarction pericarditis and mechanical complications, thrombolysis, Dressler syndrome, and viral pericarditis. The histopathologic examination of the pericardial tissue sample and electron microscopic examination established the diagnosis. (Level of Difficulty: Advanced.).

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Benign primary cardiac tumours are rare, with lipomas accounting for <9% of them. Their presentation varies depending on the size and location of the tumour, with the majority of the cases being asymptomatic. We are presenting a case of an extremely rare primary heart-tumour infiltrating the right ventricle (RV) compromising its function. RV lipomas are so unusual that there are no clear treatment guidelines. In this case, we decided to treat the patient with surgical resection of the tumour. Although a total resection was not possible, due to the tumoural proximity to vital structures, a great portion of the tumour was removed, alleviating the patient's symptoms.

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Hypertrophic cardiomyopathy (HCM) is characterized by the presence of an abnormal hypertrophy of the left ventricle (LV), without dilation, and in the absence of any condition or another cardiac or systemic disease capable of inducing such hypertrophy. This primary or idiopathic hypertrophy can occur with or without dynamic obstruction (induced by exercise) of the LV outflow tract, so in its natural history two fundamental aspects are highlighted: the production of symptoms by blocking the LV outflow tract and the occurrence of sudden cardiac death secondary to ventricular arrhythmias. This revision includes the work of different Iberoamerican investigators, who contributed in an important way to lay the groundwork of what we know nowadays as HCM. It also includes the main anatomopathological characteristics, from its initial description to the new perspective we have concerning the myofiber disarray as the main histopathologic feature.

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Objetivo Estudiar clínica y epidemiológicamente focos de leishmaniasis visceral (LV) urbana en Neiva (Colombia). Materiales y Métodos Seis niños consultaron por hepato-esplenomegalia. Presentaban anemia y leucopenia. Se realizó biopsia por aspiración de medula ósea (5 pacientes) y de bazo (1 paciente). Se hizo búsqueda activa de casos en la comunidad y de anticuerpos anti-Leishmania infantum por inmunofluorescencia indirecta (IFI) en los sintomáticos y en reservorios caninos (IFI, rK39). Se hicieron visitas domiciliarias para educación comunitaria y búsqueda de vectores. Los pacientes recibieron Miltefosina, Anfotericina B o Glucantime®. Resultados Se confirmó LV en siete niños. En seis, el aspirado de medula ósea o bazo demostró amastigotes. La IFI fue positiva en 4 pacientes y negativa en 3. Un niño se detectó por búsqueda activa comunitaria, con clínica de LV, confirmada por IFI (1:32). La miltefosina no fue útil en 6 de los 7 casos. La Anfotericina B liposomal o deoxicolato, curó 6 pacientes y el Glucantime® uno. La seroprevalencia en 1182 caninos (IFI y rK39) fue de 6.1 %; los animales positivos fueron sacrificados. Se demostró Lu. longipalpis, vector de LV, en el peridomicilio. Conclusiones Demostramos LV urbana en dos comunas de Neiva. La confirmación diagnóstica incluyó aspiración de medula ósea e IFI. La Miltefosina no fue útil. La Anfotericina B liposomal fue la terapia ideal. Para controlar la LV es necesario hacer BAC, educación comunitaria, control de vectores y reservorios.(AU)

Objective Characterize the foci of visceral leishmaniasis infection in Neiva with a clinical and epidemiological approach. Materials and Methods Six children consulted medical services with hepatosplenomegaly. They were found to have anemia and leukopenia. The diagnosis was performed by bone marrow (five patients) and spleen (1 patient) aspiration. An active search for cases was carried out in the community. Anti-Leishmania infantum antibodies were also sought out using indirect immunofluorescence (IIF) in symptomatic patients and in dogs (IFI, rK39). House calls were made in order to carry out educational activities and to collect disease vectors. Patients received miltefosine, amphotericin B or Glucantime®. Results LV was confirmed in seven children. In six of them, the bone marrow or spleen aspirate contained amastigotes. The IIF was positive in 4 patients and negative in 3. One child was detected throught the active community search, confirmed by the clinic with IIF (1:32). Six patients were cured with liposomal amphotericin B (o deoxycholate) and one patient was cured with Glucantime®. The canine seroprevalence in 1182 dogs was 6.1% (IFI and rK39); the positive animals were destroyed. L. longipalpis was found in the houses. This is the principal vector of LV in Colombia. Conclusions The study showed that two zones of Neiva have children infected with LV. Diagnostic confirmation must include aspiration of bone marrow and IIFs. Treatment with miltefosine was not helpful, but liposomal amphotericin B is an ideal therapy. To control LV, active case searching, community education and vector and reservoir control is necessary.(AU)

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Objective Characterize the foci of visceral leishmaniasis infection in Neiva with a clinical and epidemiological approach. Materials and Methods Six children consulted medical services with hepatosplenomegaly. They were found to have anemia and leukopenia. The diagnosis was performed by bone marrow (five patients) and spleen (1 patient) aspiration. An active search for cases was carried out in the community. Anti-Leishmania infantum antibodies were also sought out using indirect immunofluorescence (IIF) in symptomatic patients and in dogs (IFI, rK39). House calls were made in order to carry out educational activities and to collect disease vectors. Patients received miltefosine, amphotericin B or Glucantime®. Results LV was confirmed in seven children. In six of them, the bone marrow or spleen aspirate contained amastigotes. The IIF was positive in 4 patients and negative in 3. One child was detected throught the active community search, confirmed by the clinic with IIF (1:32). Six patients were cured with liposomal amphotericin B (o deoxycholate) and one patient was cured with Glucantime®. The canine seroprevalence in 1182 dogs was 6.1% (IFI and rK39); the positive animals were destroyed. L. longipalpis was found in the houses. This is the principal vector of LV in Colombia. Conclusions The study showed that two zones of Neiva have children infected with LV. Diagnostic confirmation must include aspiration of bone marrow and IIFs. Treatment with miltefosine was not helpful, but liposomal amphotericin B is an ideal therapy. To control LV, active case searching, community education and vector and reservoir control is necessary.

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Objetivo: Determinar la prevalencia y los factores asociados de violencia contra la mujer durante el embarazo. Métodos: Análisis secundario con la base de datos de la ENDES. Se analizaron 12587 mujeres que alguna vez estuvieron embarazadas. Se evaluaron la prevalencia y los factores asociados con la violencia como: el principal agresor, si alguna vez la hab¡an humillado, amenazado con hacerle daño o detener la ayuda económica. Se realizaron análisis bivariados para determinar la asociacion entre los factores socio-demográficos y el antecedente de haber sido v¡ctima de violencia durante el embarazó mediante el cálculo del Odds Ratio. Además, se ajustó un modelo de regresión log¡stica multiple utilizando variables sociodemográficas junto con las variables de situaciones de control. Resultados: La prevalencia de violencia f¡sica durante el embarazo fue de 11%. El 49.05% reportaron haber sido agredidas por el marido, 29.44% por la ex pareja. El 22.4% fueron humilladas por el esposo, 21.6% fueron amenazadas por el esposo de irse de la casa y detener la ayuda económica y 11.8% amenazaron con hacerle daño. Las mujeres de estrato socioeconómico medio tienen una probabilidad 64% mayor de sufrir violencia durante el embarazo en comparación a niveles más pobres. Un mayor grado de instrucción reduce en 44% la probabilidad de reportar agresión. El haber recibido amenazas aumenta 6 veces la probabilidad de sufrir violencia, el haber sido humillada por la pareja representa 5.5 veces mayor probabilidad de recibir agresión. Privarlas de ayuda económica, significó tener 4.5 veces más probabilidad de sufrir este tipo de violencia. Finalmente, según la regresión log¡stica las mujeres que sufr¡an de humillación o algún tipo de amenaza ten¡an un 73 – 80% más probabilidad de sufrir violencia durante el embarazo, en comparación a las mujeres que no. Conclusiones: Los factores psicológicos, económicos y educativos aumentan la probabilidad de violencia...

Objective: To determine the prevalence and associated factors of violence on women during pregnancy. Method: Analysis of a secondary database from the ENDES. 12587 women that suffered violence during pregnancy were analyzed. The prevalence and associated factors such as: the principal aggressor, if she had been humiliated, threatened to be harmed or stop economical aid were analyzed. Bivariated analyses and Odds ratios were used to determine the association between socio-demographic factors and the history of being a victim of violence during pregnancy. Also a logistics regression model was made using the same variables. Results: 11% of women suffered physical violence during pregnancy. 49.05% of the victims were assaulted by their husband, 29.44% were attacked by ex couples. 22.4% where humiliated by their husband, 21.6% threatened to abandon the house or stop economic aid to the women and 11.8% of them threatened to do harm to her. Middle income women had a 64% bigger probability of being attacked than low income women. Better education reduces 44% the probabilities to report aggression. Receiving threats from the husband increases 6 times the probability of suffering violence and suffering from humiliation increases 5.5 times the probability of being attacked. The threat of stopping financial aid increases 4.5 times the probability of being assaulted by the husband. Finally, a big percentage of violence could be estimated if the person suffered humiliation, or any kind of threat. Conclusions: Psychological, economical, and educational factors increase the probability of violence during pregnancy. It is necessary to set preventive programs based on training of professionals who attend pregnant women in order to identify violence cases and to promote assistant and protection too.

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El pénfigo familiar crónico (Enfermedad de Hailey-Hailey) es poco frecuente, se caracteriza por lesiones ampollosas en cuello, axila, fosa cubital, área inframamaria, zona periumbilical, ingle, escroto, vulva y zona perianal; presentamos el caso de un paciente con esta enfermedad, el que respondió en forma favorable al tratamiento con esteroides, dapsona y antibióticos.

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La presente comunicación trata sobre un caso de fractura lujación de hueso grande acompañado de fractura de escafoides carpiano, caso raro e importante por no haber sido diagnosticado hasta 5 semanas después de la lesión y cuya evolución luego de un año del tratamiento es satisfactoria

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