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Introduction and Objectives: In patients undergoing percutaneous coronary intervention (PCI) in the workup pre-transcatheter aortic valve replacement (TAVR), the clinical impact of coronary revascularization complexity remains unknown. This study sought to examine the impact of PCI complexity on clinical outcomes after TAVR in patients undergoing PCI in the preprocedural workup., Methods: This was a multicenter study including consecutive patients scheduled for TAVR with concomitant significant coronary artery disease. Complex PCI was defined as having at least 1 of the following features: 3 vessels treated, ≥ 3 stents implanted, ≥ 3 lesions treated, bifurcation with 2 stents implanted, total stent length >60mm, or chronic total occlusion. The rates of major adverse cardiac events (MACE), including cardiovascular mortality, myocardial infarction, and coronary revascularization were evaluated., Results: A total of 1550 patients were included, of which 454 (29.3%) underwent complex PCI in the pre-TAVR workup. After a median follow-up period of 2 [1-3] years after TAVR, the incidence of MACE was 9.6 events per 100 patients-years. Complex PCI significantly increased the risk of cardiac death (HR, 1.44; 95%CI, 1.01-2.07), nonperiprocedural myocardial infarction (HR, 1.52; 95%CI, 1.04-2.21), and coronary revascularization (HR, 2.46; 95%CI, 1.44-4.20). In addition, PCI complexity was identified as an independent predictor of MACE after TAVR (HR, 1.31; 95%CI, 1.01-1.71; P=.042)., Conclusions: In TAVR candidates with significant coronary artery disease requiring percutaneous treatment, complex revascularization was associated with a higher risk of MACE. The degree of procedural complexity should be considered a strong determinant of prognosis in the PCI-TAVR population., (Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Health professionals who care for patients with imported diseases often lack enough training. The aim of the study is to assess the knowledge of Chagas disease among doctors and nurses attending at-risk pregnant women in our province., Method: descriptive study through a performed anonymous and voluntary knowledge questionnaire for 278 physicians and nurses working at maternity and children's health services in the three hospitals in the province. In Poniente Hospital was established in 2007 a program of screening for the disease in pregnant women. For statistical analysis, quantitative variables were described using the mean and standard deviation. For comparison of qualitative variables we used the chi-square test or Fisher exact test as appropriate. Differences in age and years of experience depending on the hospital were measured by Brown-Forsy the robust test., Results: 116 (41.7%) professionals agreed to participate in the study. 80 (69%) were women and 36 (31%) men, mean age 36.78 years. By professional categories, physicians have a mean of 73.9% correct responses, the nurses 50.7%. Poniente Hospital had the highest percentage of correct answers on aspects of the geographical distribution of the disease (73.7%), the mechanisms of transmission (86%) and diagnosis (82.5%)., Conclusions: The Poniente Hospital professionals generally have a better Knowledge about Chagas disease compared with two other professionals hospitals, which probably is related to the existence of the screening program for the disease.

Introduction: The transmission of Chagas disease is a public health problem in non-endemic countries., Methods: Chagas screening was performed by two serological tests in pregnant women from endemic areas for 4 years., Results: We studied 261 pregnant women from 13 Latin American countries, making a confirmatory diagnosis (two positive tests) in 4 cases. There was no case of vertical transmission., Conclusion: Although Chagas disease has a low prevalence in the province of Almeria, the screening is necessary for the detection and treatment of infants with the disease., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)

Objective: To assess the perception and experience with food insecurity among Latinos living in California, as well as their interpretation of the items included in the Food Security Scale., Material and Methods: A series of four focus groups were carried out among 30 adults of Latin-American descent living in California. The participant's responses were coded by two researchers to identify the main issues, and to compare them for assessing their convergence., Results: The items were well understood and were not perceived as offensive. The conceptual framework was confirmed as a "managed process" with different severity levels. The causes of food insecurity were: unemployment, high cost of some food items, and lack of nutritional information. The demand for nutritional education was constant., Conclusion: Interpreting data on food insecurity in Latinos requires proper consideration of their particular perceptions.