Search

Hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract obstruction that doesn't improve with pharmacological management often requires septal myectomy. However, there are few centers with experience in the practice of this procedure in our country. We describe the clinical and echocardiographic characteristics and postoperative outcomes of patients with HCM indicated for septal myectomy at a reference center in Colombia., Materials and Methods: Retrospective cohort study. Patients undergoing septal myectomy between 2010 and 2023 were included. Data were collected before and two years after surgery., Results: 18 patients were included. The mean age was 50 years. The predominant functional class was NYHA II/III (94 %). Asymmetric septal variant (83.3 %) was the most frequent as well as obstructive phenotype (88.8 %). After myectomy, 70.5 % improved to NYHA I and 62.4 % had no significant gradient (<30 mmHg), and the most of patient improved SAM. One patient died post-procedure, anymore complications were presented., Discussion/conclusions: Septal myectomy is a safe procedure, with clinical and echocardiographic improvement, with low complication rates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: Locally advanced cervical cancer may present with uncontrollable vaginal bleeding in up to 70% of cases. Pelvic vessel embolization has been used as an urgent maneuver for achieving fast hemostatic control. This report describes outcomes of selective pelvic vessel embolization in patients with severe bleeding due to a locally advanced cervical cancer., Methods: In this retrospective study, technical aspects, clinical variables, and bleeding-related morbidity were described. The frequency of recurrent disease and the vital status at 1 year of follow-up were determined. Analysis was performed with statistical software R, version 3.6.2. The setting was Instituto Nacional de Cancerología- Bogotá, Colombia, between January 2009 and July 2017., Results: A total of 47 patients were included. Median age was 44 years (range, 26-70 years). The pre-embolization median hemoglobin level was 7.9 g/dL (range, 5.0-11.3 g/dL). Blood transfusions were administered to 41 women (87.2%). Bleeding control was achieved in 95.7% of cases in the first 24 hours after the embolization. There were no major complications. In 17 cases (36.2%), minor complications were reported; the most common was pelvic pain. In 17.1% of cases, a second embolization was required. After 12 months of follow-up, 27.7% of patients were alive without disease, 44.7% were alive with disease, and 25.5% of them have died of cervical cancer progression., Conclusion: Selective pelvic vessel embolization is a useful alternative in patients with locally advanced cervical cancer and life-threatening bleeding. Its impact on recurrent disease and death due to oncologic cause is not clear.

Abstract: The phenotypic structure within and between plant populations is generally influenced by their distribution patterns in space and time; therefore, the study of their divergence is a central issue for the understanding of their microevolutive processes. We boarded the hypothesis that three populations of Espeletia pycnophylla show phenotypic divergence as one of the possible implications of their geographic isolation in the Southern Colombian Andes. We used the Elliptic Fourier Descriptors (leaf shape) and traditional leaf morphometry (leaf size) of 347 leaves to measure inter and intra-population variation and a comparison between a paleogeographic reconstruction with an actual estimate of the distribution areas of E. pycnophylla in order to identify their main changes during the last 14 000 years. The three populations showed significant differences in leaf morphometry and a positive correlation between the matrices of morphometric and geographic dissimilarities, indicating that the inter-population divergence increases between further populations, so that the morphometric structure reflects their spatial distribution. The geographical and paleogeographical estimates evidenced a conspicuous process of reduction and fragmentation of the distribution area of E. pycnophylla since the Late-Glacial until the Holocene. We suggest that these results support possible scenarios of vicariance events, which allow us to approach the divergence of these populations in terms of their historic biogeographic relations. However, genetic analyses are still needed to support these results.