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Vitamin D deficiency is a serious public health problem worldwide that affects not only skeletal health, but also a wide range of acute and chronic diseases. However, there is still skepticism because of the lack of randomized, controlled trials to support association studies on the benefits of vitamin D for non-skeletal health. This review was based on articles published during the 1980-2015 obtained from the Cochrane Central Register of controlled trials, MEDLINE and PubMed, and focuses on recent challenges with regard to the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D levels from dietary sources, supplements, and sun exposure. The effect of vitamin D on epigenetic fetal programming and regulation of genes that may potentially explain why vitamin D could have such lifelong comprehensive health benefits is reviewed. Optimization of vitamin D levels in children and adults around the world has potential benefits to improve skeletal health and to reduce the risk of chronic diseases, including some types of cancer, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, and severe cardiovascular disorders such as atherothrombosis, neurocognitive disorders, and mortality., (Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)

Cardiovascular diseases are a major public health problem because of their they impact on more than 30% of all deaths worldwide. In our country and in the Instituto Mexicano del Seguro Social (IMSS) are also the leading cause of death and the main cause of lost of healthy life years due to disability or premature death. 50% of deaths are premature; most of them are due to acute myocardial infarct. However, the investment for cardiovascular health is poor and there are no comprehensive cares programs focused on the treatment of this diseases or the control of their risk factors. To address this problem, the first institutional care program was developed, called "A todo corazón", which aims to strengthen actions to promote healthy habits, prevention and care of cardiovascular diseases. The initial approach is to implement a protocol of care emergency services called "Código infarto", which is intended to ensure the diagnosis and treatment of patients demanding emergency care for acute myocardial infarction and receive reperfusion treatment with primary angioplasty in the first 90 minutes, or fibrinolytic therapy in the first 30 minutes after the admission to the IMSS emergency services.

It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94.4% showed enlargement of the right chambers by echocardiography, 55.9% showed paradoxical septal motion, PASP was 66.2+22.8 mm Hg and in 43.3% the Mc Connell sign was positive. A total of 48 patients (37.7%) received thrombolysis, the remaining patients received conventional medical treatment with anticoagulation. Overall mortality was 14%.

Noncommunicable diseases have been established as a clear threat, not only to human health but also to the development and economic growth. Claiming 63% of all deaths, these diseases are currently the main murderer worldwide. The increase in the prevalence and importance of noncommunicable diseases specifically of cardiovascular risk factors such as hypertension, diabetes, dyslipidemia and obesity is the result of a complex interplay between health, economic growth and development, which is strongly associated with universal trends such as the aging of the world population, rapid unplanned urbanization, and the globalization of unhealthy lifestyles.Cardiovascular disease refers to a group of diseases involving the heart, blood vessels, or the consequences of poor blood supply due to a vascular source ill. About 82% of the burden of mortality is caused by ischemic heart disease or coronary heart disease (IHD), Stroke (both hemorrhagic and ischemic), hypertensive heart disease or congestive heart failure (CHF). The Hospital de Cardiología of the Centro Médico Nacional Siglo XXI, serves the call to improve through innovation and technological development this area of health the "tele cardiology" (regulatory center of myocardial code), with clear objectives in the short, medium and long term.

From March 1986 to January 1993, we performed percutaneous balloon mitral commissurotomy (PBMC) in ninety-one patients with rheumatic mitral stenosis, two of them during pregnancy. The gestational age at the time of valvotomy was thirty and twenty-seven weeks respectively. Balloon Inoue technique in both cases resulted in improvement in mitral valve area (0.8 vs 1.6 and 0.7 vs 1.9 cm2) and in mean mitral gradient (19 vs 4 and 12 vs 0 mm Hg) immediately after dilation, without residual atrial septal defect or mitral insufficiency. There were no complications. The estimated radiation exposure to the fetus was of 6.4 minutes of fluoroscopy and 6 seconds of angiography. To limit of X-ray irradiation, we used color Doppler echocardiography during dilatation in both cases. The subsequent course of gestation was uncomplicated and normal babies were delivered in both cases. Fetus protection against ionising radiation was assured by lead mantles. In the follow-up the mitral valve area was 1.7 and 2.1 cm2, 15 and 4 months later respectively. PBMC can be performed safely during pregnancy and is effective in increasing the valvular area and relieving symptoms. It offers an excellent alternative for the pregnant patients, with severe mitral stenosis. The risk to the fetus appears lower than previous reports of surgical commissurotomy performed during pregnancy.