Pregnancy carries the potential risk of developing and maintaining a nutritional status characterized by persistent obesity. This can be magnified when weight gains exceed established recommendations. This postpartum weight retention can significantly contribute to long-term excess weight and cardiovascular events. Objective: to describe weight retention at 3 and/or 6 months postpartum in women who consulted at the Pediatric Development and Research Institute (IDIP). Methodology: analytical, retrospective cross-sectional study. Data were collected from the medical records of women who underwent health check-ups at 3 and/or 6 months postpartum. Multiple linear regressions were performed relating postpartum weight retention to those conditioning factors. Results: The sample was made up of 257 women who underwent controls at 3 months and 577 at 6 months postpartum. Weight retention at 3 months postpartum was negatively associated with primiparity, higher level of education, newborn weight and exclusive breastfeeding, while at 6 months it was only found with these last two factors. Weight retention at 3 and 6 months was positively related to gestational weight gain. Conclusion: Postpartum weight retention increases influenced by weight gain during pregnancy, but primiparity, schooling, newborn weight and breastfeeding seem to be factors that contribute to reducing it.
Survival and clinical prognosis after bidirectional ventricular tachycardia (BiVT), defined as a dual QRS morphologies alternating on a beat-to-beat basis in the inferior leads, is unknown. To describe events during follow-up and therapeutic approaches to BiVT. We conducted an ambispective and multicentric registry on 13 hospitals, consisting on relevant clinical characteristics, diagnosis, therapeutics and follow-up. A total of 19 patients were evaluated, with their clinical characteristics and etiologies summarized in the Table. Among them, 42% received an implantable cardioverter-defibrillator (ICD) before discharge. The mean follow-up period was 39 (12;104) months. Beta-blockers were the most commonly prescribed and clinically effective medication at discharge (26.32%), followed by flecainide and amiodarone. The recurrence rate during follow-up was 36.84%. No in-hospital mortality was observed; however, two patients died within the first year after the event, due to heart failure and septic shock. Kaplan-Meier curves (Figure) illustrate the composite endpoint of death and/or recurrences (n=9). Distinct etiologies showed varying recurrence rates (n=7), with channelopathies (Andersen-Tawil and/or CPVT) accounting for the highest recurrence rate at 71% (5 cases). In contrast, all mortality events occurred in patients with structural heart disease. Our study represents the largest population of BiVT described to date with structured follow-up. Both, recurrences and mortality are linked to the etiology rather than the descriptive bidirectionality on the ECG. Nearly half of the population suffered the composite end-point of recurrence and/or death, which might be due to the existence of a permanent trigger (i.e. channelopathy) and the absence of etiology-tailored treatments. Figure (Kaplan-Meier curve)
Ataxia-telangiectasia (A-T) is a DNA repair disorder characterized by progressive degeneration, immunodeficiency, cancer predisposition, malnutrition, metabolic disorders, and chronic liver disease. The study aims to describe the nutritional status and plasma levels of biomarkers of lipid status, metabolic profile, and liver function of patients with A-T. A total of 218 patients from 9 Latin American countries were included in the study. The distribution of patients according to nutritional status by age group revealed an over-time increase in the proportion of patients with severe thinness (p = 0.016). High glucose and triglyceride levels were observed in 9.5
Bidirectional ventricular tachycardia (BiVT) is an uncommon tachycardia which underlying etiological cause is attributed to multiple pathologies. to describe the clinical correlates and therapeutic approaches to BiVT. we conducted an ambispective and multicentric registry on 13 hospitals, consisting on relevant clinical characteristics, diagnosis and therapeutics. A total of 19 patients were evaluated (63% female). The age distribution was bimodal, with peaks at 21.5 (13;36) and 43 (32;70) years-old, corresponding to varying etiologies. In the younger group, Andersen-Tawil syndrome accounted for 36.84% of cases, and catecholaminergic polymorphic ventricular tachycardia (CPVT) represented 10.53%. Etiologies in the older group were more diverse (see Table). Potassium levels during acute episodes were within the normal range (3.8±4.4 mmol/L). Most episodes occurred without the use of antiarrhythmic medications (63.16%); β-blockers were used in 26.32% of patients, and digoxin in 15.79%. Palpitations were the most frequently reported symptom (52.63%), with cardiac arrest as the primary clinical presentation in three patients (15.79%). Most cases of bidirectional ventricular tachycardia (BiVT) resolved spontaneously, though four cases (none of which were CPVT) required electrical cardioversion, successfully restoring stable sinus rhythm. Recurrence was absent in 87.5% of patients within a short follow-up period, with 48% receiving antiarrhythmic treatment, primarily amiodarone (21.05%), or β-blockers. However, 36.84% of patients experienced additional ventricular arrhythmias (VT or VF) in the acute phase, with 45.54% of these cases requiring cardioversion or defibrillation. All patients presenting with cardiac arrest as the primary symptom were within this group. Supraventricular arrhythmias were observed in 31.58% of patients in the acute setting, with atrial fibrillation being the most common (21.05%). Additional clinical details are available in Table. Our study represents the largest population of BiVT described to date. Individuals with cardiac arrest presented with concomitant ventricular arrhythmia.
Electrocardiographical (ECG) features in patients with bidirectional ventricular tachycardia (BiVT), defined as a dual QRS morphologies alternating on a beat-to-beat basis in the inferior leads, has not been properly assessed to date. to sistematically describe the ECG characteristics during sinus rhythm and BiVT and its relationship with various etiologies. we conducted an ambispective and multicentric registry on 13 hospitals, consisting on relevant clinical characteristics and ECG characteristics. Beat A was defined has having a net positive QRS in the inferior leads, whereas beat B had a net negative QRS in the inferior leads. A total of 19 patients were evaluated, with their ECG characteristics in sinus rhythm summarized in the Table 1 and BiVT features in Table 2. During sinus rhythm a high prevalence of U wave was observed (63.16% of the patients), which is consistent with the predominant underlying etiologies (50% of Andersen-Tawil and CPVT; the other etiologies were, mainly: digoxin intoxication [15.79%] and various cardiomyopathies). The BiVT exhibits a relatively narrow QRS for both beats, with an alternating axis between 114.8º for beat A and -76º for beat B and a similar slew rate (≈0.019 volts/sec) for both beats in sinus rhythm and BiVT. The predominant morphology in V1 was right bundle branch block (RBBB), which was greater than 80% for both beats. A non-statistically significant trend of slower HR during tachycardia was noted in channelopathies vs the rest of the etiologies (150.0±9.03ms vs 169.3±20.7, p=0.40). Our study represents the largest population of BiVT described to date with structured ECG data collection. The absence of a predominant extreme axis (i.e. between -90 and -280º) and the relatively narrow QRS might be a reflect of the genesis of the arrhythmia within the His-Purkinje system via a "ping-pong" reciprocating bigeminy mechanism, as previously hypothesized.
