Abstract Background : Surgery for functional tricuspid valve insufficiency is indicated in cases of congestive heart failure usually associated to left heart valve diseases or as a concomitant surgery for other causes such as congenital or coronary disease. Aim : To assess and report the long-term results of tricuspid valve repair in adult patients in a regional cardiac surgery center in south Chile. Patients and Methods : Retrospective review of clinical and operative records of 114 patients aged 57.8 +/- 13 years (72 women) subjected to tricuspid reparative surgery concomitant with other cardiac procedures between 2009 to 2017. Results : In 45% of cases etiology was due to inactive rheumatic disease and 2.6% was due to endocarditis. 63% presented with atrial fibrillation and 75% were in NYHC CFIII. 15.8% had a previous cardiac valve surgery. Preoperative echocardiography showed severe tricuspid insufficiency in 56% of cases and pulmonary hypertension was severe in 39.5%. In all cases tricuspid repair was performed through the insertion of a semi rigid ring as a concomitant procedure for mitral repair/replacement in most cases, aortic valve replacement, surgical closure of an ASD, CABG surgery and the resection of cardiac tumors. Overall postoperative mortality was 16% due to multi-organic dysfunction in 6%, cardiac failure in 5% and cerebral hemorrhage in 4.3%. Mean long term follow up was 78.8+/- 7.2 months. Actuarial survival was 74% at 60 and 68% at 96 months. Conclusion: Surgical tricuspid valve repair for moderate to severe tricuspid insufficiency isolated or associated to other cardiac diseases provides a good symptomatic recovery, with an excellent long term survival.

Resumen Antecedentes la reparación de la insuficiencia tricuspídea funcional está indicada en casos de insuficiencia cardíaca, generalmente, asociada a enfermedades de las válvulas cardíacas izquierdas y en algunos casos de enfermedad coronaria o cardiopatías congénitas. Objetivo : evaluar los resultados a largo plazo de la reparación tricuspídea en pacientes operados en la región centro sur de Chile. Pacientes y métodos : estudio retrospectivo de registros clínicos y operatorios en 114 pacientes con edad promedio 57.8 (DE 13) años (72 mujeres) sometidos a reparación tricuspídea asociada a otros procedimientos quirúrgicos entre 2009 y 2017. Resultados : la etiología de la insuficiencia tricuspídea fue debida a enfermedad reumática inactiva en 45% y a endocarditis infecciosa en 2.6%. 63% estaban en fibrilación auricular y 75% en capacidad funcional NYHC III. 15.8% tenían cirugía valvular cardíaca previa. El ecocardiograma mostró insuficiencia severa en 56% de los casos y había hipertensión pulmonar severa en 39.5%. La cirugía consistió en la implantación de un anillo semi-rígido en forma concomitante a reemplazo o reparación de lesión valvular mitral, reemplazo valvular aórtico, cierre de comunicación interauricular, cirugía coronaria o resección de tumor intra cardíaco. La mortalidad post operatoria global fue 16%, debido a falla multisistémica en 6%, insuficiencia cardíaca en 5% y hemorragia cerebral en 4.3%. El seguimiento promedio fue 78.8 (DS 7.2) meses. La supervivencia actuarial fue 74% a los 60 y 68% a los 96 meses. Conclusión : La cirugía de reparación de la insuficiencia tricuspídea moderada o severa, asociada a otras enfermedades cardíacas provee una buena recuperación sintomática, con excelente sobrevida alejada.

Austrian syndrome is a triad characterized by pneumonia, meningitis and endocarditis, as a result of a Streptococcus pneumoniae bacteremia. We report a previously healthy 49 year-old male, who consulted at the emergency care unit with a history of one week of pleuritic pain, fever leading to an altered level of consciousness and seizures. A diagnosis of community-acquired pneumonia and meningitis was reached, isolating Streptococcus pneumoniae in the cerebrospinal fluid and blood cultures. Antibiotic treatment was started but the patient had an unsatisfactory response. During hospitalization a new heart murmur was found in the physical examination. An echocardiography was performed and a massive aortic valve insufficiency was found along with vegetations and a perforation of the same valve. The valve was replaced by a prosthetic one and the patient responded satisfactorily to the surgical and antibiotic treatment, without complications.

Comportamentos de ajuda entre passageiros de ônibus podem contribuir para a qualidade do transporte público. Durante 40 viagens e observações sistemáticas em duas linhas de ônibus registrou-se sob quais condições passageiros sentados auxiliariam quem viajava de pé, oferecendo-se para carregar as bagagens. De maneira geral, ajuda foi recebida em 60% das situações criadas. Significativamente mais ajuda foi oferecida numa linha para a periferia da cidade do que numa linha para o centro da cidade. Mulheres estiveram mais dispostas a ajudar e verificou-se uma tendência de oferecer mais ajuda em situações de contato face a face. Os dados sugerem que se pode encontrar comportamentos pró-sociais entre passageiros que favoreçam a qualidade no transporte público da cidade. A implementação de avisos educativos no interior dos ônibus e nos terminais rodoviários pode incentivar a ajuda entre passageiros, além de outros comportamentos desejáveis.

Helping behavior among passengers can contribute to the quality of mass transit. During forty bus trips, circumstances under which seated passengers would help those standing were registered by way of systematic observations. The criterion behavior was offering to hold baggage for a standing passenger. Overall, in 60 percent of the situations help was offered. Significantly more help was offered in a bus line going to a working class suburb than in a center city line. Women were more likely to offer help, as were passengers in a situation of eye to eye contact. The data suggest that helping behavior favoring better quality of mass transit may be found. The placing of educational signs inside the bus or at the bus station may further stimulate helping and other pro-social behaviors.

Utilitarismo e frieza nas relações pessoais entre habitantes de grandes cidades encontram respaldo em estudos norte-americanos. No Brasil, pouco se sabe sobre este tema. O uso do telefone como instrumento de pesquisa social experimental também não é freqüente em nossa cultura. Procurou-se verificar o nível de ajuda em função do tipo de residência (casa vs. apartamento), localização (centro vs. periferia) e gênero de quem pedia ajuda. Utilizando-se o procedimento do 'Número Errado' solicitou-se ajuda por telefone a 320 moradores de duas áreas urbanas. De modo geral, 39,3% das pessoas contatadas ajudaram da maneira solicitada. Tipo de residência e localização não influenciaram a taxa de ajuda, mas mulheres receberam significativamente mais ajuda que os homens. A utilização do telefone como instrumento de pesquisa social mostrou-se possível. Para seu uso experimental discutiram-se alguns cuidados metodológicos.

Cold and calculating interpersonal relations among residents of large cities are described in North American studies. Little is known, however, about this topic in Brazil. The use of the telephone as a research instrument in social experiments also is not common in Brazilian's culture. An attempt was made to verify helping behavior as a function of type of home (house vs. apartment), local (center vs. periphery) and gender of the person seeking help. Using the 'wrong number technique', help was solicited by phone from 320 residents in two urban areas. Overall, 39,3% of the persons contacted provided help. Type of home and local did not influence the rate of helping. However, female callers elicited more helping behavior than did male callers. The use the telephone as an instrument in social research proved possible. Several methodological aspects needing special attention in experimental use were also discussed.

A técnica da carta perdida foi adaptada para o contexto cultural brasileiro. Trezentas cartas endereçadas e seladas, foram colocadas "por engano", simulando perda, nos pára-brisas de veículos em dois estacionamentos. Um bilhete anexo explicava que o autor se desencontrara do amigo, "dono do carro". O bilhete variou, dando a entender que seu autor era masculino ou feminino (fator 1); tinha características pessoais distintas: homossexual, negro ou grupo controle (fator 2); permitindo a possibilidade de contatos telefônicos, ou não (fator 3), num delineamento 2 x 3 x 2. Quem encontrava a carta, podia enviá-la (comportamento pró-social) ou descartá-la. Sessenta e um por cento das cartas foram enviadas. Nenhuma diferença significativa foi encontrada em função das características dos três grupos (controle, negro ou homossexual), de gênero, da interação destes fatores. A possibilidade de telefonar para o remetente, aumentou significativamente o envio de cartas. A técnica mostrou-se promissora por possibilitar, enquanto instrumento não-reativo, o estudo de preconceito e ajuda.

The lost-letter technique was adapted to the cultural context of Brazil. Three hundred stamped and addressed letters were placed "by accident", i.e., simulating loss, on the wind shields of private cars in two large parking areas. A attached note explained that the author had missed the owner of the car. The note varied such that the author appeared to be either male or female (Factor 1), have certain personal characteristics, such as being black, homosexual, or control group (Factor 2), and allowed for telephone contact or not with the author (Factor 3) in a 2 x 3 x 2 experimental design. The finder of the letter could either (a) post the letter (pro-social behavior) or (b) ignore it. 60.7% of the letters were posted. No significant difference was found in terms of sex or personal characteristics, nor interaction between these two factors. Being able to telephone the author made a significant difference, more letter in this condition were posted. Methodologically, the lost letter technique showed promise, especially as a non-reactive research instrument in the study of prejudice and helping behavior.