We report long-term outcome after one-stage, surgical repair, in a two months-old girl with persistent truncus arteriosus type I, II. The operation was carried out with the remodeling of the right ventricle, using a swine bicuspid pulmonary prosthesis. Twenty-six years later, the patient is in excellent clinical condition, CF I (NYHA), with normal peripheral oxygen saturation. Recent invasive and not invasive imaging show: absence of intracardiac shunt and growing of the right ventricle outlet tract and discrete double lesion of the pulmonary valve. The pulmonary flow directed uniformly for both lungs. In selected cases, the long-term prognosis of patients with persistent truncus arteriosus, undergoing early surgical repair, avoiding the use of valved conduit, makes for an excellent evolution, without new interventions. Endovascular procedures, now well standardized, for the implantation of a pulmonary valve stent, through a catheter, will allow an effective approach, in the presence of late obstructions, in patients who have undergone right ventricular remodeling, without the use of valved conduits.

Objective: We report a case of self inserted needle into the left ventricle of the heart and a description of our surgical intervention in a psychiatric patient without decision-making capacity. We discuss issues regarding obtaining consent in this patient with a sub-acute presentation, report our operative approach, and summarize a treatment approach based on a review of current literature. Methods: A PubMed search using terms “needle, “heart”, “insertion”, “intracardiac foreign object”, yielded 69 relevant papers. 67 of these were case reports yielding 72 individual cases. Age, gender, cause of the needle entry (Accidental Plus (A+), Intravenous Drug User [IVDU], Self-inflicted (SI)), type of needle, location in heart, neuropsychiatric history, treatment, and outcome were documented. Results: Within the SI category, there were a total of 28 cases, 89.3% had a neuropsychiatric history whereas only there were only 2 such patients in both the IVDU and A+ group. The location of the needle in the heart in all 72 cases was as follows: right ventricle 40.3%, other 20.8%, left ventricle 19.4 %, ventricle and interventricular septum 16.7% and the right and left atrium were each 1.4 %. In all three groups (n=72), 77.8% of patients underwent surgery, with 92.9% having a stable outcome. Conclusion: Our case and review demonstrates that management of such cases, particularly when active mental health issues are present, requires a case-by-case evaluation and treatment as a specific standard of care has not been established. Surgical intervention appears to be the preferred management regardless of presentation with good outcomes.

Aims: According to the World Health Organization, between 1980 and 2014 the total number of people with diabetes in the world increased from 108 million to 422 million and by the end of 2020, the total number was approximately 463 million. The most frequent complication in this type of patient is diabetic foot ulcer, where conventional treatments generally fail to solve the problem and in many cases the condition ends with amputation. In 1998, an electrical stimulator was developed, called Stimul W, whose application in the healing of pressure and venous ulcers has yielded satisfactory results, allowing not only to obtain the Medical Registry by health entities in Cuba and other countries and even patent the mentioned equipment, but it has been achieved, in more than two decades of work, the healing of 1,191 ulcers of both types, with 94.5% effectiveness, a healing time that ranges between 21 and 42 days , according to the characteristics of the ulcer and without recurrence in any case treated. Starting in 2015, the application of this technique began in diabetic foot ulcers with the objectives of measuring the effectiveness and achieving an alternative treatment for this type of injury. In the present work a brief compilation of the results achieved in the treatment of diabetic foot ulcer using electrical stimulation is shown. Statistical Model: 31 diabetic patients, over 40 years old, with a total of 38 diabetic foot ulcers (some patients had more than one lesion) were treated, with times with the ulcer ranging between 1 and 6 months. The treatment consisted of a daily application for 30 minutes, using the Stimul W electrical stimulator, through the use of self-adhesive electrodes, conveniently placed around the affected area and on healthy skin, with current values ??corresponding to scale 8 of the stimulator, approximately 1.5 mA and using the two stimulation channels Results: Results: In 27 of the 31 patients treated, the ulcer was healed with an effectiveness of 87%. In relation to ulcers, 33 ulcers healed in total, for 86.8% effectiveness. Average healing times were between 30 and 42 days, considering a daily session. Conclusion: Acceleration of healing was achieved with respect to conventional treatments, reducing healing times, and not producing adverse events during and after the application of the treatment.

Rationale: Coronavirus disease is a leading remarkable critical pandemic global infection. Graded phenomenon or Yassers phenomenon is a novel electrocardiographic phenomenon that changes the arrhythmia didactic. It is decisive progress in understanding arrhythmia. The phenomenon is a contemporary vigorous instructor for monitoring and follows up the arrhythmic patients. Movable-weaning off phenomenon or Yassers phenomenon is another novel electrocardiographic phenomenon characterized by serial dynamic changes in all cases of either Wavy triple or double electrocardiographic signs (Yasser signs) of hypocalcemia. Movable-weaning off phenomenon is a guide for both Wavy triple and double an electrocardiographic. Severe symptomatic aortic stenosis has a bad outcome after the evolution of symptoms, and prompt operative intervention is advisable. Patient concerns: An elderly female COVID-19 pneumonic patient presented to physician outpatient clinic with bilateral peripheral pneumonia and both Graded and Movable-weaning off phenomenon or Yassers phenomena in severe aortic stenosis. Diagnosis: Elderly COVID-19 pneumonia with both Graded and Movable-weaning off phenomenon or Yassers phenomena. Interventions: Oxygenation, electrocardiography, chest CT scan, and echocardiography. Outcomes: Gradual dramatic clinical, electrocardiographic, and radiological improvement had happened. Lessons: It denotes the role of the anticoagulants, the antiplatelets, steroids, and antimicrobial therapy in the management of COVID-19 pneumonia with Graded and Movable-weaning off phenomenon or Yassers phenomena in severe aortic stenosis. The presence of Graded and Movable-weaning off phenomenon or Yassers phenomena, elderly, and pneumonia, in the case presentation, represent new complicated risk factors especially, with an associated severe sclerotic aortic stenosis.