An anatomical study of 54 specimens with endocardial cushion defect is described. The material was divided into two groups, according to the morphology and attachments of the anterior component of the anteroseptal mitral leaflet.We suggest that there is no divided or undivided anterior common leaflet. There are always two anterior leaflets, a mitral and a tricuspid one, separated by a commissure; depending on the degree of straddling of the mitral component over the interventricular septum, this will protrude into the interventricular septum or into the anterior papillary muscle of the right ventricle. Thus, the commissure separating the mitral and the tricuspid components will lie over the interventricular septum or will be quite separate in the right ventricle. In the latter case the straddling mitral component gives the false appearance of an undivided anterior common leaflet.The septal tricuspid leaflet was found to be underdeveloped or absent but we were not able to find any clefts or divisions in it. We suggest that this leaflet derives solely from tho division of the posterointferior endocardial cushion into two halves, right and left. The left half later becomes the posterior component of the normal anteroseptal mitral leaflet. Associated anomalies are also reviewed.

The Government of Chile has placed a high priority on health promotion. This is evident in the advances made through its National Plan for Health Promotion (Plan Nacional de Promoción de la Salud) and the Vida Chile National Council for Health Promotion (Consejo Nacional para la Promoción de la Salud Vida Chile). Chaired by the minister of health, Vida Chile is made up of 28 public and private institutions from around the country. Vida Chile has a network of local councils that have been established in the country's comunas (communes, or local-level divisions of the country's provinces) and that include government officials and representatives of local societal and community organizations and private businesses. This report details the methods used to evaluate the National Plan as well as provides a preliminary assessment of the technical and financial results for the 1998-2006 period. Coverage indicators (number of participants; number of accredited health-promoting schools, workplaces, and universities; and number of health promotion events) and the extent of strategy implementation were used to measure the success of the program. Health promotion activities grew markedly during this period. Among the notable accomplishments were the following four: (1) 98% of the communes now have their own community health promotion plan and intersectoral Vida Chile committee to implement the plan, (2) there has been an increase in societal and community groups involved in the health promotion strategies, (3) 34% of the primary and secondary schools have become accredited health-promoting schools, and (4) approximately 20% of the total population benefited directly from community-health-plan activities in 2006. The average per capita cost of the community health plans' activities in 2006 was US$ 6.60. The two most important factors that facilitated the operation of the local health promotion plans were participation by community and societal groups and having an adequate budget for the local activities. Hindering factors included a lack of time and/or human resources to devote to health promotion, a geographically dispersed population, and difficulty in accessing the activities.

There are several forms of swan-neck deformity which are amenable to surgical treatment with good results, if based on an adequate study of the mechanism. Selection of the most suitable surgical procedure must be based on the pathological type.

No abstract

No abstract