No abstract

Congenital anomalies of the inferior vena cava (IVC) are caused by an abnormal persistence or regression of embryonic precursor veins; they are usually incidental findings on imaging studies. These rare conditions have a 0.6% prevalence in individuals with congenital heart diseases and 0.3% in healthy patients. The purpose of this paper was to report two cases of interruption of IVC with hemiazygos continuation and its implications during surgery, highlighting that after recognizing this anomalous drainage the surgeon should be prepared to change the surgical strategies, especially in cardiovascular surgery, in order to obtain adequate circulatory flows or surgical exposure where venous cannulation could be difficult. We have also reported two cases of healthy patients with the same isolated IVC anomaly with no clinical repercussions, which can develop in the future.

El Hotel Samarina está ubicado frente al mar, en la cota +12 m s.n.m., en el cantón La Libertad, Provincia de Santa Elena. Fue construido al final de la década de los 50. El hotel Samarina terminado en un 70%, se compone de planta baja y tres pisos altos y estructuras de hormigón armado. La superficie total del mencionado hotel es de 2638 m2. Actualmente, se conoce que en el Ecuador y principalmente en la Provincia de Santa Elena, presenta una alta sismicidad por estar ubicada cercana a la zona de subducción de la placa de nazca y la placa sudamericana. A través de una evaluación y diagnóstico estructural, conforme a las normas ecuatorianas NEC 2011 o códigos uniformes de edificación UBC 97 la actual edificación no cumple el diseño sismoresistente, y de acuerdo al conocimiento actual se elaboró un diseño moderno donde se mejoró su nivel de desempeño o comportamiento sismo resistente ante la acción de un sismo moderado, y con la aplicación de un software libre denominado ETAB's se implementó un modelo con sistema de reforzamiento, compuesto de disipadores de energía colocados en las caras laterales y reforzamiento de columnas en los cuatro niveles que componen el edificio. ABSTRACTThe Samarina Hotel is located close to the sea, at 12 m s.n.m., at La Libertad, Province of Santa Elena. It was constructed at the end of the decade of the 50. The hotel has a ground floor and three high floors and it has reinforced concrete structures with surface of 26382. In the Ecuador and principally at Province of Santa Elena, has a high seismicity conditions because of it are located near to the zone of subduction of the Nazca South plates. An evaluation and structural diagnosis was performed, according to NEC 2011 proceeding, and also with the uniform codes of building UBC97. It is important to indicate that the actual building does not fulfill the design seismic resistant requirements. To improve the level resistant earthquake was performed. A system of reinforcement, spendthrifts' compound of energy placed in the lateral faces and columns reinforcement in four levels that compose the building was implemented with the software free ETAB's.

Background Intravascular leiomyomatosis (IVL) is a histologically benign smooth muscle tumor arising from the uterus that can spread through the pelvic veins and can extend as far as the heart via the inferior vena cava. IVL is an extremely rare phenomenon, especially when the heart is involved. However, despite its benign characteristics, it can behave like a malignant tumor leading to significant morbidity and even mortality if left untreated. Case presentation The patient is a 42-year-old woman with a past medical history of uterine leiomyomas. Recently she developed heavy bleeding and frequent spotting; therefore consulted with her gynecologist. After further evaluation, a mass within the uterus that expanded into the pelvic veins, inferior vena cava, and right atrium was discovered. After the complete removal of the mass, the patient underwent full recovery. IVL with cardiac extension was the final diagnosis. Conclusion Although IVL is rare, it must be considered in women who underwent previous hysterectomies or myomectomies and presented with pelvic masses or symptoms of right heart failure. The ideal treatment will require the joint efforts of a complete multidisciplinary team, the patient's symptoms, previous operative history, the tumor's extension, and resectability.

Este título es alegórico. No me voy a referir exclusivamente a lo que han visto mis ojos, también hablaré de lo que he leído o me han contado, cómo era el Ecuador y el mundo cuando yo nací.El Ecuador era un país cacaotero con una población de 2.700.000 habitantes y una superficie de 300.000 kilómetros cuadrados, más grande de lo que es en la actualidad; un país laico, sin religión oficial, en el que se respetaba todas las creencias políticas y religiosas, las escuelas y colegios estatales eran laicos, aunque también había escuelas y colegios particulares, casi todos confesionales. Las cuatro universidades del Ecuador eran estatales.