Abstract Carcinoid tumors can be a cause for right heart valve disease, also known as Hedinger syndrome or carcinoid heart disease. Proper understanding of the pathophysiology is of the uttermost importance for adequate treatment of these patients, especially during heart surgery.

Abstract The histological structure and biochemistry of the skin is affected by solar radiation having adverse effects ranging from sunburns, premature aging that includes wrinkles, spots, dryness, and loss of collagen to cancer development. The skin has defense mechanisms to prevent damage caused by radiation, but when radiation exposure is excessive these mechanisms are not strong enough to protect the skin. The use of sunscreen is the most common practice of photo- protection. The active ingredients of these cosmetic protective formulations are generally from synthetic origin and have presented several drawbacks at the level of photo-stability, systemic absorption and can generate contact and photo-contact dermatitis. This review illustrates skin solar radiation problems, common sunscreen ingredients limitation and mentions how algae can be an alternative according to studies that have evaluated the photo-protective potential of extracts and compounds isolated by different techniques. sunburns wrinkles spots dryness development photo protection photostability, photostability stability, stability photo-stability photocontact dermatitis problems photoprotective techniques

The goal of this research was to identify major compounds of the aerial parts of M. parvifolia (Benth.) Parra-Os., that could enhance its possible application as additive in dermocosmetic products, as well as evaluate the antioxidant properties. The extracts agreed with the broad-spectrum UVB/UVA absorption detected and could act as broad-spectrum sunscreens, covering the UVA and UVB range. Methanolic extracts showed an important antiradical capacity (0.46 and 0.47 g/µmol DPPH), TPC (37.58 and 51.41mg GAE/g DS) and TAC (1.12 and 3.31 mg C3GE/g DS) in fruits and leaves, respectively. M. parvifolia could be considered as a prospective source of natural UV-radiation absorbers with antioxidant capacity. Although the results have clearly demonstrated the potential photoprotection capacity, more studies are needed to enhance its application as an additive in pharmaceutical and medicinal formulations.

La disrupción auriculoventricular después del reemplazo valvular mitral es una rara pero letal complicación. Este caso es el de una mujer de 72 años de edad, con antecedentes de: reemplazo valvular aórtico, mitral, plastia tricúspide y Maze. Se llevó al reemplazo valvular mitral con prótesis Hancock 29 mitral. Se trasladó a la UCI y el curso postoperatorio fue normal hasta las 24 horas después de la cirugía, cuando presentó disnea y requirió soporte inotrópico. Se le realizó un angiotac y un ecocardiograma transtorácico que evidenció pseudoaneurisma ventricular. Fue llevada a cirugía, se inició circulación extracorpórea. Se evidenció disrupción auriculoventricular en el anillo posterior de la válvula mitral (tipo I perforación). La ruptura fue cerrada con un parche mixto de pericardio bovino y dacron con sutura continua. Actualmente, la paciente está en buenas condiciones sin recurrencia. Investigamos: el caso, la etiología, el reparo quirúrgico y la prevención de esta rara complicación y se discute.

Atrioventricular disruption after a mitral valve replacement is a rare but fatal complication. A case of 72 year-old woman is presented. She had a medical history of aortic and mitral valve replacement and Maze and tricuspid valve surgery. Mitral valve replacement was performed with Hancock 29 mitral prosthesis. She was taken to ICU and postoperative progress was normal until 24 hours after the surgery, when she developed dyspnea and required inotropic support. A CT angiography and transthoracic echocardiogram were performed, which evidence a ventricular pseudoaneurysm. She was taken to the operating room to start extracorporeal circulation. Atrioventricular disruption was evidenced in the posterior mitral annulus (type I perforation). Rupture was closed with a using a mixed Dacron and bovine pericardial patch with continuous suture. Patient is currently in good condition with no recurrence. Case, etiology, surgical repair and prevention of this rare complication were investigated and discussed.

El articulo trata sobre la propuesta y aplicación de una Metodología para la Construcción de un Migrador de Bases de Datos; el cual pretende constituirse en una herramienta útil para quienes evalúan la eficacia de los procesos de migración de datos entre múltiples plataformas, proceso este que viene constituyéndose en pilar de las organizaciones modernas. La finalidad es mostrar el proceso de construcción de un sistema de migración de bases de datos para empresas de bienes y servicios, en el se desarrollan los antecedentes conceptuales e investigativos inherentes a los sistemas de migración, la metodología propuesta para la construcción del prototipo planteado, así como los diagramas de casos de uso y clases que dan cuenta del análisis y diseño que soporta la aplicación, también se muestra la interfaz grafica construida para el manejo de los proceso de migración de datos.

This article talks about the proposal and application of a methodology to build a database migrator that will serve as a very useful tool for those who evaluate the efficiency of data migration processes between multiple platforms, these processes are now being identified as emerging pillars of modern organizations. The main purpose is to show the building process of a database migration system geared towards consumer goods and services companies; it involves the development of the conceptual background and research involved on migration systems, the proposed methodology to build the suggested prototype, as well as the use case and class diagrams that demonstrate the analysis and design supported by the application, it also exposes the graphical interface built to manage the database migration processes.

Objetivos: La disfunción renal en el postoperatorio de la cirugía cardiaca continúa aumentando la morbilidad, mortalidad y costos. Aunque se han realizado múltiples estudios, los factores asociados a esta no están claros en el grupo pediátrico. El propósito del estudio es determinar la incidencia de disfunción renal postoperatoria, factores de riesgo para su desarrollo, su asociación a la mortalidad y las estancias hospitalarias. Métodos: Se estudiaron de forma prospectiva 236 pacientes, menores de 12 años de llevados a cirugía cardiaca con circulación extracorpórea entre el 1 de mayo del 2000 y el 31 de julio del 2003. Fueron excluidos los pacientes llevados a cierre de CIA y los que fallecieron en las primeras 24 horas. Se evaluó la asociación de las variables pre, trans y postoperatorias al desarrollo de disfunción o falla renal por medio de análisis univariado y multivariado. Se definió disfunción como valores anormales de depuración de creatinina para la edad, aumento del 25% de la creatinina basal u oliguria y falla como el requerimiento de diálisis. Resultados: De los 236 pacientes el 72% presento disfunción renal y 4,2% desarrolló falla renal. La única variable asociada al desarrollo de disfunción renal fue el hematocrito postoperatorio con una relación positiva: P = 0.001. Conclusiones: La disfunción renal esta asociada de forma independiente con la mortalidad postoperatoria de estos pacientes y con el aumento de las estancias en UCI y la estancia hospitalaria.

Background: Postoperative renal dysfunction is associated to poor prognosis. The influence of perioperative factors in the development of renal disorder in children is not clearly understood. The aim of the study was to determine the incidence of renal dysfunction, the main risk factors and the association with mortality and hospital stay. Methods: We studied prospectively 236 patients, under 12 years old. We excluded patients who died in the first 24 hours after cardiac surgery and the ones scheduled only for atrial septal defect closure. Patients who developed renal dysfunction were the ones with abnormal values for creatinine clearance, with an increase of 25% the basal preoperative creatinine value or oliguria. The association between renal dysfunction and perioperative variables was studied by univariate and multivariate analysis. Results: Of the 236 patients, 72% developed renal dysfunction, 4.2% had renal failure that required dialysis. The mortality rate of patients with renal dysfunction was 9.9% compared with 80 % in patients with renal failure. The only variable that had independent association with renal dysfunction was postoperative hematocrit. (p= 0.001). Conclusion: There is an independent association between renal dysfunction and perioperative mortality in pediatric cardiac surgery with cardiopulmonary bypass, as well as with the increment in hospital and ICU stay.

Introducción: El levosimendan es un derivado piridazona-dinitrilo que incrementa la contracción miocárdica al estabilizar la unión del Ca++ con la troponina C. Es también un vasodilatador sistémico y pulmonar. Ha sido utilizado exitosamente para tratar los estados de bajo gasto cardiaco luego de bypass cardiopulmonar. Sin embargo, es desconocido si puede utilizarse para el tratamiento del espasmo intraoperatorio de puentes coronarios. El propósito de este estudio es investigar los efectos in vitro del levosimendan sobre las arterias mamarias internas (AMI) humanas con el fin de obtener evidencia científica antes de su aplicación clínica. Métodos:Se tomaron segmentos de AMI de 85 pacientes sometidos a revascularización miocádica. El segmento distal se cortó en anillos de 3 mm de longitud que se extendieron hasta su óptima tensión de reposo, en cámaras orgánicas que contenían 25 ml de solución de Krebs, a 37 °C y aireados con 95% de O2 y 5% de CO2. Luego de un periodo de equilibrio se constriñeron con norepinefrina (10-5.5 M) o análogo de tromboxano A2 U46619 (10_8 M). Se adicionaron de forma acumulativa, Nitroglicerina (NTG), milrinone (MIL) y levosimendan (LEV) para relajar las preparaciones, construyéndose curvas dosis-respuesta. En experimentos paralelos, la presencia o ausencia de endotelio funcional fue evaluada por la repuesta a acetil-colina (10-6 M) en anillos precontraidos con NE (10-5.5 M), sometiendose posteriormente a relajación con LEV. Resultados:Concentraciones incrementadas de NTG, MIL y LEV relajaron los segmentos de AMI constreñidos con NE o U46619, sin diferencia en anillos con y sin endotelio. Conclusiones:El levosimendan produjo una relajación, dependiente de la concentración, de anillos de AMI, similar a la obtenida con otros vasodilatadores. Su combinación de inotrópico positivo y vasodilatador puede ser beneficioso en el tratamiento perioperatorio del vasoespasmo en pacientes sometidos a revascularización miocárdica.

Introduction: Levosimendan is a pyridazinone-dinitrile derivate that increases myocardial contractility by stabilizing the Ca++ troponinc bound . It is also a pulmonary and systemic vasodilator. Levosimendan has been used successfully to treat low cardiac output states after cardiopulmonary bypass surgery. However, it unknown whether this drug can be used for the treatment of perioperative spasm of coronary artery bypass grafts. The purpose of this study is to investigate the in vitro effect of levosimendan on human internal mammary artery (IMA) to obtain scientific evidence before the clinical application. Methods:Human IMA segments were taken from 85 patients undergoing coronary artery bypass surgery. The distal segments were collected and cut into 3 mm long rings. The rings were stretched to their optimal resting tension in organ baths containing 25 ml of Krebs solution, maintained at 37°C and aerated with 95% O2 and 5% CO2 mixture. After equilibration they were constricted submaximally (50 to 80%) with norepinephine (10-5.5 M) or thromboxano A2 mimetic U46619. Nitroglycerin (NTG), milrinone(MIL) and levosimendan (LEV) were added in a cumulative fashion to relax the preparations and the concentration response curves for relaxation were constructed. In parallel experiments the presence or absence of functional endothelium was tested by the response to acetyl-choline (10-6 mol/L) in rings precontracted with norepinephrine (10-5.5 M) and the response to levosimendan was evaluated. Results:Increasing concentrations of NTG, MIL and LEVO relaxed norepinephrine or U46619 constricted human IMA. There was no significant difference in the relaxing effect of levosimendan between rings with and without endothelium. Conclusions:Levosimendan produced a concentration-dependent relaxation of the IMA rings similar to the relaxation obtained with other vasodilators. With its combination of positive inotropic and vasodilator actions, it may be beneficial in the perioperative treatment of vasospasm in patients undergoing coronary artery bypass grafting.