Tesis Especializaciones (Ciencias Médicas)

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Cáncer de mama triple negativo con sus características mamográficas y ecográficas, y factores asociados. SOLCA-Cuenca 2009-2016
(2019) Amores Grandes, Alberto Israel; Guerrero Altamirano, Eddy Francisco; Beltrán Carreño, José Patricio
Background. The worldwide incidence of breast cancer in 2012 was 1'671.149. Triple negative breast cancer is a distinctive subset of breast cancer that the receptor and hormone receptor unit (HER2). It constitutes 11% to 20% of all breast cancers. Objective. To determine the prevalence of triple negative breast cancer with its mammographic and ultrasound characteristics and its relationship with associated factors in the Cancer Institute SOLCA-Cuenca. Period October 2009-December 2016. Methodology and materials: A cross-sectional analytical study was carried out in 633 patients who met the inclusion criteria. The prevalence of the Triple negative subtype was determined, the mammographic and ultrasound characteristics were identified, and its frequency was related to the associated factors. The analysis of the data was done using the data package with descriptive statistics SPSS version 20. Results: The prevalence of triple negative breast cancer was 13.11%. The most frequent mammographic presentation findings were the presence of an oval hyperdense nodule with darkened or microlobulated margins. In ultrasound, they were preferably hypoechoic nodules with an oval or irregular shape, microlobulated margins, with posterior acoustic reinforcement and annular vascularity. Having 3 or more children constituted a risk factor (PR: 1.59). Women who are overweight or obese may be less likely to acquire a tumor of this subtype (PR: 0.91). Conclusions: Triple negative breast cancer usually has common mammographic and echographic characteristics that could suggest its diagnosis. Associated factors such as parity and overweight can relate differently to this cancer subtype.
Cáncer de Mama y su asociación con la densidad mamaria Incrementada, visualizada por Mamografía en el Instituto del Cáncer Solca. Cuenca 2013 – 2015
(2019) Mina Romero, Elizabeth Del Carmen; Guerrero Altamirano, Eddy Francisco; Beltrán Carreño, José Patricio
Background: Currently, breast cancer is the second most common type of cancer in the world, representing the fifth cause of cancer death. In Ecuador in 2012 it ranked first in incidence with 2298 cases and the third place as cause of death. Objectives: To determine the association between breast cancer and increased mammary density visualized by mammography, in women between 45 and 70 years old, at the Cancer Institute SOLCA Cuenca between January 2013 and December 2015. Method and technique: A retrospective study of cases and controls was carried out. The mammographic plates of patients diagnosed with breast cancer confirmed by histopathological study and of patients without breast cancer were analyzed to determine the mammary pattern according to the current classification of BIRADS, at the Cancer Institute SOLCA-Cuenca, period 2013-2015 . The statistical relationship between high-risk mammary density (C and D) and breast cancer was established. Radiological findings were also analyzed and described in all cases and controls. Results: The average age was 55.31 years ± 7.62. The main mammographic findings in the cases were the presence of irregular, hyperdense and spiculated nodules; focal asymmetry, architecture distortion, pleomorphic fine calcifications of grouped distribution, cutaneous thickening and ganglia of suspicious morphology. Mammary density C and D increased the risk of developing breast cancer OR 8.58 (IC 3.5 – 20.60 p=0.000). Conclusion: Mammary density C and D increases the risk of breast cancer
Características ecográficas del saco vitelino durante el primer trimestre del embarazo como predictor de aborto. Hospital José Carrasco Arteaga. Cuenca. 2016-2017
(2018) Maldonado Espinosa, Diana Soledad; Pesántez Regalado, Eugenio Ostualdo; Beltrán Carreño, José Patricio
Introduction: Abortion is a public health problema, especially in developing countries, which occurs in 70 to 80% of fertilizations. The irregular, echogenic and altered size of the yolk sac can be associated with abortion; therefore, it is important to evaluate yolk sac ultrasound throughout the first trimester, since it can determine the pregnancy prognosis. Objective: To determine the ultrasound characteristics of the yolk sac during the first trimester of pregnancy as a predictor of abortion. José Carrasco Arteaga Hospital. Basin. 2016 - 2017. Methods: This cross-sectional analytical study, was carried out on 397 clinical histories (finally working 407) of pregnant women in their 5th to 10th gestational weeks, which were referred to the imaging service of Hospital José Carrasco Arteaga during 2016 to 2017, with a follow-up every 4 weeks until reaching 20 weeks of pregnancy. Data was collected in a previous improved form through a pilot Project. The SPSS V 15 database was constructed.and analyzed by simple and multiple frequency tables for the bivariate analysis. Results: From the total of pregnant women, 24.82% had an abortion. Average age 28.75 years (± 5.9). Shape of the regular yolk sac developed 14.25% abortions, irregularly represented 10.57% (RP 37.06 IC95%: 15.08-91.01, p 0.000). Size less than 3mm and more than 5 mm developed 17.20% abortions (RP 4.08 IC95%: 2.51-6.61, p 0.000). Anechoic structure established 18.92% abortions in comparison to the echogenic and calcified structure 5.90% (RP 31.48 IC95%: 9.23-107.27, p 0.000). Conclusion: According to the results of this study, ultrasound characteristics of the yolk sac in terms of shape, size and structure were associated with further development of involuntary spontaneous abortion.
Correlación de la enfermedad hepática y la hemodinámica valorada por ecografía doppler en el Hospital Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca 2020
(Universidad de Cuenca, 2021-06-07) Matute Astudillo, Adriana Elisabeth; Maldonado Benalcázar, Dorys Jackeline; Beltrán Carreño, José Patricio
Background: Hepatic blood flow and its parameters can be affected by hemodynamic changes and these can be measured in Doppler ultrasound. Authors note that Doppler analysis is valuable for classifying liver disease according to prognosis and severity. Objective: To correlate liver disease and hemodynamics of the hepatic vein and artery and portal vein assessed by Doppler ultrasound. Methodology: Doppler in 80 cirrhotic patients correlated with the Child-Pugh score, prospectively collected data, analysis in SPSS version 2.1. and evaluated by Spearman's correlation. Results: The mean age was 56.89 + 13,87, 66.25% were men. The Child-Pugh classification corresponds to class A (23.6%), B (23.6%) and C (52.5%). The velocity of the portal decreases as the cirrhosis worsens (p = 0.01), the diameter, wave morphology and type of flow of the portal showed a positive correlation as the Child score increases with r: 0.583, p = 0.001; r: 0.684; p = 0.001 and r: 0.255, p: 0.05 respectively. The hepatic vein wave and hepatic artery resistance index were significantly higher in class C (p = 0.01). Conclusion: Of the study population, 68.75% were adults, mostly men and with a Child C score (52.50%). The speed of the portal decreases, the diameter of the portal increases, the flow reverses and fasicity is lost with the worsening of the Child-Pugh class. The change in the shape of the hepatic vein and increased resistance index of the hepatic artery suggest progressive hepatic dysfunction.
Correlación del diámetro transverso del cerebelo con la edad gestacional obtenida por ecografía obstétrica en mujeres que cursan el segundo y tercer trimestre de embarazo. Hospital Vicente Corral Moscoso, enero 2018- marzo 2020
(Universidad de Cuenca, 2021-06-11) Monar Montenegro, Alejandra Carolina; Sanclemente Villavicencio, Jessica Patricia; Beltrán Carreño, José Patricio
Antecedentes: El diámetro transverso del cerebelo (DTC), es un parámetro que aparentemente no sufre modificaciones cuando se establece en el feto una alteración en su crecimiento, en estos casos el cerebelo permanece protegido y fuera del alcance de cualquier noxa que pudiera afectar su crecimiento. Objetivos: Correlacionar la medida del diámetro transverso del cerebelo y la edad gestacional obtenida por ecografía obstétrica en mujeres que cursan el segundo y tercer trimestre de embarazo, Hospital Vicente Corral Moscoso, período Enero 2018 a Marzo 2020. Métodos: Estudio de correlación, en el cual se incluyeron 100 gestantes con embarazos únicos y que cursaron el segundo y tercer trimestre, los parámetros de predicción de edad gestacional que se evaluaron fueron el DTC, diámetro biparietal cerebral (DBP), circunferencia cefálica (CC), circunferencia abdominal (CA) y longitud femoral (LF), llevándose a cabo la prueba estadística de Pearson con el fin de determinar la correlación entre las variables, en el programa estadístico SPSS. Resultados: Existe una correlación entre el DTC medido en el segundo y tercer trimestre del embarazo, con la edad gestacional obtenida por ecografía del primer trimestre (r=0,905 y r=0,906), así como con el DBP (r=0,899 y r=0,896), CC (r=0,905 y r=0,906), CA (r=0,902 y r=0,907) y LF (r=0,878 y r=0,906) del segundo y tercer trimestre. Conclusión: El DTC se correlaciona de forma significativa con la edad gestacional medida por ecografía del primer trimestre de gestación, adicionalmente los demás parámetros evaluados se encontraron correlacionados con el DTC.
Correlación entre calcio coronario por tomografía y la Escala de Framingham, en estadificación del riesgo cardiovascular. Hospital José Carrasco Arteaga. Cuenca, 2016-2017.
(2018) Mariño Arévalo, Juan José; Maldonado Benalcázar, Dorys Jackeline; Beltrán Carreño, José Patricio
Cardiovascular diseases are the leading cause of death worldwide and coronary atherosclerosis increases the risk of suffering them. Ecuador is not the exception, with a rate of 29.32% (INEC-2014), are ratified as the first cause of death in men and the second in women. Objectives: to determine the correlation between coronary calcium measured by tomography and the Framinghan Scale, in the staging of cardiovascular risk in patients of José Carrasco Arteaga Hospital. Cuenca, April 2016- March 2017. Methodology: cross-sectional and correlational study that identified the presence of calcium in the coronary arteries by tomography, through the Agatston Index, and cardiovascular risk, using the Framingham Scale, and the correlation between these, in a sample of 96 patients of the Radiology service during a year. Results: The mean age was 63.17 (± 11.47) years, men represented 53%. The prevalent factor more frequently found in the population studied was arterial hypertension with 70.83%. 59.38% of patients presented an Agatston index of zero. The low risk of presenting cardiovascular disease, according to the Framingham Index, was 38.54%, moderate risk 29.17% and high 32.29%. The Spearman Correlation Coefficient was 0.249 (p = 0.015). Conclusion: there is a low positive correlation between the Agatston index and the Framingham scale.
Discopatía degenerativa lumbar diagnosticada por resonancia magnética nuclear en pacientes con dolor lumbar crónico y factores asociados. Hospital José Carrasco Arteaga, Cuenca 2017
(2019) Palacios Darquea, Lino Fernando; Domínguez Cambizaca, Ramón Patricio; Beltrán Carreño, José Patricio
Background: The degenerative processes of the lumbar spine represent a problem in the current world, its etiology is multiple and little studied at the local level. The use of magnetic resonance in the study of lumbar degenerative disease offers the diagnostic definition required for this pathology. Objective: To determine the prevalence of lumbar degenerative disc disease diagnosed by nuclear magnetic resonance in patients with chronic low back pain and its associated factors in the José Carrasco Arteaga Hospital in the city of Cuenca, January - December 2017 period. Method and Techniques: An analytical cross-sectional study was carried out in the Hospital José Carrasco Arteaga, from January to December 2017, in patients who presented chronic low back pain with a clinical MRI indication, with the objective of describing the imaging findings by this technique. The variables will be taken into account: age, sex, occupation, smoking, in addition to the main imaging findings. A sample was taken where 152 patients were required for the study. Results: a high prevalence of 90.1% was found, frequency of 53.9% of the female sex. In terms of age, patients were in the highest percentage between 35 and 64 years with 57.2%. The mean age was 51.77 SD ± 15.46. We found a risk of 1.38 times higher in patients who smoke, patients who perform physical activity have a 2.10 times higher risk of presenting discopathy patients with body mass index (BMI) greater than 30 had 4.44 times more risk of developing degenerative disc disease. Patients older than 50 years have a 24.2-fold greater risk of presenting degenerative disc disease with statistical significance. Conclusions: a high prevalence of discopathy was found, a statistically significant association was found with age greater than 50 years.
Eficacia del ultrasonido en relación con la radiología convencional en el diagnóstico de la displasia del desarrollo de la cadera en niños menores de 6 meses de edad. Hospital Vicente corral Moscoso. Cuenca 2016
(2018) Manzano Cárdenas, Paúl Andrés; Moscoso Correa, José Joaquín; Beltrán Carreño, José Patricio
Introduction: Dysplasia in children's hip involves abnormalities in the development of the hip joint. In Chile, newborns with developmental dysplasia of the hip range from 2 to 3%. Early diagnosis is critical to provide a favorable prognosis. Objective: to establish the effectiveness of ultrasonography in relation to traditional radiography in the diagnosis of hip dysplasia in children from birth through 6 months of age. Hospital Vicente Corral Moscoso. Cuenca 2016. Methods: Confirming research of the diagnosis test, the sample group was taken from 121 patients under 6 months worked out on the basis of: sensitivity 97%, specificity 96.7%, ratio of sick and not sick of 1: 1, confidence level 95 %, complete accuracy 5%. At the Imaging service, children had an ultrasound, performed with Graf technique and anteroposterior hip radiography as "gold standard", prior parental approval through informed agreement. Data was processed in SPSS software prevailing sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio. Results: 23% of patients tested positive for dysplasia on ultrasound, sensitivity 22.9%, specificity 100%, PPV 100%, NPV 56%, negative likelihood ratio 0.77. Conclusions: Ultrasonography does not prove to be more effective than conventional radiography on the diagnosis of Developmental dysplasia of the hip (DDH), it should not be used as a universal screening method, a pathological ultrasonographic finding delimits a high possibility of Developmental dysplasia of the hip
Hallazgos tomográficos en el trauma cráneo-encefálico y su asociación con el consumo de alcohol, Hospital José Carrasco Arteaga, Cuenca 2016-2017
(2018) Molina Baño, Vanessa Nathaly; Maldonado Benalcázar, Dorys Jackeline; Beltrán Carreño, José Patricio
Background: traumatic brain injury is one of the leading causes of death in young adults, as well as physical and psychological disabilities. Upon admission to Emergency, the patient is assessed using the Glasgow coma scale and computed tomography. Objectives: to determine the tomographic findings in patients with traumatic brain injury and its association with alcohol consumption, attended in the Emergency Service of the José Carrasco Arteaga Hospital, from May 2016 to April 2017. Methodology: cross-sectional analytical study, developed at the Jose Carrasco Arteaga Hospital. The information was taken in a format according to the study variables. The data was processed using SPSS Statistics. The population was characterized using descriptive statistics and a bivariable analysis was used, ethic norms were applied. Results: the mean age of the patients was 37,36 years (± 13,64), and no statistically significant association was found between the tomographic findings and the sociodemographic characteristics. In 45,37% of patients a tomographic lesion, 25 patients presented more than one lesion. Alcohol consumption was identified in 30,56%, traffic accidents were the most frequent cause of trauma (54,63%). Moreover, a correlation was identified between alcohol consumption and tomographic findings, risk of tomographic lesion rises 2,18 times, (IC: 1,489-3,198). Conclusions: alcohol consumption increases the likelihood that patients with traumatic brain injury show a demonstrable lesion in the tomography.
Indice esplenoportal mediante ultrasonido como predictor de várices esofágicas. Hospital José Carrasco Arteaga. Cuenca, 2019 – 2021
(Universidad de Cuenca, 2021-05-28) Paredes Ocaña, Daysi Alejandra; Vélez Dávila, Ximena Mercedes; Beltrán Carreño, José Patricio
BACKGROUND: Esophageal variceal bleeding is a common complication of portal hypertension in cirrhotic patients, which is correlated with the presence of esophageal varices. GENERAL OBJECTIVE: To determine the spleno-portal index by ultrasound as a predictor in the development of esophageal varices in patients with cirrhosis. José Carrasco Arteaga Hospital. Cuenca, 2019- 2021. METHODOLOGY: Cross-sectional analytical study in 136 patients consecutively from the Gastroenterology service of the José Carrasco Arteaga Hospital from 2019 to 2021. The clinical data were collected directly from the patient and the results of the endoscopy were taken from the clinical history, in addition to the spleno-portal index by Doppler ultrasound. The outcomes were presented in simple tables of frequency and percentage, for the quantitative variables, statistics of central tendency and dispersion were used through the SPSS statistical program. RESULTS: 136 patients with a mean age of 59 years were evaluated, the most frequent being those under 65 with 63.97%, predominantly males with 58.09%, 66.91% had type A liver disease, in 91.18% of those evaluated a positive spleno-portal index was found, the frequency of esophageal varices was 88.24%, 55.15% being grade I, 95.00% of those with varicose veins esophageal had a positive spleno-portal index, achieving that of the patients with this positive index they were 11 times more likely to have esophageal varices. CONCLUSION: The spleno-portal index is a good predictor of esophageal varices, being useful in patients with cirrhosis.
Orquiepididimitis diagnosticada por ultrasonografía y factores asociados, Hospital José Carrasco Arteaga. Cuenca, 2017
(2019) Noles Suárez, María José; Llivisaca Tacuri, José Enrique; Beltrán Carreño, José Patricio
Orchiepididymitis represents the most frequent cause of acute scrotal pathology, followed by testicular torsion and chronic causes such as varicocele, epididymal cysts, and tumors. Ultrasonography has high sensitivity and specificity (1). Objective: To determine the prevalence of orchiepididymitis diagnosed by ultrasonography and associated factors such as sexual practices, positive leukocytes in urine dipstick, mumps records, vasectomy, post-surgical inguino-scrotal hernia and trauma in patients of the José Carrasco Arteaga Hospital. Cuenca, 2017. Methodology: A cross-sectional analytical study was conducted in patients aged from 20 to 60 years who are treated in José Carrasco Arteaga Hospital in the City of Cuenca during the year 2017. An infinite population was used as the sampling for this study. The information was presented in tables through absolute and relative frequencies for findings distribution, according to the type of pathology. The quantitative variables were analyzed with measures of central tendency and dispersion. The prevalence ratio was used for acquiring significance, accepting values p < 0.05 as significant and determining association by using the Prevalence Ratio (PR) with its 95% CI. Results: 239 patients participated in the study. The prevalence of orchiepididymitis in patients from 20 to 39 years was 39.33%, 21.75% corresponded to ages between 20 to 39 years. There is statistical significance in marital status amongst the different groups, reporting a 17.99% of married participants. The most affected side was the right side (43.6%); homogenous echo-structure in 53.2% and hyperechoic in 78.7%. Edema (23.4%), hyper-vascular flow in 96.8%. Among the risk factors that have statistical significance to produce orchiepididymitis are sexual practices, positive leukocytes in urine dipstick and mumps
Quistes renales simples diagnosticados con tomografía multidetector y factores asociados. Hospital José Carrasco Arteaga. Cuenca, 2017
(2019) Revelo Villacrés, Alex David; Castillo López, Jorge Luis; Beltrán Carreño, José Patricio
Background: Simple renal cysts are closed sacs that have a thin and smooth wall, contain liquid, which is homogeneous, with a density similar to water, whose clinical significance is still uncertain. Objectives: To determine the prevalence of simple renal cysts diagnosed with 64-channel multidetector tomography and associated factors in the José Carrasco Arteaga Hospital. Methodology: An analytical cross-sectional study will be carried out, with the patients that go to the area of Imaging for the performance of a tomographic study of simple abdomen, in a simple random sample of 416 patients, during the period January-December 2017. The exam was carried out with a 64-slice Multidetector Tomography. Results: The prevalence of simple renal cysts was 22.11%, with a mean age of 51.3 ± 16.2 years, of which the male sex represented the highest proportion (58,73%). The simple renal cyst was more frequently unilateral (77,17%), and predominantly localized to the right side and peripherally (86,95%). The majority had a size smaller than 20mm (64,13%), in addition the average diameter of the largest cyst was 19,18 ± 14,75 mm, with a range of 3 to 66 mm. We found a significant association of simple renal cysts with type 2 diabetes mellitus (p = 0.020), arterial hypertension (p = 0.000) and decreased renal function (p = 0.000). Renal lithiasis did not present statistical significance (p = 0.120).
Sinusitis diagnosticada por tomografía computarizada multicorte y su asociación con las variantes anatómicas del complejo ostiomeatal. Hospital José Carrasco Arteaga. Cuenca 2017
(2019) Solís Espín, Victoria Elizabeth; Domínguez Cambizaca, Ramón Patricio; Beltrán Carreño, José Patricio
Background: The anatomical variants of the paranasal sinuses have been considered as a predisposing factor for sinus disease, especially if they involve the drainage route at the level of the osteomeatal complex. The importance of diagnosing them in tomographic studies is that this condition can lead to inadequate management in patients with recurrent sinusitis and increase the risk of surgical complications. Objectives: To determine the prevalence of Sinusitis diagnosed by multislice computed tomography and its association with the anatomical variants of the osteomeatal complex in the imaging area of the José Carrasco Arteaga Hospital in 2017. Method and technique: A transversal, analytical study was carried out in 341 patients who met the inclusion criteria. The information was collected using a form prepared according to the research variables. The data was tabulated with the SPSS v20.0 software. The study population was characterized by descriptive statistics and the association of the variants was established by bivariate analysis and logistic regression model. The ethical rules were respected. Results: the mean age was 45,11 ± 15 years, the prevalence of sinusitis diagnosed by tomography reached 68,04%, the maxillary sinus was the most affected with 42,67%, regular mucoperiosteal thickening was the most common tomographic finding in 53,96% of cases, the septal deviation was the most common anatomical variant with 68,04%, followed by the middle pneumatized turbinate with 9,38%, Haller cell with 7,33%, abnormal unciform process in the 5,57%, ethmoidal bula with 4,69% and Agger Nasi cells 2,64%. A statistically significant association was found between sinusitis and Haller's cell, ethmoid bula, middle pneumatized turbinate and abnormal unciform process (p <0.05), especially if they compromise the drainage route
Utilidad de la ecografía en dolor abdominal agudo de la fosa iliaca derecha, Hospital José Carrasco Arteaga Cuenca 2017
(2019-02) Tigsi Mendoza, Eddy Xavier; Tigsi Ganzhi, Luis Manuel; Beltrán Carreño, José Patricio
Background: The pain of the right iliac fossa in the pediatric patient is not always caused by acute appendicitis; there are benign clinical entities up to surgical diseases, called "appendicitis simulators". Objective: To determine the usefulness of ultrasound in acute abdominal pain of the right iliac fossa, compared with the diagnosis at discharge, in pediatric patients of the José Carrasco Arteaga Hospital, Cuenca 2017. Methodology: his is a descriptive study and diagnostic test in pediatric patients with acute abdominal pain in the right iliac fossa, who underwent an abdominal ultrasound, from January to December 2017. The information was taken through a data collection form and statistical software for the descriptive study. Analysis using simple frequency and percentage tables. For the diagnostic test, sensitivity and specificity were obtained, positive and negative predictive value, positive and negative likelihood ratio. RESULTS: 301 patients were evaluated, 195 with pathology, 57.8% were between 10-15 years old, 50.5% are female. The following pathologies were observed; Mesenteric adenitis (33.6%), acute appendicitis (19.3%), gastroenteritis (5.6%), intestinal invasion (3.3%), hemorrhagic cyst and ovarian torsion (<2%). The ultrasound showed sensitivity 99.42, specificity 81.40. CONCLUSIONS: Abdominal ultrasound is an excellent tool to assess acute appendicitis and pathologies that mimic the pain of this disease. Although the sensitivity and specificity is varied in the literature, it should be the first modality of imaging in the pediatric patient.
Utilidad de la tomografia multidetector en pacientes con lesiones hepáticas focales en comparación con la histopatología en SOLCA Cuenca 2010-2017.
(2019) Mendieta Marín, Víctor Marcelo; Faicán Benenaula, José Francisco; Beltrán Carreño, José Patricio
Background: The focal hepatic lesions represent a global confrontation, for the year 2012 in the United States, 700,000 cases of liver cancer were reported, of which 600,000 died. Nowadays, there is greater accessibility to imaging studies and an early and efficient diagnosis can be made in this problematic. Objective: To establish the utility of three-phase multislice computed tomography for the evaluation of hepatic lesions in comparison with the histopathological reports in the hospital of SOLCA Cuenca 2010-2017. Methodology: A diagnostic test validation study was carried out on all patients who attended the SOLCA Cuenca hospital in the period 2010 to 2017, evaluated by tomography and histopathology (Gold standard) in people with focal hepatic lesions, prior authorization by consent informed and the information was processed in software SPSS version 20.0 Results: 61.76% of patients represented the female sex with an average age of 63.5 years + - 16.26, the main characteristics of the liver lesions were; multiple; with homogeneous density, regular contours, solid consistency; and in the three-phase TCMD evaluation, in the simple phase they consisted of hypointense, in the arterial stage they were hyperdense or heterogeneous lesions, in the venous phase they presented peripheral enhancement and in the late stage they are hypodense in relation to the liver. 4.4% represented diagnosis of UFH (focal nodular hyperplasia) and lipoma, 27.9% hepatocarcinoma and metastasis 58.8%. In comparison with the histological one, a sensitivity and specificity of 100% was obtained with a correlation index between sperman diagnoses of 0.97%. Conclusions: the three-phase MDCT is very useful in characterizing a lesion as malignant or benign.
Validación de la radiografía estándar de tórax en el diagnóstico de nódulos pulmonares en pacientes oncológicos adultos, Hospital José Carrasco Arteaga. Cuenca, 2019-2020
(Universidad de Cuenca, 2021-05-21) Morocho Araujo, Adriana Mizhel; Llivisaca Tacuri, José Enrique; Beltrán Carreño, José Patricio
Background: The lungs are one of the organs most affected by metastatic nodules. Radiography is a rapid nodular detection method in cancer patients. Objective: To determine the validity of the standard chest radiograph in the diagnosis of pulmonary nodules in adult cancer patients at the “José Carrasco Arteaga” hospital in the year 2019-2020. Methodology: Diagnostic test validation study with 477 patients, taking tomography as the reference test. Results: 65% of the patients were female. The mean age was 60 years ± 14.006. In radiography 14.3% were visualized and in tomography 42.3% nodules. The nodules had well-defined borders in 77.9% on radiography and 83.7% on tomography. The predominant density of the nodules was soft tissues with 82.4% and 61.9%, for radiography and tomography respectively. The upper lobes were the most frequent site of presentation, 50% for radiography and 52% for tomography. Radiography had a sensitivity of 30.69%, specificity of 97.82%, PPV 91.18%, NPV 65.77%, and diagnostic accuracy 69.39% for the detection of pulmonary nodules. Conclusion: The predominant population was female. The mean age of presentation was 60 years ± 14.006. The predominant characteristics of the nodules in the two methods were soft tissue density, well-defined borders and located in the upper lobes. Radiography shows a sensitivity of 30.69% and a specificity of 97.82% for the detection of pulmonary nodules.
Validación de las reglas simples de la iota para el diagnóstico de malignidad de tumores ováricos. Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca, 2020
(Universidad de Cuenca, 2021-05-04) Bravo Bravo, Mayra Rosa; Sanclemente Villavicencio, Jessica Patricia; Beltrán Carreño, José Patricio
Background: Ovarian tumors are a frequent finding in reproductive age. Ultrasound has a sensitivity of 88-100% and a specificity of 62-96% to detect and characterize them, using simple rules (IOTA). Objective: To determine the validity of the simple IOTA rules for the diagnosis of malignancy of ovarian tumors compared with the histopathological, in patients attending the Vicente Corral Moscoso and José Carrasco Arteaga Hospitals, in the city of Cuenca, in 2020. Methodology: Validation of diagnostic tests that compared the simple rules (IOTA) by means of endovaginal ultrasound for the diagnosis of malignancy of ovarian tumors in women seen in outpatient and emergency services of the Imaging service of the Vicente Corral Moscoso and José Carrasco Arteaga Hospitals, the gold test was histopathology, the data were entered and analyzed in the SPSS statistical system (version 15.0). Qualitative variables are represented as absolute and relative frequencies (percentages). Sensitivity, specificity, predictive values and likelihood indices were obtained. Results: 57 women were included with a mean age of 32,2 (±14,5) with a range 18-70 years. According to IOTA criteria, 87,7% were benign and 12,3% were malignant. When compared with the histopathological, they had a sensitivity 75% and specificity 92,40%, positive predictive value 42,85%, negative predictive value 98%, Youden´s J statistic 0,674, positive likelihood ratio 9,86, negative likelihood ratio 0,27. Conclusions: simple IOTA rules allowed to adequately discriminate benign from malignant ovarian tumors.
Validación y correlación de la tomosíntesis para el diagnóstico de lesiones sospechosas de cáncer de mama en mujeres. Sociedad de lucha contra el cáncer. Cuenca, 2018 - 2019
(Universidad de Cuenca, 2021-06-14) Muñoz Calderón, María Belén; Guerrero Altamirano, Eddy Francisco; Beltrán Carreño, José Patricio
Background: The "Gold standard" for breast pathology is digital mammography, it identifies different types of breast cancers before they have a clinical presentation and thus increase overall survival. Due to its excessive false positive results, it was necessary to implement new diagnostic techniques for the determination of pathology. Objective: To determine the validity and diagnostic correlation of tomosynthesis vs. histopathology in women with suspicious breast cancer lesions. SOLCA- Cuenca 2018 - 2019. Methodology: Validation diagnostic test study that will compare tomosynthesis in lesions suspected of breast pathology with the histopathological result. The universe was made up of 306 women. The sample size will be calculated using the Epidat 3.6 program, with the following criteria: 90% sensitivity, 79% specificity prevalence of the presence of breast cancer 29%, 5% precision, 95% confidence level. Results: tomosynthesis presented a sensitivity of 79.62% and a specificity of 7.58%, indicating that this is the probability that the test will identify the person who is sick as not sick. Conclusions: It was determined that tomosynthesis is a test with little agreement between the result and the histopathological diagnosis.
Validación y correlación ultrasonido diagnóstico lesiones de rodilla. Pacientes adultos con trauma deportivo. Hospital José Carrasco Arteaga. Cuenca 2019
(Universidad de Cuenca, 2021-05-21) Vanegas Pulgarín, Karina Tatiana,; Tigsi Ganzhi, Luis Manuel; Beltrán Carreño, José Patricio
a. Background: Sports activities have increased as a lifestyle improvement, but also sports trauma injuries, which could be in any joint, the knee being the most frequent target, so an early diagnosis is necessary to minimize complications and disabilities. b. Objective: the validity and correlation of ultrasound in the diagnosis of knee injuries in adult patients with sports trauma who attended the José Carrasco Arteaga Hospital was determined. Cuenca 2019. c. Methods: was a validation study of diagnostic tests determining the effectiveness and correlation of ultrasound compared with nuclear magnetic resonance, during January 2019 to August 2020. The sample was representative, based on sensitivity of 98%, specificity 88%, prevalence of knee injuries 45.5 %, accuracy 5%, confidence level 95%. A questionnaire validated in a pilot plan was used and the analysis was performed using EPI software v.4.1, Excel, SPSS v 2.1. d. Expected results: Lesions are more frequent between 36 and 58 years old, predominantly males. Joint effusion (92,4%), intracapsular and extracapsular ligament injuries (23%), bursitis and meniscopathies (19%) were identified by ultrasound. By magnetic resonance, they were intra and extracapsular ligament injuries (31,7%), joint effusion (22,9%) and meniscopathy (22,1%). Ultrasound showed sensitivity for tendinopathies (87,32%), extracapsular injury (87,9%) and joint effusion (95,36%); specificity for tendinopathy (93,6%), intracapsular lesion (94,25%). Positive predictive value for meniscopathy (94,17%), joint effusion (91,43%) and tendinopathy (90,51%) and negative predictive value for tendinopathy (91,35%) and extracapsular injuries (84,68%)

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