Tesis Especializaciones (Ciencias Médicas)

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Antibiótico profilaxia perioperatoria en colecistitis aguda
(1990) Clavijo Campos, Hidalgo Leoman; Moscoso Abad, Teodoro Enrique; Cañizares Aguilar, Aurelio Ernesto
Caso clínico 1: tricobezoar gástrico gigante. Caso clínico 2: tumor del estroma gastrointestinal (GIST) yeyunal
(Universidad de Cuenca, 2023-05-05) Cárdenas Verdezoto, Luis Alberto; Clavijo Campos, Hidalgo Leoman
Clinical case giant gastric trichobezoar Introduction: bezoar is an uncommon pathology, which can occur associated with various diseases generally is more common in pediatric patients or with psychological and psychiatric disorders, usually occurs by ingestion of foreign bodies, both organic or inorganic matter that accumulates in the stomach and does not undergo degradation by gastric juice, preventing future ingestions are also not digested, leading to accumulation of material and ultimately different digestive disorders. Clinical case: female patient of 16 years of age, during the anamnesis refers as personal history, trichophagia and no family history of importance, also indicating that previously went to private consultation, for presenting abdominal pain and dyspepsia, before which the specialist requested an upper digestive endoscopy, the specialist requested an upper endoscopy, which revealed a giant trichobezoar of hard consistency, smooth surface, non-movable, occupying 60% of the gastric lumen, corresponding to the gastric fundus, body and antrum, with extension into the duodenum, which was confirmed with an abdominal tomography. Due to the failures of endoscopic extraction, surgery was performed. The patient had a favorable postoperative evolution, with outpatient follow-up and outpatient medical treatment. Conclusions: it can be concluded that trichobezoar is a rare pathology, generally due to its nature it is diagnosed in advanced stages being its treatment surgical, but its integral management is multidisciplinary. Clinical case gastrointestinal stromal tumor (GIST) jejunal Introduction: gastrointestinal stromal tumors (GIST) infrequent tumors at the level of the jejunum, it is considered that depending on their size and histological type they may have malignant potential. In early stages they are asymptomatic or produce non-specific symptoms such as abdominal pain, gastrointestinal bleeding of obscure origin, and early satiety among others. In some cases they are diagnosed incidentally in imaging studies, endoscopies or during surgeries in the abdominal cavity. Tumors do not usually recur but immunohistochemistry is necessary to decide if adjuvant treatment is needed. Case report: 38-year-old male patient, with no relevant history, attended the emergency room of a public hospital with symptoms of eight days of evolution characterized by melaenic stools three times a day, associated with asthenia and general malaise. Upper gastrointestinal endoscopy was performed with findings of gastric ulcers without recent bleeding, without taking a biopsy due to syncope during the procedure. Hemoglobin decreased to 5.2g/dl, so surgery was performed and a stromal tumor was found 40 centimeters from the angle of treitz, resection and anastomosis were performed. The patient presented a favorable evolution and was discharged ten days later with ambulatory treatment and outpatient control. Conclusions: jejunal gist are rare tumors of difficult diagnosis due to their location and obscure symptomatology, although with the advance of technology there is a promising future in terms of early diagnosis and treatment. keywords:
Colecistectomía laparoscópica temprana versus tardía en litiasis vesicular en el Hospital José Carrasco Arteaga 2012
(2013) Vera Pulla, Raúl David; Clavijo Campos, Hidalgo Leoman; Tenezaca Tacuri, Ángel Hipólito
This study aims to evaluate the risks and benefits of early laparoscopic cholecystectomy versus delayed. Biliary colic is one of the most frequent indications for laparoscopic cholecystectomy, laparoscopic cholecystectomy if programmed, requires several months of waiting, however patients during this period may have health complications associated with gallbladder disease. Objective: Compare morbidity, conversion rate, operative time, perioperative complications and hospital stay between laparoscopic cholecystectomy early versus delayed. Methods: A study of quasi-experimental design. Results: Information was collected from 175 patients undergoing laparoscopic cholecystectomy. 66% were female and 33% were male, aged between 16 and 92 years with a mean of 46.5 ± 16 years of age. The disease had an RR of de 1,99 (1,087 – 3,647) for patients with late surgery. Operative time, perioperative complications and hospital stay had significant differences while the conversion rate was no difference between the two study groups. Conclusions: Early laparoscopic cholecystectomy significantly decreases morbidity during the waiting period for elective laparoscopic cholecystectomy, the surgical time and hospital stay. KEY WORDS: LAPAROSCOPIC CHOLECYSTECTOMY, SURGICAL REMOVAL OF THE GALLBLADDER, CHOLECYSTECTOMY SURGICAL PROCEDURES OF THE BILIARY SYSTEM, GASTROINTESTINAL SURGICAL PROCEDURES, SURGICAL PROCEDURES OPERATIVE, JOSE CARRASCO ARTEAGA HOSPITAL, CUENCA-ECUADOR.
Efectividad y seguridad en hernioplastias inguinales, estudio comparativo técnica convencional vs laparoscópica en el Hospital Jose Carrasco Arteaga y Hospital Vicente Corral Moscoso, Cuenca 2011-2012
(2013) Pacheco Sarmiento, Jenny Alexandra; Clavijo Campos, Hidalgo Leoman; Tenezaca Tacuri, Ángel Hipólito
Objective: To evaluate the effectiveness and safety of laparoscopic inguinal hernia repair versus open repair in the short time. Methodology: A prospective quasi experimental in hospital “Vicente Corral Moscoso” and hospital “José Carrasco Arteaga”, from December 2011 to December 2012, the study sample was 63 patients open repair, and 63 patients laparoscopic repair. Patients were followed at 6 hours and 24 hours, 7, 15, and 30 days. Results: Most patients were male 73.81%, to analyze the variable pain no differences between the two groups in the 4 weeks, p values are not statistically significant, the return to activities of daily living showed differences only in car trips and bus in the first week, favoring the laparoscopic technique, with p 0.0001 and p 0.0067, respectively, also showed differences in up and down stairs with p values of 0.041 and 0.048 in the first and second week, the return to work was earlier in laparoscopic surgery with an average of 13.90 days and for conventional surgery and 18.46 days p-value of 0.005, and Kaplan Meier curve with a test with log rank p of 0.0001 and 0.0002 Wilcoxon favoring laparoscopic surgery. Conclusion: Laparoscopic surgery showed better results in the return to work activities
Prevalencia de malnutrición y depresión en el adulto mayor y su asociación a complicaciones quirúrgicas en el Hospital Vicente Corral Moscoso y Hospital José Carrasco Artaga, Cuenca 2012
(2012) Guerrero Mogrovejo, Juan Carlos; Clavijo Campos, Hidalgo Leoman; Tenezaca Tacuri, Ángel Hipólito
Introduction: increased life expectancy has increased the proportion of elderly (1). According to the National Census of Population and Housing, 2010 at the Azuay there are 55,835 older adults (2). Malnutrition in Chile has a prevalence of 46% (3), (4). The prevalence of depression in older adults, ranging from 10 to 27% (5). The postoperative complications are common in older adults and are associated with malnutrition and depression. Objective: To determine the prevalence of malnutrition, depression and its association with postoperative complications such as infection, wound dehiscence, hematoma, seroma, abdominal abscess, pneumonia and atelectasis, in older adults, in Vicente Corral Moscoso Hospital and the José Carrasco Arteaga Hospital, Cuenca, 2012. Methodology: A cross sectional study was conducted to determine the prevalence of malnutrition, depression and its association with postoperative complications in older adults. The universe constituted 352 and the sample was 235. Was used for data collection based questionnaire, the Mininutritional Assesmet, Yesavage scale, complications were diagnosed clinically and by laboratory tests. Statistical analysis was performed in SPSS 19.0 statistical software, using descriptive statistics and inferential statistics RP was obtained (95%) and Chi square p value of 0.05 as significant. Results: The prevalence of malnutrition was 25.5% and 20.4% of the population at high risk of malnutrition, the prevalence of major depression was 27.7% and 34.9 mild depression, the prevalence of postoperative complications was 37, 4%, the most frequent surgical site infection and pneumonia 13.2%, constituting risk factors. Conclusions: Malnutrition and depression are a significant risk for postoperative complications in older adults. KEYWORDS: ELDERLY, MALNUTRITION, DEPRESSION, POSTOPERATIVE COMPLICATIONS, RISK FACTORS.

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Browsing Tesis Especializaciones (Ciencias Médicas) by Author "Clavijo Campos, Hidalgo Leoman"