Tesis Especializaciones (Ciencias Médicas)

Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/3934

Browse

Browsing Tesis Especializaciones (Ciencias Médicas) by Author "León Astudillo, Edgar José"

Filter results by typing the first few letters
Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Estudio de concordancia entre la biopsia por aspiración con aguja fina y el diagnóstico anatomopatológico de Cáncer de tiroides, Hospital José Carrasco Arteaga, Cuenca, 2017
    (Universidad de Cuenca, 2019-11-11) Vélez Carrión, María Alejandra; León Astudillo, Edgar José; Morales Sanmartín, Jaime Rodrigo
    Introduction: Thyroid cancer is a frequent pathology, it affects more women. The nodules suspected of malignancy by ultrasound are easily accessible to cytological study which allows a diagnostic approach and make correct decisions regarding the need or not of surgery. Objective: To determine the concordance and validity between the cytological study performed by thyroid puncture with the anatomopathological study to assess the malignancy of thyroid nodules in patients over 20 years of age hospitalized and outpatient of José Carrasco Arteaga Hospital, in the city of Cuenca, during 2017. Material and methods: A study of concordance and validation of diagnostic test between cytological analysis performed by thyroid puncture and anatomopathological study (gold test), was performed in the population of patients with suspected thyroid malignancy. Data was obtained from the medical records, available in the AS400 program of the aforementioned hospital. These were analyzed with the SPSS version 22. Results: Research developed with 311 patients with suspected thyroid neoplasm. Age fluctuated between 23 and 89 years, with a median of 57. 89.7% were women; 66.2%, married; 36.7% had primary education and 82.6% resided in the urban area. According to cytology and Bethesda classification, malignancy was detected in 55.6%, and according to histology malignancy was detected in 43.7%. Concordance according to Cohen's Kappa coefficient was 0.296, sensitivity 72.8%, specificity 57.7%, positive predictive value 57.2 and negative predictive value 73.2. Conclusion: The concordance is lower, in comparison to the international literature cited and similar to the national literature. The validity is lower than that found in the cited literature.
  • Thumbnail Image
    Item
    Prevalencia de depresión y factores de riesgo asociados en pacientes con insuficiencia renal crónica de la Unidad Renal del Austro, 2009
    (Universidad de Cuenca, 2010-11-11) León Astudillo, Edgar José; Vázquez Morales, José Hernán; Vintimilla Maldonado, Jaime Rosendo
    Objective: To IDENTIFY the prevalence and risk factors associated with depression in End Stage Renal Disease patients, that usually receive Hemodialysis in the Unidad Renal del Austro, during 2009.- Methodology A transversal study was made with a universe of 134 patients to determine depression prevalence and its level applying the Beck Depression Test.. The data were obtained by direct interview. The results were analyzed with the software SPSS and Microsoft Excel. Results.- The depression prevalence was 45.5%: in males 27.8%, in females 57.5%; In people younger than 45 years old 30,0%, between 45 and 64 years old it was 50,8% and older than 64 was 54,8%. The relation between depression and the duration of treatment less than 1 and five years gave an RP of 1.0 (in both cases) (IC 95% 0.7-1.5 y 0.6-1.6), p= 0.952 and 0.932 respectively. With lack of familiar support , RP of 1.9 (IC 95% 1.5-1.5), p= 0.591 and with type 2 diabetes, RP of 1.9 (IC 95% 1.3-2.8) y p=0.000.- Conclusions: The depression prevalence was 45.5%. There was positive association with the diagnose of type 2 diabetes and there was no any association between depression and the studied variables as hemodiaylisis duration of treatment, neither the lack of family support
  • Thumbnail Image
    Item
    Prevalencia de enfermedad arterial periférica y factores asociados en clubes de pacientes con diabetes mellitus tipo 2, Cuenca 2014
    (Universidad de Cuenca, 2015-11-11) Palacios Quezada, Marco Vinicio; León Astudillo, Edgar José; Morocho Malla, Manuel Ismael
    Objective: To determine the peripheral arterial disease prevalence and its related factors in type 2 diabetes people from the primary care diabetic patients clubs from Ministry of Public Health in the urban area from Cuenca city, 2014. Methods: Cross-sectional study in a calculated sample with an infinite universe, based on the 95% confidence inference with an error of 4.5% and lower expected prevalence of 10%. Diagnosis established by determining the ankle brachial index with a bidirectional vascular doppler examination with an 8 MHz probe EZ8 or VP5HS 5 MHz probe for edematous extremities, with the technique from American Heart Association 2012. Results: 254 patients were included with a mean age of 63.6 ± 11.4 years, predominantly female (70.3 %). The prevalence of peripheral arterial disease was estimated to be 47.2; 95% CI 41.1 - 53. 3 with significant association for a diabetes mellitus evolution of ≥ 5 years (OR 2.06; 95% CI 1.15 - 3.68, p = 0.015). 58.6 % of the population had a concomitant diagnosis of hypertension. The lipid profile values were close to the recommended ranges, the Glycosylated Hemoglobin A1c average value was 9.2 ± 2.7 %. Conclusions: The estimated prevalence of peripheral arterial disease is similar to that reported Studies with the ankle brachial index as a diagnostic criteria and was associated statistically with a diabetes duration for 5 years or more.
  • Thumbnail Image
    Item
    Prevalencia de hipotiroidismo y factores asociados en pacientes con diabetes mellitus tipo 2 de la consulta externa del Hospital Vicente Corral Moscoso. Cuenca, 2017 - 2018
    (Universidad de Cuenca, 2019-11-11) Vanegas Cedillo, Pablo Esteban; León Astudillo, Edgar José; Morales Sanmartín, Jaime Rodrigo
    Introduction: type 2 diabetes mellitus (T2DM) and hypothyroidism are the most frequent endocrine disorders of endocrinology, their association has been demonstrated in the medical literature and it is necessary to know their association in Cuenca city. Objective: to determine the prevalence and factors associated with hypothyroidism in patients with T2DM of 40 years or older, who attended the endocrinology outpatient clinic of Vicente Corral Hospital during 2017 - 2018. Material and methods: an analytical cross-sectional study was carried out in a sample of 193 patients, calculated with 95% confidence, HDL cholesterol prevalence of 14%, inference error 5% and infinite population. The data were collected directly and analyzed with the software SPSS version 15. The statistical association had value with the confidence intervals and the value of p <0.05. Results: the age fluctuated between 40 and 93 years and 75.1% were women. Prevalence of hypothyroidism in patients with DM2 of 31.6%. Associated factors: age ≥ 70 years (PR: 2.26, 95% CI = 1.18 - 4.33, p = 0.012), evolution of DM2 ≥ 10 years (PR: 3.23, 95% CI = 1.58 - 6.56, p = 0.000). Conclusions: the higher prevalence of hypothyroidism in diabetic patients is positively associated with: age ≥ 70 years and evolution of DM2 ≥ 10 years.