Revista de la Facultad de Ciencias Médicas de la Universidad de Cuenca

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Browsing Revista de la Facultad de Ciencias Médicas de la Universidad de Cuenca by Author "Alvarado Corral, Raúl Francisco"

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    Adenocarcinoma pleomórfico de células giganates de vías biliares(osteoclastoma like)
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Quezada Morales, Manuel Emilio; Alvarado Corral, Raúl Francisco; Jara Sánchez, Laura Fabiola
    Osteoclast-type giant cells (CGTO) of the pancreas are not frequent originally described by Rosaien 1968, characterized by osteoclasts that are giant cells identical mononuclear stromal cells in bone tumors observed. Since then, there are few reports of tumors containing giant cells in other anatomic locations. The CGTO can be distinguished from the pleomorphic type giant cells (CGTP), due to the lack of an associated marked nuclear pleomorphism. Often a pancreatic carcinoma histologically recognizable CGTO accompanies, leading to a bad result. CGTO pure forms have a better prognosis because it takes a long time to develop metastases, but this form is very rare, with few cases reported in the English literature. Most times the benign diagnosis of these tumors based on immunohistochemistry evaluation is discussed. This case is a female patient 56 years old with picture characterized by cramping pain that improves with antispasmodics, several months of evolution, with periods of remission and exacerbation. A physical exam features: light skin and mucous subictérico dye, abdominal level: diffusely painful abdomen without viseromegalias or palpable masses
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    Apendicitis aguda en pacientes pediátricos oncológicos en el Instituto del Cáncer SOLCA-Cuenca. 2017
    (Universidad de Cuenca, 2018-12) Guerrero Quiroz, Enmanuel Isidoro; Alvarado Corral, Raúl Francisco; Bravo Muñoz, Marx Italo; Quizhpi Paredes, Diana Elizabeth; Martínez Reyes, Fray Cleiton
    Background: Acute appendicitis is a surgical abdominal emergency, in which the clinical presentation and diagnosis are generally different when it occurs in oncological patients as a consequence of the immunological alteration characteristic of cancer and secondary to treatment with chemotherapy. Method: A descriptive, retrospective study was conducted from January 2011 to June 2017. The medical records of 433 patients with cancer in children under 18 years of age were reviewed; they were treated in SOLCA-Cuenca, and 12 patients who presented acute appendicitis were included. A description of its clinical, pathological and therapeutic characteristics was made. The information was included in a database and then analyzed in the portable program EXCEL and SPSSv20 Results: The average age of the patients was 9.58 years in the same proportion for men and women. The average of white blood cells was 10,500 cells per microliter and its range was between 400 and 21,600 cells per microliter. The neutrophils, platelets and hemoglobin had an average of 66%, 275,416 cells per microliter and 11g / dl respectively, with an average hospitalization of 18.5 days. A 66% of patients presented a value higher than 7 on to 10 in the Alvarado scale (method used to diagnose acute appendicitis). Acute appendicitis was more frequent (4 cases) in the maintenance phase of oncological treatment. The most common pathological results were: congestive appendix, phlegmonous, perforative, with 3 cases each. The ceftriaxone was the most used pre-surgical antibiotic (5 patients) and the combination of meropenem with metronizadol during the post-surgery period (4 patients). One patient (8.3%) died 9 days after the surgical procedure due to septic shock secondary to acute peritonitis. Conclusions: Acute appendicitis occurred in 2.7% of cancer patients. The natural history as far as clinical manifestations was presented in the oncological patients as in the non-oncological patients. The Alvarado scale was a valid diagnostic test in both groups. It is necessary to be careful with the interpretation of laboratory and image data.