Volumen 33 No. 1 (2015)

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Browsing Volumen 33 No. 1 (2015) by Author "Morocho Malla, Manuel Ismael"

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    Intento de suicidio por intoxicación con organosfosforado bajo administración parenteral (síndrome compartimental): reporte de un caso
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Bojorque Iñeguez, Vilma Mariela; Morocho Malla, Manuel Ismael; Jaramillo Oyervide, Julio Alfredo
    INTRODUCTION: The ideation and attempted suicide are emerging entities for a mental health professional; the intake of organophosphate (OP) is one of the most common ways of poisoning due to their availability and easy accessibility in our country (Ecuador); it is common that people who use these substances, do auto lytic purposes orally. Find someone who uses the parenteral path for this purpose is rare and there is little literature on the subject, for this reason it is considered important the publication of the following case. OBJECTIVE: To describe the psychopathological aspects of the patient who had attempted suicide with use of organophosphate administered parenterally. METHOD: Review, presentation and analysis of the clinical case. RESULTS: The patient aged 32 was admitted to the Homero Castanier Crespo Hospital in Azogues city (Ecuador) due to the severity of their injuries caused by the OP parenteral administration; the assessment of the patient’s mental state led to a diagnosis of attempted psycho-dysplastic suicide with mood disorder and borderline personality disorder; He was diagnosed in addition to abscess in the right arm and compartment syndrome in the left upper limb, so the performance was necessary drainage and fasciotomy respectively. CONCLUSION: The OP pesticide poisonings are the most used methods, it is known that the intake of the OP is common, but not parenteral administration as in the present case, which involved treatment of physical area and the mental sphere
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    Remifentanilo como analgesia complementaria en bloqueo paracervical para aspiración manual endouterina. Hospital Vicente Corral Moscoso. Cuenca, 2013
    (Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Espinoza Juela, Miguel Ignacio; Pacheco Bacuilima, Juan Pablo; Morocho Malla, Manuel Ismael
    OBJECTIVE: To reduce the pain of manual vacuum aspiration (MVA) in patients involved under paracervical block. MATERIALS AND METHODS: In a clinical randomized controlled blind design, 80 patients were included (in two groups of 40) selected for an incomplete treatment of abortion with manual vacuum aspiration, in the Gynecology and Obstetrics Department of the Vicente Corral Moscoso Hospital. The group “A” (n = 40) received additional to the paracervical block 1 mcg / kg intravenous remifentanil as an initial dose followed by 0.5 mcg / kg every 4 minutes and the group “B” (n = 40), the procedure was performed only under paracervical. Pain intensity was determined by visual analog scale of 10 points, hemodynamic changes and side effects. RESULTS: There is no a significant difference in the study groups in both age (p = 0.118), weight (p = 0.522), height (p = 0.114), BMI (p = 0.668), educational level (p = 0.699). The addition of remifentanil, reduced pain according to the EVA of 7.58 group “B” with respect to 2.98 group “A”, (p = 0.000); it had no significant changes in arterial pressure and heart rate (p> 0.05); the side effect was presented with statistically significant difference (p = 0.001) it is nausea which is higher in group “B”. DISCUSSION: The addition of remifentanil to paracervical block, decreased the pain through EVA by 46%, without much change in hemodynamics and with fewer side effects than has the control group (92.3% nausea with p 0.001).