Browsing by Author "González Domínguez, Esteban Horacio"

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Evaluación de la dosis efectiva de inhibidores de bomba de protones en pacientes con enfermedad por reflujo gastroesofágico erosivo en el Centro de Gastroenterología González de enero del 2016 a diciembre del 2023
(Universidad de Cuenca, 2025-05-20) Jeton Mejía, Andrea Michelle; Rivera Cepeda, Karen Gissela; González Domínguez, Esteban Horacio
Background: Gastroesophageal reflux disease is a condition that occurs when the stomach contents flow towards the esophagus causing irritation. To alleviate this, proton pump inhibitors are used that mitigate the amount of gastric acid produced by the glands in the lining of the stomach. Objective: to evaluate the effective dose of proton pump inhibitor in patients with erosive esophageal reflux disease at the González Gastroenterology Center from 2016 to 2023. Methodology: descriptive, retrospective study with 176 patients from the González Gastroenterology Center from 2016 to 2023. Information collected from medical records was processed in SPSS27. Frequencies and percentages were used to show the results of the variables. Results: Patients aged 40 years or older (84.7%), without distinction of sex, urban residence (86.4%) and mestizos (97.2%) were predominant. The diagnosis was mainly made by endoscopy (81.8%). The treatments used were mainly lansoprazole and dexlansoprazole, in doses of 40 or 60 mg respectively and with varying frequencies. 99.4% reported being asymptomatic after therapy and a single case presented diarrhea as an adverse effect. Conclusions: The minimum effective dose was 40 mg in 48.9% of patients. To control the disease, 41.5% required one dose a day, while 23.9% needed one dose on Mondays, Wednesdays and Fridays. There was a positive and statistically significant relationship between the daily dose increase and the severity of erosive esophagitis in cases with endoscopic diagnosis.
Frecuencia y asociación entre helicobacter pylori, metaplasia, displasia y neoplasia gástricas en el Laboratorio H&E de la ciudad de Cuenca en el periodo julio 2020- diciembre 2021
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2025-11-18) Espinoza Lituma, Juan David; Chicaiza Capón, David Mateo; González Domínguez, Esteban Horacio
Background: Helicobacter pylori (H. pylori) can colonize the gastric mucosa and affects more than half of the world's population, with a higher prevalence in developing countries. The World Health Organization (WHO) recognizes it as a Type I carcinogen due to its association with gastric adenocarcinoma. High rates of infection and gastric neoplasms are recorded in our setting, although recent local studies are limited. Objectives: To determine the frequency and association of H. pylori infection, metaplasia, dysplasia, and gastric neoplasia in patients evaluated at the H&E laboratory in the city of Cuenca between July 2020 and December 2021. Methods: An analytical, observational, retrospective, cross-sectional study. A total of 653 histopathological reports were analyzed to evaluate the frequency and association between variables using analytical statistical analysis. Results: The prevalence of H. pylori was 62.6%. Intestinal metaplasia reached 45.9%, dysplasia 22%, and neoplasia 2.8%, with poorly differentiated adenocarcinoma and the intestinal subtype predominating. Metaplasia (χ2=143,3; p=0,001; OR adjusted=0,420; IC95%: 0,201–0,879) and dysplasia (χ2=38,1; p=0,001; OR crude=0,332; IC95%: 0,203–0,544) were more frequent in H. pylori-negative subjects. Glandular atrophy showed a positive gradient association with metaplasia (OR=4,1– 7,2) y dysplasia (OR=7,7–21,2). Neoplasia was not associated with H. pylori in the crude analysis (χ2=0,735; p=0,391), but an independent association emerged after adjustment (OR=202,4; IC95%: 2,71–15.129; p=0,016). Furthermore, incidentally, a considerable frequency (83.5%) of patients with data suggestive of autoimmune gastritis was found.
Frecuencia y características clínicas de pacientes con hepatitis autoinmune atendidos en el Hospital de Especialidades José Carrasco Arteaga en el periodo 1/01/2017 al 31/12/2021
(Universidad de Cuenca, 2022-11-29) Ramón López, Juan Carlos; Sangurima Quinde, William Miguel; González Domínguez, Esteban Horacio
Background: Due to the clinical variety of presentation of autoimmune hepatitis (HAI) and the lack of pathognomonic findings in diagnostic tests, this pathology is considered infrequent and commonly underdiagnosed, however, thanks to new ways of approach to it, its frequency has increased worldwide. Objectives: To determine the frequency and clinical characteristics of patients with autoimmune hepatitis treated at the José Carrasco Arteaga Specialty Hospital from 01/01/2017 to 12/31/2021. Methodology: Descriptive, retrospective study in patients with HAI. We worked with the information obtained from the hospital's anonymized database, collected with forms, creating an Excel matrix with the data that was analyzed with the statistical program SPSS version 23. The results were presented in contingency tables. Results: 36.4% of the sample (n=88) were categorized as definitive AIH after treatment. This was made up mainly of women (85.2%). Chronic AIH was the predominant form of presentation, mainly associated with hypothyroidism (39.8%). Abdominal pain (78.4%) and jaundice (54.5%) were the outstanding symptoms. The overlap syndrome occurred in 26.2 % of all patients. Anti-nuclear (83%) and anti-smooth muscle (20.5%) antibodies, and interface hepatitis (36.4%) were the predominant immunohistological findings. Combined initial therapy (56.8%) and maintenance immunomodulatory treatment (50%) were the most indicated therapeutic strategies. Conclusion: There is a high frequency of HAI in the sample, with clinical-epidemiological characteristics comparable to other studies.
Frecuencia y factores de riesgo de la resistencia a la claritromicina, amoxicilina, metronidazol, levofloxacina y azitromicina en pacientes con infección por helicobacter pylori en el Centro de Especialidades: gastroenterología, hepatología y endoscopia en Cuenca-Ecuador en el período diciembre 2020- mayo 2021
(Universidad de Cuenca, 2021-09-29) Pesántez Araujo, Juan Daniel; Tobar Lima, Diego Enrique; González Domínguez, Esteban Horacio
ABSTRACT BACKGROUND: H. pylori is a bacterial infection of high prevalence in developing countries, however, the usual treatment presents significant failure rates. It is believed that the main reason for this problem is resistance to antibiotics, which has been increasing considerably in different parts of the world. OBJECTIVE: To identify the frequency and risk factors for resistance to clarithromycin, amoxicillin, azithromycin, metronidazole and levofloxacin in patients with H. pylori infection at the Specialty Center: Gastroenterology, hepatology and endoscopy during the period December 2020-May 2021. METHODS: A prospective descriptive study that included 157 patients studied endoscopically, of whom biopsies were taken and cultured to obtain resistance rates to different antibiotics. General, sociodemographic and public service information was collected. Data were presented in tables, with relative frequencies and percentages. RESULTS: The frequency of infection by H. pylori was 31.2% according to the urea test and 12.7% per culture of 48 hours. The lowest percentage of resistance was observed in levofloxacin (0%), followed by azithromycin with 16.7%; clarithromycin 21.1%; amoxicillin 25 26.3%; amoxicillin 31.6% and with a higher percentage of resistance, metronidazole with 63.2%. Resistance to metronidazole and amoxicillin 25 was only significantly associated with the age of patients, being higher in those over 60 years of age. CONCLUSIONS: Metronidazole had a high rate of resistance in the studied population, while levofloxacin presented a sensitivity of 100%. Resistance to metronidazole and clarithromycin was associated with patient longevity
Profilaxis y tratamiento de la hemorragia digestiva alta en pacientes cirróticos. Hospital Vicente Corral Moscoso. 2019
(Universidad de Cuenca, 2021-10-01) Amoroso Ortega, Doménica María; Calderón Avila, Rommel Ariel; González Domínguez, Esteban Horacio; Sacoto Molina, Adrián Marcelo
INTRODUCTION: Variceal bleeding is the leading cause of upper gastrointestinal bleeding in cirrhotic patients. Due to the significant risk of morbidity and mortality, effective primary prophylaxis and treatment protocols have been established, so we want to analyze compliance with these guidelines at the Vicente Corral Moscoso Hospital (HVCM). GENERAL OBJECTIVE: Recognize the characteristics of cirrhotic patients with variceal upper gastrointestinal bleeding, as well as compliance with prophylaxis and treatment of upper gastrointestinal bleeding in cirrhotic patients at the Vicente Corral Moscoso Hospital in 2019. MATERIALS AND METHODS: A descriptive cross-sectional study was carried out with all cirrhotic patients who were admitted due to variceal upper gastrointestinal bleeding during 2019 at the HVCM. The data were collected using a form created in the Kobo Tool Box program from medical records; The results were analyzed in the Microsoft Excel 2016 and PSPP programs. Approval was obtained from the Health Research Bioethics Committee (COBIAS) of the University of Cuenca and authorization from the Hospital. RESULTS: From all the patients studied, 70% were men; 25% were between 50 and 59 years old; 59% of the population studied did not receive primary prophylaxis and it stood out that 56% did not receive treatment. CONCLUSION: The data obtained show that less than half of the patients studied received primary prophylaxis and/or treatment, corresponding to non-selective beta-blockers and endoscopic ligation, respectively.