Browsing by Author "Monsalve Toral, Pablo Arturo"

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Leucemia limfoblástica aguda y su relación con la lactancia materna en los niños del Instituto del Cancer Solca, Cuenca, 2010
(Universidad de Cuenca, 2010-11-11) Guerrero Quiroz, Enmanuel Isidoro; Quito Riera, Lauro Bolívar; Encalada Torres, Lorena Esperanza; Monsalve Toral, Pablo Arturo
Introduction.- The breast-feeding and its relation to cancer are uncertain. The majority of studies show a protective association when breastfeeding is exclusive, at least the first six months. Objective.- To determine the association between a history of non-exclusive breastfeeding in the first six months and the risk of ALL in children 0-15 years of SOLCA Cancer Institute between the years 2000-2010 and compared with children did not develop the disease, the HVCM. Methodology.- The study was of 130 children (cases) SOLCA Institute, diagnosed with ALL and 390 HVCM controls, matched for age, sex, origin and familial risk factors. Data were collected from a direct survey of mothers, parents or guardians and then tabulated in EXCEL and SPSS, for the analysis used descriptive statistics (percentage frequency) to establish an association OR, CI (95%) and chi square for statistical significance and multivariate logistic regression to control variables. Results.- In the cases, 45.38% had an exclusive breastfeeding for the first six months, versus a 65.38% that was observed in controls. The association OR was 2.27 and multivariable logistic regression showed that increased risk of ALL (5.6) in those children who breastfed less than 8 times a day. Conclusion.- They have more risk of developing ALL children not exclusively breastfed the first 6 months compared to children who do.
Linfangiomatosis kaposiforme: reporte de un caso y revisión de la literatura
(2020) Guerrero Quiroz, Enmanuel Isidoro; Alvarado Corral, Raul Francisco adolfo; Monsalve Toral, Pablo Arturo; Bravo Muñoz, Marx Italo; Urdiales Valarezo, Adriana Ines; Manterola, Carlos; Albarracin Navas, Lorena Carlota
Lymphangiomatosis is a benign pathology, of unknown etiology. Affects especially to pediatric population and is characterized by development of subcutaneous masses that involve one or more organs. When it presents with coagulopathy and chylous effusions, it is called kaposiform lymphangiomatosis (KL). The available evidence of KL is scarce. The objective of this manuscript was to report a case of pediatric KL treated at SOLCA Cancer Institute, Cuenca, Ecuador. Female patient of 1 year and 7 months age. She had a bilateral inguinal hernia and altered coagulation times. Imaging studies revealed a mediastinal mass associated with fluid in the pleural space and in the abdominal-pelvic cavity. Furthermore, the existence of multiple hypogenic images in the spleen was evidenced. Minimal thymectomy, biopsy of mediastinal lymph nodes was performed to establish the diagnosis, and a drain was installed in the chest to treat the aforementioned pleural effusion. Other pathologies like lymphomas, lupus, etc. were ruled out. Given the continuous respiratory deterioration, coagulopathy, splenic hypogenic lesions and abundant drainage of the chylothorax through the chest tube, the diagnosis of KL was raised. Parenteral nutrition (lipid-free) was started; Vincristine was indicated, and a pleurodesis with bleomycin was performed without a good response. The patient died 16 days after her admission. It is a case of very bad prognosis, with a rapidly progressive evolution towards a fatal outcome.
Oral health in children with acute lymphoblastic leukaemia: before and after chemotherapy treatment
(2020) Parra Coronel, Janeth Judith; Alvarado, Ma C; Monsalve Toral, Pablo Arturo; Ferreira Costa, André Luiz; Montesinos Parra, Gonzalo André; Parra Coronel, Pablo Agustín
© 2019, European Academy of Paediatric Dentistry. Aim: To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. Materials and methods: A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Löe plaque index (SLPI) and gingiva status was evaluated with the gingival Löe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar’s test, t test (for related samples), and Wilcoxon test. Results: There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P < 0.000); salivary flow increased significantly from 0.54 ± 0.34 to 1.22 ± 1.07 after chemotherapy treatment (P < 0.00). Oral mucositis was present in 24 children (75%) with a 1–2 severity level. Conclusions: After chemotherapy treatment, there were changes in the oral conditions of children with ALL. Some manifestations decreased after treatment, whereas in others increased.
Resultados del tratamiento del hepatoblastoma en los Andes ecuatorianos
(2021) Guerrero Quiroz, Enmanuel Isidoro; Alvarado Corral, Raúl Francisco; Monsalve Toral, Pablo Arturo; Peñafiel Martínez, Eulalia Cumandá; Díaz Gómez, Carla Tatiana; Duque, Galo; Manterola, Carlos; Albarracín, Lorena
Hepatoblastoma (HB), is a malignant neoplasm, which originates in the liver. Survival (SV) depends on the extent of disease progression. The objective of this study was to determine differences in overall SV (OS) and disease-free (DFS) in patients with HB, according to the extent of their disease. Case series with follow-up. Patients between 4 and 160 months of age treated at an oncology center in the Ecuadorian Andes (2000-2019) were included. The result variables were affected lobe, lung metastasis, vascular infiltration, PRETEXT stage, risk, histology, alpha-fetoprotein levels (AFP), complete remission (RC), OS and DFS. Descriptive and analytical statistics (Chi2, Fisher's exact and continuity correction) were used. SV analyzes were performed with Kaplan Meier and log-rank curves. In this analysis 28 patients (53.6 % men), with a median age of 40 months, were studied. Lung metastases and vascular infiltration were verified in 25.0 % and 35.7 % of the cases, respectively. Histology, clinical stage, and high risk were mainly epithelial type (42.8 %), PRETEXT II (50.0 %), and high risk (67.8 %), respectively. The mean AFP at diagnosis was 1055712 ng / ml and 9 patients achieved CR. OS and DFS at 19 years were 33.1 % and 26.0 % respectively. According to their extension, the OS and DFS for standard and high risk patients were 50.0 % and 25.4 % (p = 0.148); and 50.0 % and 14.7 % (p = 0.037) respectively. The verified OS and DFS are lower than those reported in other studies. DFS according to its extension, presented a significant difference, however, this result should be considered with caution due to the small number of patients.
Síndrome de Lennox-Gastaut: descripción clínica y correlación de la frecuencia de crisis con el coeficiente intelectual
(Universidad de Cuenca, 1990-11-11) Cisneros González, Ana Eugenia; Monsalve Toral, Pablo Arturo; Calle Galán, Hugo Marcelo; Carpio Rodas, Luis Arturo