Browsing by Author "Ortega Nivelo, Italo Ismael"

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Caso clínico 1: miopatía inflamatoria idiopática. Reporte de caso, Caso clínico 2: disección de aorta. Reporte de caso
(Universidad de Cuenca, 2023-09-04) Ortega Nivelo, Italo Ismael; Guevara Pacheco, Sergio Vicente
Background: Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by muscle weakness and inflammatory infiltrates in muscle tissue, which can affect different organs. Clinical case: a 40-year-old female patient who presented with musculoskeletal pain and muscle weakness in the upper limbs accompanied by scaly papular lesions on the back of the hands and erythema on the eyelids, with increased serum muscle enzymes, suspected IIM, and a muscle biopsy was performed. Reporting perivascular infiltrate, with abnormal electromyography, the Bohan and Peter criteria are applied with a diagnosis of dermatomyositis; Immunosuppressive treatment was started with favorable clinical evolution, medical discharge and outpatient follow-up were decided Clinical case: A 40-year-old female patient who attended for musculoskeletal pain and muscle weakness in the upper limbs accompanied by scaly papular lesions on the back of the hands and erythema at the level of the eyelids, with increased serum muscle enzymes, suspected IIM, a muscle biopsy was performed reporting perivascular infiltrate , with abnormal electromyography, the Bohan and Peter criteria are applied with a diagnosis of dermatomyositis; Immunosuppressive treatment was started with favorable clinical evolution, medical discharge and outpatient follow-up were decided Conclusions: In patients presenting with musculoskeletal pain and muscle weakness associated with skin lesions, IM should be clinically suspected, so the Bohan and Peter criteria should be applied to define the diagnosis. Introducción: la disección de aorta (DA) consiste en una rotura de la capa íntima de la pared del vaso permitiendo el paso de sangre a la capa media separando la luz verdadera de la falsa, es una patología poco frecuente, que puede presentarse en pacientes con antecedentes de traumatismo torácico. Caso clínico: paciente masculino de 35 años, con antecedente de accidente en vehículo motorizado hace 18 meses, acude al servicio de emergencia por un cuadro de hemiparesia derecha más disartria de 4 horas de evolución, se realiza tomografía de cráneo sin encontrarse lesión, catalogándose como evento cerebrovascular isquémico, con recuperación neurológica espontánea, posterior presenta disnea de grandes esfuerzos, se realiza ecocardiograma reportando DA ascendente más aneurisma, se instaura tratamiento mediante medidas de soporte, con derivación para cirugía cardiotorácica. Conclusión: en pacientes con antecedentes de traumatismo torácico, debe realizárseles valoración cardiológica temprana, para detectar cuadros de DA.
Efectos adversos de la vacuna AH1N1 en los pacientes crónicos y embarazadas inscritos en el centro de salud del área no. 3, Cuenca 2010
(2012) Ortega Nivelo, Italo Ismael; Palacios Rodas, Rodrigo Isaías; Pimienta Rodríguez, Samuel Xavier; Freire Solano, Eulalia del Carmen; Freire Solano, Eulalia del Carmen
ABSTRACT Objetive: Determine the adverse effects of the vaccine influenza A H1N1 in chronic patients and pregnant women registered in Health Area Center No. 3. Methods and materials: The present study is descriptive. The universe are N= 442 patients. It was used the structured interview applying a questionnaire consisting of socio-demographic variables, also the test “European Medicines Agency en la European Strategy for Influenza A/H1N1 Vaccine Benefit-Risk Monitoring”. The results had a statistical analysis in Microsoft Excel software version 2010. Results: In our study we found that 71.04% (314 patients) were female and 28.96% (128 patients) were male sex. Of all women, 100 of them, ie 22.62% of the universe were in some gestation stage, although the 342 patients corresponding the 77.38% have some chronic disease. The Celtura Vaccine was the most used equivalent to the 83.48%, although the 16.52% received Monovalent vaccine. From the total of the patients who received the vaccine, only the 25.11% which corresponds to 111 patients showed some adverse effect. Pain and inflammation were the most frequent with the Celtura Vaccine in a 47.62%, and the 56.67% with Monovalent Vaccine. In this study, there wasn’t presence a Guillain Barré Syndrome, compared to studies directed in other countries like Korea and Brazil. Conclusions: The Influenza A H1N1’s vaccine produces the same adverse effects than the Common Influenza. From the four people vaccinated, one presented some adverse effect. The pain and the inflammation were the most adverse effect where they received the vaccine. About chronic adverse effects in this study, there were none.