Browsing by Author "Pacheco Bacuilima, Juan Pablo"

Now showing 1 - 8 of 8

Adecuada utilización de la escala curb-65 en el manejo de adultos mayores con neumonía recibidos en el servicio de emergencia. Hospital José Carrasco Arteaga. Cuenca. 2016
(2017) Rodas Escandón, José Gabriel; Orellana Crespo, Darwin Octaviano; Toral Tenorio, Federico Marcelo; Pacheco Bacuilima, Juan Pablo
Background: Community-acquired pneumonia (CAP) is a pathology that potentially endangers the patient's life, and has a significant economic impact. The CURB-65 scale is recommended by the British Thoracic Society to predict mortality and patient admission; however, there are no studies in our locality to evaluate the proper use of the scale. Objective: to evaluate the adequate use of the CURB-65 scale in the management of elderly patients with CAP in the emergency service of José Carrasco Arteaga Hospital, January-June 2016. Methodology: a retrospective, analytical and scale evaluation study was performed in 180 Clinical Histories of elderly patients diagnosed with community acquired pneumonia who attended the José Carrasco Arteaga Hospital emergency in the first half of 2016. It was applied chi-square statistic test and relative risk (RR) to determine association between variables. Results: The therapeutic decision applied in the patients was ambulatory in 62.2% and hospital in 37.8%. The CURB-65 scale recommended an ambulatory treatment in 71.7% and hospital treatment in 28.3% of the patients. Hospitalized patients have 6.3 times higher probabilities to have a classification of CURB-65 to hospitalization. 27.2% of the elderly with acquired pneumonia in the community receive inadequate treatment according to the CURB-65 scale. Conclusions: A considerable amount of 27.2% of the patients receive an inadequate treatment according to the recommendations of the CURB-65, so this scale should be applied in a protocolized management in all patients with community-acquired pneumonia
Características del trauma raquimedular en pacientes ingresados en el área de emergencia del Hospital Vicente Corral Moscoso abril 1999 - abril 2002. Cuenca Ecuador
(2002) Ortega Berrezueta, Jaime Fernando; Pacheco Bacuilima, Juan Pablo; Castro Calle, Fernando Eugenio; Mosquera Vallejo, Lorena Elizabeth
Determinación del periodo de apnea y número de intentos para la intubación oro traqueal con laringoscopía directa y con video laringoscopía. Hospital Vicente Corral Moscoso. Cuenca ecuador 2016
(2018) Pacheco Bacuilima, Juan Pablo; Viteri León, Enrique Octavio; Torracchi, Carrasco, Aldo Mateo
Background: The endotracheal intubation through direct laryngoscopy is used for correct maintenance of the airway, in the last decade another technique used for incubation is the video laryngoscopy, which uses an optical device that allows a panoramic visualization of the glottis, through a screen that can be located next to the patient or be in the device’s handle. Objective: comparison of the apnea period and the number of attempts to endotracheal intubation with direct laryngoscopy in relation to video laryngoscopy. Materials and methods: This study is observational, prospective that comparer the apnea period and the number of attempts to endotracheal intubation with direct laryngoscopy in relation at video laryngoscopy, it was done at the Vicente Corral Moscoso Hospital, with a sample of 107 patients for the intubation group, were recorder data age, sex, BMI, predictive scales difficult airway, apnea in seconds that it took intubation each of the groups, the number of attempts, aid maneuvers intubation and O2 saturation. For the analysis of the results statistical data were used, such as frequencies, percentages, and dispersion as standard deviation. Results: We studied patients of about 40 years of age (+/- 15) with normal or overweight, most of them had an oxygen saturation of 99% (+/- 1.6%). No differences were found between the use of conventional laryngoscopy and the video laryngoscope, in terms of the number of intubation attempts. The apnea period between patients intubated with conventional laryngoscopy (4-7 seconds) was lower than that found in those who were intubation with video laryngoscopy (7-10 seconds). Conclusions: no differences were found between intubation with video laryngoscopy and conventional intubation. A relationship was found between the diameter of the neck greater than 40 cm and the increase in the number of intubation attempts.
Efecto del programa integral de estimulación de la inteligencia en el mejoramiento de la memoria de trabajo. Cuenca. Septiembre 2015 – Junio 2016
(2017) Gualpa Bustamante, Helen Daniela; Guaman Quilli, Lourdes Angélica; Bojorque Iñeguez, Vilma Mariela; Pacheco Bacuilima, Juan Pablo
Background: We now know that these skills are not innate, but are developed in the first years of life, when the person is exposed to stimuli. Here we analyze the improvement of one of them, the working memory. General Objective: to determine the effect of the integral program of stimulation of the intelligence (PIENSO) in the improvement of the working memory in children of the canton Cuenca. September 2015 - June 2016. Methodology: is a quasi experimental study. 368 students enrolled in fourth year of basic divided into two groups: experimental and control. The experimental group formed 7 schools in which the authorities chose to train for the application of the PIENSO. The control group comprised 6 schools where teachers were not trained. In the experimental group the PIENSO was applied during a school year and the control group did not. Before and after the intervention, the working memory scores were obtained using the WISC IV scale in the two groups, for analysis. Results: Mean scores increased significantly at the end of PIENSO in both groups. Although this increase was greater in the experimental group it was not statistically significant (p = 0.183). Conclusions: PIENSO showed that it can improve working memory in the experimental group, although the differences with the control group are not significant; we conclude that the use of these programs are not a guarantee to achieve an improvement in working memory
Frecuencia y características asociadas al síndrome del cuidador quemado en FASEC, Cuenca 2024
(Universidad de Cuenca, 2025-01-17) Quezada Castillo, Priscilla Geraldine; De Jesús Izquierdo, Marlon Paúl; Pacheco Bacuilima, Juan Pablo
Background: Burned-out caregiver syndrome, is defined as a set of physical and psychological symptoms experienced by people who are constantly engaged in the care of family members or loved ones who have some chronic illness, disability or dependency. Objective: To establish the frequency and associated characteristics of Burnt Caregiver Syndrome among caregivers of patients attended at FASEC, Cuenca. Method: A quantitative, observational, descriptive and cross-sectional study was carried out at the Fundación al Servicio del Enfermo de Cáncer (FASEC), with palliative care patients according to the inclusion criteria and with prior informed consent. The information was tabulated and processed with descriptive statistics in the SPSS24 program. Results: it was found that there is a predominance of female sex 70% in relation to male sex 30%, with an average age of 46 years, residence in an urban area, catholic religion, the most frequent relationship was children with 30%, the participants have higher education in 48.3% of the cases. Of the caregivers, 36.7% had no overload; 23.3% had slight overload and a significant 40.0% had intense overload, of whom 18 were informal caregivers and 6 were formal caregivers. Conclusion: the study shows that burned-out caregiver syndrome among FASEC caregivers has a presence of 63% which underlines a need to implement support strategies.
Prevalencia de hernia incisional y sus factores de riesgo, Hospital Homero Castanier Crespo. Azogues 2014-2015
(2017) Vásquez Velasco, Javier Alonso; Vélez Quinteros, Esteban Paúl; Ordóñez Cumbe, Julio César; Pacheco Bacuilima, Juan Pablo
Background: the incisional hernias are a defect of the abdominal wall, produced by the failure of the reconstruction of the wall in a previous surgery, being indeterminate its prevalence in Homero Castanier Crespo Hospital in the city of Azogues. General Objective: to determine the prevalence of incisional hernia and identify risk factors in patients with a diagnosis of incisional hernia in Homero Castanier Crespo Hospital, Azogues January 2014 – December 2015. Materials and Methods: quantitative, descriptive study, information was collected through forms with data obtained from the medical records of patients with a diagnosis of incisional hernias admitted in the area of surgery. Data were tabulated using SPSS software V15, to be analyzed, to present the results were used frequencies and percentages, for the statistical association Chi square of Pearson and p value for statistical significance. Results: the prevalence of incisional hernia in the Homero Castanier Crespo Hospital was 26.4%; the most affected groups were: elders 40.8%; Women 73.2%; Residents in the urban area 69%, sedentary patients 18.3%; with alcohol consumption 2.8% and diabetes 8.5%. In 31% of the cases, patients had recurrent hernias. In 36.6% of the cases, the hernia was supra umbilical and polyglactin 910 (Vicryl) was the most used suture. Conclusions: the incisional hernia is a pathology that can show up in any patient, however, the control of the modifiable risk factors is a good strategy, which, together with the surgeon's technical abilities, can effectively reduce its presentation
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).
Variabilidad en estimación clasificación asociación americana de anestesiología por personal de anestesiología. hospitales Vicente Corral Moscoso - José Carrasco Arteaga. Cuenca 2019.
(Universidad de Cuenca, 2020-06-17) Hurtado Aguilar, Jonathan Oswaldo; Terán Pintado, Andrés Santiago; Peñafiel Martínez, Nadia Rosalía; Pacheco Bacuilima, Juan Pablo
Background: the American Society of Anesthesiologists Classification physical status classification system is the most employed tool by the anesthesiologist as a surgical risk predictor. However, there is a variability in its employment and interpretation. General Objective: To evaluate the variability of the estimate ASA classification by the anesthesiology personnel from the hospitals Vicente Corral Moscoso and Jose Carrasco Arteaga. Cuenca 2019. Methodology: a descriptive-observational study was performed in which 85 anesthesiologists and postgraduates participated. A questionnaire that presented 10 hypothetical clinical cases was applied, and the information was tabulated through SPSS v23 and Excel 2016. The analysis was created with tables and graphics using frequency, percentages, and centralization measures. Results: The average age was 35.7 years old. The female sex predominated with 58.5%, whose majority were specialist doctors. The best classified scenarios between treating physicians and postgraduates corresponded to N°3 (98.8% specialists and 94.1% residents) and N°10 (94.1%) for both of them. The case N°4 registered the highest variability 49.4% specialists against 51.6% postgraduates. The specialist doctors registered a variation of even four categories of ASA for the same case. Furthermore, it was found that the more years of experience, the higher the error rate. The postgraduates R1 presented the best classification criteria for the total number of cases. Conclusions: It was verified that there is variability between the anesthesiologists from the hospitals Vicente Corral Moscoso and Jose Carrasco Arteaga when using the American Society of Anesthesiologists Classification physical status classification system.