Browsing by Author "Reinoso Naranjo, Jeovanni Homero"

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Capacitación b-learning en manejo inicial y prevención de trauma en niños y adolescentes
(Abya-Yala, 2017) Palacios Espinoza, Elvira del Carmen; Vanegas Coveña, Diana Patricia; Pino Andrade, Raúl Haldo; Reinoso Naranjo, Jeovanni Homero; Ortiz Segarra, José Ignacio; Cabrera Solis, Vanessa Elizabeth; Velasco Piedra, Luis Enmanuel; Rodas Vanegas, Adrián Fernando; Merchán Morales, Marco Andrés
Caso clínico 1: trauma penetrante cardiaco manejado mediante ventana pericárdica subxifoidea. Caso clínico 2: vólvulo de colon transverso
(Universidad de Cuenca, 2023-06-23) Ulloa Aguilar, Boris Javier; Reinoso Naranjo, Jeovanni Homero
Abstract 1 Penetrating cardiac trauma is a type of injury that presents a high mortality rate, even conditioning the victim not to reach an emergency department for management. Depending on the hemodynamic status of the patient, it has been observed the different management that could be provided in a hospital center, from the need for thoracotomy in severe patients or the practice of pericardial window for confirmation and treatment of cardiac trauma in a clinically stable patient, without neglecting the importance of complementary examinations that we have today. We present a single case of a 43-year-old male patient who was admitted with a diagnosis of cardiac tamponade following penetrating chest trauma with a stab wound. The patient presented with lesion in the anterior precordial face, with tendency to hypotension and tachycardia; in addition to psychomotor agitation. A subxiphoid pericardial window was performed where a hemopericardium of approximately 200cc of blood plus clots was found. It was also necessary to perform pleural drainage for presenting grade II pneumothorax. The patient remained hospitalized for 5 days, and due to his favorable evolution and the absence of complications, he was discharged from hospital. The management and treatment of patients with penetrating cardiac trauma depends on their hemodynamic status and the anatomical site of injury. It has been observed that starting with aggressive surgical treatment such as a thoracotomy may not always be necessary, thus committing the patient to greater comorbidity and hospital stay. The new diagnostic methods that we have in the emergency rooms of the hospital centers, help us a lot nowadays to take a more effective course of action. According to these results, the surgeon could choose the pericardial window as a good first option for this type of management. Abstract 2 Introduction: Volvulus of the gastrointestinal tract are an important cause of acute abdomen, both because of their frequency and the severity of their potential complications. (1) They are difficult to diagnose clinical entities that can occur in any tract of the gastrointestinal tract and with high complication value (1). Volvulus occurs when parts of the intestine become entangled in a mesenteric axis, which can lead to impairment of the blood supply or can cause total or partial obstruction of the intestinal lumen (2). We present the clinical case of a 17-year-old male patient with acute obstructive abdomen due to volvulus of the transverse colon, where exploratory laparotomy was performed plus intestinal resection plus end terminal anastomosis of the transverse colon, who was also diagnosed with a malformation in the form of sequential dilatation of the middle third of the transverse colon (intestinal duplication), including malformation of the mesentery (lax tissue). Patient presented favorable evolution and after 5 days of hospitalization was discharged. Volvulus of the gastrointestinal tract is an important cause of acute abdomen, its late diagnosis can lead to complications even compromising the patient's life. There are several anatomical sites of the colon that could be affected by this pathology, being the transverse colon the one with the lowest incidence with 1-4%. At present, depending on the clinical condition of the patient, less invasive management such as decompression by colonoscopy is decided in the absence of peritoneal signs, but in the presence of findings such as suspected intestinal necrosis, perforation and shock, surgical treatment is the first choice.
Caso clínico 1: vía biliar accesoria en colecistectomía laparoscópica de emergencia, Caso clínico 2: intususcepción de ciego sobre colon ascendente en cáncer de ciego
(Universidad de Cuenca, 2023-06-19) Preciado Vásquez, Jimmy Vinicio; Reinoso Naranjo, Jeovanni Homero
Introduction: Anatomical anomalies and variations of the bile ducts constitute surgical challenges and a risk of intra- and postoperative complications. These types of anatomical abnormalities of the biliary tract do not have to be evidenced by specific symptoms and their discovery is generally accidental, during gallbladder or bile duct surgery. Clinical case: The case of a patient of 59 years is presented, that it refers suffering since 72 hours abdominal pain accompanied of nausea. The patient to surgery for laparoscopic cholecystectomy decides to move to the not much hours of the income, with presumptive diagnosis of cholelithiasis. Findings were: The gall bladder of fine walls with two litos in its inside of 0.7cm, in cystic duct of 0.5 mm, next to cystic duct becomes evident hepatic aberrant leaving of common bile duct to 1 cm of the bifurcation, enter along with cystic again to common bile duct, confirmed for intraoperative cholangiography. Conclusion: When accomplishing the laparoscopic cholecystectomy they should have in account important aspects like the possible presence of anatomic variants that can drive an iatrogenic injury. The finding if it becomes evident in not much proportion in the present-day population and for that reason revert importance. The surgical and laparoscopic- imaging courses of action were the adequate and with this complications were avoided for the patient and he received its certificate of discharge in less than 72 hours after the income. Introducción: Las intususcepciones en adultos, son raras y representan <5% de los casos de todas las invaginaciones y 1-5% de todas las obstrucciones intestinales. La intususcepción colónica en adultos ocurre principalmente en el colon sigmoide, el colon transverso y el ciego. Caso clínico: Se presenta el caso de una paciente que tras sufrir trauma superficial de abdomen, presenta dolor tipo opresivo a nivel de epigastrio, sin otro síntoma acompañante; dicho dolor se exacerba dos semanas antes de la consulta, acompañado de náusea y vómito de características alimenticias. Se decide el ingreso de la paciente con diagnóstico de abdomen oclusivo parcial, se realiza una ecografía observándose imagen sugestiva de invaginación intestinal, por lo que para corroborar información se solicita tomografía simple y contrastada de abdomen corroborando resultados. Se le practica laparotomía exploratoria, encontrando una masa en ciego de 6 x 6 cm, aplanada con intususcepción de intestino delgado y apéndice, múltiples ganglios a nivel de mesenterio. Además, se realizó una hemicolectomía derecha, anastomosis ileotransversa termino lateral, y colocación de drenaje de Jackson Pratt. Conclusión: La laparotomía exploratoria es la técnica de primer orden para la detección de las anomalías intestinales. En este caso la intususcepción de intestino delgado y apéndice a partir de un cáncer de ciego. El tratamiento óptimo para la invaginación intestinal en adultos sigue siendo el quirúrgico, el definitivo depende de la etiología y la localización subyacentes. Debido a que la invaginación intestinal en estos pacientes está altamente correlacionada con tumores malignos.
Comparación entre las escalas Apache II, Bisap y Marshall modificada, en la evaluación de la severidad de la pancreatitis aguda de origen biliar. Hospital Vicente Corral Moscoso. 2018-2019.
(Universidad de Cuenca, 2020-03-04) Vélez Lara, Andrea Monserrath; Reinoso Naranjo, Jeovanni Homero
Background: Acute pancreatitis is a pathology with high morbidity and mortality. To detect its severity there are several scales whose validation criteria are not yet standardized. Objective: To compare the effectiveness of the APACHE, BISAP and MARSHALL scales, in the evaluation of the severity of acute biliary pancreatitis in Hospital Vicente Corral Moscoso 2018-2019. Material and methods: A diagnostic test validation study was carried out based on an analysis of 226 medical records of patients diagnosed with acute pancreatitis. The scales (APACHE, BISAP and MARSHALL) were applied and sensitivity, specificity, positive and negative predictive value, ROC curve, positive and negative likelihood ratio were compared. Results: The mean age was 52.8 ± 20.1 (SD). The female gender predominated 59.7%, mixed ethnicity 88.1% and low socioeconomic status 52.2%. Mild pancreatitis (69.5%) was more frequent than moderate (21.2%) and severe (9.3%). The sensitivity and specificity for the 3 scales was: APACHE II S: 95.2% and E: 80.4%, BISAP S: 71.4% and E: 93.7% and MARSHALL S: 90.5% and E : 76.1% The discriminatory power to predict severity was high with an ACU for APACHE II 0.87, followed by MODIFIED MARSHALL 0.83, and BISAP 0.82. The RVP was better for BISAP 53.57, followed by APACHE 33.3 and MARSALL of 27.94. In contrast, the RVN was better for APACHE II 99.40, then MARSHALL 98.73 and finally for BISAP 96.97. Conclusions: APACHE, BISAP and MARSHALL, showed similar predictive accuracy to determine the severity of acute pancreatitis.
Comportamiento de la patología biliar aguda y su manejo en el servicio de trauma y emergencia del Hospital "Vicente Corral Moscoso" Cuenca. Enero a junio de 2014
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Reinoso Naranjo, Jeovanni Homero; Pino Andrade, Raúl Haldo; Salamea Molina, Juan Carlos; Rodas Andrade, Juan Edgar; Fernández de Córdova Rubio, Germán Lenín; Zurita Batallas, María Cristina; Cabrera Ordóñez, Catherine Mercedes; Andrade Gómez, Jorge Andrés
Biliary disease affects a large percentage of the adult population, for this reason its treatment now has shifted to a new paradigm of care under the concept of “Acute Care Surgery” (ACS) 1, which is characterized by prioritize the comprehensive patient assessment and the early intervention of pathology. In the Vicente Corral Moscoso Hospital (VCMH) under this model ACS and using standardized protocols, has achieved an important turn in the early treatment of biliary pathology using standard tools such as laboratory tests, radiology and if it is necessary in any case through the resolution by minimally invasive surgical technique or by conventional means. OBJECTIVE: To describe the behavior of the biliary disease and its management in the service of Trauma and Emergency of the “Vicente Corral Moscoso Hospital” during the period January-June 2014, under the model (ACS) during the period January-June 2014. METHODS: A cross-sectional study, which analyzed cases of acute cholecystitis (CAL), choledocholithiasis, acute biliary pancreatitis (ABP) and their management, registered in the digital database service of the Emergency in the Vicente Corral Moscoso Hospital, under clinical criteria, laboratory and imaging, during the period January-June 2014. RESULTS: The study involved a total of 240 patients treated in the Trauma and Emergency in the VCMH during the period January- September 2014. The pathology in order of frequency was 47% choledocholithiasis, 35% acute cholecystitis and acute biliary pancreatitis 18%, the prevalence was higher in women by 85%, 67% and 81% respectively and treatment was adapted to the corresponding pathologies. CONCLUSIONS: The implementation model of Trauma and Emergency Surgery at our institution has achieved an integrated management of the acute cholecystitis, acute biliary pancreatitis and choledocholithiasis, reducing the associated complications and avoiding the recurrence of more serious pictures
Determinación de la eficacia de la profilaxis antibiótica en pacientes con heridas limpias y limpias contaminadas, servicio de cirugía general, Hospital Vicente Corral Moscoso Cuenca-Ecuador 2007: estudio a realizarse en patologia biliar, apendicular y herniaria
(Universidad de Cuenca, 2008-11-11) Palacios, Diego Patricio; Reinoso, Jeovanni Homero; Moscoso Abad, Enrique; Pinos Abad, Guido Marcelo; Reinoso Naranjo, Jeovanni Homero
Determinación de la eficacia de la profilaxis antibiótica en pacientes con heridas limpias y limpias contaminadas, servicio de cirugía general. Hospital Vicente Corral Moscoso, Cuenca-Ecuador 2007: estudio a realizarse en patología biliar, apendicular y herniaria
(2008) Palacios Vintimilla, Diego Patricio; Reinoso Naranjo, Jeovanni Homero; Moscoso Abad, Teodoro Enrique; Pinos Abad, Guido Marcelo
Evaluación del uso del programa b-learning en estudiantes de Medicina, sobre tratamiento inicial y prevención de trauma en niños. Cuenca 2015
(2016) Reinoso Naranjo, Jeovanni Homero; Palacios Espinoza, Elvira del Carmen; Vanegas Coveña, Diana Patricia; Pino Andrade, Raúl Haldo; Ortiz Segarra, José Ignacio
Recognizing the importance of incorporating ICT in higher education and in order to evaluate the degree of satisfaction, participation and perceptions about the B-learning training course in initial trauma management in children and adolescents, a descriptive study was carried out using a satisfaction survey, records of participation in virtual activities and perceptions of knowledge, abilities and skills. Little previous participation in courses on the MOODLE platform and lack of knowledge of B-learning courses was evidenced. Regarding the training program, there was good acceptance of the planning and each of the activities, there was a statistically significant difference in the acquisition of knowledge, skills and abilities for the resolution of trauma problems in children and adolescents, there was no evidence of changes in knowledge about prevention. The pilot program for the use of the B-learning model on initial management and prevention of trauma in children and adolescents for medical students was a positive experience, which achieved significant acceptance by students.
Frecuencia de mortalidad y factores asociados en pacientes con trauma severo que se aplicó hipotensión permisiva en el Hospital Vicente Corral Moscoso desde el 1 de noviembre de 2012 al 31 de octubre de 2015
(2018) Reinoso Naranjo, Jeovanni Homero; Salamea Molina, Juan Carlos; Torracchi Carrasco, Aldo Mateo
INTRODUCTION Severe trauma has a 10% death prevalence worldwide. In our country, it constitutes a real public health problem, generally affecting healthy people in their productive age, and rating first as a cause of death and disability. GENERAL OBJECTIVE: To determine the mortality frequency and associated factors in patients with severe trauma who were applied permissive hypotension in the Trauma and Emergency service of the “Vicente Corral Moscoso” Hospital. MATERIAL AND METHOD: This research was 107 medical histories. Descriptive statistics were employed, including central tendency measures as well as dispersion, frequency, and percentage measures. Bivariate statistics were also used, such as the t-test and Chi-square, p value < 0,05, OR with IC at 95%, as well as the logistic regression multivariate analysis. RESULTS: It was determined that the largest number of injuries were men (90%) and the most frequent mechanism of injury was by short-pricking weapon (56%); the prevalence of death is 10.3% of all severe traumas. A mortality rate of 1 was established in 75 cases with severe trauma, with permissive hypotension (prevalence 1.3%); while with conventional therapy the mortality was 10 in 32 cases. CONCLUSIONS: A lower frequency of mortality was determined in cases with severe trauma, with permissive hypotension being applied in the Trauma and Emergency service, resulting in a lower prevalence of mortality of 1.3%.
Frecuencia y factores asociados de infección de sitio quirúrgico en pacientes apendicectomizados por abordaje abierto y laparoscópico en un Hospital de Loja, 2022
(Universidad de Cuenca, 2024-07-19) Castro Cuenca, Isis Juliette; Reinoso Naranjo, Jeovanni Homero
Background: According to the “Instituto Nacional de Estadísiticas y Censos”, in 2017, in Ecuador, acute appendicitis became the main cause of morbidity, making appendectomy the most performed surgical procedure nationwide in its open and laparoscopic modality. Among the most frequent complications, Surgical Site Infection stands out, the result of which not only influences the patient’s health, but also increases the healthcare costs. Therefore, it is essential to know the frequency of presentation of this complication and to know the predisposing factors of patients to present it, to take measures to reduce its incidence. Objective: To determine the prevalence of Surgical Site Infection of open and laparoscopic appendectomy, and describe the main risk factors in the study population. Methods: A descriptive, quantitative, observational, retrospective study was carried out. Statistical methods were used to present the results in tables with their respective analyses. Results: 61,15% male; 27 to 59 years old (40.12%); 59,87% single; students 40,13%; and 57,96% with adequate weight. The frequency of surgical site infection was 5,73%, which corresponded to the conventional approach. The necrotic phase was the dominant one with 46,50%. The 77,78% had surgical time longer than one hour and Diabetes Mellitus was not found associate. Conclusions: this discovery provides valuable information on the epidemiology and factors associated with the presentation of SSI in appendectomy patients, highlighting the dominance of other factors not considered.
Grado de severidad de la colecistitis aguda según la escala de Parkland y factores asociados en pacientes mayores de 18 años en el Hospital Vicente Corral Moscoso. Cuenca 2020
(Universidad de Cuenca, 2022-02-11) Tenezaca Alao, Diego Antonio; Reinoso Naranjo, Jeovanni Homero
Background: Cholecystitis is considered one of the most common causes of abdominal pain; represents about 3-10% of patients with abdominal pain. Objective: To determine the degree of severity of acute cholecystitis according to the Parkland Scale and associated factors in patients over 18 years of age who attend the emergency service of the Vicente Corral Moscoso Hospital. Cuenca 2020. Methodological design: Quantitative, analytical and cross-sectional study, with a sample of 200 patients. The data were obtained from the clinical history to apply the Parkland scale to classify the severity of cholecystitis. The characterization was carried out using descriptive statistics; the association between variables through the prevalence ratio and statistical significance according to the value of p <0.05 and the 95% confidence interval. The SPSS v25 programs were used. Results: 49.0% are 35–64 years old with an average of 39.0 ± 14.9 years; 62.5% are women; 56.0% are overweight and 16.5% are obese. 49.5% have Parkland Grade III. 57.0% had symptoms of up to 3 days. Parkland's degrees of severity were found to be significantly associated with surgical time greater than 72 min (GI p = 0.018; GII p = 0.037; GIII p = 0.014; GIV p = 0.005; GV p <0.001), obesity (GII p = 0.041; GV p = 0.029), symptom onset time less than 3 days (GIII p = 0.048; GIV p = 0.041; GV p = 0.016), leukocytosis (GV p = 0.005), female sex (GV p = 0.015) and conversion of surgery (GV p <0.001). Conclusions: The Parkland scale for cholecystitis is applicable to patients at Hospital Vicente Corral Moscoso.
Hallazgos tomográficos en pacientes con traumatismo craneoencefálico. Departamento de Imagenología. Hospital Vicente Corral Moscoso. Cuenca. Julio-diciembre, 2012.
(2013) Avilés Chamaidan, Cristian Xavier; Ayala Yunga, Jonathan Alfredo; Bermeo Cornejo, Juan Carlos; Reinoso Naranjo, Jeovanni Homero; Flores Durán, Carlos Teodoro
Objective. To determine the CT findings in patients with head injury. Methods. Descriptive study - retrospective study in which we worked with all tomographic reports of patients diagnosed with head trauma. Imaging Department, Hospital "Vicente Corral Moscoso" Basin City, during the period July to December 2012. Results. From reports the tomographic by sex (66.3%) were men, and women one (33.8%). The most common age group of patients who undergo a CT conducting plain skull is between 50 - 59 years old (41.50%), followed by (23.5%) between the ages of 40 -49 years. of (34.8%) were diagnosed with reports cerebral edema. (14.8%) with epidural hematomas. Subarachnoid hemorrhage is represented by a (10.8%). The most common site of injury was at the level of various locations (38.8%), followed by a (21.4%) in the frontal region. The (16.7%) and represents the open fractures (83.3%) of closed fractures. tomographic most common feature was blade with one (33%), and one (59%) mixed. There is little information on the characteristics of tomographic brain images present in head injury which does not allow a comparison of densities specific information provided is general. Conclusions. It is considered important to encourage student health areas deep analysis of imaging studies, particularly CT scan as it is today and complementary method for early diagnosis of the lesion
El impacto de la inclusión de médicos en la atención prehospitalaria en el cuarto shock del Hospital Vicente Corral Moscoso, Cuenca 2011-2012
(Universidad de Cuenca. Facultad de Ciencias Mëdicas, 2014-12) Guachún Guachún, Mayra Alejandra; Reinoso Naranjo, Jeovanni Homero; Abad Tapia, Marcelo Alfonso
Impacto de la terapia ansiolítica en los pacientes quirúrgicos del servicio de cirugía general del Hospital Vicente Corral Moscoso, Cuenca 2014
(2016) Tapia Gudiño, Johnny Amilcar; Reinoso Naranjo, Jeovanni Homero
General Objective: To determine the impact of anxiolytic therapy in surgical patients of General Surgery Vicente Corral Moscoso Hospital, Cuenca 2014. Methodology: Randomized Clinical trial in 103 patients who were undergoing schedule surgery at the Vicente Corral Moscoso Hospital, the patients were diagnosed through the use of the State-Trait Anxiety Inventory- Self Evaluation Questionnaire (STAI) of anxiety, we used anxiolytic therapy: alprazolam 0,5 mg in single-dose; then again the prevalence of anxiety was assessed and the impact of the medication on pain, blood pressure, cardiac and respiratory frequencies; the utility of having information about the surgery and hospital stay; the data was tabulated in the program SPSS version 15 and presented in simple spreadsheets, chi-square for qualitative variables and t-students for quantitative variables were used for the pre and post-operative contrast. Results: A significant reduction up to a level of 18.4% of the post-surgery anxiety was obtained; besides anxiolytic treatment also changed statistically (p <0,05) the following variables: post-operative pain, heart rate (reduction) and respiratory rate (reduction); not so for the hospital stay (p >0,05); the impact on the reduction of post-surgery anxiety was higher in the younger population (5,9%), women (16,4%); singles (8,7%); higher education (10%); without previous surgery (14,5%); without surgery information (16,7%) and subject to trauma surgery (12,5%). The average score of anxiety that can be reduced with anxiolytic therapy is 2, 68 points (p=0,00)
Is the whole greater than the sum of its parts? the implementation and outcomes of a whole blood program in Ecuador
(2021) Himmler, Amber Nicole; Galarza Armijos, Monica Eulalia; Reinoso Naranjo, Jeovanni Homero; Peña Patiño, Sandra Gioconda; Sarmiento Altamirano, Doris; Flores Lazo, Nube Lucia; Pino Andrade, Raul Haldo; Sacoto Aguilar, Hernán; Fernández de Córdova, Lenin; Cevallos Agurto, Cecibel Yadira; Raykar, Nakul; Puyana, Juan Carlos
Background Hemorrhagic shock is a major cause of mortality in low-income and middle-income countries (LMICs). Many institutions in LMICs lack the resources to adequately prescribe balanced resuscitation. This study aims to describe the implementation of a whole blood (WB) program in Latin America and to discuss the outcomes of the patients who received WB. Methods We conducted a retrospective review of patients resuscitated with WB from 2013 to 2019. Five units of O+ WB were made available on a consistent basis for patients presenting in hemorrhagic shock. Variables collected included gender, age, service treating the patient, units of WB administered, units of components administered, admission vital signs, admission hemoglobin, shock index, Revised Trauma Score in trauma patients, intraoperative crystalloid (lactated Ringer's or normal saline) and colloid (5% human albumin) administration, symptoms of transfusion reaction, length of stay, and in-hospital mortality. Results The sample includes a total of 101 patients, 57 of which were trauma and acute care surgery patients and 44 of which were obstetrics and gynecology patients. No patients developed symptoms consistent with a transfusion reaction. The average shock index was 1.16 (±0.55). On average, patients received 1.66 (±0.80) units of WB. Overall mortality was 13.86% (14 of 101) in the first 24 hours and 5.94% (6 of 101) after 24 hours. Discussion Implementing a WB protocol is achievable in LMICs. WB allows for more efficient delivery of hemostatic resuscitation and is ideal for resource-restrained settings. To our knowledge, this is the first description of a WB program implemented in a civilian hospital in Latin America. Level of evidence Level IV.
Manejo del Trauma Cardiaco en el Hospital Vicente Corral Moscoso. 2015 -2017
(2019) Salamea Molina, Juan Carlos
Introducción: las lesiones cardiacas son entidades desafiantes en la ci-rugía de emergencia, su alta mortalidad obliga a tomar decisiones rápidas y precisas. Metodología: serie de casos que analizó las historias clínicas de pacien-tes con trauma cardiaco atendidos en el Centro de Trauma y Emergencia del Hospital Vicente Corral Moscoso (HVCM) durante el período noviembre del 2015 – abril 2017. Objetivos: presentar el manejo de esta patología, así como su mortalidad en nuestro medioResultados: durante el período analizado se atendieron 18 pacientes con trauma cardiaco, 12 por lesión penetrante, 2 iatrogénicas y 4 contusos. El sexo masculino fue el más expuesto a estas lesiones. Dentro de las lesiones por violencia la más frecuente fue: lesión por arma blanca 8 casos y fuego 4. La incisión más utilizada para la reparación cardiaca fue la to-racotomía lateral izquierda. El ventrículo izquierdo fue el más afectado en 6 pacientes y el derecho en 5. La mortalidad en este grupo de pacientes fue del 17%. Conclusión: la mortalidad en esta serie de casos fue del 17%, el aborda-je quirúrgico fue preferentemente por toracotomía lateral izquierda en un 67%
Patologías asociadas a mayor mortalidad en pacientes de la unidad de cuidado crítico de emergencia, Hospital Vicente Corral Moscoso, de marzo 2014 a septiembre 2015
(2018) Reinoso Delgado, Geovanny Xavier; Reinoso Naranjo, Jeovanni Homero
Background: The Critical Care Unit is an area specialized in the care of serious patients with a high risk of mortality. Objetive: To determine the pathologies associated with increased mortality in patients from the Emergency Critical Care Unit at the Vicente Corral Moscoso Hospital from March 2014 to September 2015. Methodology: A quantitative, descriptive and retrospective study was carried out. The universe consisted of 1113 clinical histories of patients attended, of which 195 patients represent mortality in the Emergency Critical Care Unit of the Hospital Vicente Corral Moscoso. The information has been registered by reviewing the medical records and has been entered into forms. The data was processed using the Microsoft Excel V.2016 and SPSS V.15 programs by absolute frequency and percentage, which were represented in tables. Results: The mortality in the Critical Care Unit was 17.5%. The average age of the deceased patients was 58.78 ± 22.64 years, 47.7% were ≥65 years old, 59% were male and 43.6% came from other wards of the hospital. 66.2% suffered from clinical pathologies; the main causes of death were: cardiovascular disease (21%), trauma (15.9%), cerebrovascular event (15.9%), septic shock (14.4%), respiratory disease (7.2%) and gastrointestinal (7.2%). Conclusions: The observed mortality is similar to that reported in other studies; the most affected were elderly and male patients. The pathologies that were associated with a higher mortality were cardiovascular disease, trauma and cerebrovascular event
Perfil epidemiológico de trauma en el Centro de Trauma y Emergencia Quirúrgica de un hospital de referencia del sur de Ecuador, septiembre a diciembre de 2014
(Universidad Politécnica Salesiana, 2017) Ortiz Segarra, José Ignacio; Cabrera Prieto, Mayra Priscila; Timbi Sisalima, Cristian Fernando; Quisi Peralta, Diego Fernando; Vanegas Coveña, Diana Patricia; Reinoso Naranjo, Jeovanni Homero; Pino Andrade, Raúl Haldo; Palacios Espinoza, Elvira del Carmen
Prevalencia de mortalidad y factores asociados en pacientes con diagnóstico de trauma de tórax y abdomen moderado y severo, ingresados al servicio de emergencia del Hospital Vicente Corral Moscoso. Cuenca, periodo 2016 – 2018
(Universidad de Cuenca, 2021-05-13) Quizhpi Lazo, Julia Marcela; Reinoso Naranjo, Jeovanni Homero
Introduction: in Ecuador, deaths due to accidental trauma are the leading cause of death in patients of productive age. In HVCM, this is traffic accidents. There are no data that characterize the mortality of trauma in order to the associated factors that can cause serious injuries, alter the quality of life, or cause the death of the patient. Objective: To determine the prevalence of mortality and factors associated with moderate and severe trauma to the chest and abdomen, admitted to the Vicente Corral Moscoso hospital. Cuenca, period 2016 - 2018. Materials and Methods: Cross-sectional analytical study, data were collected from medical records with a diagnosis of chest and abdomen trauma, from January 2016 to December 2018. Results: Mortality was 18.9%; men aged 18-29 with 48.3%, victims of traffic accidents (PR = 4.24; p = 0.001), tachycardia (PR = 2.7 p = 0.027), hypotensive (PR = 5.05 p = <0.001), with severe ISS (PR = 7.1 p = 0.000). DCS and whole blood transfusion were associated with higher mortality. Trauma location is not a risk factor. Conclusions: the highest prevalence is in male patients, of productive age; hemodynamic instability, severity of trauma, traffic accidents, determine its prognosis and mortality; We consider that the treatments received have a greater tendency to mortality, this due to causes other than trauma, without being associated with mortality in these specific cases.
Respuesta del score RIPASA versus el histopatológico como predictor diagnóstico de apendicitis aguda en el Hospital Vicente Corral Moscoso año 2018
(Universidad de Cuenca, 2020-06-03) Peña Pérez, Edisson Fernando; Reinoso Naranjo, Jeovanni Homero
Background: Acute Appendicitis (A.A) is a surgical emergency that requires timely diagnosis and treatment. Many times it can be a great challenge for the surgeon because of its relationship with other pathologies, hence the importance of specifying its diagnosis. Objective: To validate the diagnostic accuracy of the RIPASA score in acute appendicitis by comparing it with the histopathological examination. Methodology: A study of validation of diagnostic tests was carried out with the information of 300 medical records of appendectomized patients, treated at the Vicente Corral Moscoso Hospital during 2018. It was evaluated by means of the RIPASA score at admission and compared with the histopathology results. as gold standard test. Sensitivity, specificity, positive predictive value, negative predictive value were calculated, in addition Odds Ratio was obtained with its 95% CI to establish the predictive validity of this scale. Results: The mean age was 32 years ± 13.7 (SD), more than half were: female 52%, urban area 74.7% and high school 62.7%, mixed race ethnicity predominated 99.7%. There was a risk association between a high probability of appendicitis according to the RIPASA score with A.A (OR 96.36; 95% CI: 16.03–578.68; p = 0.000). The RIPASA score has a sensitivity of 98.97%, specificity 50.0%, PPV 98.63%, NPV 57.14%, RVP 1.8% and RVN 0.2% Conclusions: RIPASA has a high probability of detecting people with acute appendicitis, but not healthy ones, so it is necessary to continue with more studies to find such validity