Browsing by Author "Salamea Molina, Juan Carlos"

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A case report: regarding transduodenal sphincteroplasty
(2021) Ordoñez Velecela, Maria Soledad; Arteaga Huiracocha, Jorge Alejandro; Himmler, Amber N; Reinoso, Jeovanni; Salamea Molina, Juan Carlos
Introduction: Stenosing papillitis is rare. It can be primary or secondary and occurs due to the presence of stones in the common bile duct. The initial treatment of choledocholithiasis is endoscopic retrograde cholangiopancreatography (ERCP). However, when ERCP is unsuccessful, the transduodenal sphincteroplasty is an alternative strategy that obtains satisfactory results in select patients. Case description: A 27-year-old female patient presents right-upper quadrant pain associated with scleral icterus. She had choledocholithiasis and cholestasis. The ERCP performed was failed, so an open cholecystectomy with common bile duct exploration was undertaken. As the ampulla could not be cannulated, a “T” tube was placed. On a postoperative day 15, a cholangiography was performed without evidence of contrast passage into the duodenum. A re-exploration of the bile duct was undertaken 30 days after and a papillary exploration through a transduodenal approach was performed. A new cholangiography was done on postoperative day 9, at which point adequate passage of contrast into the duodenum was appreciated. Conclusion: Transduodenal sphincteroplasty is a procedure rarely performed in the era of endoscopy. Nonetheless, when these cases do come up, knowing the appropriate surgical technique is crucial to obtain satisfactory results for the patient.
Alimentación temprana en pacientes aleatorizados poscolecistectomía laparascópica electiva en los Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. 2013
(2014) Martínez Calderón, Hernán Patricio; Salamea Molina, Juan Carlos; Tenezaca Tacuri, Ángel Hipólito
Objective: Determine the benefits of early feeding in patients undergoing elective laparoscopic cholecystectomy (LC) in hospitals Vicente Corral Moscoso and José Carrasco and Arteaga Methodology:it was an experimental study. The study population included patients 18 to 60 years with indications for laparoscopic cholecystectomy, presenting to surgery department of Vicente Corral Moscoso and José Carrasco Arteaga Hospital, who were operated on electivel. We worked with 220 patients. By Epidat was randomly divided , 50 % were initiated early feeding at 6 and a half hours , the remaining 50 % delayed feeding at 24 hours postoperative . Early feeding defined as the entry of clear fluids, water 100cc. For the collection of data based on the study variables form was used. The data were tabulated and analyzed in the program SPSS18.0 to analyze descriptive statistics percentage rate and measure of central tendency was used to find association prevalence ratio with confidence intervals of 95 %, Chi square for statistical significance with p value Results: The mean age of the experimental group was at 42.17 years with SD of 11.36 and the control group started with a SD 42.21 years 11.37 years, sex was the most prevalent with 70.5% female and 55% of the population had less than 60 minutes operating time. Benefit of early initiation of feeding in patients CL elective post in the following variables were determined: nausea at 6 and a half hours (; RRR 0.7; RAR NNT 6 RR 0.17 and 0.30); vomiting at 6 and a half hours (RR 0.14, RRR 0.86, 0.11 RAR and NNT 10) and pain at 24 hours (0 % of mild to moderate pain in the experimental group and 76.4 % in control group). Conclusions: Early feeding after elective LC patients reduces the risk of nausea, vomiting and pain. Keywords: FOOD, CHOLECYSTECTOMY, LAPAROSCOPY, NAUSEA, VOMITING, PAIN.
Categorización del trauma según escalas de lesiones de causa externa de los pacientes ingresados en el Hospital Vicente Corral Moscoso. Cuenca. 2014
(2016) Astudillo Bravo, Diana Katherine; Salamea Molina, Juan Carlos; Morocho Malla, Manuel Ismael
BACKGROUND: People each time more seriously injured have given way to a series of predictor parameters and which have become useful in order to catalogue patients as serious, to re-direct treatment, and the definite care of patients. GENERAL OBJECTIVE: Categorize traumatized patients interned in the surgery area of VCMH in Cuenca, according to trauma levels RTS, ISS, NISS, TIA, depending on the severity of external cause injuries. METHODOLOGY: Descriptive Prospective Study, applied to all the patients interned in the trauma area on Vicente Corral Moscoso Hospital, ≥ age 16, with a trauma injury record. RESULTS: The categorization according to RTS shows that the 78.4% of patients had to be commuted to a hospital and the 2.1% to trauma room; according to the ISS, the 51.5% of patients had a minor trauma and the 16.4% were considered to be in the category of imminent danger of death and unknown survival rate, which opposite to the NISS which shows that the 44.1% of patients had a minor trauma and the 19.8% in the category of imminent danger of death and unknown survival. The ATI showed difficulties in the registrations due to a lack of records of egress diagnostic and injures descriptions of the 45 patients with abdominal trauma which after detecting the scale, could be partially applied to only 7. CONCLUSSIONS:Trauma scales categorize patients positively, detecting patients with threatening injuries and predicting mortality rate
Colecistectomía temprana versus diferida posterior a pancreatitis aguda biliar leve en el “Hospital Vicente Corral Moscoso” enero 2014 - junio 2015
(2015) Andrade Gómez, Jorge Andrés; Salamea Molina, Juan Carlos; Tenezaca Tacuri, Ángel Hipólito
Introduction: Acute pancreatitis is the third common cause of acute gastrointestinal hospitalization. It has 5% of mortality rate. In most Western countries approximately 30-55% of cases are caused by gallstones or biliary sludge called gallstone pancreatitis. Cholecystectomy has been established as definitive treatment of biliary pancreatitis but the optimal timing is still in debate. Objective: To determine the benefits and complications of early cholecystectomy versus delayed cholecystectomy to subsequent biliary mild acute pancreatitis in the HVCM Surgery department during January 2014 to June 2015. Materials and methods: Prospective descriptive comparative research. Universe of 79 patients from 18 to 75 years that evaluated advantages and disadvantages of early cholecystectomy versus delayed after mild acute biliary pancreatitis. Descriptive analysis was conducted of statistical variables in SPSS version 21. Results: 49 corresponded to early cholecystectomy group 30 to delayed group. The female was most affected in 21 to 50 years group. Hospital stay was lower in the first group (mean 3.8 days, p <0.000). Surgery time was less than 60 minutes in early cholecystectomy. Inflammatory adhesions were presented in both groups. Timing of cholecystectomy does not affect the number or type of intraoperative complications. Conclusions: Early cholecystectomy (<72h admission) in the management of patients with mild gallstone pancreatitis has led to a significant reduction in hospital stay without increasing complications
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
Eficacia de la escala BISAP para predicción temprana de severidad en pancreatitis aguda biliar. Hospital Vicente Corral Moscoso. Cuenca, enero 2014 – julio 2015
(2016) Aguilar Gaibor, Carlos Iván; Salamea Molina, Juan Carlos; Tenezaca Tacuri, Ángel Hipólito
Introduction: the acute pancreatitis is a pathology in our environment, presents a high morbility and mortality according to the severity, hospital stay and complications. To detect early severity assessment scales as there BISAP, APACHE II and Ranson affects their aggressive initial management to prevent complications Objetive: to determine the effectiveness of the scale BISAP in early prediction of severity in pancreatitis acute biliary, Vicente Corral Moscoso Hospital. Cuenca, 2014 - 2015. Material and methods: we conducted a diagnostic test study, with a sample of 127 patients with acute pancreatitis calculated as EPIDAT 4.0, infinite poblation, proportion 30%, confidence level 95%, precition 8% which discharged with criteria of inclution and exclution. It was in used the consensus Atlanta 2012 for the diagnosis of Acute Pancreatitis was used and the three scales applied to predict severity. Data were analized in SPSS 15 Software. Results: the prevalence of severe pancreatitis was 14,2 % and the mortality rate of 3.9 %. The values for the scale APACHE-II of the sensitivity is 55.56 %, specificity 98.17 %, Value Predictive Positive 83.33 %, Value Predictive Negative 93.04 %. For BISAP the sensitivity is 61.11 %, a specificity of 96.33 %, Value Predictive Positive 73.33 %, Value Predictive Negative 93.75 %. The lowest are for Ranson. According to the area under the curve, the highest value was observed for the scale of BISAP with a value of 0.942, APACHE-II 0.937 and the scale Ranson whose value is 0,874. Conclusions: the best scale to predict the severity of acute pancreatitis is the BISAP for presente the value low of curve y sensibility higher than the other scales
Equipos de protección personal
(Universidad del Azuay, 2020) Salamea Molina, Juan Carlos
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%.
Infección del sitio quirúrgico y relación con factores asociados en cirugía abdominal. Hospital Vicente Corral Moscoso, 2016
(2016) Sarmiento Altamirano, Doris Adriana; Salamea Molina, Juan Carlos; Morocho Malla, Manuel Ismael
Objective: to determine the prevalence of surgical site infection, and its relationship with associated factors in patients with abdominal surgery that were assisted by the trauma and emergency service at Vicente Corral Moscoso Hospital in 2016. Methods and Materials: we carried out a cross-sectional study with 206 patients that met the inclusion criteria, and signed the consent. They were observed since they were admitted until they developed an infection, or thirty days after the surgery. Variables such as age, gender, wound contamination, overweight, obesity, cigarette smoking, preoperative stay, comorbidities, surgical time, steroids or immunosuppressive, hyperglycemia, transfusions, using drainage, ICU stay, antibiotic prophylaxis, prior antibiotic, antibiotic treatment were studied. The data was entered in a database to then carry out a bivariate and multivariate analysis. Results: the prevalence was of 17.48 %, finding significant statistic relevance in age (above 65 years of age), length of the surgery (longer than 120 minutes), preoperative stay (longer than 24 hours), hyperglycemia (above 180 mg/dL) ASA III and IV, contaminated and dirty wound, transfusions, using drainage, ICU stay, the non-use of antibiotic prophylaxis, open approach, using prior antibiotic and BMI over 35. Statistic relevance was not found on the following variables: cigarette smoking, taking immunosuppressants, antibiotic prophylaxis longer than 60 minutes and use of antibiotic treatment. Conclusion: surgical site infection is higher to those reported, and is related to various risk factors that correspond to both, the patient, and the surgery itself
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%
Manejo quirúrgico del secuestro pulmonar complicado. Informe de un caso.
(2019) Ayala Yunga, Jonathan Alfredo; Quizhpi Lazo, Julia Marcela; Crespo Guillen, Mauro Rogelio; Salamea Molina, Juan Carlos; Endis Miranda, Miurkis
Introduction: pulmonary sequestration is a rare disease in adulthood; its highest incidence is in early stages of life. It is accompanied by repeated or severe chronic lung infections, and may be associated with congenital malformations. The diagnosis is based on the detection of anomalous irrigation through a vessel of the systemic circulation.This case allows us to propose a differential diagnosis in patients of adulthood, even when it is pathology with higher incidence in children and young people, and guide the management according to this diagnostic possibility.Clinical case: female patient, 19 years old, with a history of asthma and respiratory infections after a month of evolution. The patient was admitted with respiratory distress, fever and productive cough.A tomography and chest X-ray are performed; that show images compatible with collection in the left pulmonary field and pleural effusion. BAAR is performed in sputum with a negative result for tuberculosis.Posterolateral left thoracotomy is performed, left lower lobe resection, and pleural drain is placed. Pulmonary abscess is identified in the left lower lobe, and findings of anatomical pulmonary sequestration. Patient presents positive evolution; The clinical and radiographic control in the immediate and intermediate postoperative period was satisfactory.Conclusion: we present the case of adulthood, where an adequate diagnosis and multidisciplinary management allows a satisfactory evolution of the patient.
Meningitis tuberculosa en el Hospital Vicente Corral Moscoso, Cuenca 1990-1999
(2001) López Cuesta, Juan Sebastián; Merchán Astudillo, Karina Alexandra; Salamea Molina, Juan Carlos; Díaz Heredia, Favian Eduardo; Flores Durán, Carlos Teodoro
Descriptive study in 69 patients with a diagnosis of tuberculous meningitis, between 16 and 74 years, reviewing in each medical history. The incidence rate was 57.35 per 10,000 discharges department clinic HVCM In 1994 the highest incidence was recorded with 13casos. There was an increase of casuistry in June, August and December. The most affected age groups were the 40-49 [24.64 per cent] 20-29 [23.19 per cent] and 30 to 39 [20.29 per cent]. It predominance of males with 58 percent. Rural residence reached 77 percent of cases. A 47.83 percent had an evolution of clinical picture of 1-4 weeks. Signs and symptoms are: impaired consciousness, headache, meningeal irritation, fever, nausea and vomiting, motor deficit, cranial neuropathy, seizures, papilledema. The sputum smear was positive in 4 percent of patients; chest radiography established prior pulmonary tuberculosis [5.80 percent] and concomitant [47.82 per cent]. The study was conpatible CSF in 59 patients. CT skull performed in 42 cases, it was normal in 11, in 12 hicrocefalia revealed in Tuberculomas and 9. For treatment schemes three and four drugs were used; corticosteroids were used in 54 cases. At discharge showed improvement one 73.91 percent of patients; and a mortality rate of 10.14 percent
Prevalencia de infección del sitio operatorio y factores asociados, en Cirugía General del Hospital San Vicente de Paúl-Pasaje, junio a septiembre, 2014
(2015) Ganán Romero, Manuel Fernando; Salamea Molina, Juan Carlos; Tenezaca Tacuri, Ángel Hipólito
Background: Surgical site infection increases morbidity and mortality, and economic costs, and they are associated with surgical endogenous and exogenous factors. Objective: To determine the prevalence of surgical site infection and associated factors in general surgery in San Vicente de Paul Hospital - Pasaje, June- September 2014. Methodology: A cross-sectional study was made in the universe of operated patients in San Vicente de Paul Hospital from Pasaje. The information was processed in SPSS 22. Odds ratio was used with confidence interval (CI) at 95%, and it was considered statistically significant p-value <0.05. Results: The prevalence of surgical site infection is 6.5% (95% CI 3-10). The 73.4% of patients belong to the age group of 11-50 years, mainly female with 60.4%. Some wounds were found: clean (44.4%); clean contaminated (50.9%) and dirty (4.7%). The surgery time higher than two hours reaches 17.8%. The ISO superficial incisional is more often. Females had ISO at 3.5% and 3% in men. In women, the 25.5% were clean wounds and 32.5% to clean contaminated. In males: the 18.9% were clean wounds and 18.3% clean contaminated. The 85.2% of patients up to 60 years had ASA I, and females (52.1%) were classified as ASA I. Conclusions: The prevalence of ISO is similar to which was found in the literature; showed no statistically association with risk factors.
Recomendaciones generales para la atención de la patología quirúrgica urgente en el contexto de la pandemia por COVID-19
(Universidad del Azuay, 2020) Cevallos Agurto, Cecibel Yadira
Sensibilidad y especificidad del ultrasonido en apendicitis aguda en mujeres en el Hospital Vicente Corral Moscoso, 2013
(2014) Cevallos Agurto, Cecibel Yadira; Salamea Molina, Juan Carlos; Tenezaca Tacuri, Ángel Hipólito
Objective: To validate the effectiveness of abdominal ultrasound in women with clinical suspicion of acute appendicitis. Methodology: Descriptive study of diagnostic test, 323 patients with clinically suspected acute appendicitis who presented to the emergency area Vicente Corral Moscoso hospital between February and July 2013 were included. An abdominal ultrasound was performed to confirm the diagnosis and sensitivity, specificity, positive and negative predictive values in both women and men was measured and a general evaluation of the results was performed. Result: 323 abdominal ultrasounds were performed to assess the probable diagnosis of acute appendicitis determined by the patient's clinical, obtaining globally sensitivity 78.52% (73.29%-83.74%), specificity 78.52% (73.29%-83.74%), positive predictive value 84.81% (80.03%-89.59%) and negative predictive value of 36.05% (25.32%-46.78%). Correspond to 170 women and 153 men, in women there was sensitivity 76.38% (68.6%-84.16%), specificity 41.86% (25.95%-57.77%), positive predictive value 79.51% (71.94%-87.08%) and negative predictive value of 37.5% (22.76%-52.24%). In men found sensitivity of 80.62%, specificity 54.17%, positive predictive value 90.43% and negative predictive value of 34.21%. Conclusions: The diagnosis of acute appendicitis remains a clinical but abdominal ultrasound has an overall performance in our acceptable medium, due to its accessibility and low cost is the ideal test when faced with borderline cases especially women adnexal pathology and its use in men is restricted to cases greater diagnostic doubt. My results validated the sensitivity of the test with low level of specifity. Keywords: ACUTE APPENDICITIS, ACUTE ABDOMEN, ABDOMINAL ULTRASOUND.
Sutura subcuticular en apendicectomías no complicadas, Hospital Viente Corral Moscoso, 2006-2007
(2008) López Macas, Luis Vinicio; Salamea Molina, Juan Carlos; Figueroa Morales, Francisco Efraín; Pinos Abad, Guido Marcelo
The successful implementation of a trauma and acute care surgery model in Ecuador
(2020) Sarmiento Altamirano, Doris Adriana; Himmler, Amber Nicole; Chango Siguenza, Oscar Miguel; Pino Andrade, Raul Haldo; Flores Lazo, Nube Lucia; Reinoso Naranjo, Jeovanni Homero; Sacoto Aguilar, Hernan Patricio; Fernandez de cordova Rubio, German Lenin; Rodas, Edgar B.; Puyana, Juan Carlos; Salamea Molina, Juan Carlos
For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of “trauma and acute care surgery” (TACS) to the reality of Cuenca, Ecuador. A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality.
Trauma, diez años de experiencia, Hospital Vicente Corral Moscoso
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2010-04) Astudillo Molina, Rubén Arturo; Salamea Molina, Juan Carlos; Crespo Riquetti, Paola Marcela; Salamea Molina, Pablo Javier
Objective. To carry out a demographic description, its form and arrival state, etiology, trauma type and findings, in patients surgically intervened and discharged from surgery service of Vicente Corral Moscoso Hospital, Cuenca – Ecuador. Patients and methods. Descriptive study in a ten years period from 1995 to 2005.The hospital book of discharges was revised, finding 1415 medical charts. Registering year, sex, age, origin, vital signs, state of conscience, forms of arrival, and presence of ethylic breath and finding traumatic etiology, trauma type in relation to the affected area, variety, classification and findings. Results. A total of 1415 patients were reported, 79.65% being of the male sex and 20.35% being of the female one, on a relationship of 3,9: 1. The most affected group was from 20 to 29 years of age (28.06%). The patients of rural area were 51.45%. Arriving at the Hospital most were brought by another person in 43.46%. In 77.38% of the patients the state of conscience was possible to determine through the Glasgow Coma Scale. The presence of ethylic breath was found in 30.88%. In 38.37% the most frequent etiology was by traffic accidents. As head trauma 37.79% was registered, 16.69% of maxillofacial trauma, 14.26% of thoracic trauma, 11.45% of abdominal trauma, 5.95% of pelvic trauma, 3.01% of vascular trauma and burns in 10.87% of the cases. Conclusion. Traffic accidents were found as the main cause of trauma, specifically the ones caused by automobiles; men in their second decade of life were the most affected; in most cases, a third party brings in the patients; the subdural hematoma is the most frequent lesion found in the moderate head trauma. Wounds in face and nasal fractures are the most common in maxillofacial trauma. Trauma of the thorax is more frequent than the abdominal trauma. Pneumothorax is the most frequent lesion of the thorax and lesion of the small intestine is the most frequent of the abdomen.
Utilidad de examen de orina en apendicitis aguda
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-04) Alvear Quito, Nataly Mireya; Martínez, Patricio; Salamea Molina, Juan Carlos; Padilla ZHucuzhañay, Marcia Alexandra
INTRODUCTION: The aim of this study is to observe the frequency of positive elementary microscopic examination of urine (EMO) in regard to acute appendicitis appendiceal phase, and at the same time to determinate the sensitivity of the EMO to determine the infectious appendix phase. MATERIALS AND METHODS: We performed a prospective comparative study, which evaluated the sensitivity of the positivity of the EMO, the appendix phase and the urinary symptoms seen in these patients. We included 100 patients (64 women and 46 men) with an average age of 60. RESULTS: From the patients operated on and with histological test, positive signs and symptoms were showed which were obtained in pre-surgical clinical assessment in the Vicente Corral Moscoso Hospital. EMO was considered positive when leukocytes per field exceeded 8, and presence of red cells per field larger than 4. Of the 48 cases (48%) of Suppurative Appendicitis phase only 12 of them (12%) showed positivity to make the EMO, followed in frequency by the inflammatory phase in which inside these 32 cases (32%) only 7 (7% ) of them have to do the EMO positivity. A 100% of patients with acute appendicitis suffer pain at the right fist percussion and 98% of them did not have urinary frequency. CONCLUSIONS: The positive EMO has low sensitivity to determine the appendix phase and it is higher in the gangrenous stage. EMO can be positive in patients with acute appendicitis 4-1 Patients with acute appendicitis may present positive urinary symptoms including right fist percussion and middle ureteral points.