Browsing by Author "Tigsi Mendoza, Luis Gabriel"

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Colitis colagenosa, una causa poco estudiada de diarrea crónica. Reporte de caso
(2022) Sanchez Leon, Juan Sebastian; Parra Alvarez, Marcela Nataly; Tigsi Mendoza, Luis Gabriel
Introduction: collagenous colitis, is a subtype of microscopic colitis, which presents as a picture of diarrhea without blood, of insidious onset with periods of remission, exacerbation and abdominal pain. It has a prevalence of 10 to 15 per 100b000 inhabitants.Clinical case: It is a case of a 27-year-old patient with watery diarrhea of 1 year 6 months of evolution, associated with food consumption and accompanied by abdominal discomfort, this person presents an increase in evacuation frequency. Fecal calprotectin was performed with a result of 516 ug/g, so upper and lower gastrointestinal endoscopy was decided, with normal endoscopic findings and histopathology with a colon report compatible with collagenous colitis. Food and trigger medication restrictions apply; therapy with bismuth subsalicylate is started, obtaining improvement.Conclusion: in the case of unknown chronic diarrhea, the study must be exhaustive for an accurate diagnosis like this case of collagenous colitis to define a specific treatment.
Eficacia y seguridad de la terapia biológica en pacientes mayores de 18 años con colitis ulcerosa moderada y grave: revisión sistemática
(Universidad de Cuenca, 2022-01-31) Delgado Suconota, María Fernanda; Tigsi Mendoza, Luis Gabriel; Tapia Cárdenas, Jeanneth Patricia
Background: Ulcerative Colitis (UC) is the most frequent form of Inflammatory Bowel Disease (IBD), impacts the quality of life of patients and generates high costs in treatment. Objective: to determine the efficacy and safety of biological therapy in patients over 18 years of age with moderate and severe Ulcerative Colitis. Methods: observational study, systematic review of treatment clinical trials, including 16 published in the last 5 years, without language discrimination, with quality of evidence from quintile 1 to 4, and comparison reports of placebo, immunosuppressants or other biologicals, with different quantitative, cross-sectional, controlled clinical trials, meta-analysis, prospective designs in various scientific databases. Results: the efficacy rate of the biological therapy was observed by the clinical improvement and the healing of the mucosa with the intervention of Vedolizumab, Adalimumab and Tofacitinib. Remission at 13 weeks with Tofacitinib. The adverse effects were associated in a higher percentage to Tofacitinib, Golimumab, Vedolizumab, related to: headache, nausea, herpes zoster, arthragia, neoplasms, nasopharyngitis and serious infections. Conclusions: the Vedolizumab was the most effective (clinical response and mucosal healing). The highest remission rates were with infliximab, tofacitinib, and vedolizumab. The duration of remission was between 13-56 weeks, the longest time corresponding to vedolizumab and the shortest time with Tofacitinib. Adverse effects were more associated with Tofacitinib, Golimumab, and Vedolizumab.
Evaluación de las escalas predictores de severidad de pancreatitis aguda. Revisión sistemática
(Universidad de Cuenca, 2022-02-01) Carvajal Freire, Ana María; Tigsi Mendoza, Luis Gabriel; Tapia Cárdenas, Jeanneth Patricia
Background: acute pancreatitis (AP) is a very common condition, which can negatively affect the morbidity and mortality of the population, therefore, standardized risk stratification is essential in the timely management of this pathology. General objective: to determine the efficacy of AP severity predictive scales. Methodology: systematic review. Full text articles published in the last five years were included, without language restriction, quantitative methodological designs and quality of evidence categorized in quartile one to four. The research was carried out in databases such as: Cochrane Library Plus, Pubmed, Ebsco, Lilacs, among others. The information was consolidated in personalized tables based on the PICO parameters of the Prism Guide. Results: the Ranson and Bisap scales with a cut-off ≥3, the CTSI ≥4 and the Apache II ≥8, were considered scoring systems with good diagnostic capacity for AP severity according to the area under the curve (AUC) assessment. In the comparison to the Bisap, Ranson and Apache II mortality scales, they showed a good diagnostic value (p <0.05). Regarding pancreatic necrosis, the CTSI was the scale that presented the highest AUC score (p<0.05); in multi-organ failure, Bisap and CTSI maintained high AUC values with a statistically significant relationship (p<0.05). Conclusions: the different scoring scales had a good diagnostic value in predicting AP severity. Limitations: access to scientific articles was limited due to a restricted budget.
Prevalencia de infarto lacunar y factores asociado en pacientes mayores de 44 años que consulta al departamento de imagen para realizar resonancia magnética nuclear en el Hospital José Carrasco Arteaga, IESS, Cuenca 2013
(2013) Iñiguez Guzmán, Carlos Alfredo; Tigsi Mendoza, Luis Gabriel; Tigsi Ganzhi, Luis Manuel; Vintimilla Maldonado, Jaime Rosendo
Target: Determine the prevalence of lacunar infarction and frequency of risk factors in patients older than 44 years consulting in the hospital Imaging Department José Carrasco Arteaga MRI performed during 2013.- Material and methods: We performed a descriptive one sample 355 patients. The size was calculated on the basis of 95% confidence, 20% prevalence of lacunar infarction, 5% inference error and 20% for losses. Patients entered the study sequentially. Data were collected by direct interview transcripts of the electronic database that rest in the hospital's Imaging Department questionnaire designed for the purpose, and analyzed with the help of SPSS software.- Results: The 56.5% were women.- The median age of 60 years. The frequency of hypertension was 56.1%, dyslipidemia, 43.9% of sedentary, 82.2% of overweight and obesity, smoking 41.6% and 28.4%. Lacunar infarct prevalence of 62.25% (95% CI 59.96-67.28%). In 59.7% of cases, lacunar infarction in the region was located in the subcortical and 57.2% had a size less than 5 mm.- Conclusion: The prevalence of lacunar infarction was 62.25% (95% CI 59.96-67.28) and the frequency of hypertension and sedentary exceed 50%.AU