Tesis Especializaciones (Ciencias Médicas)

Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/3934

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Gestión del tiempo de oportunidad quirúrgica de los modelos de atención cirugía de cuidado agudo y cirugía de llamada en el tratamiento de apendicitis aguda, Cuenca, 2014
(2016) Valverde Guerrero, Luis Gabriel; Pino Andrade, Raúl Haldo; Tenezaca Tacuri, Ángel Hipólito
Introduction: Opportunity’s surgical time demonstrates the management’s quality of a health facility. The delay generated emergency’s department saturation, patient dissatisfaction and increased complications. Objective: We are going to determine the opportunity’s surgical time to care models of acute care surgery and call home surgery, in the treatment of acute appendicitis. Methods: Cross-sectional study. Universe: patients treated in emergency’s hospital Vicente Corral and Jose Carrasco Arteaga during 2014 in Cuenca, Ecuador. The sample 435 patients who met the inclusion and exclusion criteria, divided into: group 1, acute care surgery with 225 patients and group 2 call home surgery 210 patients. The analysis was conducted at the Software SPSS 21, with comparison of means. Results: We determined opportunity’s surgical time in group 1 0:19 vs. 6:54 ± 8:26 ± 0:21 minutes in group 2. Emergency’s treatment waiting time vs. 0:34 ± 0:02 2:42 ± 0:13 minutes; less than 1 hour in 92.5 % vs 24.3 %. Ultrasound result timeout 0:02 vs. 0:30 ± 1:11 ± 0:04 minutes. Available operating room time 0:12 vs. 3:21 ± 3:40 ± 0:10 minutes, statistically significant; p<0.001. No significant results of laboratory pending the outcome time and surgical decision time. Conclusion: acute care surgery model reduces opportunity’s surgical time
Prevalencia de bloqueo neuromuscular residual con rocuronio en la unidad de cuidados postanestésicos Hospital José Carrasco Arteaga, 2013
(2013) Orozco Arce, Katerine Fernanda; Buenaño Barrionuevo, Eduardo Efrén; Morocho Malla, Manuel Ismael
Objective: To determine the prevalence of muscular residual paralysis caused by neuro-muscular blockers, which are not depolarizing in the post-anesthetic care of the Jose Carrasco Arteaga Hospital department. Methodology: Transversal descriptive studio, carried out in the post-anesthetic care area of the Jose Carrasco Arteaga Hospital in 197 patients, who were selected at random. The diagnosis the residual neuro-muscular blocking was performed through the train of four (TOF) minor to 0.9; furthermore variables such as age, and sex were gathered, corporal mass index (IMC), ASA, surgical procedure and medical complications. This is a form for gathering data and after receiving the acceptance from the patient, relative frequencies were used for the analysis of data, percentages, central trend and dispersion measures, for the association square chi and the value of p and the measure the effect of prevalence rate (RP) with a confident interval of 95%. Results: The measure of age was set in 35.05 years with a DE of 12.32 years, noticing that the most prevalent sex is the female with the 52.3%. The patients ASA I with the 75.1% and the most prevalent nutritional distort was the overweight with the 44.2%. The most repeated procedure that of laparoscopic colecystomy with the 26.9% and the surgical time mean was of 75.39 minutes with a DE of 30.19 minutes. The trend of residual BNM was of 68.5%. It was not associated with the age, or the sex, neither the ASA, quantification with the BNM residual; likewise, the nutritional condition was not associated. The BNM residual increase the risk of hyphoxemy, disnea, disartria, visual disturbance and muscular weakness. Conclusions: The prevalence of BNMR is high in our population, similar to what the world literature has reported. It has not been related to demographic nor nutritional variables, but it increased the post-anesthetic health worsening. Key Words: RESIDUAL NEURO-MUSCULAR BLOCKING, POST ANESTHESIA RISK, TRAIN OF FOUR AND COMPLICATIONS.
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
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.
Validación de escalas RIPASA y Alvarado Modificada para diagnóstico de apendicitis aguda. Hospital Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca 2017
(2019) Guallpa Guallpa, Edison Patricio; Reinoso Barzallo, Darío Aníbal; Álvarez Serrano, Marlene Elizabeth
Objective: To determine which diagnostic scale between RIPASA and modified Alvarado is more effective in the diagnosis of acute appendicitis. Method and materials: A validation study of diagnostic tests was carried out that compared the scales of RIPASA and Modified Alvarado, with the histopathological result as a gold test. The sample consisted of 201 patients who attended the emergency service of surgery of the Hospitals José Carrasco Arteaga and Vicente Corral Moscoso with a diagnosis of acute appendicitis and who underwent surgery. The analysis was performed using Excel software, R program for Windows version 1.0.3 and the SPSS program version 25 Results: The RIPASA scale obtained a sensitivity and specificity of 98.34% and 75%, respectively, compared to 93.92% and 85% for the Modified Alvarado scale. The diagnostic accuracy was 96.02% for RIPASA and 93.03% for the Modified Alvarado score, showing a difference of 2.99% statistically significant (p 0.006). However, the areas under the curve of the two tests are similar (RIPASA 0.963, Alvarado modified 0.964). Conclusions: The scales of RIPASA and Alvarado Modified have a high sensitivity, specificity and diagnostic precision for acute appendicitis and could be a useful tool, decreasing the use of complementary tests and facilitating decision making in our population
Validación de la escala de Alvarado y criterios del síndrome de respuesta inflamatoria sistémica para apendicitis aguda complicada, Hospital Vicente Corral Moscoso, Cuenca 2014
(2016) Guachún Guachún, Mayra Alejandra; Reinoso Naranjo, Jeovanni Homero
Objective: to determine the validity of the scale of Alvarado and criteria of systemic inflammatory response syndrome for complicated acute appendicitis in the emergency area of surgery Vicente Corral Moscoso Hospital. Materials and Methods: a validation study was performed diagnostic test, the sample was 360 patients attending from January to November 2014 and the emergency area who met the inclusion criteria; a questionnaire was applied. Database with the ROC curve, sensitivity and specificity of the variables was obtained. Program Excel 2010 and SPSS version 15 was used. Results: acute appendicitis complicated according to histological result was found in 27.2% (n = 98) and presented an average evolution time 30 hours 50 minutes (p = 0.00). Alvarado score with a score of 7-10 had a sensitivity of 100% and a specificity of 20.2% for the diagnosis of acute apendicitis complicate, SIRS criteria had sensitivity and specificity of 68% and the time evolution of the pain again specificity of 81%. The ROC curve Alvarado score, SIRS and the time evolution of pain had an area larger than the value of 0.5. Conclusions: the diagnosis of acute apendicitis complicate may be suspected when the scale of Alvarado, SIRS criteria are high and the time evolution of the pain is prolonged
Valoración del Test de Alvarado en el diagnóstico dudoso de la apendicitis aguda. Hospital Vicente Corral Moscoso y José Carrasco Arteaga. Cuenca, octubre del 2002 a abril 2003
(2003) Delgado Pauta, Jorge Antonio; Zaldúa Reyes, Jorgito Antonio; Figueroa Morales, Francisco Efraín; Maldonado Sánchez, Luis Rogelio

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Browsing Tesis Especializaciones (Ciencias Médicas) by Subject "Apendicitis Aguda"