Tesis Especializaciones (Ciencias Médicas)

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Características del uso de antimicrobianos en el servicio de medicina interna de los hospitales Vicente Corral Moscoso y José Carrasco septiembre 2006
(Universidad de Cuenca, 2006-11-11) Astudillo Espinoza, Nelly del Rocío; Idrovo Vásquez, Víctor Aníbal; Ojeda Orellana, Marco Ribelino
Caracterización de escherichia coli fecal no patógena y factores asociados en leucemia infantil, SOLCA, Cuenca 2011
(2011-11-11) Muñoz Ortíz, Eudoxia Georgina; Palacios Espinoza, Elvira del Carmen; Encalada Torres, Lorena Esperanza; Iñiguez, Diana
Introduction: Escherichia coli fecal resistant is a risk to leukemia children health´s. The gut is a source germ´s and generates septicemias. Objective: Characterizer Escherichia coli fecal non pathogen from children with leukemia and determinate the associate factors like: type of leukemia, neutropenia, antibiotic treatment, hospital stays, in SOLCA, Cuenca, 2011 Methodology: It was a transversal study, the universe were the children under 15 years old with leukemia diagnoses, the information gets of the institutional system´s. We establish sensibility or resistance with the CLSI guidelines. The bioethics committee approved this study. We used the EPIDAT program, descriptive statistics, square chi to statistic significance, prevalence reason’s with 95% IC to association. Results: We estudied 55 isolates of Escherichia coli fecal, were resistant to Trimetoprim sulfametoxazol (50,9%), amoxicillin-clavulanate (30,9%), Ceftazidime (16,4%), Cefotaxime (16,4%), Ciprofloxacin (14,5), also Extended-Spectrum-β-Lactamases ESBL (10,9%). The neutropenia was associate to ESBL (p=0,01); the antibiotics intake was associate to ESBL (p=0,01). The hospital stay in the last month and six last months were associate to ESBL (p= 0,001). The ESBL was associate to ciprofloxacin resistance. Conclusion: There was Escherichia coli fecal resistant to Trimetoprim sulfametoxazol, amoxicillin-clavulanate, Ceftazidime, cefotaxime, ciprofloxacin, also ESBL. The neutropenia, antibiotics intake and hospital stay are associate factors. KEYWORDS: PREVALENCE, RESISTANCE, ESCHERICHIA COLI, Β-LACTAMASES
Detección de anticuerpos contra el bacilo tuberculoso humano: estudio de la sensibilidad y especificidad de anticuerpos IGG en el plasma sanguíneo, en personas que acuden a los hospitales José Carrasco Arteaga del IESS y Vicente Corral Moscoso de la ciudad de Cuenca
(Universidad de Cuenca, 1997-11-11) Martínez Loaiza, Jorge Alberto; Molina Palacios, Irene Beatriz; Muñoz L., Hernán; Sempértegui Vega, Julio Cesar; Flores Durán, Carlos Teodoro
Determinación del perfil bacteriológico en pacientes con pie diabético según la clasificación de Wagner, Hospital Vicente Corral Moscoso, Cuenca-Ecuador
(Universidad de Cuenca, 2010-11-11) Ruilova González, Lizbet Yolanda; Vázquez Morales, José Hernán; Vintimilla Maldonado, Jaime Rosendo
Objective: To determine the clinical and bacteriological characteristics in diabetic foot patients diagnosed and hospitalized in the Internal Medicine Department of Vicente Corral Moscoso Hospital, from January 2004 to January 2009.- Materials and Methods A descriptive study was conducted over a universe of 54 patients. The data were obtained from the archive of medical records and analyzed with help of Excel and SPSS software.-Results: 31 patients (57.4%) were female; minimum age was 34 years, maximum age was 86 with an average of 58.3 ± 11.7. The larger prevalence of diabetic foot was observed between 45 and 65 years old, with 34 cases (63%). Wagner’s grades II, III and IV were the most frequent 50 (92.5%). Gram’ negative bacilli were isolated in 35 cases (65%) and from those 12 (34.3%) presented Escherichia coli. In 15 patients (28.0%), Gram positive cocci were identified and of these Staphylococcus aureus were the most frequent 11 (73.3%). Finally, 4 cases (7.0%) the cultures were negative. The antibiotic combination of Ciprofloxacin plus Clindamycin was the most used, 38 patients (70.4%). At 33 (89.2%) of 37 cases glycosylated hemoglobin values were found in excess of 7%. At 24 cases (44.4%) trauma was identified as triggering factor for diabetic foot lesions and the majority, 44 patients (81.5%) had a favorable clinical outcome.- Conclusions Wagner’s grades II, III and IV were the most frequent; the Gram negative were isolated more often; the combination of Ciprofloxacin plus Clindamycin was the most widely used therapeutic regimen, almost all the cases had poor metabolic control and clinical outcomes were favorable in the majority
Factores asociados a infecciones por Staphylococcus aureus resistente a la meticilina, Hospital Vicente Corral Moscoso. Cuenca, 2016-2018
(Universidad de Cuenca, 2019-11-11) Peralta Quito, Sandra Gabriela; Cárdenas Bernal, Ana María
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium related to high morbidity and mortality, increase of stays and hospital costs. Objective: To determine the associated factors with methicillin-resistant Staphylococcus aureus infections, at Vicente Corral Moscoso Hospital, 2016 – 2018. Materials and methods: Observational, analytical, case-control study. The sample was calculated according to the proportion of cases and controls exposed in a similar study taking into account the OR of the most important associated factor; 2 controls were taken per case. OR values were calculated with 95% CI, and a p-value < 0.05 was accepted. Results: Data from 135 patients (45 cases and 90 controls) were analyzed. Soft tissue infection is the most frequent in the cases (55.6%), and pneumonia in the controls (42.2%). The factors with positive association were: previous hospitalization (OR: 2.33, 95% CI: 1.07 - 5.07, p = 0.03), previous antibiotic therapy (OR: 4.75, 95% CI: 2 , 03 - 11.09, p = 0.0002), CVC (OR: 3.38, 95% CI: 1.19-9.61, p = 0.017), bladder catheter (OR: 14.33; 95% CI: 4.46 - 46.02, p = 0.00), gastric tube (OR: 53.53, 95% CI: 3.05 - 938.05, p = 0.00) and surgery (OR: 9.70 95% CI: 2.96 - 31.74, p = 0.00). With the multivariate binary logistic regression analysis, the associated factors predict infections by MRSA in 59,8%; previous antibiotic therapy, bladder catheter and medical intervention being the most influential factors Conclusions: The associated factors: previous antibiotic therapy, previous hospitalization, CVC, bladder catheter, gastric tube and surgery are the most significant for the development of MRSA infections.
Frecuencia de clostridium difficile en pacientes pediátricos con diarrea asociada al uso de antibióticos. Hospital Vicente Corral Moscoso Cuenca 1997-1998
(Universidad de Cuenca, 2003-11-11) Padilla de C., Cruz; Villacrés Luna, Sandra María; Pesántez Beltrán, Nancy del Rocío; Quito Riera, Lauro Bolívar; Morales Sanmartín, Jaime Rodrigo
Frecuencia de cryptosporidiosis en niños con diarrea. Hospital Vicente Corral Moscoso Cuenca 1991-1993
(Universidad de Cuenca, 1994-11-11) Villamagua Jiménez, Edith del Carmen; Espinoza Vintimilla, Hugo Stalin; Quito Riera, Lauro Bolívar; Galindo Banegas, Telmo Benjamín; Barros Chica, Arturo José
Helicobacter pylori en patología gastroduodenal detección por cultivo y tratamiento doble acortado
(Universidad de Cuenca, 1996-11-11) Mejía Moscoso, Ruth Cecilia; Palacios Abad, Marcelo Patrico; Coronel Mosquera, Cornelio Enmanuel; Cañizares Aguilar, Aurelio Ernesto
Perfil epidemiológico - clínico de pacientes con fibrosis quística atendidos en el área de neumología pediátrica del Hospital Vicente Corral Moscoso en el periodo de enero – diciembre 2017
(Universidad de Cuenca, 2019-11-11) Peñafiel Vicuña, Ana Karen; Maestre Calderón, Manolo Patricio; Marcano Sanz, Luis Enrique
Objective: To determine the clinical and epidemiological characteristics of patients with confirmed diagnosis of cystic fibrosis, treated in the area of Pediatric Pneumology of the Hospital Vicente Corral Moscoso Cuenca, during the period January - December 2017. Methodology: Descriptive study of patients with a confirmed diagnosis of cystic fibrosis. The data were collected directly through a validated survey and information was also taken from the medical records. The information was processed in the SPSS program version 15 and was obtained: frequencies, average percentages, standard deviations, maximum and minimum values. Results: A total of 31 patients were found, 61.3% male, 38.7% female, the current average age was established in 94.06 months, residents in the urban area 74.2% and did not have insurance. of health 58.1%. 25.8% of the patients consulted between 4 and 6 doctors to determine the disease and 90.3% had previous hospitalizations. The reason for frequent consultation is repeated respiratory infections in 77.4% of cases. The age at diagnosis of the disease was 38.7% of cases between 1 and 35 months of life. During the last 12 months, 45.2% of patients have required hospitalizations due to infectious exacerbations. Bacterial colonization is evident in 51.6% of the patients, the pseudomonas aeruginosa being the frequent germ in 35.5%, 87.1% of the cases reported having an adequate adherence to treatment.
Prevalencia de Helicobacter Pylori por antígeno fecal y factores de riesgo en la población del cantón Cuenca.Año 2003
(Universidad de Cuenca, 2003-11-11) Bustamante Zalamea, Mónica Yolanda; Vivar Bustos, Fabiola Alexandra; Jadán Heredia, Libia Maribel; Morales Sanmartín, Jaime Rodrigo
Prevalencia de mortalidad en pacientes infectados con enterobacterias productora de carbapenemasas y factores asociados. Hospital Vicente Corral Moscoso. Cuenca, 2014- 2017.
(Universidad de Cuenca, 2019-11-11) Zhapa Quezada, Diana Fernanda; Cárdenas Bernal, Ana María
Background: intrahospital Infections, are a public health problem, for the economic cost, and the high mortality. Objective: To determine the prevalence of mortality in patients infected with enterobacteria producing carbapenemase and factors associated. Methodology: It is a transversal analytical study in which all patients diagnosed with infection by carbapenemase producing enterobacteria from 2014 to 2017, and the prevalence of mortality and factors is analyzed. For statistical analysis, the prevalence ratio was used with a IC 95% and a level of significance of p <0.05. Results: the prevalence of mortality is 39.7%, the associated factors for mortality in patients with serious infection are: immunosuppressive treatment (p 0.004), and the Charlson index (p 0.01). In patients with minor infection the associated factors for mortality are: age (p 0.01), hospital stay (p:0.006), previous bacterial infection (p: 0.02), Previous antibiotic treatment (p 0.01), immunosuppressive treatment (p 0.01), comorbidities (p 0.0006), and Charlson index (p 0.000). Conclusions: a high prevalence of mortality due to carbapenemase infections has been found, the associated factor in serious infection are immunosuppressive treatment and Charlson index, and in patients with minor infection age, prolonged hospitalization, previous bacterial infection, previous antibiotic treatment, immunosuppressive treatment, comorbidities, and Charlson index.
Prevalencia de multirresistencia y factores asociados en pacientes con infección bacteriana, Hospital Vicente Corral Moscoso, Cuenca 2017
(Universidad de Cuenca, 2018-11-11) Maldonado Tenesaca, Andrea Paulina; Ochoa Muñoz, Javier Fernando; Morales Sanmartín, Jaime Rodrigo
Introduction: Bacterial infections that are caused by multi-resistant germs increase morbidity and mortality, health costs and make treatment difficult. Due to this, it is necessary to know the clinical factors associated with multiresistant infections, for an adequate management of and control that improve the attention of health. Objective: To determine the prevalence and factors associated with multiresistant bacterial infections in the Hospital “Vicente Corral Moscoso” Materials and methods: A cross-sectional study was carried out, using the medical records and interviews with hospitalized patients. Data analysis was performed with SPSS 21.0 software, descriptive and association measures were calculated. The Universe are the patients who enter the clinic and intensive care unit of the hospital, with diagnosis of infection in July to December 2017, the sample was selected in a simple randomized manner, corresponds to 204 patients. Comparisons of the variables studied were made and the PRs were calculated with their respective 95% confidence interval (CI) and a significant p value <0.05. Results: The prevalence of multiresistance was 62.7%. Factors associated with multiresistance with a significant difference were found: the clinical history of neurological disease (RP: 1.31, 95% CI: 1.07-1, 61, p = 0.02), infections associated with health care (PR: 2.28, 95% CI: 1.76-2.95, p-value = 0.0000), hospital stay in the ICU (RP: 0.67, 95% CI: 0.55-0.82, p = 0.01), history of previous hospitalization in the last 30 days (PR: 1.45, 95% CI: 1.09-1.66; = 0.02), the previous use of antibiotics (RP: 3.34, 95% CI: 2.27-4.91, p = 0.0000), hospital stay greater than 10 days (PR: 1.66, 95% CI: 1 , 35-2.04, p = 0.0000), surgical interventions during hospitalization (RP: 1.44, 95% CI: 1.18-1.75, p = 0.0007), and the use of medical invasive devices (RP: 1.97, 95% CI: 1.49-2.6, p = 0.000) like nasogastric tube (RP: 1.4, IC1,15-1.7, p = 0.0028), urinary catheter (RP: 1.74, 95% CI: 1.35-2.23, p = 0.0000), central venous catheter (CVC) (RP: 1.58, 95% CI: 1.31-1.9, p = 0.000), and endotracheal tube ( RP: 1.51, 95% CI: 1.26-1.81; p = 0.001). The risk factors that did not show significant difference were: lung disease (PR: 1.26 IC 95% 0.99-1.61, p = 0.1), renal failure (PR 0.92, 95% CI 0, 73-1.16 and p = 0.5), diabetes (RP: 0.99, 95% CI: 0.74-1.26, p = 0.96), immunodeficiency (RP: 0.98, 95% CI: 0.74-1.3, p = 0.93), hypoalbuminemia (RP: 1.12, 95% CI: 0.88-1.43, p = 0.324), parenteral nutrition (RP: 1.34, 95% CI: 0 , 92-1.94, p = 0.28), APACHE score (p = 0.07), smoking (PR: 1.11, 95% CI: 0.76-1.62, p = 0.61) and alcoholism (PR: 0.84, 95% CI: 0.57-1.22, p = 0.31).
Prevalencia del Helicobacter Pylori y factores asociados en escolares urbanos de la etnia Shuar del Cantón Sucua-Morona Santiago, 2014.
(Universidad de Cuenca, 2015-11-11) Arias Neira, Jaime Guillermo; Arévalo Peláez, Carlos Eduardo; Charry Ramírez, José Ricardo
Introduction: According to WHO, more than 50% of the adult population is infected with the Helicobacter pylori, with prevalences of up to 90 %. The majority of infection occurs before 10 years of age. Since the discovery of the H. pylori (1983), it has been linked with the peptic ulcer, gastritis, gastroesophageal reflux, and even Gastric Cancer. Can be purchased at very early ages. Methodology: a cross sectional study was conducted. The sample consisted of 250 school children of the Shuar ethnic group of the canton Sucua. The test used for the detection of Helicobacter pylori is the detection of antigens in the stool by immunochromatography. For the determination of the association we used the OR with its 95% confidence interval. It was considered statistically significant p-values < .05. Results: The average age was 8.8 years (SD 2.0), with a predominance of women 54.4%. The 56.4 % consume potable drinking water, the 71.65 % living in overcrowded, the 42.0 % have sanitation services and the 49.2 % has sewerage services. Statistically significant association was found with the level of instruction OR 1.68, 95% CI: 1.00 - 2.84, p=0,049; latrine OR 1.99 , 95% CI: 1.17 - 3.36 , p=0.010 ; outdoor stools OR 4.32 , 95% CI: 2.13 - 8.77 , p=0.000 ; Conclusions: The prevalence of Helicobacter pylori infection is high in the school population in the Shuar ethnic group and is linked to the level of parental education, latrines and stools in the open air.

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