Tesis Especializaciones (Ciencias Médicas)

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Aborto en la adolescencia: prevalencia, factores de riesgo, perfil psicosocial y secuelas psico-biológicas según el tipo de aborto en las adolescentes, que acudieron al servicio de gineco-obstetricia del Hospital Enrique Garcés de Quito, año 2009
(Universidad de Cuenca, 2009-11-11) González Bósquez, Sandra; Naranjo, Jorge; Naranjo, Jorge
Actitudes y percepciones sobre la sexualidad de los adultos mayores del Cantón el Pan, Cuenca 2015-2016
(Universidad de Cuenca, 2017-11-11) Chimborazo Shicay, Mónica Piedad; Ñauta Baculima, Manuel Jaime
Introduction: Sexuality in the elderly is linked to negative beliefs and attitudes that can generate negative prejudices, with repercussions on the health and well-being. In addition, it is a problem that is influenced and determined by the society and the cultural aspects. Objective: To determine the attitudes and perceptions on the sexuality of older adults of the canton the Pan, Cuenca 2015-2016. Materials and Methods: A study was conducted with mixed qualitative and quantitative approach. The sample for the quantitative study was made up of 153 older adults of the parish of the Pan. Through direct interview was applied a questionnaire containing questions with the sociodemographic variables, in addition to the test of family functionality, questionnaire of attitudes toward sexuality in old age. For the qualitative part is working with two interviews to depth and two focus groups. The data were analyzed with the SPSS v15 and the Atlas program you v. 5. Results: The family functionality of the older adults was mainly moderately functional. The andropause and menopause were considered mostly as markers of the home of old age and the end of the sexual lives of older adults. Behaved as false the fact they look ridiculous the elderly when they show love, supplemented with that was mainly true considering that the elders have the right to love and sex life. It was true in a 45.8% that the elders to repress their sexual activity, however, in a similar way was regarded as false with a 44.4%. It was established as true that diseases and medical treatments limit and complicate the sexual activity. Conclusions: sexuality is present in the life of the older adults with different forms of expression that differ according to the perception of each adult and the influence of the culture, society and religion
Actualización de hemorragia posparto. Revisión sistemática
(Universidad de Cuenca, 2021-05-31) Morales Ayora, Xavier Santiago; Matute Ortega, Viviana Soledad; Salazar Torres, Zoila Katherine
Background: Postpartum hemorrhage (PPH) is an obstetric complication with high morbidity and mortality, a problem that is accentuated in developing countries, due to its repercussions, timely identification and management is a priority. General objective: to determine the prevalence, causes, risk factors and effectiveness of the medical and / or surgical treatment of PPH. Methodology: systematic review. Controlled, randomized clinical trials, analytical, descriptive studies, published in the last 5 years, without language discrimination, were included. The search was carried out in electronic databases such as Cochrane Library Plus, Embase, Pubmed and Lilacs. The information was synthesized in personalized tables. Results: the prevalence of PPH fluctuates between 2.1% and 79.6%. Uterine atony was the most common cause of PPH, followed by trauma. Age ≥ 35 years, nulliparity, history of PPH, hypertensive disorders of pregnancy, longer duration of the third stage of labor, instrumental deliveries, and perineal tears were considered as risk factors. Hayman suture showed effectiveness between 87 and 95.1% and hydrostatic balloon tamponade between 91 and 96% in the PPH control. Conclusions: the prevalence varies according to access to health, uterine atony was the most frequent cause, nulliparity was the factor most commonly associated with PPH. The Hayman suture and hydrostatic tamponade showed high effectiveness in the management of PPH. Limitations: restriction on access to information by economic category, in addition, limited studies with representative samples that evaluated the effectiveness in the management of PPH.
Actualización en el uso de sulfato de magnesio en obstetricia. Revisión sistemática
(Universidad de Cuenca, 2021-05-28) Ortiz Saltos, Elsa Raquel; Ballesteros Quijije, Favia Gabriela; Salazar Torres, Zoila Katherine
Background: Magnesium sulfate is a drug widely used in obstetrics for its anticonvulsant, antihypertensive, antineuroinflamatory and fetal neuroprotection effects, thus contributing to the reduction of maternal and neonatal mortality. Objective: describe maternal and neonatal benefits, complications, symptoms and signs of the use of magnesium sulfate in the obstetric field Methodology: observational study, systematic review. Controlled clinical trials, systematic reviews, analytical and descriptive studies were included. The articles analyzed were published in the last five years as quartile evidence 1 to 3, in English and Spanish, and extracted from electronic bases such as Pubmed, Medline, Lilacs and Cochrane Result: Inhibition of seizures was the main beneficial effect in pregnant women after the administration of magnesium and especially premature neonates, this drug was found to be a protective factor in the occurrence of cerebral palsy and intraventricular hemorrhage. Hypotension and hyporeflexia were the most frequent signs of intoxication. Regarding maternal complications, the most common included: renal failure, acute lung edema and postpartum hemorrhage, and in neonatal disorders, bradycardia was described as the most common. Conclusions: magnesium sulfate showed multiple benefits during perinatal administration, especially in the management of seizures and fetal neuroprotection; Although adverse events were evidenced, its benefits outweigh the risks inherent in its use. Limitations: the difficulty of access to high quality information due to its high economic categories.
Afectación psicológica en adolescentes expuestos a violencia intrafamiliar de la parroquia Ricaurte. Cantón Cuenca. 2015-2016
(Universidad de Cuenca, 2017-11-11) Moscoso Pineda, Blanca Luzmila; Ortiz Segarra, José Ignacio
Introduction: Violence as a social problem at a global, national and local level results from the use of physical force or power, causing injury, death or psychological damage, affecting the psychological sphere of adolescents, with negative repercussions on their future. Objective: To determine the different types of psychological affection in adolescents exposed to intrafamily violence. Materials and Methods: A cross - sectional, analytical study was carried out on the psychological involvement of adolescents exposed to intrafamily violence, Ricaurte parish, Cuenca canton. With structured questionnaires to 255 participants, collecting information on sociodemographic, family characteristics, violence, detecting psychological affection analyzing prevalences, a bivariate and multivariate analysis determining association by OR and 95% CI. Considering significant results at p <0.05. Results: The prevalence of psychological affection was for moderate anxiety 22.35%, severe depression 14.90%, medium-low self-esteem 25.88% and verbal aggressiveness 52.16%. The type of psychological violence showed 45.1%. The bivariate analysis showed a statistically significant association between anxiety OR = 2.16 (95% CI: 1.18-3.95) (p = 0.011), depression OR = 1.91 (95% CI = 1.11-3.29 ) (P = 0.018), verbal aggressiveness OR = 5.29 (95% CI = 1.16-24.17) (p = 0.01) and rage OR = 2.15 (95% CI = 1.26-3, 68) (p = 0.005), with types of violence. The multivariate analysis found an association between family functionality and adolescent psychological distress OR = 2.68 -2.80, (95% CI = 1.459 - 5.260) (p <0.05). CONCLUSIONS: Exposure to intrafamily violence triggers in the adolescents psychological consequences determined the functionality of the family, which makes it necessary to address this significant social problem
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.
Alteración del PH vaginal e infección genital en pacientes con amenaza de parto pretérmino, en el Hospital Vicente Corral Moscoso, Cuenca 2003
(2003) Dután Villalta, Fabián Darío; Vega Crespo, Bernardo José; Narváez Ayala, Jorge Oswaldo; Morales Sanmartín, Jaime Rodrigo
Alteraciones de la glucemia en anestesia general con halotano vs. fentanyl. Hospital José Carrasco Arteaga [IESS]
(1998) Mera González, Rita del Consuelo; Marín Torres, Esperanza del Carmen; Cañizares Aguilar, Aurelio Ernesto; Barzallo Sacoto, Jorge Eduardo
Alteraciones de la glucemia en anestesia general con halotano vs. fentanyl. Hospital José Carrasco Arteaga [IESS].1997
(Universidad de Cuenca, 1998-11-11) Mera González, Rita del Consuelo; Marín Torres, Esperanza del Carmen; Barzallo Sacoto, Jorge Eduardo; Cañizares Aguilar, Aurelio Ernesto
Analgesia con el uso de fentanilo en la anestesia raquídea
(1993) Berrezueta, Luis; Vega, Laura; Barzallo Sacoto, Jorge Eduardo
Analgesia del bloqueo ecoguiado del plano transverso del abdomen como coadyuvante en anestesia general para apendicectomía laparoscópica. Hospital “José Carrasco Arteaga”. Cuenca - Ecuador, 2020– 2021
(Universidad de Cuenca, 2022-09-06) Valdivieso Díaz, Angie Cecibel; Espinoza León, Juan Carlos
Background: the transversus abdominis plane (TAP) block is a multimodal analgesia technique, with proven efficacy in abdominal surgery; the ultrasound-guided technique in real time allows to reduce complications. General objective: to determine the analgesic degree of ultrasound-guided TAP in laparoscopic appendectomy. Methods: observational, descriptive, cross-sectional. 118 patients who underwent laparoscopic appendectomy and TAP block participated. A survey was applied in which postoperative pain was assessed at 5 and 120 minutes using the Visual Analog Scale for pain (VAS) and the need for rescue analgesia. Descriptive statistics and personalized tables were extracted to record the information. Results: according to the VAS at 5 min at rest, 50% of patients were categorized with a grade 0, followed by 36.4% in level 2; at 2 hours, 69%, 18.6%, and 15.3% are classified as grade 0, 4, and 2, respectively. It was reduced that 13.6% and the participants required rescue analgesia upon postoperative awakening and 33.9% in the Post Anesthesia Care Unit (PACU). In PACU, opioids were the drugs most used in rescue analgesia, since 3 out of 10 patients were managed with these drugs. The prevalence of complications of the transversus abdominis block was only 0.8%, detailing that there was intoxication by local anesthetic. Conclusions: The TAP block contributed to the fact that patients undergoing laparoscopic appendectomy presented postoperative pain intensity values between mild and moderate according to VAS, in addition, a low prevalence of rescue analgesia with minimal complications was evidenced.
Analgesia epidural con bupivacaína en el trabajo de parto en multíparas del Hospital Vicente Corral Mosoco 1995-1996
(1997) Washco Castro, Wilson Fabián; Auquilla Tacuri, Martha Cecilia; Andrade Iglesias, Luis Bolívar; Cárdenas Herrera, Oswaldo José; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
Analgesia post operatoria con morfina por vía caudal en cirugía pediátrica
(1992) Landy Guamán, César Alberto; Aucapiña V., José; Barzallo Sacoto, Jorge Eduardo; Aguilar Moscoso, Juan Marcelo
Analgesia postcesárea con 10 mg de bupivacaína al 0,5% más 0,15mg de morfina vs 10 mg de bupivacaína al 0,5%, en anestesia subaracnoidea, Hospital Vicente Corral Moscoso, Cuenca 2010
(2012) Urgilés González, Paola Xiomara; Barzallo Sacoto, Jorge Eduardo; Orellana Cabrera, Iván Eladio
Objective. To compare the analgesia posoperatoria and indirect effect produced by 10 mgs of bupivacaína to 0.5% + 150 micrograms of morphine versus 10 mgs of bupivacaína to 0.5%, in subarachnoid anesthesia for Cesarean. Material and methods. With an experimental design maternal ones programmed for Cesarean were included 150, divided in two equal groups group VM it received 10 mgs of bupivacaína + 150 micrograms of morphine and group B 10 mgs of bupivacaína to 0.5%. The analgesia in a scale EAV of four dimensions was moderate (without pain, slight pain, moderate pain and severe pain), to 2, 6, 12, 24 and 48 h of the surgery and registered the indirect effect. Results. During the first 6 hours 94.7% of patients of group VM and 8% of group B, did not have pain (P < 0.0001), but to the 12 and 24 hours the pain was similar in both groups. To the 48 hours P were more patients with slight pain in group VM (= 0.012) although in no of the groups there was moderate nor severe pain. The nausea incidence was significantly greater in the patients than they received morphine and was prurito in 60% of this group. Discussion. The results of the work differ from the published ones that report major time of analgesia. The indirect effect were similar to the described ones in Literature. DeCS: COMPARATIVE STUDY; MORPHINE-THERAPEUTIC USE; BUPIVACAINE- THERAPEUTIC USE; PAIN, POSTOPERATIVE-THERAPY; ANESTHESIA, SPINAL-METHODS
Analgesia postcesarea y estudio del apgar en recién nacidos con fentanyl y morfina por vía peridural en los años 1992-1993 lugar de estudio HVCM
(1994) López Bustamante, Lauro Raúl; Marín Torres, Tarquino Gerardo; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
Analgesia postoperatoria con bloqueo de plexo braquial con: L-bupivacaina al 0,25% VS bupivacaina al 0,25% en pacientes mayores de 18 años, Hospital Vicente Corral Moscoso, 2009-2010
(2010) Molina Neira, Sofía Marcela; Barzallo Sacoto, Jorge Eduardo; Orellana Cabrera, Iván Eladio
Objective. Compare produced by L-bupivacaine sensitive block time and frequency motor lock compared with bupivacaine, to the same concentration and dose administered to patients in whom was blocking brachial plexus for upper limb surgery. Materials and methods. With an experimental design included 90 patients of both sexes, age 18, divided into two equal groups to receive either 30-40 ml of L-bupivacaine 0.25% (n = 45) or 30-40 ml of 0.25% bupivacaine (n = 45). Measured time sensitive lock postoperative, frequency motor lock, hemodynamic behavior and secondary reactions to drugs. Results. Groups were comparable in demographic characteristics and the control variables. There was also significant differences in hemodynamic behavior of groups but was detected transient tachycardia in 8.9% (n = 4) of the group that received bupivacaine (P = 0,041). The average time sensitive lock was 637,3 ± 72.6 min (range 540-840) for the group to receive L-bupivacaine and 314.8 ± 51,1 min (range 180-420) for the group that received bupivacaine (P < 0.01). There was no engine block in the group receiving L-bupivacaine but yes in 80% (n = 36) of the group that received bupivacaine (P < 0.01). Conclusions. L-bupivacaína is as effective as bupivacaine for brachial plexus block when required surgery of the upper limb in patients 18 years of age or older. L-bupivacaine relevant feature is its long time sensitive lock and the lower frequency motor lock as bupivacaine. Key words: L-bupivacaine, bupivacaine, brachial plexus, sensitive block, motor block.
Analgesia postoperatoria en traumatología: eficacia analgésica de la buprenorfina intratecal a dosis única estándar en comparación con dipirona IV Cuenca- H.V.C.M.-2000
(2000) Viteri León, Octavio Enrique; Barzallo Sacoto, Jorge Eduardo; Morales Sanmartín, Jaime Rodrigo
Analgesia postoperatoria: efecto de la adición de fentanil a la anestesia peridural lumbar convencional: lidocaina al 2 por ciento con y sin epinefrina en pacientes quirúrgicos del H. Vicente Corral M. de Cuenca 1991-1992
(1992) Puruncajas Segarra, Jorge Enrique; Barzallo Sacoto, Jorge Eduardo; Flores Durán, Carlos Teodoro
Analgesia preventiva en pacientes sometidos a colecistectomía laparoscópica en el Hospital Vicente Corral Moscoso entre octubre del 2003 y enero del 2004
(2005) Merchán Bueno, Miguel Oswaldo; Cabrera Guanuchi, José Jonhy; Astudillo Molina, Rubén Arturo; Rojas Reyes, Rosendo Iván
Anemia asociada a la inflamación: prevalencia y factores asociados en pacientes ingresados en el Hospital Vicente Corral Moscoso Cuenca 2021
(Universidad de Cuenca, 2023-07-21) Idrovo Macancela, Mayra Estefania; Dita Salabert, Liermis Michael
Introduction: Inflammatory Anemia (IA) is the impaired production of erythrocytes associated with chronic immune activation, it is mainly a disorder of iron distribution and the second cause of anemia in the world.Objectives: to determine the prevalence of anemia due to inflammation and its associated factors in patients admitted to the Vicente Corral Moscoso Hospital (HVCM) during the year 2021.Methodology: A cross-sectional analytical study was carried out in a sample of 440 patients hospitalized in the Internal Medicine area of the HVCM, the sample calculation was performed with 95% confidence, 50% probability of occurrence and 4.2% error, for data collection, a form designed and prepared by the author was applied, for the analysis the Chi Square was applied for association between variables and OR to measure the intensity of association, with a significance level of 5% (p<0.05 ), processing performed in the SPSS V27.Results: a prevalence of IA of 18.18% was found in all hospitalized patients. Associated factors were: age (p=0.018); diabetes (p=0.003), infection (p=0.001) and chronic kidney disease (p=0.025). The presence of IA was not related to mortality in this study. Conclusions: the prevalence of IA was 18.18% and is mainly associated with the age of the patients and the presence of chronic diseases such as diabetes mellitus, infections and chronic kidney disease.