Revista de la Facultad de Ciencias Médicas de la Universidad de Cuenca

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Abuso de alcohol e intervención mediante habilidades sociales en estudiantes del colegio “Ezequiel Cárdenas Espinoza” Azogues-Ecuador
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-12) Romero Romero, María de Lourdes; Lorenzo Ruiz, Alexis
Objective: To identify cases of alcohol abuse and develop a prevention strategy through the strengthening of social skills from a cognitive-behavioral approach. Material and Methods: A study with a quantitative approach and a descriptive and intervention design was developed. About 232 students were enrolled in Ezequiel Cardenas Espinoza High School in Azogues, who agreed to participate by informed consent, and who had no physical or mental illness. The Self Reporting Questionnaire (SRQ) and CAPs were applied to evaluate the knowledge, attitudes and practices. A psychotherapeutic program with cognitive behavioral approach also was applied to enhance the social skills of selected students in 16 sessions with specific subtopics through participatory and motivational workshops. Results: About 232 students had an average age of 14.9 ± 2.07 years. The 47% male and 53% female; according to the SRQ the 23.3% (n = 54) of students consumed alcohol with a pattern that suggests problematic consumption, men consume more than women in relation 3 to 1. With the prevention strategy focused on cognitive-behavioral approach, significant statistical changes were obtained in knowledge and attitudes (p <0.05), but not in changing practices (p> 0.05). Conclusion: The prevalence of alcohol abuse in the students from Ezequiel Cardenas HighSchool is higher than the reported in other studies. The Intervention with cognitive behavioral approach by strengthening social skills produced an improvement in knowledge and attitudes.
Adenocarcinoma pleomórfico de células giganates de vías biliares(osteoclastoma like)
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Quezada Morales, Manuel Emilio; Alvarado Corral, Raúl Francisco; Jara Sánchez, Laura Fabiola
Osteoclast-type giant cells (CGTO) of the pancreas are not frequent originally described by Rosaien 1968, characterized by osteoclasts that are giant cells identical mononuclear stromal cells in bone tumors observed. Since then, there are few reports of tumors containing giant cells in other anatomic locations. The CGTO can be distinguished from the pleomorphic type giant cells (CGTP), due to the lack of an associated marked nuclear pleomorphism. Often a pancreatic carcinoma histologically recognizable CGTO accompanies, leading to a bad result. CGTO pure forms have a better prognosis because it takes a long time to develop metastases, but this form is very rare, with few cases reported in the English literature. Most times the benign diagnosis of these tumors based on immunohistochemistry evaluation is discussed. This case is a female patient 56 years old with picture characterized by cramping pain that improves with antispasmodics, several months of evolution, with periods of remission and exacerbation. A physical exam features: light skin and mucous subictérico dye, abdominal level: diffusely painful abdomen without viseromegalias or palpable masses
Adherencia a la terapéutica farmacológica en pacientes hipertensos del Hospital "José Carrasco Arteaga" del IESS. Cuenca 2007
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2010-04) Martínez Reyes, Fray Cleiton
Objective. To establish the prevalence of no adherence to the pharmacologic therapeutic and to relate it to the variables: Sex, age, educational level, social security type, knowledge of the disease, time of treatment, pharmacologic treatment, dose, synchrony in the consumption of medications, collateral effects, access to medications, doctor - patient information and support to the fulfillment. Methods and materials. Cross sectional study; Population: The hypertensive patients attended during July 2007; Randomized Sample 93 patients; A later visit was carried out at home and a variables form was applied; Beside the medication count was made. Fulfillers were considered those persons who consumed between 80 and 100% of the medications, taken at the same hour the day previous and the visit day. Non Fulfillers consumed less of the 80% and over the 100% or those who had between 80 and 100% fulfillment, but their schedule varied between a day and another one. Results. The prevalence was 79,57%. They were representative: Age less than 66 years old, PR 1.21; A synchronic consumption of medications, PR 1.17; No access to medications PR 1.17; multi-drug treatment PR 1.13; Being active, voluntary, peasant, craft affiliate to the Social Security PR 1.04; Collateral effects of the medications PR 1.04. Conclusion. The prevalence of no adherence to the pharmacologic treatment is high. There was no statistically significant association in relation to the studied factors.
Alimentos ancestrales que sanan.
(Universidad de Cuenca, 2018-12) Matute García, Segundo Patricio
In this time of transformations of humanity, planting, harvesting and cooking healthy food that guarantee a good diet and nutrition, is a political and revolutionary act by antonomasia, which tries to break the monopoly of the agroindustry and the pharmaceutical industry linked to the production of food, preserve the original seeds and maintain the cultural identity and historical memory through the alimentary practice of Security, Sovereignty and Decoloniality Ancestral foods that heal, it is a set of reflections that are part of the project "Sacred Foods that Heal" executed in communities of Cañar and Saraguro with the support of ReAct Latin America. The essay addresses some determinants of changes in diet, supports the theme of feeding in indigenous people as an alternative and develops an example of the management of bacterial processes linked to food, all of them within the framework of ancestral agriculture.
Analgesia preventiva: ketoprofeno-levobupivacaina en colecistectomía laparoscopica comparada con el efecto de su administración postoperatoria
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2012-01) Merchan B., Miguel
Introduction: 84% of patients have postoperative pain, there is not a consensus control, and the preemptive analgesia (PA) is an interesting alternative. Objective: To determine the analgesic efficacy of levobupivacaine – ketoprofen combination administered before the nociceptive stimulus (preoperative) compared with post laparoscopic cholecystectomy administration (after surgery), Homer Castanier Hospital. Methods: A randomized clinical trial single-blind was conducted, 100 patients into two groups are divided, 50 received preoperative ketoprofen – levobupivacaine combination (experimental group) and 50 received the same combination in the postoperative period (control group), to measure the intervention effectiveness the pain intensity was assessed -using the Visual Analogue Scale (VAS)- and additional analgesic requirements postoperatively. The analysis was performed using chi-square test and Student t test. The P value p<0.05 was considered significant. Results: Both groups were comparable (p>0.05). Experimental group had a lower postoperative pain intensity than control group at first 24 hours (p <0.05), after 24 hours the difference was not significant (p=0.063); The PA provided a lower risk of postoperative pain with RR=0,313 and ITT=2.27. The average supplemental analgesics doses are used was significantly higher in the control group 2.3 ± 1.03 than the experimental group 1.2 ± 0.72 (p <0.05), but the PA did not eliminate need for additional analgesia. Conclusions: Ketoprofen + levobupivacaine combination was effective, pain intensity decreased and the additional analgesics doses postoperatively were lower too, but did not eliminate the need for additional analgesia.
Anestesia con temifentanil+desflurano vs. fentanil+desflurano, para colecistectomía laparoscópica
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2010-04) Barzallo Sacoto, Jorge Eduardo; Flores Durán, Carlos Teodoro
Remifentanil is a novel agonist of mu receiving, metabolized for inespecific esterase in blood and tissues, without lolling any organ and its metabolites they are inactive. Due to their unique pharmacological profile, anesthesia base don Remifentanil combines an opioid, sure and deep for surgery, with a quick and predictable recovery. It presents other advantages like the hemodynamic stability, especially on endotracheal intubations and cutaneous incision, as well as a reduced risk breathing depression in the post-operative room. Compared with conventional classic technique fentanildesfluorano whose obstacle was fear opioids overdose being carried out for it control of anesthesia base on the anesthetic inhalator or propofol. In such virtue, use of remifentanil in infusión bombs probably will change our current anesthesia administration methods.
Angioqueratoma nevoide curcunscrito: reporte de un caso
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2014-09) Rosero, Carla; Inca, Caroline; Castillo Soto, Gladys
The angiokeratoma circunscrito Naeviorme is a vascular malformation, this is present in the superficial dermis, is the rarest of the five variants of angiokeratoma, appears at birth or in the first two decades of life, is more common in women, in a ratio of 3 to1, generally located on thigh, buttock, showing a distribution unilateral (1, 2, 3), some therapies are used as electrocoagulation, cryotherapy, surgery, laser. We report a patient with nevoid circumscribed angiokeratoma laser treatment neodimiun yang, with a favorable evolution of the first session.
Anticuerpos antipéptico citruliano en pacientes con artritis reumatoide. Hospital Vicente Corral Moscoso, Facultad de Ciencias Médicas. Cuenca. 2008
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2012-12) Pacheco, Esteban; Jara, Javier; Pacheco, María Verónica; Guevara, Sergio
Objective: To determine the sensibility and specificity of the anti-péptico citruliano antibodies versus rheumatoid factor in the diagnosis of patients with rheumatoid arthritis in the Vicente Corral Moscoso Hospital Methods: Two groups, 30 patients with rheuma - toid arthritis according to American College of Rheumatology criteria and 30 control patients were established. They assisted the Vicente Corral Moscoso Hospital ′s Rheumatologic Department from January to May 2008. The laboratory tests were carried out and the results were confronted. The statistic analysis included specificity, sensibility, negative and positive predictor values. Results: The determination of anti-citrulline anti - bodies ELISA second generation show a 53,3% of sensibility, 83,3% of specificity, positive predictor value of 76,19 % and a negative predictor value of 64,10%; to third generation the sensibility was 50%, specificity 86,67%, positive predictor value of 78.95% and a negative predictor value of 63,41 % and the Rheumatoid Factor IgM sen - sibility 53,3%, specificity 70%, positive predictor value 64% and negative predictor value 60%. Conclusion: anti-citrulline antibodies ELISA have a better specificity than Rheumatoid Factor; the sensibility was the same in both tests.
Antropometría del neonato de madres indígenas y mestizas, Hospital Básico de Saraguro, 2016
(Universidad de Cuenca, 2018-06) Tacuri Quezada, Juan José; Maldonado Merino, Kathia Del Cisne
The gaps between the indigenous and mestizo population are notorious for the different socioeconomic practices that differentiate them, so the state of health of the newborns is closely related to the conditions in which the pregnant woman develops. Objective: To determine the anthropometry of the newborn of indigenous and mestizo mothers born in the Basic Hospital of Saraguro, 2016. Method: This descriptive study was carried out through the review of 143 clinical records of term pregnancies, without risk, whose delivery was attended at the Saraguro Hospital between January and October 2016, with the obtaining of a single live product without apparent pathology. The maternal variables (age, ethnic self-identification, marital status, education, residence, occupation, type of feat) and neonatal variables (sex, age, weight, height, head circumference and thoracic perimeter) were compiled in a questionnaire structured by the authors, and they were analyzed in the SPSS 20 program. Results: The average age of the mothers was 23.8 years, the 46.8% were indigenous, 49% had primary education and 51% had multigestations; On the other hand, the means of weight (3295 g, p: 0.024), length (49.7 cm, p: 0.013) and head circumference (34 cm, p: 0.021) were closely higher in neonates of mestizo mothers than the averages of children of indigenous mothers (weight: 3147 g, length: 49.0 cm, head circumference: 33 cm), the thoracic perimeter did not obtain significant differences (p: 0.71). Conclusions: The weight, height and cephalic perimeter of neonates of mestizo mothers are superior to the neonates of indigenous mothers of Saraguro - Ecuador.
Apendicitis aguda en pacientes pediátricos oncológicos en el Instituto del Cáncer SOLCA-Cuenca. 2017
(Universidad de Cuenca, 2018-12) Guerrero Quiroz, Enmanuel Isidoro; Alvarado Corral, Raúl Francisco; Bravo Muñoz, Marx Italo; Quizhpi Paredes, Diana Elizabeth; Martínez Reyes, Fray Cleiton
Background: Acute appendicitis is a surgical abdominal emergency, in which the clinical presentation and diagnosis are generally different when it occurs in oncological patients as a consequence of the immunological alteration characteristic of cancer and secondary to treatment with chemotherapy. Method: A descriptive, retrospective study was conducted from January 2011 to June 2017. The medical records of 433 patients with cancer in children under 18 years of age were reviewed; they were treated in SOLCA-Cuenca, and 12 patients who presented acute appendicitis were included. A description of its clinical, pathological and therapeutic characteristics was made. The information was included in a database and then analyzed in the portable program EXCEL and SPSSv20 Results: The average age of the patients was 9.58 years in the same proportion for men and women. The average of white blood cells was 10,500 cells per microliter and its range was between 400 and 21,600 cells per microliter. The neutrophils, platelets and hemoglobin had an average of 66%, 275,416 cells per microliter and 11g / dl respectively, with an average hospitalization of 18.5 days. A 66% of patients presented a value higher than 7 on to 10 in the Alvarado scale (method used to diagnose acute appendicitis). Acute appendicitis was more frequent (4 cases) in the maintenance phase of oncological treatment. The most common pathological results were: congestive appendix, phlegmonous, perforative, with 3 cases each. The ceftriaxone was the most used pre-surgical antibiotic (5 patients) and the combination of meropenem with metronizadol during the post-surgery period (4 patients). One patient (8.3%) died 9 days after the surgical procedure due to septic shock secondary to acute peritonitis. Conclusions: Acute appendicitis occurred in 2.7% of cancer patients. The natural history as far as clinical manifestations was presented in the oncological patients as in the non-oncological patients. The Alvarado scale was a valid diagnostic test in both groups. It is necessary to be careful with the interpretation of laboratory and image data.
Aportes para la historia del médico laboratorista y los laboratorios clínicos de la Ciudad de Cuenca
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-07) Cordero Jaramillo, Leoncio; Landívar Heredia, Jacinto Adrián
The preparation academic of Clinical Pathologists or Clinical Laboratory Physicians started from the first decade of the previous century in Ecuador. First as a practical learning experience with a mentor, then independently by going to a foreign country to study, taking actualization courses and keeping knowledge abreast of modern techniques and procedures. Early Clinical Pathologists began working in the ancient Hospital “San Vicente de Paul”. The first laboratory tests were conducted from 1912, after the return of Dr. Emiliano J. Crespo A., from Europe, who initiated studies of parasitology and bacteriology. The first Clinical Laboratory was founded en Hospital “San Vicente de Paul” assigned to Professor Manuel MaloCrespo, after his early death, succeeded by Dr. Juan Cuesta y Cuesta and since 1933 Dr. Timoleón Carrera Cobos formed a prestigious School of Clinical Laboratory Physicians. Its graduates exercised this specialty in the second half of the twentieth century and have also continued forming many current Clinical Laboratory Technicians city of Cuenca. The article finishes by highlighting the importance of Clinical Pathology Physicians today, not only in general medicine, but in most specialties, diagnosis, progression, prognosis and disease monitoring.
Artesanos de servicio: Apreciaciones sobre los Barberos, Sangradores, Sacamuelas
(Universidad de Cuenca, 2018-06) Pino Andrade, Raúl Haldo
Barbers over time, have left a trail which is little appreciated. The present account tries to enhance its name, observing it briefly from several aspects: guitar player and singer, navigator and craftsman; trying to break the belief that they were uncultured and uneducated people. There will also be an approach to the barbers who worked in our city “Cuenca de los Andes” from the sixteenth century until its extinction in the twentieth century.
Atención Primaria de la Salud
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-12) Soliz Rivero, Gardenia
The Primary Health Care and its holistic vision go beyond the limited medical model. Since the Alma Ata international conference until now, about 37 years have passed and it is still the best way to reform the health, reduce morbidity, increase equity and improve significantly the effectiveness of health systems. Although there are great advances in public health and some encouraging national indicators, it is important to emphasize the disease prevention activities and health promotion, because according to WHO data, the load morbidity could be reduced in 70% around the world if it is applied correctly. This article compiles a review in the main biomedical scientific literature databases which are available (PubMed, Lilacs, Scielo, EBSCO, SeCiMed), to resume, update and strengthen the concepts, approaches and progress made by the APS in order to share them with current and future health professionals
Auscultación cervical: alternativa no invasiva en el diagnóstico de disfagia en niños con problemas de neurodesarrollo
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Huiracocha Tutivén, María de Lourdes; Rojas Sulbarán, Rubén Darío; Huiracocha Tutivén, Mirian Sofía
The children with neurological disorders often have dysphagia, a condition that causes respiratory infection to repetition, malnutrition, poor quality of life, their early diagnosis allow to decide on the best intervention. The videofluoroscopy and videoendoscopia are invasive diagnostic techniques, which are expensive and therefore difficult to make, causing delay in diagnosis and intervention. Today there are new noninvasive medical technologies that can be very effective, one is the cervical auscultation which listens to the sounds of swallowing through a stethoscope or other measuring device such as placing a microphone or an accelerometer on the surface of the neck. This method has the principle that the sound and/or biological normal swallowing movements are different of the abnormal. In this article we review the social relevance, the diagnosis of dysphagia, the clinical applications of the cervical auscultation and the devices used to perform it, which is presented as a basis to establish its potential use for the detection of dysphagia in children with neurodevelopmental problems. These theoretical orientations allow the doctor to have more successful performances in the comprehensive diagnosis of children with neurological dysfunction
Automedicación y crisis de modelo biomédico
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2012-06) Cuvi Santiago, Juan Raúl
El bullying en las unidades educativas. Estrategias de intervención. Cuenca. 2016
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2016-05) Robalino Izurieta, Gladys
The bullying for its characteristics and consequences, has become a central concern in education and health, which have developed different ways of facing in order to reduce their impact and ensure compliance with the rights in children and adolescents. This work, describes the harassment or abuse between peer, “bullying” in students of primary, secondary and superior level, the interventions are analyzed and it is showed the role that health care providers should have in the field of promotion, prevention and intervention
Calidad de atención al niño/a de 2 meses a 4 años de edad con la aplicación de la estrategia AIEPI. Estudio realizado en el Centro de Salud parque Iberia. Cuenca-Ecuador
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-06) Cando Tenesaca, Lourdes del Cisne; Escandón Rea, Marco Rafael; Merchán, María Gerardina; Larrea Tapia, Delia Marieta
OBJECTIVE: To describe the characteristics of quality child care in children from 2 months to 4 years old based on the integrated management of childhood diseases prevalent attention. METHODS: A descriptive cross-sectional study; observational case management of 211 children from 2 months to 4 years old, who attended to the medical consultation. The results were analyzed using the descriptive statistical percentages method, frequency and reasons, using the SPSS version 18 and Excel 2010. RESULTS: The evaluation index was 0.84 at the Medical staff being the optimum value 1 and 0.49 in Nursing; nevertheless, it is the largest health care provider to fulfill multiple tasks. The service is characterized by the good treatment. CONCLUSIONS: The study allowed describing the quality of care with the implementation of the integrated management of childhood diseases prevalent attention. It was regular because it is not fulfilled in an integral form by a lack of training, updating, monitoring and lack of material and human resources, the request of the staff and users is that it is fulfilled
Cáncer de pulmón de células no pequeñas
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-04) Bustamante Medina, José Leonardo; Alvarez Pineda, Valeria Estefanía; Freire P., Víctor; Calle S., Michelle; Chango A., Juan José
Background: Lung cancer is the leading cause of oncological death in the world, its incidence almost equals its mortality, it is estimated that there will be an increase of 70% by 2025. Lung cancer is considered one of the major health problems worldwide. Smoking is the main risk factor. No small cell carcinoma (NSCLC) is the most common type. Case report: This is a 32 years old woman case, who comes to preventive medicine consultation referring to repeated respiratory symptoms in the last year, a simple chest radiography is performed showing radiopaque image with spiculated edges slightly rounded, measuring 3.39 x 3.13 cm at the left lung base. Further CT scan shows an homogeneous mass in the lower left lung lobe, with poorly defined borders with spiculations; a biopsy is performed reporting as a lung adenocarcinoma. Conclusion: Adenocarcinoma is the most common type of NSCLC, is also the most common type in non-smoking patients, its incidence is increasing, appearing at younger ages. Imaging is helpful for diagnosis and surgery is the cornerstone of treatment in most stages.
El cáncer: un problema de salud pública en el Ecuador y en el Cantón Cuenca
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2012-01) Campoverde Arévalo, Nicolás Luciano; Campoverde Merchán, Felipe Xavier
Características clínicas y epidemiológicas de las quemaduras en pacientes ingresados en la unidad de quemados. Hospital Luis Vernaza, Guayaquil. 2009-2010
(Universidad de Cuenca. Facultad de Ciencias Médicas, 2013-12) Velasco García, Diego; Méndez Torres, Francisco
Introduction. Burns are an enormous biological and cause severe injury metabolic disorders, are prone to secondary infection and systemic alterations, with important consequences deformities as well as functional limitations with its own socio-economic cost. Objectives. To determine the incidence and prevalence of burns patients admitted to the Burns Unit. Knowing the causes of burns patients in the study. Set which gender is most affected. Identify the most vulnerable age groups. Prescribe the treatment to be established once the depth of injury. Knowing the place where most accidents occur frequently associated with burns. Methods. This study is descriptive. Study of patients admitted to the Burns Unit of Hospital Luis Vernaza, the city of Guayaquil. Results. There was a predominance of males (69.7%) between the 31 - 45 years (35.4%). The most frequently refers to domestic accidents (51.6%) and work (49.3%

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