Volúmen 35 no .2 (diciembre 2017)

Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/29751

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Displasia Torácica Asfixiante o Síndrome de Jeune
(Universidad de Cuenca, 2017-12) Sempértegui Cárdenas, Pablo; Escalante Canto, Paul; Maestre Calderón, Manolo Patricio
Jeune Syndrome is a rare skeletal dystrophy, characterized by short ribs and alterations in limbs and pelvis. The respiratory distress is determined by the degree of thoracic stricture, and later, pancreatic or renal insufficiency may occur. A case of a 7-months-old infant who came to the Vicente Corral Moscoso Hospital for pneumonia without treatment response in the cantonal hospital was presented. When the patient arrives he presents a respiratory insufficiency and it calls the attention a cylindrical thorax, markedly narrow and elongated in addition of micromelia and polydactyly. A respiratory support and antibiotics were given during hospitalization having a favorable evolution.
Producción bibliométrica de la medicina social y la salud colectiva en América Latina. Período 1980 - 2016
(Universidad de Cuenca, 2017-12) Casallas Murillo, Ana Lucía
Objective. This is a bibliometric review to identify and analyze the scientific activity and the evolution of epistemological categories generated by the current of thought of Social Medicine and Collective Health in Latin America. Methodology. This is an exploratory study, using different search engines and the Endnote document manager for the fields: categories: social medicine, collective health and the categories: health and work, social class, health process, illness, social determination of health. The search was conducted in Spanish, English and Portuguese for the period 1980 to 2016. Results and Discussion. The bibliometric analysis selected for social medicine and collective health about 5571 texts and their content analysis included 1269 works. Brazil is the country with the highest production on collective health, followed by Colombia and the United States, among 22 countries. The social medicine and collective health require having its thought in the spaces where the publication and circulation of the scientific information has been concentrated. Also they must report the epistemological and methodological advances and the relation with the subjects in the social praxis, in order to affect the symbolic power instituted, in research and education spaces in the undergraduate and postgraduate programs, where there are many publications that use the categories of Social Medicine and Collective Health, with discreet value, maintaining the hegemony of the discourse that keeps the power of the positivist model.
Uso inercial de técnicas estadístico-inferenciales: su posible impacto en el hallazgo de resultados falsos en salud
(Universidad de Cuenca, 2017-12) Silva Ayçaguer, Luis Carlos; Montenegro Martínez, Gino; García Restrepo, Elizabeth; Gómez Rúa, Natalia Eugenia; Arcila Quiceno, Víctor Hernán
Objective: To evaluate the degree in which important statistical resources, particularly p-values, confidence intervals and procedures for determining sample sizes, are used in the biomedical literature through a ritual way. Methodology: A total of 25 original articles published in each of 4 journals indexed in the biomedical field were selected. For each of them, it was assessed whether they follow the instructions of the STROBE and CONSORT guidelines regarding the sample size, as well as the use of p- values, confidence intervals, and the use of these in the discussion of the article. Results: The 97.0% of the articles reported the sample size, but only 62.9% explained how it was determined. The p-value is used more frequently (68.0%) than the confidence intervals (63.9%). Only 15.5% uses confidence intervals in the discussion section. Conclusion: the most conventional statistical tolos are used more in ceremonial way rather than in a functional one.
Medicina narrativa, un complemento a la historia clínica formal
(Universidad de Cuenca, 2017-12) Pino Andrade, Raúl; Páez Iturralde, Joanna
El continuo desarrollo de la ciencia, la accesibilidad a los medios diagnósticos, modelos curriculares centrados en la enfermedad, han gestado un deterioro en la relación médico – paciente. Este hecho ha generado en el personal médico una visión centrada en la enfermedad y cada vez menos en el enfermo. Ante este panorama, la Medicina Narrativa es una herramienta útil que puede complementar nuestra práctica clínica formal en aras de lograr una visión integral del paciente y mejorar la empatía con él.
Contaminantes emergentes y su impacto en la salud
(Universidad de Cuenca, 2017-12) Reinoso Carrasco, Julieta del Carmen; Serrano Delgado, Clara Yamilet; Orellana Cobos, Danilo Fernando
The industrial development of the last decades has caused the accumulation of substances that damage the environment and health.Recently, some substances have been detected, they have always been present, but they have gone unnoticed due to a lack of adequate techniques for their identification, which are called "emerging contaminants", including products such as drugs, pesticides, cosmetics, cleaning and personal hygiene items, among others. This article presents a review of the available evidence and the importance of the study of emerging contaminants and their impact on the environment and health. The emerging contaminants are substances that although they can be biodegradable, are very dangerous for the environment and the human organism due to their bioaccumulation and persistence.Another serious problem lies in the fact that the current water treatment plants do not eliminate them, so the development of new purification technologies is important.
Incidencia de Áscaris en vía biliar y factores asociados en pacientes que acuden al Hospital General Macas. Agosto 2015- junio 2016
(Universidad de Cuenca, 2017-12) Cabrera Campoverde, Jannella; Torres Medicis, Catalina; Peña Cordero, Susana
Introduction: The intestinal ascaridiasis is sometimes complicated by the migration of the parasite to the hepatobiliary pathway or to the gallbladder, giving symptoms similar to that of cholecystitis or choledocholithiasis. The endoscopic cholangiopancreatography (ERCP), computerized axial tomography (CT), and mainly ultrasound are among the main means to reach the diagnosis. Materials and methods: An observational, descriptive, cross-sectional study was conducted with a sample of 183 patients who attended to the Macas General Hospital due to upper abdominal pain. A validated questionnaire was applied to obtain data on the sociodemographic, clinical and ultrasound characteristics of the patients. A descriptive univariate and bivariate analysis was performed. The association was determined with the chi square test. Statistically significant results were considered at values of p <0.05. Results: The majority of patients were between 19- 44 years old, everybody were women of the Shuar ethnic group, with low socioeconomic status and extreme poverty. More than half of the population studied does not have drinking water, very few people reported surgical history, and a quarter of the sample analyzed expressed expulsion of worms. The main symptoms for which the patients attended were: nausea, vomiting, abdominal pain and thermal rise. The incidence of ascaris in the biliary tract was 29.0%, with 13.2% of complications, mainly pancreatitis and hepatic abscess. There was an association with thermal rise; however, sex, drinking water consumption, surgical history and nutritional status were not associated with the disease. Conclusions: the incidence of ascariasis is high and it is associated with thermal rise as a risk factor for migration of the parasite to the bile ducts.
La interacción entre la exposición a agrotóxicos y componentes relevantes del sistema inmune en comunidades de La Paz Bolivia: una mirada desde la epidemiología crítica
(Universidad de Cuenca, 2017-12) García, Carmiña; Breilh, Jaime; Larrea, María de Lourdes
Health from critical epidemiology is a complex, dynamic and dialectic process, socially determined, with general, particular, and singular domains where unhealthy (destructive) processes and healthy (protective) processes are developed. Some authors point to an increase in the prevalence of diseases associated with alterations in the immune response, due to pesticides exposure, but this information in humans is limited and controversial. We intend to know the interaction between exposure to pesticides and components of the immune system: MPO and FAG phagocytic enzymes by cytochemistry and Interleukins 6 and 8 by chemiluminescence) in 5 communities of La Paz Bolivia, applying a questionnaire corresponding to critical epidemiology (matrix of processes) and work stress. Epidemiological profiles of 113 volunteers (farmers) were analyzed: 60 women and 53 men, finding significant differences (Chi-square): lifestyle typology (economic reproduction, pesticides use and secondary work), destructive processes, protective equipment, training, age. Observing decreased enzymatic activity MPO and increased FAG, for both genders of active working age. Without significance: interleukins and work stress. There is an affectation in the enzymatic functionality in cells of the first line of defense of the immune system and in the concentration ratio of interleukins, in farmers more or less exposed to pesticides considering their styles and ways of life.
Perfil de alteraciones del lenguaje en diferentes tipos de demencias
(Universidad de Cuenca, 2017-12) Maldonado Merchán, Rosa Silvana
Introduction: Worldwide the life expectancy has increased, so the frequency of diseases of the elderly is increasing, among which are the dementias where different types of disorders are evidenced, being the language abilities one of the most affected areas. Method: This is a descriptive observational study with a sample of 12 patients: three with diagnosis of Alzheimer's with language onset, three with prodromal Alzheimer's disease, three with Mild Cognitive Impairment without evidence of AD and three with Fronto-temporal dementia. The logopedic evaluation was carried out through the application of the Test: Boston "abbreviated format", Test of denomination by Visual Confrontation of Boston and the Test of Comprehension of TOKEN. The analysis was carried out using descriptive statistics with frequencies and percentages. Results: Ten women and two men with an average age of 74.8 ± 5.6 participated, of whom nine had basic studies. In the "Aphasia Severity Scale" of the Boston test, it was determined that three patients with Alzheimer's and three with Fronto-Temporal Dementia were at level one. In listening comprehension and oral expression, eleven patients had difficulty. In the Boston Visual Confrontation Denomination test, nine patients presented alterations in the denomination; four paraphasia, four circumlocutions and three stereotypes. Finally, in the TOKEN Comprehension Test four patients presented very serious deterioration. Conclusions: In this study, all the patients with different types of dementia, presented mixed aphasia with expressive predominance.
Características de la enfermedad de Hansen y contagio a familiares en El Oro. Estudio descriptivo.
(Universidad de Cuenca, 2017-12) Polo Checa, Ana María; Sanmartín Plaza, Milton Mauricio; Toro Manzanares, Ximena María; Roldan Fernández, José Vicente
Introduction: The incidence of Hansen's disease registered in Ecuador is 0.71 per 10,000 inhabitants in 2006; it is within the global elimination parameter. The Province of El Oro still presents positive cases for the disease. Objective: To determine the characteristics of Hansen's disease in the Province of El Oro and diagnosis of the contagion to relatives. Material and Methods: It is a quantitative descriptive study which was carried out in the Province of El Oro in people who were diagnosed with Hansen's disease registered in the Epidemiology Center of this province in the period July 2012 to June 2013 and their relatives who were living with them. The sample of the lymph of the auricular pavilion and nasal swab for the diagnosis was made by means of the staining of Ziehl Neelsen and filling out a form. In the analysis of the information, a descriptive statistics were applied using the SPSS software. Results: A total of 32 patients with Hansen's disease were registered, 59.4% were lepromatous, 81.3% had skin lesions, the spots were 50% and the nodules were 12.5%. The preferred location of the lesions was the extremities. The 53.1% of the patients had loss of sensation in extremities. The 15.6% presented deformity and 9.4% presented disability due to illness. The 11.8% of the relatives presented a positive sputum smear test, of which 60% corresponded to the lepromatous subtype. Conclusions: There are still cases of Hansen in the province of El Oro and the contagion persists to relatives who live with the patients.
Estudio cualitativo sobre el malestar: perspectivas de la medicina tradicional en Cuenca, El Tambo y Saraguro - Ecuador
(Universidad de Cuenca, 2017-12) Angulo Rosero, Aydeé Narcisa; Brito Roby, Liliana Alexandra; Achig Balarezo, David Ricardo; Arévalo Peláez, Carlos Eduardo; Rojas Reyes, Rosendo Iván; Quizhpi Merchán, Carmita Victoria; Mosquera Vallejo, Lorena Elizabeth; Quispe Bolaños, Marcelo
Antecedents and objective: The Andean cosmo-vision looks at the reality according to its paradigms, laws and principles based on the observation of nature and an analogical reasoning; the discomfort or disease has been understood as the imbalance of the harmony of being with oneself, with the family, with nature and with the cosmos. Therefore, the present study aims to understand the meanings and senses of the Kichwa malaise of the sages of ancestral medicine. Methodology: a qualitative, post-positivist phenomenological study of the discomfort was carried out from the perspective of traditional medicine with men and women of Andean wisdom from the city of Cuenca, El Tambo and Saraguro. A snowball sampling was used and for convenience. The interviews were recorded and transcribed literally. The data was analyzed with the Atlas program using content analysis Results: ancestral medicine for disease and health are unique concepts in which refer to a state of the human being and not only to the state of organs or isolated parts of the body. Important elements of discomfort are pain and suffering. Discomfort is shared, sufferings are communal and the healing of someone is also the healing of others. The discomfort born in the coexistence that is always communal, the discomfort of others is also the discomfort of each one. Conclusions: The discomfort in the Kichwa communities of Cuenca, El Tambo and Saraguro is caused by the disconnection or imbalance with oneself, with others, with nature and with the supernatural. The discomfort can be healed with the intermediation of the Yachaks or healers through different methods or elements, which constitutes a medicine different from conventional one whose approach is of the biochemical - molecular type.

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