Volumen 33 No. 2 (2015)
Permanent URI for this collectionhttps://dspace-test.ucuenca.edu.ec/handle/123456789/23367
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Item Contexto historico de la creación de la Facultad de Medicina en Cuenca(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Abad Vázquez, Jaime PatricioItem Los programas de posgrado de la Facultad de Ciencias Médicas y su impacto social(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Morocho Malla, Manuel Ismael; González Cárdenas, Gina Eugenia; Peñafiel Vargas, María de LourdesItem Cirugía para la obesidad y sus efectos metabólicos. articulo de revisión(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Negrete Ocampo, José Ricardo; Ayala Ochoa, Andrés Vinicio; Guadalupe Rodríguez, Ramiro AntonioIn Ecuador, according to the National Health and Nutrition Survey published in 2013, the prevalence of obesity in people over 19 and under 60 years is 62.8%, while the main cause of Ecuadorians´ death in 2011 according to the INEC was the Diabetes Mellitus Type II. The association between obesity and its comorbidities generates a significant impact on public health and its costs. The metabolic surgery is an excellent treatment option for long-term treatment of obesity and its comorbiditiesItem 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 SofíaThe 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 dysfunctionItem Estenosis esofágica. Aplicación de una técnica quirúrgica. Caso clínico(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Aguilar Gaibor, Carlos Iván; Muñoz Vásquez, Wilson Antonio; Aguirre Vintimilla, Marcos Andrés; Tenesaca Castro, Jesús EstebanThe clinical case of a patient with esophageal stenosis after caustic ingestion is presented with dysphagia to liquids, so a transhiatal esophagectomy was performed with gastric tube technique alternatively for esophageal replacement mediastinal rise and feeding jejunostomy. After the procedure, it has a fistula in the proximal anastomosis cervical level and a pleural effusion is drained through bilateral pleural drainage. It is managed conservatively without disfunctionalization of the cervical fistula by semi-rigid drain with spontaneous closure and the patient is discharged after tolerated dietItem Manejo del dolor postoperatorio con morfina en anestesia espinal en cirugía gineco-obstétrica de la Fundación Pablo Jaramillo Crespo(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Tapia Cárdenas, Jeanneth Patricia; Salazar Torres, Zoila KatherineObjective: To evaluate the efficacy of the treatment in postoperative pain with the use of morphine in conductive anesthesia in patients with gynecological obstetric surgery. Pablo Jaramillo Crespo Foundation; September-December 2011, Cuenca 2015. Methods: It is an observational, analytical, prospective and quantitative study. They included, with the classification of the American Society of Anesthesiologists (ASA) I and II, to 231 patients between 15 and 65 years, who were hospitalized in the Pablo Jaramillo Crespo Foundation for gynecological-obstetric surgery, conducted from September to December 2011. Doses of morphine were administered: 2 mg for epidural and 0.2 mg for spinal anesthesia. The pain was assessed at 12 and 24 hours, with the visual analog scale of pain intensity (VAS). Results: The morphine used did not have preservatives. It was observed that spinal anesthesia shows a slight advantage to the epidural, with better tolerance to pain at 12 and 24 hours (p <0.05). There was no a relationship between the etiology of obstetric and gynecological surgeries with pain at 12 and 24 hours (p>0.05). In 25.78% of cases, the morphine analgesia for spinal administration was supplemented using ketorolac intravenously. A 49.2% of patients did not show side effects of these. The most observed were: pruritus (13.14%), urinary retention (11. 3%), nausea (9.8%) and vomiting (6.9%). Conclusion: The use of morphine dose: 2 mg for epidural and 0,2 mg for spinal anesthesia, provides a favorable recovery of pain in patients with gynecological and obstetric surgery. The side effects caused by their administration can be handled efficiently without altering the postoperative recoveryItem Factores que influyen en la prevalencia de bullyng en estudiantes de los colegios rurales del Cantón Cuenca, Azuay, 2014.(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Robalino Izurieta, GladysObjective: To determine the factors that influence in the prevalence of bullying among students from rural schools in Cuenca, Azuay, 2014 Methods: A cross-sectional study involving 493 students (283 men and 210 women) from 11 to 19 years old. The sample selection is performed by simple randomization. Data were collected through a self-applied survey; the instruments used were the questionnaire bullying CIE-A (Modified) and the Test of Family APGAR. The data were processed in SPSS 19 program. Results: The prevalence of bullying in the students from rural high schools in Cuenca is 20.0% in women, and 17.3 in men. The bullying was more evident in students from eighth, ninth and tenth year with a 21.9%. The more frequent aggression was the damage to the ownership with a 98.6%. The risk factors found were an unfavorable school environment with a 71.4%, an unfavorable familiar environment also with a 71.4%, and finally a 42.2% unfavorable individual environment. Conclusions: A significant prevalence of bullying among students in rural schools from Cuenca was found, and there is a significant association with the same family, school and individual factors which are unfavorableItem Parto hospitalario en embarazadas de consulta externa del Hospital "San Sebastián" del Sigsig. Periodo Octubre de 2011-julio 2012.(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Mejía Chicaiza, Jorge Victoriano; Matute Astudillo, Adriana Elizabeth; Argudo Chicaiza, María FernandaObjective: To determine the number of children birth, compared to the first prenatal control of pregnant women in the external consultation in “ San Sebastián “ hospital in Sigsig town. Material and methods: A descriptive study was conducted on a sample of 404 pregnant women who attended to their first prenatal control in “San Sebastián” hospital, and then the percentage of pregnant women who had their babies in the hospital was determined. Results: The prevalence children birth in relation to the first control was 54.4%: A total of 220 women had their babies in the hospital. The other 45.6% of pregnant women did not come back to this institution. The average age was 25.7 years old. The average years of the institution were 7. The average pregnancy was 3. Conclusions: The children birth in relation to the first control in this area is low: from the 54.4% of pregnant women, almost the half or one in two pregnant women go to the hospital to have their babies; therefore a large number of pregnant women are in risk to have childbirth complicationsItem Factores relacionados a sépsis neonatal. Unidad de Neonatología Clínica Humanitaria-Fundación Pablo Jaramillo(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Avilés Parra, Tamará; Cabrera Ordóñez, Paola; Vintimilla Coello, Esteban; Córdova-Neira, FernandoAn observational study of septic newborns occurred in the Neonatal Unit of Humanitarian Foundation Pablo Jaramillo was performed between January 2009 and December 2011. Its objective was to analyze the incidence of maternal antecedents and the newborn parameters as possible risk factors for sepsis, the laboratory parameters that help to diagnose infectious process in newborns and their results. During the time of the study 164 cases were admitted at risk of sepsis, suspected sepsis and bacterial sepsis (42.62 / 1000 born alive) and the mortality was 3.04%. Premature onset sepsis prevailed over late onset sepsis. The main factors in the maternal history were premature rupture of membranes followed by urinary tract infection. According to the factors of newborn, males prevailed, prematurity and low birth weightItem Comparación de apendicectomía laparoscópica de puerto único con abordaje de 3 puertos, Hospitales "José Carrasco Artega" y "Vicente Corral Moscoso"(Universidad de Cuenca. Facultad de Ciencias Médicas, 2015-10) Quiroz Hernández, Saúl; Ortíz Calle, Juan Carlos; Tenezaca Tacuri, Ángel HipólitoObjective: To compare the single-port laparoscopic appendectomy with 3 ports surgery in patients with acute appendicitis from the hospitals “Vicente Corral Moscoso” and “José Carrasco Arteaga” during 2013. Materials and Methods: An experimental study was done in which were included 170 emergency patients from the hospitals “Vicente Corral Moscoso” and “José Carrasco Arteaga”; half of them, underwent the appendectomy with single port (group 1) and the other half underwent the appendectomy with 3 ports (group 2). Results: The most affected age group was between 18 and 25 years, and the male gender predominates in both groups. The operating time of 61-120 minutes was 61.2 % in group 1, in group 2 was 55.3 %. The mild pain postoperative was presented in group 1 in 63.5% and in group 2 was 41.2%, with a hospital stance of 13-24 hours in the group 1 with 62.4%. Meanwhile in group 2, about 25 to 36 hours with 47.1%. Analyzing the results of the single port with less surgical time, we found an RR of 0.71 (95% CI 0.4-1.2), RRR 0.29, NNT 15, RAR 0.07; for pain intensity (mild) RR of 1.54 (CI 95% 1.1-2), RRR -0.54, RAR -0.22 and NNT 5 and for shorter hospital stay (less than 12 hours) RR = 3.5 0.71 (95% CI 0.75 to 12.3) -2.5 RRR, NNT 17 RAR 0.06. Conclusion: The single port laparoscopic appendectomy has similar results with international research only on postoperative pain compared to 3 port access.